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Specific scapular kinematic patterns to differentiate two forms of dynamic scapular winging.
[thoracic outlet syndrome]
Dynamic
scapular
winging
(
DSW
)
is
a
rare
and
misdiagnosed
disorder
causing
considerable
disability
due
to
reduced
scapular
stability
and
abnormal
motion
.
Two
common
causes
are
long
thoracic
nerve
lesions
resulting
in
serratus
anterior
muscle
palsy
and
spinal
accessory
nerve
lesions
resulting
in
trapezius
muscle
palsy
.
The
aim
of
this
study
was
to
analyse
3
D
scapular
kinematic
patterns
in
patients
with
DSW
due
to
long
thoracic
(
LTNL
)
or
spinal
accessory
nerve
lesions
(
SANL
)
.
3
D
scapular
kinematics
were
assessed
using
a
non
invasive
method
involving
an
electromagnetic
device
during
arm
elevation
in
the
frontal
and
sagittal
planes
in
9
patients
(
4
with
SANL
and
5
with
LTNL
)
with
unilateral
DSW
confirmed
by
electrical
evidence
.
Within
subject
affected-unaffected
differences
were
measured
and
compared
between
pathological
groups
(
Mann-
Whitney
)
.
Differences
between
affected
and
unaffected
shoulders
were
significantly
greater
for
scapular
posterior
tilt
(
at
rest
and
30
°
for
sagittal
arm
elevation
,
at
rest
,
30
°
and
60
°
for
frontal
arm
elevation
)
in
the
LTNL
compared
to
the
SANL
group
.
Differences
between
affected
and
unaffected
shoulders
were
significantly
greater
for
scapular
protraction
(
at
rest
and
60
°
of
sagittal
arm
elevation
,
at
rest
,
30
°
and
60
°
of
frontal
arm
elevation
)
and
scapular
lateral
rotation
at
60
°
for
frontal
arm
elevation
in
the
SANL
compared
to
the
LTNL
group
.
These
kinematic
findings
show
two
different
scapular
patterns
that
are
specific
to
the
neurological
lesion
.
Moreover
our
kinematic
data
relate
to
specific
clinical
signs
and
the
functional
roles
of
the
muscles
involved
.
Diseases
Validation
Diseases presenting
"spinal accessory nerve lesions resulting in trapezius muscle palsy"
symptom
thoracic outlet syndrome
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