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Effects of pectoralis minor stretching on resting muscle length and scapular kinematics during elevation of the arm in asymptomatics subjects and people with shoulder pain


There are evidences that shortening of the pectoralis minor is an important factor of change in biomechanics and can influence scapular kinematics. The stretching of this muscle is one of the most widely used techniques in clinical practice as an attempt to decrease the pain and improve function in patients with shoulder pain. However, this is not usually the only technique used in the rehabilitation protocol. There is lack of studies that assess the real effectiveness of a stretching program for the pectoralis minor on its resting length and on scapular kinematics. Therefore, the purpose of this study is to verify the effects of a stretching protocol for the pectoralis minor muscle on its resting length and on the 3D kinematics of the scapula during arm flexion in asymptomatic subjects and patients with impingement syndrome with shortened pectoralis minor. Fifty subjects (25 symptomatic and 25 asymptomatic for shoulder pain) will be recruited. All of them will be initially assessed twice with one week between the assessments. On each day, they will complete two questionnaires (DASH and SPADI) to assess pain and shoulder function. The resting length of the pectoralis minor muscle and scapular kinematics data during arm flexion will also be measured using an electromagnetic tracking system. Initially, the resting length of the pectoralis minor will be measured, and then 3 repetitions of arm elevation in the sagittal plane will be completed. The stretching protocol will be performed daily for 6 weeks. The stretching will be performed with the subject standing, with 90° of arm abduction and 90° of elbow flexion and palm on a flat planar surface. The subject then will place the leg opposite to the flat surface in front of the other with slight knee flexion and tilt the trunk forward like a rigid block and rotate it slightly increasing the horizontal abduction at the shoulder. This procedure will be done 4 times for 1 min and 30s interval between repetitions. After the 6 weeks, the subject will have the same variables from the initial assessments reassessed. For the questionnaires and length of pectoralis minor a two-way ANOVA for repeated measures will be used to check the main effects of group and evaluation and whether there is interaction between them. For scapular internal/external rotation, upward/downward rotation, and tilt anterior/posterior a three-way ANOVA for repeated measures will use to analyze the main effects of group (symptomatic and asymptomatic), elevation angle of the arm (30°, 60°, 90° and 120°) and evaluation (1, 2 and 3) and whether there is evaluation x group x angle interaction. A p value less than 0.05 will be considered significant. (AU)

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(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
ROSA, DAYANA P.; BORSTAD, JOHN D.; PIRES, ELISA D.; CAMARGO, PAULA R.. Reliability of measuring pectoralis minor muscle resting length in subjects with and without signs of shoulder impingement. BRAZILIAN JOURNAL OF PHYSICAL THERAPY, v. 20, n. 2, p. 176-183, . (13/50363-2, 12/20305-8)
ROSA, DAYANA P.; BORSTAD, JOHN D.; POGETTI, LIVIA S.; CAMARGO, PAULA R.. Effects of a stretching protocol for the pectoralis minor on muscle length, function, and scapular kinematics in individuals with and without shoulder pain. JOURNAL OF HAND THERAPY, v. 30, n. 1, p. 20-29, . (12/20305-8, 13/50363-2)

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