Altered scapular orientation during arm elevation in patients with insidious onset neck pain and whiplash-associated disorder.

STUDY DESIGN Controlled laboratory study using a cross-sectional design. OBJECTIVES To investigate whether there is a pattern of altered scapular orientation during arm elevation in patients with insidious onset neck pain (IONP) and whiplash-associated disorder (WAD) compared to asymptomatic people. BACKGROUND Altered activity in the axioscapular muscles and impairments in scapular orientation are considered to be important features in patients with cervical disorders. Scapular orientation has until now not been investigated in these patients. METHODS A 3-dimensional tracking device measured scapular orientation during arm elevation in patients with IONP (n = 21) and WAD (n = 23). An asymptomatic group was selected for comparison (n = 20). RESULTS The groups demonstrated a significantly reduced clavicle retraction on the dominant side compared to the nondominant side. The WAD group demonstrated an increased elevation of the clavicle compared to the asymptomatic group and the IONP group, and reduced scapular posterior tilt on the nondominant side compared to the IONP group. CONCLUSION Altered dynamic stability of the scapula may be present in patients with cervical disorders, which may be an important mechanism for maintenance of recurrence or exacerbation of symptoms in these patients. Patients with cervical disorders may demonstrate a difference in impairments, based on their diagnosis of IONP or WAD.