Thoracic position effect on shoulder range of motion, strength, and three-dimensional scapular kinematics

Objectives: To determine the effect of thoracic posture on scapular movement patterns, active range of motion (ROM) in scapular plane abduction, and isometric scapular plane abduction muscle force. Study Design and Method: Repeated measures design. There were 34 healthy subjects (mean age, 30.2yrs). Each subject was positioned and stabilized while sitting in both erect and slouched trunk postures. In each sitting posture a three-dimensional electromechanical digitizer was used to measure thoracic flexion and scapular position and orientation in three planes, Measurements were taken with the arm (1) at the side, (2) abducted to horizontal in the scapular plane, and (3) at maximum scapular plane abduction. In each posture, isometric abduction muscle force was measured with the arm at the side and abducted to horizontal in the scapular plane. Results: In the slouched posture, the scapula was significantly more elevated in the interval between 0 to 90 degrees abduction. In the interval between 90 degrees and maximum abduction, the slouched posture resulted in significantly less scapular posterior tilting, There was significantly less active shoulder abduction ROM in the slouched posture (mean difference = 23.6 degrees +/- 10.7 degrees), Muscle force was not different between slouched and erect postures with the arm at the side, but with the arm horizontal muscle force was decreased 16.2% in the slouched position. Conclusion: Thoracic spine position significantly affects scapular kinematics during scapular plane abduction, and the slouched posture is associated with decreased muscle force. (C) 1999 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.