journÉe kinÉ 2016 - slks | sport-kine.lu
TRANSCRIPT
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Mercredi 01.06.2016
Amphithéâtre CHL-CENTRE13h00 à 17h00
JOURNÉE KINÉ 2016
„De l‘évidence au traitement“
Académie Luxembourgeoisede Médecine, de Kinésithérapie et des Sciences du Sport
Scapular Dyskinesis :
current concepts in rehabilitation
Danièle Schaack
Physiotherapist CHL-CE
Journée Kiné Ι 01.06.2016Centre Hospitalier de Luxembourg
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Role of the scapula
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Role of the scapula in normal shoulder function
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Cools WCPT 2015,Kibler 2013
UT/MT/LT UT LT
SA SA SA
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Normal scapular movement and muscle recruitment patterns
Int / Ext Rotation Upward Rotation Posterior tilt
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
= alteration of static scapular position or dynamic scapular
motion
= general term reflecting the loss of normal control of scapular
motion
„DYS“: alteration of „KINESIS“: motion
Kibler 2013, Kibler,Sciascia 2016, Cools 2013
Definition of Scapular Dyskinesis
Individual’s functional requirements and problematic activities
Cools 2013
Screening Kinetic Chain examination
Cools 2013,Kibler 2013,2016
Clinical evaluation of scapula: position,motion,strength,…..
Kibler 2013,2016 Cools 2013
Identify predominant type of dyskinesis based on observation
Kibler 2002,Cools 2015
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Evaluation for Scapular Dyskinesis
Guideline for a science based scapular rehab program
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Cools 2013, Kibler 2013
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Pectoralis Minor
Angular Stretching
self-stretching program in healthy athletes
Cools et al Shoulder & Elbow 2011
Direct manual stretching
in patients
Van de Velde 2011,Ann Cools.ESSKA 2016
Soft tisse technique?
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Other muscles
Levator scapulae
Rhomboidei
Latissimus dorsi
External rotators (ISP,Teres major,…)
Soft tissue techniques including dry needling
Ischemic compression (by manual TRP)
might be an added value,clinical practice
B.Cagnie 2013
Teres major
Levator scapulae
Teres minor
Heidi Tanno-Rast Praxisbuch Myofsziale Triggerpunkte Elsevier 2014
Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
POSTERIOR GLENOHUMERAL MUSCLES/CAPSULAR STIFFNESS
Posterior capsule
Infraspinatus
Latissimus dorsi
Sleeper‘s Stretch
Cross Body StretchCools 2015
Manual Mobilisation
Manske 2010,Cools 2011,Cools 2015
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Conscious muscle control
Goals: improve local muscle control and proprioception
correct scapular position
selective activation of LT
Challenge: maintenance of new scapular position under load
functional requirement of the patient
Cools WCPT 2015,Kibler 2016
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Conscious muscle control
Spinal Posture correctionBarbara Cagnie 2014
Taping GIRD,Posterior tilt,
Cools,Cagnie 2013,Van Herzeele 2013
NMES with feedbackHorsley ESSKA 2016
Don‘t forget the brain:make rehab sensory richGibson ESSKA 2016
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
„Low load functional movements“
Activation of key stabilisers in retraction
LT and SA
Scapular co-contraction maybe trained
in basic positionsmovementsexercises
in response to open or closed-chain acivities
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Low row
Lawnmower
Robbery
Inferior glide
+ER
……
Kibler 2016,Cools 2013
Examples of exercices for muscle control and co-contraction
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Wall push-up
Wall wash
Wall slide (with resistance)
Rhytmic stabilisations
Bench slide exercise
Closed-chain or semi-closed chain exercises
Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Cools 2013, Kibler 2013
Improve muscle strength and
inter/intra muscular balance
„High load strengthening exercises“
LT/MT/SA = weak
UT = hyperactive
SA
Exercises to restore the balanceProgression to functional exercises
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Intramuscular trapezius training
Side lying external rotation
Side lying forward flexion
Prone horizontal abd with ER
Prone extension
Isometric low row exercise (+ball sitting)
Examples of exercices for balance-ratio
Cools 2013,Kibler 2013,Castelein 2013
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Activity of SA
Push-up Plus exercise
Serratus punch in CKC (bench slide)
Dynamic Hug
Bouncing exercise
Wall slide exercises Elbow Push-up
Serratus punch supine
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Throwing athletes
load external rotators eccentrically
Swimers
no focus on plyometrics
train in sport-specific positions such as lying prone or supine
in situations demanding a lot of core stability
Gymnasts and climbing sports
high-level closed chain exercises
sling exercises might be added to their programCools 2013
Advanced control during sport movements
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Catching exercise with plyo-ball
X-Tube
W-V exercise
Bouncing serratus punch
Side bridging and prone bridging
Sling exercises
…
Cools 2013,Kibler 2013,Maenhout 2016
Examples of exercises
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Any stage of rehabilitation implementation of KC
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Diagonals
Open-chain exercises
standing the controlateral leg
Close-chain exercises
extend the controlateral leg
Cools 2013,Kibler 2016
Kinetic chain
CLINICAL CASE
Female patient: O.C.
Age: 30 years
Profession: secretary-receptionnist
Sports: dance 2/week
Actual complaints: shoulder + neck pain
Physiotherapy: massages
mésothérapie Neck
Actually: back rehabilitation
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Treatment goals
flexibility (LS-PM-UT,ER,Lat.dorsi,scaleni,SCM…)
GIRD increase shoulder mobility
posture correction (f.ex. while woking with computermouse,…)
improve neuro-muscular control
imrove scapular muscle strength
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Rehabilitation of scapular dyskinesis:from the office worker to the elite overhead athlete
Cools,Struyf,De Mey,Maenhout,Castelein,Cagnie Br J Sports Med (2013)
Effect of ischemic compression on Trigger Points in the neck and shoulder muscles in
office worker:a cohort study
Cagnie,Dewitte,Coppieters,Van Oosterwijck,Cools,Daneels Journal of Manipulative and Physiological
Therapeutics (2013)
Prevention of shoulder injuries in overhead athletes:a science based approach
Cools,Johansson,Borms,Maenhout Brazilian Journal of Physical Therapy (2015)
Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus
statement from the ‚scapular summit
Kibler,Ludewi,McClure,Michener,Bak,Sciascia Br J Sports Med (2013)
The role of the scapula in preventing and treating shoulder instability
Kibler,Sciascia Knee Surg Sports Traumatol Arthrosc (2016)
The relevance of scapular dysfunction in neck pain:a brief commentary
Cagnie,Struyf,Cools,Castelein,Danneels,O Leary Journal of Orthopedic and Sports Physical Therapy
(2014)
Current Concepts:scapular dyskinesis
Kibler,Sciascia Br J Sports Med (2010)
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Centre Hospitalier de Luxembourg
Effect of 2 stretching techniques on the length of the pectoralis minor in adolescent
swimers.Paper in progress
Annemie Van de Velde,Ann Cools.ESSKA 2016
Serratus anterior or pectoralis minor: Which muscle has the upper hand during
protraction exercises?
Castelein,Cagnie,Parlevliet,Cools
Internal impingement in the tennis player:rehabilitation guidelines
Cools,Declercq,Cagnie,Cambier,Witvrouw Br J Sports Med (2008)
Rehabilitation of scapular muscle balance:Which exercises to prescribe?
Cools,Dewitte,Lanszweert,Notebaert,Roets,Soetens,Cagnie,Witvrouw The American Journal of Sports
Medicine (2007)
Clinical assessment of the scapula:a review of the literature
Struyf,Nijs,Mottram,Roussel,Cools,Meeusen Br J Sports Med (2014)
Conscious correction of scapular orientation in overhead athletes performing selected
shoulder rehabilitation exercises:the effect on trapezius muscle activation measured by
surface Electromyography
De Mey,Danneels,Cagnie,Huyghe,Seyns,Cools Journal of Orthopedic and Sports Physical Therapy
(2013)
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Reduced glenohumeral rotation,external rotation weakness and scpular dyskinesis are
risk factors for shoulder injuries among elite male handball players:a prospective cohort
study
Clarsen,Bahr,Andersson,Munk,Myklebust Br J Sports Med (2014)
Scapular-muscle performance:two training programs in adolescent swimers
Van de Velde,De Mey,Maenhout,Calders,Cools Journal of athletic training (2011)
Shoulder muscle activation levels during four closed kinetic chain exercises with ans
without record slings
De Mey,Danneels,Cagnie,Borms,Jonck,Van Damme,Cools Journal of Strength and Conditioning
research (2014)
Kinetic chain influences on upper and lower trapezius muscle activatiob dúring eigth
variations of a scapular retraction exercise in overhead athletes
De Mey,Danneels,Cagnie,Van den Bosch,Flier,Cools Journal of science and Medecine in Sport (2013)
Is neuroplasticity in the central nervous system the missing link to our understanding of
chronic musculoskeletal disorders?
Pelletier,Higgins,Bourbonnais BMC Musuloskeletal Disorders (2015)
Impact of movement training on upper limb motor strategies in persons with shoulder
impingement syndrome
Roy,Moffet,McFadyen,Lirette Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology
(2009)
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Journée Kiné Ι 01.06.2016
Centre Hospitalier de Luxembourg
Shoulder Rehabilitation course Level II
Cools (2015)
Rehablitation of scapular dyskinesis in patients with impingement related shoulder pain
(SIS)
Cools WCPT Congress 2015 Singapore
Role of specific muscle training in shoulder rehabilitation
Cools ESSKA 2016 Barcelona