Effects of NMES-Guided Scapular Retraction Exercise Program in Amateur Female Handball Players with Scapular Dyskinesis Without Shoulder Pain: A Randomized Controlled Clinical Trial

TL;DR

This study found that combining electrical stimulation with scapular exercises improved shoulder positioning and strength in female handball players with scapular issues.

Contribution

The study introduces a novel combination of NMES with scapular retraction exercises for treating scapular dyskinesis in athletes.

Findings

NMES combined with scapular retraction improved scapular positioning and external rotation strength significantly.

The number needed to treat was 2 for upper scapular positioning and 4 for external rotation strength.

Results were statistically significant across multiple measured parameters.

Abstract

Objective: This study aimed to evaluate the effect of simultaneously combining therapeutic scapular retraction exercise with and without Neuromuscular Electrical Stimulation (NMES) in amateur female handball players with scapular dyskinesis. Methods: In a randomized, single-blind, controlled trial, the sample (n = 34) was randomized into two groups (Group 1 (n = 17) and Group 2 (n = 17)). The intervention consisted of applying a supervised scapular retraction exercise (SRE) program alone or combined with NMES for 4 weeks (2 ss/week). Scapular Static Positioning Assessment parameters (upper and lower horizontal distance of the scapula from the spine (mm)), internal rotation range of motion (degrees), and external rotation strength (newtons and BW%) were measured. Results: A significant interaction was found to favor the group that received the supervised SRE program + NMES (Group 1) in upper horizontal distance (F1,30 = 30.93 [p < 0.000]; d = 0.65); lower horizontal distance (F1,30 = 12.79 [p = 0.001]; d = 0.72); ER Strength (N) (F1,30 = 19.58 [p < 0.000] d = 0.71); and ER Strength (BW%) (F1,30 = 16.84 [p < 0.000]) d = 0.69), which was statistically significant (p ≤ 0.001 for p < 0.05). In the analysis for treatment benefit, the number needed to treat (NNT) was 2 for upper scapular positioning and 4 for external rotation strength. Conclusions: NMES improves the Scapular Static Positioning and ER Strength when combined with an SRE program in amateur female handball players diagnosed with scapular dyskinesis, with clinically relevant effects. These findings, while promising, are based on a small sample and should be confirmed in larger studies.

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