- 06:03 am
This article by Ann Cools and colleagues considers the topic of scapula dyskinesis in relation to neck pain but also with consideration to shoulder function. Cools and colleagues are prominent authors in the field of scapula dyskinesis and there is now a large body of literature available in this area. This originates essentially from the fields of sports medicine and manual therapy but much of the information has relevance for the neurological patient and certainly can inform neurophysiotherapy practice in this area.
It is suggested that so far the literature has focused largely on shoulder function without much attention to neck pain. The movement interactions and influences between scapula function and the cervical spine are highlighted. It is also proposed that a form of clinical reasoning algorithm that could inform practice across a wide spectrum of patients ‘from office worker to elite athlete’ would be a helpful step forward for clinical practice. This paper proposes such an algorithm with the main components being soft tissue flexibility and muscle performance. Potential influences/considerations in both these areas are identified within the algorithm and manual therapy approaches to treatment of specific problems suggested.
The algorithm in its present form has limitations for use in neurological physiotherapy but its main compo-nents (flexibility/muscle control) lend themselves to the fundamental problems of orientation and stability observed within neurological patients. Consideration of the algorithm can be helpful to the neurological physiotherapist in order to further inform and develop clinical practice.