Korean J Sports Med.  2022 Mar;40(1):12-21. 10.5763/kjsm.2022.40.1.12.

Effects of Thoracic Spine Mobility Exercise on Symptom Improvement and Scapular Position in Patient with Subacromial Impingement Syndrome

• Choi MY
• Kong DH
• Kim JS
• Jang SH

• KMID: 2526684
• DOI: http://doi.org/10.5763/kjsm.2022.40.1.12

Abstract

Purpose
The purpose of this study was to identify effects of the thoracic spine mobility exercise in patients with subacromial impingement syndrome (SIS).
Methods
Twenty patients diagnosed with SIS were selected and randomized into the combination exercise (CE) group (n=10) and shoulder exercise (SE) group (n=10). Both groups performed the same SE program for 12 weeks, and CE group performed the thoracic spine mobility exercises additionally. Before and after the exercises, visual analogue scale (VAS), shoulder range of motion (ROM), thoracic spine mobility, American Shoulder and Elbow Surgeons Shoulder Score (ASES) and Constant score, isokinetic strength, and scapula position were assessed.
Results
After 12 weeks of exercise intervention, there were significant improvements in VAS, thoracic spine mobility, ASES, isokinetic shoulder external rotation, and abduction strength in the CE group (p＜ 0.05). However, there were no significant interaction effects between the groups in shoulder ROM, Constant score, isokinetic shoulder internal rotation, and adduction strength. With scapular position, the internal rotation, anterior tilting, and protraction angles were significantly decreased after thoracic spine mobility exercise in the CE group (p＜ 0.05).
Conclusion
The symptoms and scapular positions of patients with SIS showed more improvement when the thoracic spine mobility exercises were performed in combination with shoulder exercises compared to shoulder exercises only.

Keyword

Muscle strength; Scapula; Shoulder; Subacromial impingement syndrome; Thoracic vertebrae

Figure

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  Fig. 1 Thoracic spine mobility exercise program. (A) Bench thoracic extension. (B) Kneeling sphinx pose. (C) Foam roller thoracic extension. (D, E) Thoracic cat-cow stretch. (F) Seated thoracic rotation. (G) Supine thoracic rotation. (H) Sidelying thoracic rotation. (I) Quadruped thoracic rotation. (J) Half-kneeling thoracic rotation.

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  Fig. 2 Measurement of thoracic spine extension mobility. (A) Posture for measurement of thoracic spine extension mobility. (B) Vertebral centroid angle (arrow).

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  Fig. 3 Measurement of thoracic spine rotation mobility. (A) Posture for measurement of thoracic spine rotation mobility. (B) Measuring angle in reference to the line connecting both acromions (dotted line) using a goniometer (solid line).

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  Fig. 4 Scapular position analyzed by 3-dimensional wing computer tomography. (A) Upward rotation (UR). (B) Internal rotation (IR). (C) Anterior tilting (AT). (D) Superior translation (ST). (E) Protraction (PRO).

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