Three-dimensional motion of the scapula and shoulder during activities of daily living

The purpose of this study was to describe 3-dimensional scapular motion during the activities of daily living (ADL) and the full range of arm motion, and to suggest a standardized method for evaluating scapular mobility. Eight healthy subjects between the ages of 25-40, with no prior history of shoulder pathology or surgery for the post 12 months, were recruited for this study. Touching 8 predetermined landmarks on the head and the trunk was used to simulate ADL. Touching the contralateral ear and contralateral shoulder resulted in the maximum scapular protraction 46 degrees (8 degrees) and 48 degrees (8 degrees), respectively, and the maximum degrees of the scapular anterior tilt, -11 degrees (4 degrees) and-11 degrees (5 degrees), respectively. Asking patients to reach to the back of the neck, and the contralateral shoulder, the clinician can evaluate the overall scapular mobility in all directions. A protocol controlling the performance variability during ADL tasks was suggested to improve the clinical evaluation of the shoulder joint complex. Findings of this study can guide clinicians to identify specific tasks which may relate to particular shoulder girdle dysfunction. (J Shoulder Elbow Surg 2008; 17:936-942.)