Comparison the effect of six weeks of neuromuscular and Proprioceptive Neuromuscular Facilitation (PNF) exercises on the rhythm and position of the scapula in elite bodybuilding athletes with scapular dyskinesis
Irtiqa Imini Pishgiri Masdumiyat (Safety Promotion and Injury Prevention),
Vol. 12 No. 2 (1403),
16 September 2025
,
Page 96 - 83
https://doi.org/10.22037/iipm.v12i2.46305
Abstract
Background and Aim: The scapula and its optimal movement quality are vital factors in the health of the shoulder girdle system, and scapular dyskinesis is a common issue in this area. The aim of this study was to comparison the effect of six weeks of neuromuscular and PNF exercises on the rhythm and position of the scapula in elite bodybuilding athletes with scapular dyskinesis.
Materials and Methods: This semi-experimental study employed a pre-test, post-test design. The sample consisted of 30 bodybuilders with scapular dyskinesis who were randomly divided into three groups of 10: a neuromuscular exercise group, a PNF group, and a control group. Scapular dyskinesis was assessed using the McClure test, scapulohumeral rhythm was evaluated with an inclinometer at 45, 90, and 135 degrees, and scapular position was measured using the Kibler test in three positions: 0, 45, and 90 degrees. The training groups underwent their specific exercises for six weeks, while the control group received no specific intervention. Post-tests were conducted after the six-week period. Statistical analysis was performed using one-way ANOVA and paired t-tests at a significance level of 0.05.
Results: The one-way ANOVA results showed a significant difference between the study groups in the post-test for the variables of scapular position and scapulohumeral rhythm (P<0.05). LSD post-hoc test results indicated that the PNF training group had significantly lower values in all dependent variables compared to the other two groups in the post-test (P<0.05). Additionally, the neuromuscular training group had lower values in all variables, except for the 0-degree angle in scapular position, compared to the control group in the post-test (P<0.05).
Conclusion: PNF exercises had a greater effect on improving the scapulohumeral rhythm and scapular position in bodybuilders with scapular dyskinesis. Therefore, it is recommended that coaches consider incorporating these exercises.
Please cite this article as:
Moshrefi M, Minoonejad H, Rajabi R. Comparison the effect of six weeks of neuromuscular and Proprioceptive Neuromuscular
Facilitation (PNF) exercises on the rhythm and position of the scapula in elite bodybuilding athletes with scapular dyskinesis. Irtiqa
Imini Pishgiri Masdumiyat. 2024: Vol 12: No 2: 83- 96. https://doi.org/10.22037/iipm.v1403i12.46305
- Scapular Dyskinesis, Shoulder Girdle, Bodybuilders
How to Cite
References
Voight ML, Thomson BC. The role of the scapula in the rehabilitation of shoulder injuries. Journal of athletic training. 2000;35(3):364.
Kibler WB, Ludewig PM, McClure PW, Michener LA, Bak K, Sciascia AD. Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the ‘Scapular Summit’. British journal of sports medicine. 2013;47(14):877-85.
Gumina S, Carbone S, Postacchini F. Scapular dyskinesis and SICK scapula syndrome in patients with chronic type III acromioclavicular dislocation. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2009;25(1):40-5.
Gorman PP, Butler RJ, Plisky PJ, Kiesel KB. Upper Quarter Y Balance Test: reliability and performance comparison between genders in active adults. The Journal of Strength & Conditioning Research. 2012;26(11):3043-8.
Westrick RB, Miller JM, Carow SD, Gerber JP. Exploration of the y-balance test for assessment of upper quarter closed kinetic chain performance. International journal of sports physical therapy. 2012;7(2):139.
Garrett WE. Principles and practice of orthopaedic sports medicine: Lippincott Williams & Wilkins; 2000.
Peggy AH. Therapeutic exercise for athletic injuries. USA: HumanKineticsPublishers. 2000:354-86.
Ben Kibler W. The role of the scapula in athletic shoulder function. The American journal of sports medicine. 1998;26(2):325-37.
Akodu AK, Akinbo SR, Young QO. Correlation among smartphone addiction, craniovertebral angle, scapular dyskinesis, and selected anthropometric variables in physiotherapy undergraduates. Journal of Taibah University Medical Sciences. 2018;13(6):528-34.
Kibler WB, Sciascia A. Evaluation and management of scapular dyskinesis in overhead athletes. Current Reviews in Musculoskeletal Medicine. 2019;12:515-26.
Panagiotopoulos AC, Crowther IM. Scapular dyskinesia, the forgotten culprit of shoulder pain and how to rehabilitate. SICOT-J. 2019;5.
Burn MB, McCulloch PC, Lintner DM, Liberman SR, Harris JD. Prevalence of scapular dyskinesis in overhead and nonoverhead athletes: a systematic review. Orthopaedic journal of sports medicine. 2016;4(2):2325967115627608.
Provencher MT, Kirby H, McDonald LS, Golijanin P, Gross D, Campbell KJ, et al. Surgical release of the pectoralis minor tendon for scapular dyskinesia and shoulder pain. The American journal of sports medicine. 2017;45(1):173-8.
Yeşilyaprak SS, Yüksel E, Kalkan S. Influence of pectoralis minor and upper trapezius lengths on observable scapular dyskinesis. Physical Therapy in Sport. 2016;19:7-13.
Umehara J, Nakamura M, Nishishita S, Tanaka H, Kusano K, Ichihashi N. Scapular kinematic alterations during arm elevation with decrease in pectoralis minor stiffness after stretching in healthy individuals. Journal of shoulder and elbow surgery. 2018;27(7):1214-20.
Borstad JD, Ludewig PM. The effect of long versus short pectoralis minor resting length on scapular kinematics in healthy individuals. Journal of orthopaedic & sports physical therapy. 2005;35(4):227-38.
Barlow JC, Benjamin BW, BIRT PJ, Hughes CJ. Shoulder strength and range-of-motion characteristics in bodybuilders. The Journal of Strength & Conditioning Research. 2002;16(3):367-72.
Liebenson C. Functional training handbook: Lippincott Williams & Wilkins; 2014.
Wu G, Van der Helm FC, Veeger HD, Makhsous M, Van Roy P, Anglin C, et al. ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion—Part II: shoulder, elbow, wrist and hand. Journal of biomechanics. 2005;38(5):981-92.
Zech A, Huebscher M, Vogt L, Banzer W, Hänsel F, Pfeifer K. Neuromuscular training for rehabilitation of sports injuries: a systematic review. Medicine & science in sports & exercise. 2009;41(10):1831-41.
Jancosko JJ, Kazanjian JE. Shoulder injuries in the throwing athlete. The Physician and sportsmedicine. 2012;40(1):84-90.
Kibler WB, Uhl TL, Maddux JW, Brooks PV, Zeller B, McMullen J. Qualitative clinical evaluation of scapular dysfunction: a reliability study. Journal of shoulder and elbow surgery. 2002;11(6):550-6.
Hurd WJ, Kaplan KM, ElAttrache NS, Jobe FW, Morrey BF, Kaufman KR. A profile of glenohumeral internal and external rotation motion in the uninjured high school baseball pitcher, part II: strength. Journal of athletic training. 2011;46(3):289-95.
Guirro E, Silveira D, Perez C, Montezuma T, Rezende M, Oliveira R, et al. Proprioceptive neuromuscular facilitation in shoulder rehabilitation of women submitted to surgical treatment for breast cancer. Int J Phys Ther Rehab. 2019;5(1):1-6.
De V. Proprioceptive neuromuscular facilitation patterns and techniqes. 3ED Harper and Row. 1985:298-311.
Kibler BW, Sciascia A, Wilkes T. Scapular dyskinesis and its relation to shoulder injury. JAAOS-journal of the American academy of orthopaedic surgeons. 2012;20(6):364-72.
Westwater-Wood S, Adams N, Kerry R. The use of proprioceptive neuromuscular facilitation in physiotherapy practice. Physical Therapy Reviews. 2010;15(1):23-8.
Mahto P. Effect Of Proprioceptive Neuromuscular Facilitation On Pain, Forward Head Posture, Scapular Dyskinesis And Quality Of Life Among Fulltime Housewives–A Pilot Study. Educational Administration: Theory and Practice. 2024;30(4):10229-40.
Severini G, Cacchio A, Campana V, Milano G. Prevention strategies of shoulder injuries. Sports Injuries: Prevention, Diagnosis, Treatment and Rehabilitation: Springer; 2014. p. 279-90.
Guido Jr JA, Stemm J. Reactive neuromuscular training: A multi-level approach to rehabilitation of the unstable shoulder. North American journal of sports physical therapy: NAJSPT. 2007;2(2):97.
McClure P, Tate AR, Kareha S, Irwin D, Zlupko E. A clinical method for identifying scapular dyskinesis, part 1: reliability. Journal of athletic training. 2009;44(2):160-4.
Altaf I, Maqbool A, Maqbool A, Akram A, Iqbal S, Ali Z. Effects of Scapular Proprioceptive Neuromuscular Facilitation Technique on Scapular Dyskinesis. Pakistan Journal of Medical & Health Sciences. 2023;17(04):416-.
Shaikh SB, Ganvir SS. Effect of 4 Weeks of Scapular Proprioceptive Neuromuscular Facilitation on Scapular Alignment and Upper Extremity Motor Performance in Patients with Stroke: A Repeated Measure Design. Medical Journal of Dr DY Patil University. 2023.
Khodaverdizadeh M, Mohammad Rahimi N, Esfahani M. The effect of scapular-focused exercise therapy on shoulder pain and function and scapular positioning in people with scapular dyskinesia-a systematic review and meta-analysis. Iranian Rehabilitation Journal. 2023;21(4):0-.
Ciğercioğlu NB, Ünüvar E, Hazimlioglu P, Tan F, Kılınç HE, Deniz HG. Proprioceptive neuromuscular facilitation training improves scapular muscle strength and pectoralis minor length in individuals with scapular dyskinesis. Journal of Basic and Clinical Health Sciences. 2022;6(1):238-46.
Saeed M, Hafeez S, Asad F, Haider W, Nawaz S, Kocub S. Comparison of scapular proprioceptive neuromuscular facilitation and myofascial release techniques on pain and function in scapular dyskinesia associated with adhesive capsulitis: Scapular dyskinesia associated with adhesive capsulitis. Pakistan BioMedical Journal. 2022:123-7.
Hwang M, Lee S, Lim C. Effects of the proprioceptive neuromuscular facilitation technique on scapula function in office workers with scapula Dyskinesis. Medicina. 2021;57(4):332.
Meneghini GO, Adamatti FS, Dhein W. Immediate effect of proprioceptive neuromuscular facilitation on scapular dyskinesia of volleyball players. Manual Therapy, Posturology & Rehabilitation Journal. 2020;18:1-9.
Tedla JS, Sangadala DR. Proprioceptive neuromuscular facilitation techniques in adhesive capsulitis: a systematic review and meta-analysis. Journal of musculoskeletal & neuronal interactions. 2019;19(4):482.
Myers JB, Ju Y-Y, Hwang J-H, McMahon PJ, Rodosky MW, Lephart SM. Reflexive muscle activation alterations in shoulders with anterior glenohumeral instability. The American Journal of Sports Medicine. 2004;32(4):1013-21.
Myers JB, Lephart SM. Sensorimotor deficits contributing to glenohumeral instability. Clinical Orthopaedics and Related Research®. 2002;400:98-104.
Inman VT, Saunders JdM, Abbott LC. Observations on the function of the shoulder joint. JBJS. 1944;26(1):1-30.
Lewit K. Manipulative therapy in rehabilitation of the locomotor system. (No Title). 1991.
Tate A, Turner GN, Knab SE, Jorgensen C, Strittmatter A, Michener LA. Risk factors associated with shoulder pain and disability across the lifespan of competitive swimmers. Journal of athletic training. 2012;47(2):149-58.
Mottram S. Dynamic stability of the scapula. Man ther. 1997;2(3):123-31.
- Abstract Viewed: 96 times
- pdf 2 (فارسی) Downloaded: 92 times