Date of Paper/Work

3-2017

Type of Paper/Work

Research Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Cort J. Cieminski

Abstract

Comparison of Three-Dimensional Motion of the Scapula during the Hawkins-Kennedy Test and the Sleeper Stretch. Alyssa S. Buchner, Tami J. Buus, Brittany N. Evans, Kirsten E. Lambert, Lisandra M. Scheevel Advisor: Cort J. Cieminski, PT, PhD, ATR PURPOSE: The Hawkins-Kennedy test is a pain provocation test used to identify shoulder pathology. With this test, it is hypothesized the scapula tips anteriorly and compresses soft tissue structures of the shoulder, causing pain. A common intervention for this type of shoulder pathology is the sidelying sleeper stretch. Although the glenohumeral (GH) joint is in the same anatomical position for both conditions, the sleeper stretch does not typically provoke pain. In the sidelying position the scapula was stabilized by the subject’s body weight, theoretically limiting the amount of anterior tipping. Currently, there is no research investigating the scapular arthrokinematics in both conditions. The purpose of this study is to measure scapular tipping accompanying shoulder internal rotation (IR) range of motion (ROM) in the sidelying sleeper stretch position compared to the Hawkins-Kennedy test position.

METHODS: While passive moving from full shoulder external to internal rotation, scapular tipping and GH IR were measured in the Hawkins-Kennedy and sidelying sleeper stretch using three-dimensional motion analysis, on the dominant shoulder of 30 healthy subjects (13 male [31.3±13.0 years, 24.6±2.7 BMI] and 17 female [27.4±8.7 years, 23.2±2.3 BMI]).

RESULTS: Hawkins-Kennedy GH IR mean was 94.1°±13.2° and sidelying GH IR mean was 71.9°±15.9° (p<0.0001). Scapular tipping excursion was -8.7°±6.3° and in sidelying was 4.7°±4.2° (p<0.0001). In the Hawkins-Kennedy position, excursion of scapular IR was found to be 6.4°+5.2°, and in sidelying an excursion 4.0°+3.5° of scapular external rotation was found (p=<0.0001). The ratio of tip excursion to GH IR excursion mean was -9.7°±7.0° and the sidelying mean was 6.2°±5.5° (p<0.0001). CONCLUSION: In a healthy population, the scapula anteriorly tipped during passive shoulder IR in the Hawkins-Kennedy test position and posteriorly tipped in the sidelying position. Posterior tipping is hypothesized to protect the subacromial space, decreasing the compressive forces on the soft tissue structures of the shoulder. Therefore, stabilizing the scapula may protect the subacromial space, lending to the lack of pain typically noted in the sidelying sleeper stretch position.

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