The Effectiveness Of A
Scapular Brace On Scapular Kinematics
Uhl TL, Kibler WB, Tripp BL, Spigelman TH, McClelland R
Purpose: Scapular dyskinesis commonly occurs in patients with a variety of clinical injuries. Clinically observed scapular dyskinesis is associated with significant increased internal rotation and decreased upward rotation of the scapula. Initial conservative treatment focus on controlling and stabilizing scapular kinematics. The study evaluated the effect of a vest-type Spine and Scapula Stabilizing brace (S3) on scapular kinematics during dynamic arm elevation.
Subjects: Ten healthy volunteers (age 25 +/- 4 years, ht. 1.75 +/- .08m, wt 70 +/- 7kg) without previous injury to shoulder.
Materials/Methods: Each subject performed five repetitions of forward arm elevation under two conditions, with and without the S3 brace (Alignmed, Santa Ana, CA). We collected three-dimensional scapular and humeral kinematic using electromagnetic sensors attached to the thorax, bilateral acromion and humerii. We analyzed scapular internal rotation, upward rotation, and posterior tilt at 10 degree intervals of humeral elevation between 20-90 degrees.
Results: Repeated measures (ANOVA) revealed a statistically significant effect bilaterally on scapular internal rotation with brace (40 + 10°) versus without brace (45 +10°)(P<0.05). The brace showed no statistical significance on upward rotation. Posterior tilt effect with S3 brace on right scapula were close to statistical significance (P=.054)
Conclusion: The S3 brace can affect scapular kinematics. Excessive internal rotation was reduced by the brace facilitating scapular motion into external rotation.
Clinical Relevance: This is the first brace that has documented scapular position change. This brace offers potential benefit to the conservative management of patients with scapular dyskinesis. This brace attempts to counter scapular internal rotation and anterior tilt previously described in patients found in impingement patients.