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To investigate whether scapular movement training (SMT) is superior to standardized exercises in improving scapular biomechanics, behavioral, and clinical aspects of individuals with shoulder pain. A total of 64 individuals with chronic shoulder pain were randomly assigned to receive 16 sessions of SMT or SE over 8 weeks. Outcome measures included three-dimensional scapular kinematics, muscle activity of scapulothoracic muscles, pain, disability, fear-avoidance, kinesiophobia, and self-perceived changes. Kinematics and muscle activity were assessed at baseline and after treatment, and self-reported measurements at baseline, 4, 8, and 12 weeks. SMT significantly (p < 0.05) decreased scapular internal rotation during arm elevation and lowering at sagittal and scapular planes (mean difference [MD]: ranged from 2.8 to 4.1°), and at lower angles of arm elevation and lowering at the frontal plane (MD: 3.4° and 2.4°, respectively), increased upper trapezius (UT) activity (MD: 10.3%) and decreased middle trapezius (MT) (MD: 60.4%) and serratus anterior (MD: 9.9%) activity during arm lowering compared to SE. Both groups significantly improved pain, disability, fear-avoidance, kinesiophobia, and self-perceived changes over 4 weeks, which was sustained over the remaining 8 weeks. SMT is not superior to standardized exercises in improving scapular biomechanics, behavioral, and clinical aspects of individuals with shoulder pain. NCT03528499 Scapular movement training (SMT) showed small and likely not clinically relevant changes in scapular kinematics and muscle activity compared to standardized exercises. SMT and standardized exercises presented similar improvements in pain, disability, fear-avoidance beliefs, kinesiophobia, and self-perceived change in health condition immediately following 4-weeks of treatment, which was sustained over the following 8 weeks. The changes in patient-reported outcome measures are unlikely to be associated with changes in scapular kinematics and electromyographic activity. Clinicians should consider other factors than scapular movement during the treatment of patients with shoulder pain. [ABSTRACT FROM AUTHOR]

Purpose: To verify the measurement properties of the Brazilian versions of Fear-avoidance Beliefs Questionnaire (FABQ) and Tampa Scale of Kinesiophobia (TSK) in individuals with shoulder pain. Methods: Individuals with shoulder pain (>18 years) were included in this study. Structural validity was verified by exploratory factor analysis, which was used to identify dimensionality of the FABQ and TSK. Test-retest reliability was assessed with intraclass correlation coefficient(3,1) and internal consistency with Cronbach's alpha. Floor or ceiling effects were also investigated. Responsiveness was verified by effect sizes and area under the receiver operating characteristic curve (AUC). Results: Exploratory factor analysis identified two and one factor in the FABQ and TSK, respectively. FABQ and TSK presented moderate to good reliability and adequate internal consistency (Cronbach's alpha > 0.70). The floor effect was present in one factor of the FABQ. The FABQ and TSK showed small to moderate effect sizes and did not show adequate AUC. Conclusion: FABQ and TSK are multidimensional and unidimensional instruments, respectively. Those instruments presented moderate to good reliability and the responsiveness was considered to be suboptimal in individuals with shoulder pain. [ABSTRACT FROM AUTHOR]

• The angular onset of pain is associated to upper limb function in RCRSP. • Male sex and being younger are related to better functioning of the upper limbs. • Angular onset of pain above 120° is highly frequent in individuals with RCRSP. Rotator cuff related shoulder pain (RCRSP) is the main diagnosis for shoulder pain. A painful arc during active arm elevation is a common finding in RCRSP. The angular onset of pain during arm elevation may play an important role on functioning of the upper extremities. This study aimed to: 1) determine and characterize the association between the angular onset of pain during arm elevation and upper-limb self-reported functioning, 2) verify whether demographic and clinical characteristics contribute to this association, and 3) investigate whether these characteristics differ considering distinct ranges of angular onset of pain in individuals with RCRSP. 252 individuals with RCRSP were divided in 3 groups based on the angular onset of pain during arm elevation in the sagittal plane: <60°, 60°-120°, and >120°. The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used to assess functioning of the upper limbs. Demographic and clinical characteristics were selected for the multivariable analysis. Individuals with an angular onset of pain above 120° of arm elevation presented lower DASH score (lesser disability) than individuals with an angular onset of pain between 60°- 120°. Male sex, age, dominance of the side affected, duration of symptoms, and the angular onset of pain during arm elevation explained 31% of the DASH score variance. Individuals with RCRSP and angular onset of pain above 120° of arm elevation present better functioning than individuals with onset of pain between 60°-120°, and similar functioning as those with pain below 60°. Male sex, lower age, non-dominant side being affected and longer duration of symptoms are also associated to better functioning as assessed by the DASH questionnaire. [ABSTRACT FROM AUTHOR]