Discinese escapular em atletas overhead: uma revisão sistemática de estudos eletromiográficos

Abstract

Theoretical background: Scapular dyskinesis occurs when there is a noticeable disruption in the position and movement of the scapula and is directly related to the function of the periscapular muscles. It is highly prevalent in overhead athletes. however, it is not clear in the literature about the muscular behavior of the main scapula stabilizers in this population. Objective: To summarize the data regarding the electromyographic activity of the main stabilizing muscles of the scapula in overhead athletes with scapular dyskinesis (SD). Study design: Systematic review.

Methodology: Electronic searches were performed in Pubmed (MedLine), Embase, CINAHL and SPORTDiscus databases. Cross-sectional observational studies were included if they were conducted with overhead athletes and investigated the electromyographic activity of the upper (TS), middle (TM), and lower (TI), and serratus anterior (SA) trapezius. Two independent reviewers performed the screening, data extraction and assessment of the methodological quality of the included studies, which was analyzed using the 'Checklist for Analytical Cross-Sectional Studies', provided by the Joanna Briggs Institute. Results: 847 articles were found; 623 references were evaluated and six studies were included in this review. Moderate to high evidence suggested that the TS, TM, TI, and SA muscles have altered EMG activity in overhead athletes with ED during a variety of tasks described in the included studies. The TS had its activity increased during shoulder extension and external rotation movements, in abduction in the scapular plane and in the frontal plane at angles of 90° and 120°, and during the lifting and lowering phases of abduction and flexion without load. The TS activity was associated with pattern II of DE, considering the lowering of the limb in the scapular plane. The TM showed greater activity in extension and external rotation of the shoulder, and in abduction in the scapular and frontal planes at 90° and 120° angulations, in addition to its activity being related to pattern II of ED. The TI showed greater activity during extension and external rotation of the shoulder. There was also greater TI activity in abduction in the scapular plane at 90° and 120°, being related to pattern I of DE. The SA showed greater activity during abduction in the scapular and frontal planes at 90°

and 120°, as well as during the lowering phase of flexion and abduction with load. Its activity was related to pattern II of DE. Conclusion: This review revealed that the behavior of the main scapula stabilizing muscles has important changes in overhead athletes with ED, but it has similarities with the changes observed in non-overhead individuals, suggesting that the therapeutic approach would be similar for both populations.