PURPOSE To quantify the effects of scapular stabilization on scapulothoracic and glenohumeral (GH) stretching. METHODS Motion capture data during external rotation and abduction with and without scapular stabilization were collected and analyzed for 26 children with brachial plexus birth palsy. These positions were performed by an experienced occupational therapist and by the child's caretaker. Scapulothoracic and GH joint angular displacements were compared between stretches with no stabilization, stabilization performed by the therapist, and stabilization performed by the caretaker. The relationship between the age and ability of the therapist and caretaker to perform the stretches with scapular stabilization was also assessed. RESULTS During external rotation there were no significant differences in either the scapulothoracic or GH joint during stabilization by either the therapist or the caretaker. During abduction, both scapulothoracic and GH joint angular displacements were statistically different. Scapulothoracic upward rotation angular displacement significantly decreased with scapular stabilization by the therapist and caretaker. Glenohumeral elevation angular displacement significantly decreased with scapular stabilization performed by the therapist and caretaker. There were only weak correlations between age and the differences in scapulothoracic and GH joint angular displacement performed by both the therapist and the caretaker. CONCLUSIONS The findings of this study indicate that scapular stabilization may be detrimental to passive stretching of the GH joint in children, as demonstrated by a reduced stretch. Based on the findings of this study, we have changed our practice to recommend passive stretches without scapular stabilization for children aged 5 years and older with brachial plexus birth palsy. In infants and children aged less than 5 years, we now recommend stretching with and without scapular stabilization until the effect of scapular stabilization is objectively assessed in these age groups. LEVEL OF EVIDENCE/TYPE OF STUDY Therapeutic IV.

中文翻译：

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肩胛骨稳定限制了臂丛神经损伤儿童的盂肱拉伸。

目的 量化肩胛骨稳定对肩胛胸和盂肱 (GH) 拉伸的影响。方法 收集和分析 26 名臂丛神经分娩性麻痹患儿在外旋和外展过程中的运动捕捉数据，包括稳定和不稳定肩胛骨。这些位置由经验丰富的职业治疗师和孩子的看护人执行。比较了没有稳定的伸展、治疗师执行的稳定和看护人执行的稳定之间的肩胛胸和 GH 关节角位移。还评估了年龄与治疗师和看护人进行肩胛骨稳定伸展的能力之间的关系。结果 在外旋期间，治疗师或看护人在稳定期间肩胸关节或 GH 关节没有显着差异。在外展期间，肩胸和 GH 关节角位移在统计学上是不同的。治疗师和看护人稳定肩胛骨后，肩胛胸向上旋转角位移显着降低。随着治疗师和看护人进行肩胛骨稳定，盂肱上仰角位移显着降低。年龄与治疗师和看护人进行的肩胛胸和 GH 关节角位移的差异之间只有微弱的相关性。结论 本研究的结果表明，肩胛骨稳定可能不利于儿童 GH 关节的被动拉伸，正如拉伸减少所证明的那样。根据这项研究的结果，我们改变了我们的做法，建议 5 岁及以上患有臂丛神经出生性麻痹的儿童进行无肩胛骨稳定的被动拉伸。对于 5 岁以下的婴儿和儿童，我们现在建议在有或没有稳定肩胛骨的情况下进行拉伸，直到在这些年龄组中客观地评估肩胛骨稳定的效果。证据水平/研究类型 治疗 IV。我们改变了我们的做法，建议 5 岁及以上患有臂丛神经出生性麻痹的儿童进行无肩胛骨稳定的被动拉伸。对于 5 岁以下的婴儿和儿童，我们现在建议在有或没有稳定肩胛骨的情况下进行拉伸，直到在这些年龄组中客观地评估肩胛骨稳定的效果。证据水平/研究类型 治疗 IV。我们改变了我们的做法，建议 5 岁及以上患有臂丛神经出生性麻痹的儿童进行无肩胛骨稳定的被动拉伸。对于 5 岁以下的婴儿和儿童，我们现在建议在有或没有稳定肩胛骨的情况下进行拉伸，直到在这些年龄组中客观地评估肩胛骨稳定的效果。证据水平/研究类型 治疗 IV。