Thesis (M.Sc) - Cairo University - Faculty of Physical Therapy - Department of Musculoskeletal Disorders

Background: Shoulder impingement syndrome (SIS) is the most diagnosed shoulder disorder. Patients with impingement symptoms consistently show altered scapular kinematics {u2018}scapular dyskinesis{u2019}.There is high evidence that scapular exercises improved scapular muscle performance and decrease the clinical symptoms related to subacromial impingement, yet there have been no studies that have found clinical examination variable indicate whether patients with the disease would respond well to scapular training.Objective: To investigate if pain severity, disability, scapular upward rotation angle and upper trapezius/serratus anterior (UT/SA) isometric strength ratio at baseline assessment can predict patient{u2019}s response to scapular training in cases of subacromial impingement syndrome. To investigate the association between demographic data of the patients (age, sex, BMI, duration of symptoms and activity level) and outcome measures. Methods: Forty-five patients male and female between age 18-45 years old, their mean age (34.28±8.3) years and their mean body mass index (BMI) (29.2±6.2) kg/m²,suffering from subacromial impingement syndrome, the assessment include Pain severity (SPADI), disability (SPADI), scapular upward rotation angle and UT/SA isometric strength ratio before and after exercise program of scapular muscle training (Cools exercises), serratus anterior strength and scapular stabilization exercises for one month. Results: The area under the ROC curve (receiver operating characteristic curve) showed excellent results with pain percent 0.93(sensitivity 0.9, specificity 0.33), disability percent 0.94(sensitivity 0.956, specificity 0.156) and UT/SA isometric strength ratio 0.9(sensitivity 0.9, specificity 0.33) and poor results with scapular upward rotation angle 0.66(sensitivity 0.62, specificity 0.36). No association between the patients{u2019} demographic data and outcome measures

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