title: Can clinical observation differentiate individuals with and without scapular dyskinesis?
abstract: BACKGROUND
  Altered scapular rotation and position have been named scapular dyskinesis. Visual dynamic assessment could be applied to classify this alteration based on the clinical observation of the winging of the inferior medial scapular border (Type I) or of the prominence of the entire medial border (Type II), or by the excessive superior translation of the scapula (Type III).
  
  
  OBJECTIVE
  The aim of this study was to determine if there were differences in scapular rotations (Type I and II) and position (Type III) between a group of subjects with scapular dyskinesis, diagnosed by the clinical observation of an expert physical therapist, using a group of healthy individuals (Type IV).
  
  
  METHODS
  Twenty-six asymptomatic subjects volunteered for this study. After a fatigue protocol for the periscapular muscles, the dynamic scapular dyskinesis tests were conducted to visually classify each scapula into one of the four categories (Type IV dyskinesis-free). The kinematic variables studied were the differences between the maximum rotational dysfunctions and the minimum value that represented both normal function and a small dysfunctional movement.
  
  
  RESULTS
  Only scapular anterior tilt was significantly greater in the type I dyskinesis group (clinical observation of the posterior projection of the inferior angle of the scapula) when compared to the scapular dyskinesis-free group (p=0.037 scapular and p=0.001 sagittal plane).
  
  
  CONCLUSIONS
  Clinical observation was considered appropriate only in the diagnoses of dyskinesis type I. Considering the lower prevalence and sample sizes for types II and III, further studies are necessary to validate the clinical observation as a tool to diagnose scapular dyskinesis.
authors.affiliation: Ribeirao Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
authors.forename: Newton Y
authors.initials: NY
authors.lastname: Miachiro
authors.affiliation: Ribeirao Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
authors.forename: Paula M F
authors.initials: PM
authors.lastname: Camarini
authors.affiliation: Department of Human Movement Sciences, Universidade Federal de São Paulo, Santos, SP, Brasil.
authors.forename: Helga T
authors.initials: HT
authors.lastname: Tucci
authors.affiliation: School of Medicine, University of Washington, Seattle, WA, United States of America.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: McQuade
authors.affiliation: Ribeirao Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
authors.forename: Anamaria S
authors.initials: AS
authors.lastname: Oliveira
mesh_terms: D020820:Dyskinesias / Q000145:classification / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D019370:Observation; D012540:Scapula; D055815:Young Adult