Comparison the Effect of Scapula-Focused Exercises and Kinetic Chain Rehabilitation on Strength, proprioception, pain and disability on Athletes with Scapula Dyskinesia

Comparison the effect of scapula-focused and kinetic chain exercises on strength, proprioception, pain and disability of athlete with scapula dyskinesia

Two arm parallel group randomized trial with blinded outcome assessment

The present study was an interventional, semi-experimental, and applied research design. All participants performed the exercises under the supervision of a corrective exercise specialist for 8 weeks in their respective groups. Assessments were conducted one week prior to the intervention and after the two 8-week interventions by a blinded evaluator. The measured variables included pain, disability, muscle strength, and proprioception. All measurements were carried out in the university laboratory.

Inclusion Criteria: Males aged 18–30, ≥3 years in overhead sports, positive Kibler lateral scapular slide test, and VAS pain score 3–7. Exclusion Criteria: Lack of consent, abnormal BMI, shoulder trauma, fracture, dislocation, ROM limitation, upper limb surgery in past 2 years, structural deformities (kyphosis, scoliosis), or neurological/musculoskeletal disorders limiting motion.

Experimental Group 1 (Scapula-Focused): Performed 8 strengthening exercises for the serratus anterior, middle and lower trapezius, and rotator cuff to improve scapulohumeral rhythm and glenohumeral stability. Experimental Group 2 (Kinetic Chain): Performed 11 exercises involving upper limbs, trunk, and lower limbs to enhance neuromuscular coordination and force transfer, including dynamic movements mimicking daily and sports activities.

muscle strength, proprioception, pain and disability

Following the baseline examination, by using the method on the website http://randomizer.org participants are randomly assigned into the two experimental groups (neuromuscular training with an attentional focus), (therapeutic exercise), and control group. Simple randomization is used. Concealed allocation is performed using a computer generated block randomized table of numbers ( 1 and 2 for experimental groups and 3 for control group) created before the start of data collection by researcher who is not involved in the recruitment or treatment of patients. Then, the random numerical sequence is placed in sealed opaque envelope and processed with treatment according to the group assignment. A blinded outcome assessor who does not know the hypothesis and study methods, measures outcome at baseline and 8 weeks post-intervention.

In this study, blinding will be carried out in a single-blind manner. This means that only the participants and outcome assessor will be unaware of the type of intervention and the group to which they have been allocated (experimental or control), while the main researchers will be aware of the allocation. To minimize bias, the allocation of participants to groups will be performed using a block randomization method by an individual independent from the data collection team. Participants will be informed that they are taking part in a comparative study, but details about the exact type of intervention and the differences between groups will not be disclosed. All interventions will be delivered under similar timing and environmental conditions so that no obvious differences are detectable by the participants. Additionally, participants will be asked to refrain from inquiring about the type of intervention or comparisons with the other group. Data collection will be carried out by a trained assessor who, as much as possible, will remain minimally informed about the final objectives and main hypotheses of the study, in order to reduce observer bias in outcome measurement. In case of circumstances where blinding may be compromised (such as direct questioning by a participant or specific side effects), such events will be documented and considered in the final analysis.