Cinemática escapular de indivívuos com síndrome do impacto: revisão da literatura

Abstract

The impingement syndrome is one of the most common musculoskeletal disorders and the one that is more often associated with pain and shoulder dysfunction. This syndrome is related to an impairment of the subacromial structures and it is usually associated with changes in scapular kinematics. By lifting the arm the scapula must provide a stable base for the glenohumeral movement, and still be mobile, allowing appropriate range of motion and muscular tension-length. In general the elevation of the humerus has a progressive upward rotation, a progressive increase in posterior tilt and a lateral rotation of the scapula. Changes of scapular motion during activities with the upper limb are related to compression of subacromial structures and overload of the rotator cuff. Some researchers investigated the scapular kinematics in individuals with impingement syndrome and found changes in the pattern of the movement. The aim of this study was to review the literature on the characteristics of scapular kinematics in individuals with impingement syndrome. It was done a research in the literature of published studies until February 2012 that investigated the scapular kinematics in individuals with impingement syndrome in the following databases: MEDLINE (PubMed), LILACS and SciELO. The selected papers indicated that most changes observed in these individuals were: decreased upward rotation and posterior tilt and increased elevation and medial rotation of the scapula. Longitudinal studies are needed to determine whether kinematic patterns are predictive or consequences of the development of subacromial impingement. But we can infer that a proper kinematics is important for the maintenance of the subacromial space. Thus, the understanding of the scapular kinematics of individuals with impingement syndrome is considered important to create preventive strategies and intervention programs aimed at the restoration of the appropriate kinematics for these individuals.