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Scapula Stability of Symptomatic and Asymptomatic Competitive Female Swimmers
Abstracts
603
SPORTS MEDICINE SECTION
Scapula Stability of Symptomatic and Asymptomatic Competitive Female Swimmers V A P Coombs University of Birmingham Introduction The influence of swimming training on the stabilising structures of the shoulder complex is thought to contribute to the inherent scapula instability of competitive swimmers. Lack of reliable conclusive research into the symptomatic population (those with current shoulder pain interrupting training) means it is unclear whether scapula instability is solely a primary phenomenon associated with the forces of training, or whether it is further compromised with injury. The purpose of this study was to investigate scapula stability in symptomatic and asymptomatic competitive swimmers. Method Scapula stability was compared between six asymptomatic and six symptomatic competitive female swimmers who were randomly selected from a university swimming squad. The Lateral Slide Test, developed by Kibler (1991), investigated scapula stability by measuring the amount of scapula abduction and upward rotation in three positions of humeral abduction (position 1: relaxed standing, position 2: hands on hips, position 3: 90˚ humeral abduction). Electronic digital calipers measured the distance between bony landmarks of the scapula and
thoracic spine in accordance with the lateral slide test protocol and measurements were used to calculate a rotary index and the amount of scapula abduction for each subject in each testing position. Results The rotary index of the symptomatic and asymptomatic groups was compared in each position using the unrelated t-test. Scapula abduction was compared using the same statistical procedure. There was a significant difference in the rotary index and scapula abduction in positions 2 and 3 (position 2: rotary index t = 1.82, p < 0.05, scapula abduction t = 2.339, p < 0.05, position 3: rotary index t = 2.194, p < 0.05, scapula abduction t = 2.439, p < 0.05). These results indicate that the scapulae of the symptomatic swimmers were more abducted and upwardly rotated in positions 2 and 3. These positions correspond to increased challenge on the stabilising muscles. Conclusion The results of this small-scale study suggest that the scapulae of symptomatic competitive swimmers are more unstable than the asymptomatic group when there is an increase in challenge on the stabilising muscles, suggesting that the inherent scapula instability associated with competitive swimming is further compromised with injury. Reference Kibler, W (1991). ‘The role of the scapula in the overhead throwing motion’, Contemporary Orthopaedics, 22, 5, 525-532.
RESPIRATORY CARE SECTION
Respiratory Physiotherapy Manual Techniques Review of the literature D E Tydeman, J L Cross School of Occupational Therapy and Physiotherapy, University of East Anglia Introduction The evidence base for the use of manual techniques in respiratory physiotherapy was critically reviewed in order to develop clear and comprehensive guidelines for their application. This work was sponsored by the Association of Chartered Physiotherapists in Respiratory Care. Method Medline, Cinahl, Pedro and Cochrane databases were searched and papers identified using a list of relevant key words. Articles which were in abstract form only and trials which were animal based or included ventilated patients or babies and neonates were excluded.
Findings/Analysis A total of 51 papers fitted the criteria and were reviewed. There was a lack of uniformity between trials, which made direct comparisons difficult. Most researchers did not evaluate individual manual techniques but looked at a combination of two or more techniques. These usually included percussion, vibrations and shaking. Postural drainage was also commonly part of the treatment protocol. True control groups were rarely used for comparison. Discussion There is little evidence from current and past research that separately identified manual techniques alone have a positive effect on airway clearance. Most papers reported collectively on ‘chest physiotherapy’ which usually incorporated more than one manual technique and other treatment modalities. There is evidence that ‘chest physiotherapy’ is effective if sputum production is copious. Conclusion Further research is needed; namely a randomised controlled trial which would evaluate individual manual techniques separately. Physiotherapy November 2001/vol 87/no 11
603
SPORTS MEDICINE SECTION
Scapula Stability of Symptomatic and Asymptomatic Competitive Female Swimmers V A P Coombs University of Birmingham Introduction The influence of swimming training on the stabilising structures of the shoulder complex is thought to contribute to the inherent scapula instability of competitive swimmers. Lack of reliable conclusive research into the symptomatic population (those with current shoulder pain interrupting training) means it is unclear whether scapula instability is solely a primary phenomenon associated with the forces of training, or whether it is further compromised with injury. The purpose of this study was to investigate scapula stability in symptomatic and asymptomatic competitive swimmers. Method Scapula stability was compared between six asymptomatic and six symptomatic competitive female swimmers who were randomly selected from a university swimming squad. The Lateral Slide Test, developed by Kibler (1991), investigated scapula stability by measuring the amount of scapula abduction and upward rotation in three positions of humeral abduction (position 1: relaxed standing, position 2: hands on hips, position 3: 90˚ humeral abduction). Electronic digital calipers measured the distance between bony landmarks of the scapula and
thoracic spine in accordance with the lateral slide test protocol and measurements were used to calculate a rotary index and the amount of scapula abduction for each subject in each testing position. Results The rotary index of the symptomatic and asymptomatic groups was compared in each position using the unrelated t-test. Scapula abduction was compared using the same statistical procedure. There was a significant difference in the rotary index and scapula abduction in positions 2 and 3 (position 2: rotary index t = 1.82, p < 0.05, scapula abduction t = 2.339, p < 0.05, position 3: rotary index t = 2.194, p < 0.05, scapula abduction t = 2.439, p < 0.05). These results indicate that the scapulae of the symptomatic swimmers were more abducted and upwardly rotated in positions 2 and 3. These positions correspond to increased challenge on the stabilising muscles. Conclusion The results of this small-scale study suggest that the scapulae of symptomatic competitive swimmers are more unstable than the asymptomatic group when there is an increase in challenge on the stabilising muscles, suggesting that the inherent scapula instability associated with competitive swimming is further compromised with injury. Reference Kibler, W (1991). ‘The role of the scapula in the overhead throwing motion’, Contemporary Orthopaedics, 22, 5, 525-532.
RESPIRATORY CARE SECTION
Respiratory Physiotherapy Manual Techniques Review of the literature D E Tydeman, J L Cross School of Occupational Therapy and Physiotherapy, University of East Anglia Introduction The evidence base for the use of manual techniques in respiratory physiotherapy was critically reviewed in order to develop clear and comprehensive guidelines for their application. This work was sponsored by the Association of Chartered Physiotherapists in Respiratory Care. Method Medline, Cinahl, Pedro and Cochrane databases were searched and papers identified using a list of relevant key words. Articles which were in abstract form only and trials which were animal based or included ventilated patients or babies and neonates were excluded.
Findings/Analysis A total of 51 papers fitted the criteria and were reviewed. There was a lack of uniformity between trials, which made direct comparisons difficult. Most researchers did not evaluate individual manual techniques but looked at a combination of two or more techniques. These usually included percussion, vibrations and shaking. Postural drainage was also commonly part of the treatment protocol. True control groups were rarely used for comparison. Discussion There is little evidence from current and past research that separately identified manual techniques alone have a positive effect on airway clearance. Most papers reported collectively on ‘chest physiotherapy’ which usually incorporated more than one manual technique and other treatment modalities. There is evidence that ‘chest physiotherapy’ is effective if sputum production is copious. Conclusion Further research is needed; namely a randomised controlled trial which would evaluate individual manual techniques separately. Physiotherapy November 2001/vol 87/no 11