Effects of Stabilization Exercises and Posture Training on Breast Feeding Females Suffering From Scapular Dyskinesia

Effects of Stabilization Exercises and Posture Training on Breast Feeding Females Suffering From Scapular Dyskinesia

Comparative Effects Of Stabilization Exercises And Posture Training On Pain Function And Range Of Motion In Breast Feeding Females Suffering From Scapular Dyskinesia

A randomized clinical trial study will be conducted through a non-probability convenience sampling technique. Study will be conducted at Jinnah Hospital, Lahore. Sample size will be collected through open epi tool. The total sample size of 52 is calculated. Two treatment groups will be taken for conducting the research. Group A with twenty-six (26) patients will be treated with stabilization exercises and Group B with twenty-six (26) patients whom will be treated with posture training. Difference between pre-treatment and post-treatment readings will be calculated using Paired sample t-test for parametric data. For nonparametric data Wilcoxon signed rank test will be used. This is a non-parametric test that compares paired groups. Generalized physiotherapy rehabilitation protocol will be implemented in Group A for scapular stabilization by demonstrating scapular retraction (Shoulder Blade Squeezes), External Rotation, Shoulder Diagonals, Horizontal Rows, Shoulder Extension, Angel Wings, Active: Push with a plus, Physio ball Scapular Exercises, Platform Walks. In Group B, postural training different nursing positions will be guided as crossover hold, laid-back position, on the pillow position, cradle, football hold, side-lying position. The intervention will be provided in twelve sessions over a 4-week intervention period (three sessions per week) each session of 30 to 50 minutes accompanied by an individual daily at-home exercise program. The participants were advised not to use other forms of treatment during the trial (pharmacologic or non-pharmacologic treatment). NPRS will be used to measure the pain intensity and functional limitation will be assessed using the UEFI, goniometer to check the range limitation. Total study duration will be ten months after the approval of synopsis. Data will be analysed by using SPSS 26.

Scapular dyskinesis is a change or deviation in the normal resting or active position of the scapula during shoulder movement due to the repetitive use of the shoulder, most people's scapula moves abnormally. Scapular winging is a clinical observation in which any part of the scapular departs excessively from the thorax soon after movement begins causing hinderance in performing movements like Elevation/depression, Protraction/retraction, Internal/external rotation, Superior/inferior rotation, Anterior/posterior tilt. Scapular dyskinesia can be caused by one of three factors, Shoulder-related, Neck-related, Posture-related. The significance of this study is to lessen the musculoskeletal disorders causing scapular dyskinesia through provision of the stabilization, stretching exercises and posture training, improving function and range of motion in breast feeding females.

Twenty-six (26) patients will be treated with stabilization exercises in breast feeding females suffering from scapular dyskinesia.

Twenty-six (26) patients will be treated with posture training of breast-feeding females suffering from scapular dyskinesia.

It consists of 26 patients who will receive stabilization exercises which will be divided in three components in lying posture, sitting, standing, rolling and kneeling positions to treat posterior, inferior muscles of scapula for 35-45 min for 3 days a week for 4 weeks.

It consists of 26 patients who will receive postural training and breast-feeding patterns for the mother and child for 35-45 min in 3 days a week for 4 weeks.

The Numeric Pain Rating Scale (NPRS) (an outcome measure) that is a one dimensional measure of pain intensity in adults, including those with chronic pain due to rheumatic diseases. Validity 0.86 to 0.95

The Upper Extremity Functional Index (UEFI) is a patient reported outcome measure used to assess the functional impairment in individuals with musculoskeletal upper limb dysfunction.

A goniometer is an instrument that measures the available range of motion at a joint. The art and science of measuring the joint ranges in each plane of the joint are called goniometry.

Inclusion Criteria: Positive Scapular Dyskinesis Test Age 25-40 Years Breast feeding females from last 6 months Primigravida females Exclusion Criteria: Cesarean section females Neck or shoulder pain due to any other comorbidity e.g. Previous history of trauma or fracture Any spinal deformity like scoliosis or kyphosis Disc prolapse facet joint stenosis

Panagiotopoulos AC, Crowther IM. Scapular Dyskinesia, the forgotten culprit of shoulder pain and how to rehabilitate. SICOT J. 2019;5:29. doi: 10.1051/sicotj/2019029. Epub 2019 Aug 20.

de Carvalho SC, Castro ADAE, Rodrigues JC, Cerqueira WS, Santos DDCB, Rosemberg LA. Snapping scapula syndrome: pictorial essay. Radiol Bras. 2019 Jul-Aug;52(4):262-267. doi: 10.1590/0100-3984.2017.0226.

Ezeukwu OA, Ojukwu CP, Okemuo AJ, Anih CF, Ikele IT, Chukwu SC. Biomechanical analysis of the three recommended breastfeeding positions. Work. 2020;66(1):183-191. doi: 10.3233/WOR-203162.