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Anthony M J Bull - One of the best experts on this subject based on the ideXlab platform.
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3d morphometric and posture study of felid Scapulae using statistical shape modelling
PLOS ONE, 2012Co-Authors: Kai Yu Zhang, Alexis Wiktorowiczconroy, John R Hutchinson, Michael Doube, Michal M Klosowski, Sandra J Shefelbine, Anthony M J BullAbstract:We present a three dimensional (3D) morphometric modelling study of the Scapulae of Felidae, with a focus on the correlations between forelimb postures and extracted Scapular shape variations. Our shape modelling results indicate that the Scapular infraspinous fossa becomes larger and relatively broader along the craniocaudal axis in larger felids. We infer that this enlargement of the Scapular fossa may be a size-related specialization for postural support of the shoulder joint.
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skin fixed Scapula trackers a comparison of two dynamic methods across a range of calibration positions
Journal of Biomechanics, 2011Co-Authors: Joe A I Prinold, Aliah F Shaheen, Anthony M J BullAbstract:The aim of this study was to establish the optimal methodology for skin-fixed measurement of the Scapula during dynamic movement. This was achieved by comparing an optimally positioned Scapula Tracker device (ST) to a previously described palpation device, taken as the true measure of Scapular kinematics. These measurements were compared across a range of calibration positions, including the use of multiple calibration positions for a single movement, in order to establish an optimal calibration approach. Ten subjects' Scapular motion was measured using this ST and a previously described Acromial Method (AM). The two datasets were compared at a standard, an optimal and a ‘multiple’ calibration position, thus allowing a direct comparison between two common skin-fixed methods to track the bony kinematics of the Scapula across different calibration positions. A comparison was also made with a bone-fixed technique from the literature. At both the standard and optimal calibration positions the ST was shown to be the more accurate measure of internal rotation and posterior tilt, particularly above 100° of humerothoracic elevation. The ST errors were found to be acceptable in relation to clinically important levels. Calibration positions have been shown to have a significant effect on the errors of both skin-fixed measurement techniques and therefore the importance of correct calibration is highlighted. It has thus been shown that a ST can be used to accurately quantify Scapular motion when appropriately calibrated for the range of motion being measured.
Peter J. Millett - One of the best experts on this subject based on the ideXlab platform.
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Association between Scapula bony morphology and snapping Scapula syndrome.
Journal of Shoulder and Elbow Surgery, 2015Co-Authors: Ulrich J. Spiegl, Maximilian Petri, Sean W. Smith, Charles P. Ho, Peter J. MillettAbstract:Hypothesis and background Scapular incongruity has been described as a contributing factor to the development of snapping Scapula syndrome (SSS). The purpose of this retrospective case-control study was to determine the association between Scapula bony morphology on magnetic resonance imaging (MRI) and the diagnosis of SSS. Methods Bony morphologies of the Scapula were evaluated on MRI scans of 26 patients with SSS and 19 patients with non-SSS pathologies. The medial Scapula corpus angle (MSCA) was measured on axial MRI sequences. Scapulae were categorized as straight, S shaped, or concave. Two independent observers performed the measurements. Interobserver and intraobserver agreements of MSCA measurements were determined with intraclass correlation coefficients. Results Axial Scapula bony morphology identified 28 Scapulae of the straight type, 14 S-shaped Scapulae, and 5 concave Scapulae. All 5 concave Scapulae had confirmed SSS. Measurement of the MSCA showed excellent interobserver agreement of 0.80 (95% confidence interval [CI], 0.67 to 0.89) and intraobserver agreement of 0.70 (95% CI, 0.52 to 0.82). There were significant differences in the mean MSCAs between shoulders with SSS (14.4° ± 19.3°) and non-SSS shoulders (−3.3° ± 15.3°, P = .001). The odds ratio was 8.4 (95% CI, 2.2 to 31.8) for positive MSCA and SSS. The scapulothoracic distance was significantly decreased in the SSS group (14.9 ± 5.8 mm) compared with the non-SSS patients (24.0 ± 6.7 mm, P Discussion and conclusion Anterior angulation of the medial Scapula in the axial plane was associated with SSS. Patients with a concave-shaped Scapula and a positive MSCA have a 12-fold increased risk of SSS. The MSCA may prove helpful in determining the location and amount of Scapular resection needed for patients with SSS.
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scapulothoracic bursitis and snapping Scapula syndrome a critical review of current evidence
American Journal of Sports Medicine, 2015Co-Authors: Ryan J Warth, Ulrich J. Spiegl, Peter J. MillettAbstract:Background:Symptomatic scapulothoracic disorders, such as painful Scapular crepitus and/or bursitis, are uncommon; however, they can produce significant pain and disability in many patients.Purpose:To review the current knowledge pertaining to snapping Scapula syndrome and to identify areas of further research that may be helpful to improve clinical outcomes and patient satisfaction.Study Design:Systematic review.Methods:We performed a preliminary search of the PubMed and Embase databases using the search terms “snapping Scapula,” “scapulothoracic bursitis,” “partial scapulectomy,” and “superomedial angle resection” in September 2013. All nonreview articles related to the topic of snapping Scapula syndrome were included.Results:The search identified a total of 167 unique articles, 81 of which were relevant to the topic of snapping Scapula syndrome. There were 36 case series of fewer than 10 patients, 16 technique papers, 11 imaging studies, 9 anatomic studies, and 9 level IV outcomes studies. The level of...
Paolo Cherubino - One of the best experts on this subject based on the ideXlab platform.
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Scapular dyskinesis and sick Scapula syndrome following surgical treatment of type iii acute acromioclavicular dislocations
Knee Surgery Sports Traumatology Arthroscopy, 2013Co-Authors: Luigi Murena, Gianluca Canton, Ettore Vulcano, Paolo CherubinoAbstract:Purpose To evaluate the incidence of Scapular dyskinesis and SICK Scapula syndrome (defined as Scapular malposition, infero-medial border prominence, coracoid pain and malposition, and dyskinesis of Scapular movement) in patients treated surgically for acute type III AC dislocation.
Ann Cools - One of the best experts on this subject based on the ideXlab platform.
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superficial and deep scapulothoracic muscle electromyographic activity during elevation exercises in the Scapular plane
Journal of Orthopaedic & Sports Physical Therapy, 2016Co-Authors: Birgit Castelein, Barbara Cagnie, Thierry Parlevliet, Ann CoolsAbstract:Study Design Controlled laboratory study. Background In Scapular rehabilitation training, exercises that include a humeral elevation component in the Scapular plane are commonly implemented. While performing humeral elevation, the Scapula plays an important role, as it has to create a stable basis for the glenohumeral joint. However, a comparison of both deep and superficial muscle activity of the Scapula between different types of elevation exercises is lacking and would be helpful for the clinician in choosing exercises. Objectives To evaluate scapulothoracic muscle activity during different types of elevation exercises in the Scapular plane. Methods Scapulothoracic muscle activity was measured in 21 healthy subjects, using fine-wire electromyography in the levator Scapulae, pectoralis minor, and rhomboid major muscles and surface electromyography in the upper trapezius, middle trapezius, lower trapezius, and serratus anterior muscles. Measurements were conducted while the participants performed the fol...
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clinical assessment of the Scapula a review of the literature
British Journal of Sports Medicine, 2014Co-Authors: Filip Struyf, Ann Cools, Jo Nijs, Sarah Mottram, Nathalie Roussel, Romain MeeusenAbstract:Scientific evidence supporting a role for faulty Scapular positioning in patients with various shoulder disorders is cumulating. Clinicians who manage patients with shoulder pain and athletes at risk of developing shoulder pain need to have the skills to assess static and dynamic Scapular positioning and dynamic control. Several methods for the assessment of Scapular positioning are described in scientific literature. However, the majority uses expensive and specialised equipment (laboratory methods), making their use in clinical practice nearly impossible. On the basis of biometric and kinematic studies, guidelines for interpreting the observation of static and dynamic Scapular positioning pattern in patients with shoulder pain are provided. At this point, clinicians can use reliable clinical tests for the assessment of both static and dynamic Scapular positioning in patients with shoulder pain. However, this review also provides clinicians several possible pitfalls when performing clinical Scapular evaluation. On the basis of its clinical relevance, its proven reliability, its relation to body length and its applicability in a clinical setting, this review recommends to assess the Scapula both static (visual observation and acromial distance or Baylor/double square method for shoulder protraction) and semidynamic (visual observation and inclinometry for Scapular upward rotation). In addition, when the patient demonstrates with shoulder impingement symptoms, the Scapular repositioning test and Scapular assistant test are recommended for relating the patients’ symptoms to the position or movement of the Scapula.
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rehabilitation of Scapular dyskinesis from the office worker to the elite overhead athlete
British Journal of Sports Medicine, 2014Co-Authors: Ann Cools, Birgit Castelein, Filip Struyf, Annelies Maenhout, Barbara CagnieAbstract:The Scapula functions as a bridge between the shoulder complex and the cervical spine and plays a very important role in providing both mobility and stability of the neck/shoulder region. The association between abnormal Scapular positions and motions and glenohumeral joint pathology has been well established in the literature, whereas studies investigating the relationship between neck pain and Scapular dysfunction have only recently begun to emerge. Although several authors have emphasised the relevance of restoring normal Scapular kinematics through exercise and manual therapy techniques, overall Scapular rehabilitation guidelines decent for both patients with shoulder pain as well as patients with neck problems are lacking. The purpose of this paper is to provide a science-based clinical reasoning algorithm with practical guidelines for the rehabilitation of Scapular dyskinesis in patients with chronic complaints in the upper quadrant.
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trapezius activity and intramuscular balance during isokinetic exercise in overhead athletes with impingement symptoms
Scandinavian Journal of Medicine & Science in Sports, 2006Co-Authors: Ann Cools, Ga Declercq, Dirk Cambier, Nele Mahieu, Erik WitvrouwAbstract:We compared normalized trapezius muscle activity and intramuscular balance ratios between overhead athletes with impingement symptoms and non-injured athletes during isokinetic abduction and external rotation movements. Thirtynine overhead athletes with chronic impingement symptoms and 30 non-injured athletes participated in the study. Electromyographic activity of upper, middle, and lower trapezius was measured during isokinetic abduction and external rotation, using surface electrodes. The results show a significant increase of upper trapezius activity during both movements in the patient group, with decreased activity in the lower trapezius during abduction, and in the middle trapezius during external rotation. Analysis of the intramuscular activity ratios revealed muscle imbalance on the injured side of the patient group for upper/middle trapezius and upper/lower trapezius during abduction, and for all three muscle activity ratios during external rotation. These results confirm the presence of Scapular muscle imbalances in patients with impingement symptoms and emphasize the relevance of restoration of Scapular muscle balance in shoulder rehabilitation. The Scapula plays a vital role in normal upper extremity function. The quality of Scapular function depends, among others, on Scapular muscle performance. Through their actions, the Scapular muscles must provide stability as well as controlled mobility to the Scapula. Compared with other joints in the human body, this double task, performed by the same muscle group, is specific for the scapulo-thoracic muscles, and puts them under considerable stress. These demands are aggravated by the fact that there are very less bony articulations between the Scapula and the trunk. Particularly in overhead
Michael J Botte - One of the best experts on this subject based on the ideXlab platform.
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Management of Snapping Scapula Syndrome
Orthopedics, 2016Co-Authors: Mark L. Wang, Andy Miller, Brooke L. Ballard, Michael J BotteAbstract:Snapping Scapula syndrome is a rare condition caused by the disruption of the gliding articulation between the anterior Scapula and the posterior chest wall. The etiology of snapping Scapula syndrome is multifactorial, and contributing factors include Scapular dyskinesis, bursitis from repetitive use or trauma, and periScapular lesions. Although the majority of cases are initially treated with nonoperative modalities, recalcitrant snapping Scapula syndrome can warrant surgical management. This report describes a 34-year-old amateur weight lifter with a 1-year history of increasing pain and fullness over his posterior shoulder region. He reported full shoulder motion associated with an audible, palpable, and painful crepitus, exacerbated with overhead movement and wall pushups. Previous periScapular stabilization exercises and corticosteroid injection yielded minimal resolution of his symptoms. Prior to being referred to the authors' clinic, the patient was evaluated at an outside facility and deemed a suboptimal candidate for arthroscopic bursectomy because of the large size and location of this lesion. Magnetic resonance imaging showed a large polylobulated fluid collection causing scapulothoracic distention. There was no evidence of osseous abnormalities originating from the Scapular body. Computed tomography-guided placement of methylene blue and contrast dye was used to facilitate localization and, in an effort to minimize recurrence, ensure the complete removal of bursal tissue. During 8 weeks, this patient recovered unremarkably and returned to full-duty activities with resolution of symptoms. The authors present the management of chronic and recalcitrant snapping Scapula syndrome, and report the open excision of the largest scapulothoracic bursal lesion described, to their knowledge, in the English literature. [Orthopedics. 2016; 39(4):e783-e786.].
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osseous anatomy of the Scapula
Clinical Orthopaedics and Related Research, 2001Co-Authors: Herbert P Von Schroeder, Scott Kuiper, Michael J BotteAbstract:Detailed anatomy and morphometry of the Scapula were obtained to provide information for surgical procedures such as hardware fixation, drill hole placement, arthroscopic portal placement, and prosthetic positioning. Twenty-six measurements were made in 15 pairs of Scapulas from cadavers. The average length of the Scapulas from the superior to the inferior angle was 155 ± 16 mm (mean ± standard deviation). The thickness of the medial border 1 cm from the edge was 4 ± 1 mm. The superior border was sharp and thin, and the supraScapular notch was present as a foramen in two Scapulas. The distance from the base of the supraScapular notch to the superior rim of the glenoid was 32 ± 3 mm. The length of the spine from the medial edge of the Scapula to the lateral edge of the acromion was 134 ± 12 mm. The anteroposterior width of the spine at 1 and 4 cm from the medial edge was 7 ± 1 and 18 ± 3 mm, respectively; the width at the lateral edge (spinoglenoid notch) was 46 ± 6 mm. The acromion measured 48 ± 5 mm × 22 ± 4 mm and was 9 ± 1 mm thick. The acromial shape was flat in 23%, curved in 63%, and hooked in 14% of Scapulas. The distance from the glenoid to the acromion was 16 ± 2 mm. The glenoid dimensions were 29 ± 3 mm (anteroposterior) X 36 ± 4 mm (superoinferior) and faced posterior by 8 ± 4°. Anteroposterior thickness of the head of the Scapula 1 cm from the surface was 22 ± 4 mm. The thickness of the coracoid was 11 ± 1 mm. The average length of the coracoacromial ligament was 27 ± 5 mm. Scapulas from male cadavers were significantly larger than Scapulas from female cadavers in 19 measurements.
