Effects of Scapular Stability-Based Corrective Exercises on Scapular Upward Rotation and Scapulohumeral Rhyhtm, in Wheelchair Basketball Athletes With Bilateral Scapular Downward Rotation Syndrome

Aims: The purpose of the present study was to investigate The Effect of a Scapular Stability Based Corrective Exercise Program on scapular upward rotation and scapulohumeral rhyhtm in Wheelchair Basketball(WB) Athletes with bilateral scapular downward rotation syndrome. Methods: According to the research conditions, 24 wheelchair basketball athletes with spinal cord injury were purposefully participated in this study. Initially, 8 players were selected from each sport classes (1 to 1.5 classe, 2 to 2.5 classe and 3 to 4.5 classe). Then, 4 subjects in each group were randomly assigned to each group (12 control subjects with mean and standard deviation of age 43± 11.23 years and 12 experimental subjects with mean and standard deviation of age 39.08 ± 5.08 years). Thus, the control and experimental groups were present in an equal number of three sport classes. WB athletes were professional players in  mashhad city leagues. The participants were classified according to the Classification Committee of the IWBF, as well as the corresponding national classification from the Islamic republic of Iran sports federation for the disabled (IRISFD). Two Digital inclinometers were used to measure humeral range of motion and scapular upward rotation and scapulohumeral rhythm in rest position, 45°, 90° and 135° degrees shoulder abduction in scaption plane. The exercise group performed Scapular stability-based Corrective exercises based on the Gym training principles and in accordance with ACSM guidelines for 8 weeks. indipendent t-test, ANOVA and ANCOVA were used for statistical analysis at the significant level of P≤0.05. Findings: The results showed that there was no significant asymmetry between dominant and non-dominant shoulders in the upward rotation of Scapula at different angles of shoulder abduction. However, in the dominant shoulder than the non-dominant shoulder, Scapula had a less downward rotation at rest position and a higher upward rotation at 45 degrees of shoulder abduction. Also, in 45° humeral abduction, dominant shoulder have less scapulohumeral rhythm ratio than non-dominant shoulder. WB Athletes’  dominant shoulders in lower classes (2-2.5 and 3-4.5) have less scapular downward rotation in scapular rest position and more scapular upward rotation in 45°, 90° and 135° degrees humeral abduction. there were no significant different in  scapulohumeral rhythm ratio in WB Athletes with different classes. scapular upward rotation, was increased significantly after the 8–week Scapular Stability Based Corrective Exercise Program (p ≤ 0.05). After the 8– week  Scapular Stability Based Corrective Exercise program, significant decreased in scapular upward rotation was observed at postprogram in rest position(p=0.001) and significant increased in 45°(p=0.01), 90°(p=0.001) and 135°(p=0.001) humeral abduction compared with pre–program in dominant and non-dominant shoulders. But the ratio of scapulohumeral rhythm in dominant shoulder did not improve significantly and ratio of scapulohumeral rhythm in non- dominant shoulder improved at 90 and 135 degrees. Conclusion: Scapular stability-based corrective exercises can be used as one of the training methods to restore muscle balance and prevent and correct scapular upward rotation and scapulohumeral rhythm in wheelchair basketball athletes. Therapists should be note that some degree of scapular upward rotation and scapulohumeral rhythm asymmetry may be common in WB athletes. This asymmetry should not always be considered as a pathological symptom, but may be an adaptation to exercise training and frequent use of the upper extremity.