Scapular Kinematic During Arm Elevation in Shoulder Impingement Syndrome Using Motion Analysis System: A Systematic Review and Meta-analysis

Context:

 With a key role in normal shoulder function, scapular kinematics have been investigated in shoulder impingement syndrome (SIS).

This systematic review aimed at determining scapular kinematic patterns in patients with SIS compared to in asymptomatic individuals.

Data Sources: 

Databases such as PubMed, Scopus, Web of Science, Ovid, Embase and PEDRO were searched from January 1995 to June 2021. Study Selection: Articles in English published in peer-reviewed journals and using motion analysis systems to compare scapular kinematics between patients with SIS and asymptomatic subjects during arm elevation were included. Data Extraction: A modified Downs and Black checklist was used to assess the risk of bias of the included studies. A random-effects model was employed to perform a meta-analysis.

Nine out of 1650 screened abstracts were included for data extraction. Scapular upward rotation significantly decreased during arm elevation in SIS (SMD = -0.13, 95% CI = -0.23 to -0.02) with a low effect size (I2 = 46%). No differences were observed in scapular posterior tilt (SMD = -0.07, 95% CI = -0.18 to 0.03) and external rotation (SMD = 0.02, 95% CI = -0.06 to 0.09) between patients with SIS and asymptomatic subjects.

This review revealed that except for scapular upward rotation, scapular movement was generally insignificantly different between the subjects with and without SIS during arm elevation. Between-group differences might have been overlooked as a result of the high risk of bias in the included studies. The high-quality studies addressing confounders are required to provide a definitive conclusion on the relationship between SIS and scapular kinematics.