{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:00:33Z","timestamp":1760144433151,"version":"build-2065373602"},"reference-count":110,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,4,13]],"date-time":"2024-04-13T00:00:00Z","timestamp":1712966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","doi-asserted-by":"publisher","award":["SFRH\/BD\/140874\/2018","UIDB\/05210\/2020"],"award-info":[{"award-number":["SFRH\/BD\/140874\/2018","UIDB\/05210\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Applied Sciences"],"abstract":"<jats:p>Despite the existence of several studies about the scapula\u2019s position and motion, in shoulder pain conditions, there are still conflicting findings regarding scapular adaptations and reduced research about the scapula\u2019s role during functional tasks. The present study aimed to compare scapular-related kinematic and electromyographic outcomes during different shoulder movements (with and without load) and the drinking task, between symptomatic and asymptomatic subjects. Forty subjects (divided into two groups) participated in this cross-sectional observational study. Scapulothoracic motion, scapulohumeral rhythm, and movement quality (considering trunk compensation, time-to-peak acceleration, and smoothness), as well as the relative surface electromyographic activity and muscle ratio considering the trapezius, serratus anterior, and levator scapulae (LS), were assessed. The symptomatic group presented the following: (1) changes in scapular upward rotation (p = 0.008) and winging (p = 0.026 and p = 0.005) during backward transport and drink phases; (2) increased muscle activity level of the middle trapezius (MT) in all tasks (p &lt; 0.0001 to p = 0.039), of LS during shoulder elevation with load (p = 0.007), and of LS and LT during most of the drinking task phases (p = 0.007 to p = 0.043 and p &lt; 0.0001 to p = 0.014, respectively); (3) a decreased serratus anterior lower portion activity level (SAlow) during shoulder lowering with load (p = 0.030) and drink phase (p = 0.047); and (4) an increased muscular ratio between scapular abductors\/adductors (p = 0.005 to p = 0.036) and elevators\/depressors (p = 0.008 to p = 0.028). Compared to asymptomatic subjects, subjects with chronic shoulder pain presented scapular upward rotation and winging adaptations; increased activity levels of MT, LT, and LS; decreased activity levels of SAlow; and increased scapular muscle ratios.<\/jats:p>","DOI":"10.3390\/app14083291","type":"journal-article","created":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T10:24:26Z","timestamp":1713176666000},"page":"3291","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Scapular Motor Control and Upper Limb Movement Quality in Subjects with and without Chronic Shoulder Pain: A Cross-Sectional Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7001-0157","authenticated-orcid":false,"given":"Ana S. C.","family":"Melo","sequence":"first","affiliation":[{"name":"Centro de Investiga\u00e7\u00e3o em Reabilita\u00e7\u00e3o (CIR), Escola Superior de Sa\u00fade, Polit\u00e9cnico do Porto, Rua Dr. Ant\u00f3nio Bernardino de Almeida, 400, 4200-072 Porto, Portugal"},{"name":"Centro de Investiga\u00e7\u00e3o em Actividade F\u00edsica, Sa\u00fade e Lazer (CIAFEL), Faculdade de Desporto, Universidade do Porto, Rua Dr. Pl\u00e1cido Costa, 91, 4200-450 Porto, Portugal"},{"name":"Laborat\u00f3rio de Biomec\u00e2nica do Porto (LABIOMEP), Universidade do Porto, Rua Dr. Pl\u00e1cido Costa, 91, 4200-450 Porto, Portugal"},{"name":"Centro Interdisciplinar de Investiga\u00e7\u00e3o Aplicada em Sa\u00fade (CIIAS), Escola Superior de Sa\u00fade, Instituto Polit\u00e9cnico de Set\u00fabal, Campus do IPS Estefanilha, 2914-503 Set\u00fabal, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4157-1386","authenticated-orcid":false,"given":"Diana C.","family":"Guedes","sequence":"additional","affiliation":[{"name":"Centro de Investiga\u00e7\u00e3o em Reabilita\u00e7\u00e3o (CIR), Escola Superior de Sa\u00fade, Polit\u00e9cnico do Porto, Rua Dr. Ant\u00f3nio Bernardino de Almeida, 400, 4200-072 Porto, Portugal"}]},{"given":"Ricardo","family":"Matias","sequence":"additional","affiliation":[{"name":"Physics Department & Institute of Biophysics and Biomedical Engineering (IBEB), Faculty of Sciences, University of Lisbon, 1749-016 Lisbon, Portugal"},{"name":"Kinetikos, 3030-199 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1812-1815","authenticated-orcid":false,"given":"Eduardo B.","family":"Cruz","sequence":"additional","affiliation":[{"name":"Departamento de Fisioterapia, Escola Superior de Sa\u00fade, Instituto Polit\u00e9cnico de Set\u00fabal, Campus do IPS Estefanilha, 2914-503 Set\u00fabal, Portugal"},{"name":"Centro de Investiga\u00e7\u00e3o Integrada em Sa\u00fade (CHRC), Universidade Nova de Lisboa, 1169-056 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4109-2939","authenticated-orcid":false,"given":"J. Paulo","family":"Vilas-Boas","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Biomec\u00e2nica do Porto (LABIOMEP), Universidade do Porto, Rua Dr. Pl\u00e1cido Costa, 91, 4200-450 Porto, Portugal"},{"name":"Centro de Investiga\u00e7\u00e3o, Forma\u00e7\u00e3o, Inova\u00e7\u00e3o e Interven\u00e7\u00e3o em Desporto (CIFI2D), Faculdade de Desporto, Universidade do Porto, Rua Dr. Pl\u00e1cido Costa, 91, 4200-450 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9528-1463","authenticated-orcid":false,"given":"Andreia S. P.","family":"Sousa","sequence":"additional","affiliation":[{"name":"Centro de Investiga\u00e7\u00e3o em Reabilita\u00e7\u00e3o (CIR), Escola Superior de Sa\u00fade, Polit\u00e9cnico do Porto, Rua Dr. Ant\u00f3nio Bernardino de Almeida, 400, 4200-072 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1016\/j.jbiomech.2014.04.028","article-title":"Validity and reliability of 3D marker based scapular motion analysis: A systematic review","volume":"47","author":"Lempereur","year":"2014","journal-title":"J. Biomech."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"90","DOI":"10.2519\/jospt.2009.2808","article-title":"The association of scapular kinematics and glenohumeral joint pathologies","volume":"39","author":"Ludewig","year":"2009","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"378","DOI":"10.2106\/JBJS.G.01483","article-title":"Motion of the shoulder complex during multiplanar humeral elevation","volume":"91","author":"Ludewig","year":"2009","journal-title":"J. Bone Joint Surg. Am."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Umehara, J., Yagi, M., Hirono, T., Komamura, T., Nishishita, S., and Ichihashi, N. (2019). Relationship between scapular initial position and scapular movement during dynamic motions. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0227313"},{"key":"ref_5","first-page":"111","article-title":"Upper to Middle Trapezius Muscle Activation Ratio During Scapular Retraction Exercise at Different Shoulder Abduction Angles","volume":"28","author":"Harput","year":"2017","journal-title":"T\u00fcrk Fiz. Rehabil. Derg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1111\/j.1600-0838.2010.01274.x","article-title":"Scapular positioning and movement in unimpaired shoulders, shoulder impingement syndrome, and glenohumeral instability","volume":"21","author":"Struyf","year":"2011","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1177\/1758573215592266","article-title":"Physiotherapy treatment for atraumatic recurrent shoulder instability: Early results of a specific exercise protocol using pathology-specific outcome measures","volume":"7","author":"Bateman","year":"2015","journal-title":"Shoulder Elb."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1590\/S1413-35552009005000012","article-title":"Scapular and rotator cuff muscle activity during arm elevation: A review of normal function and alterations with shoulder impingement","volume":"13","author":"Phadke","year":"2009","journal-title":"Rev. Bras. Fisioter."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/j.jse.2014.10.010","article-title":"The effect of trunk rotation during shoulder exercises on the activity of the scapular muscle and scapular kinematics","volume":"24","author":"Yamauchi","year":"2015","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.math.2015.09.005","article-title":"Modifying the shoulder joint position during shrugging and retraction exercises alters the activation of the medial scapular muscles","volume":"21","author":"Castelein","year":"2016","journal-title":"Man. Ther."},{"key":"ref_11","first-page":"617","article-title":"The role of the scapula","volume":"8","author":"Paine","year":"2013","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1136\/bjsports-2013-092425","article-title":"Clinical implications of scapular dyskinesis in shoulder injury: The 2013 consensus statement from the \u2018scapular summit\u2019","volume":"47","author":"Kibler","year":"2013","journal-title":"Br. J. Sports Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.gaitpost.2007.03.002","article-title":"Complete 3D kinematics of upper extremity functional tasks","volume":"27","author":"Wolterbeek","year":"2008","journal-title":"Gait Posture"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.jelekin.2009.04.001","article-title":"Scapulothoracic motion and muscle activity during the raising and lowering phases of an overhead reaching task","volume":"20","author":"Ebaugh","year":"2010","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/j.apmr.2009.12.021","article-title":"Scapular muscle activity in overhead athletes with symptoms of secondary shoulder impingement during closed chain exercises","volume":"91","author":"Tucker","year":"2010","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1002\/jor.21300","article-title":"Adaptive patterns of movement during arm elevation test in patients with shoulder impingement syndrome","volume":"29","author":"Lin","year":"2011","journal-title":"J. Orthop. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"636","DOI":"10.2519\/jospt.2014.5339","article-title":"Comparison of 3-dimensional shoulder complex kinematics in individuals with and without shoulder pain, part 1: Sternoclavicular, acromioclavicular, and scapulothoracic joints","volume":"44","author":"Lawrence","year":"2014","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.rehab.2017.09.002","article-title":"Kinematic patterns in normal and degenerative shoulders. Part II: Review of 3-D scapular kinematic patterns in patients with shoulder pain, and clinical implications","volume":"61","author":"Nguyen","year":"2018","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_19","first-page":"266","article-title":"Adhesive capsulitis: Use the evidence to integrate your interventions","volume":"5","author":"Page","year":"2010","journal-title":"N. Am. J. Sports Phys. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"12","DOI":"10.4085\/1062-6050-48.1.13","article-title":"Scapular bracing and alteration of posture and muscle activity in overhead athletes with poor posture","volume":"48","author":"Cole","year":"2013","journal-title":"J. Athl. Train."},{"key":"ref_21","first-page":"527","article-title":"Shoulder rehabilitation strategies, guidelines, and practice","volume":"32","author":"Kibler","year":"2001","journal-title":"Orthop. Clin."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"184","DOI":"10.2519\/jospt.2016.5927","article-title":"Superficial and Deep Scapulothoracic Muscle Electromyographic Activity During Elevation Exercises in the Scapular Plane","volume":"46","author":"Castelein","year":"2016","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.jht.2017.03.006","article-title":"Scapular muscle dysfunction associated with subacromial pain syndrome","volume":"30","author":"Castelein","year":"2017","journal-title":"J. Hand Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.2522\/ptj.20140230","article-title":"Critical and Theoretical Perspective on Scapular Stabilization: What Does It Really Mean, and Are We on the Right Track?","volume":"96","author":"McQuade","year":"2016","journal-title":"Phys. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1016\/j.jse.2009.02.021","article-title":"Analysis of the scapulohumeral rhythm and electromyography of the shoulder muscles during elevation and lowering: Comparison of dominant and nondominant shoulders","volume":"18","author":"Yoshizaki","year":"2009","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/j.jelekin.2005.01.006","article-title":"Functional activity characteristics of individuals with shoulder dysfunctions","volume":"15","author":"Lin","year":"2005","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1093\/rheumatology\/kez046","article-title":"Patients\u2019 experience of shoulder disorders: A systematic review of qualitative studies for the OMERACT Shoulder Core Domain Set","volume":"58","author":"Page","year":"2019","journal-title":"Rheumatology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1016\/j.jse.2008.04.008","article-title":"Three-dimensional motion of the scapula and shoulder during activities of daily living","volume":"17","author":"Sheikhzadeh","year":"2008","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.clinbiomech.2005.02.006","article-title":"Requirements for upper extremity motions during activities of daily living","volume":"20","author":"Magermans","year":"2005","journal-title":"Clin. Biomech."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1080\/14763141.2019.1597153","article-title":"Electromyographic analysis in elite swimmers with shoulder pain during a functional task","volume":"20","author":"Sabzehparvar","year":"2021","journal-title":"Sports Biomech."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jelekin.2018.02.011","article-title":"Use of optical motion capture for the analysis of normative upper body kinematics during functional upper limb tasks: A systematic review","volume":"40","author":"Valevicius","year":"2018","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"102632","DOI":"10.1016\/j.humov.2020.102632","article-title":"Comparison of upper limb kinematics in two activities of daily living with different handling requirements","volume":"72","author":"Mesquita","year":"2020","journal-title":"Hum. Mov. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Jiang, Y., Chen, C., Zhang, X., Chen, C., Zhou, Y., Ni, G., Muh, S., and Lemos, S. (2020). Shoulder muscle activation pattern recognition based on sEMG and machine learning algorithms. Comput. Methods Programs Biomed., 197.","DOI":"10.1016\/j.cmpb.2020.105721"},{"key":"ref_34","first-page":"57228","article-title":"Kinematic Analysis Using 3D Motion Capture of Drinking Task in People With and Without Upper-extremity Impairments","volume":"2018","author":"Murphy","year":"2018","journal-title":"J. Vis. Exp."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2915","DOI":"10.1016\/j.jbiomech.2010.07.006","article-title":"Three-dimensional motion of the upper extremity joints during various activities of daily living","volume":"43","author":"Aizawa","year":"2010","journal-title":"J. Biomech."},{"key":"ref_36","first-page":"8","article-title":"The kinematics of upper extremity reaching: A reliability study on people with and without shoulder impingement syndrome","volume":"2","author":"Roy","year":"2010","journal-title":"Sports Med. Arthrosc. Rehabil. Ther. Technol."},{"key":"ref_37","first-page":"51","article-title":"Shoulder muscle imbalance and subacromial impingement syndrome in overhead athletes","volume":"6","author":"Page","year":"2011","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1093\/ptj\/80.3.276","article-title":"Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement","volume":"80","author":"Ludewig","year":"2000","journal-title":"Phys. Ther."},{"key":"ref_39","first-page":"482","article-title":"Proprioceptive neuromuscular facilitation techniques in adhesive capsulitis: A systematic review and meta-analysis","volume":"19","author":"Tedla","year":"2019","journal-title":"J. Musculoskelet. Neuronal Interact."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.clinbiomech.2013.11.011","article-title":"Modifying a shrug exercise can facilitate the upward rotator muscles of the scapula","volume":"29","author":"Pizzari","year":"2014","journal-title":"Clin. Biomech."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.math.2010.03.002","article-title":"Thoracic outlet syndrome part 2: Conservative management of thoracic outlet","volume":"15","author":"Watson","year":"2010","journal-title":"Man. Ther."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1016\/j.jse.2014.12.022","article-title":"Specific kinematics and associated muscle activation in individuals with scapular dyskinesis","volume":"24","author":"Huang","year":"2015","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1016\/S0268-0033(02)00136-5","article-title":"Comparison of scapular kinematics between elevation and lowering of the arm in the scapular plane","volume":"17","author":"Borstad","year":"2002","journal-title":"Clin. Biomech."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"615","DOI":"10.3389\/fneur.2018.00615","article-title":"Smoothness Metrics in Complex Movement Tasks","volume":"9","author":"Gulde","year":"2018","journal-title":"Front. Neurol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1186\/1743-0003-11-137","article-title":"Assessment of movement quality in robot- assisted upper limb rehabilitation after stroke: A review","volume":"11","author":"Nordin","year":"2014","journal-title":"J. NeuroEng. Rehabil."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/j.pain.0000000000001384","article-title":"Chronic pain as a symptom or a disease: The IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11)","volume":"160","author":"Treede","year":"2019","journal-title":"Pain"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.math.2014.10.017","article-title":"Comprehensive classification test of scapular dyskinesis: A reliability study","volume":"20","author":"Huang","year":"2015","journal-title":"Man. Ther."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1067\/mse.2002.126766","article-title":"Qualitative clinical evaluation of scapular dysfunction: A reliability study","volume":"11","author":"Kibler","year":"2002","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1136\/bjsports-2012-091059","article-title":"Clinical assessment of the scapula: A review of the literature","volume":"48","author":"Struyf","year":"2014","journal-title":"Br. J. Sports Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/j.jbiomech.2004.05.042","article-title":"ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion--Part II: Shoulder, elbow, wrist and hand","volume":"38","author":"Wu","year":"2005","journal-title":"J. Biomech."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Seth, A., Matias, R., Veloso, A.P., and Delp, S.L. (2016). A Biomechanical Model of the Scapulothoracic Joint to Accurately Capture Scapular Kinematics during Shoulder Movements. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0141028"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.3389\/fpsyg.2016.01466","article-title":"Cut-Off Points for Mild, Moderate, and Severe Pain on the Numeric Rating Scale for Pain in Patients with Chronic Musculoskeletal Pain: Variability and Influence of Sex and Catastrophizing","volume":"7","author":"Boonstra","year":"2016","journal-title":"Front. Psychol."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Kamonseki, D.H., Haik, M.N., Ribeiro, L.P., Almeida, R.F.d., Almeida, L.A.d., Fonseca, C.L., and Camargo, P.R. (2021). Measurement properties of the Brazilian versions of Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia in individuals with shoulder pain. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0260452"},{"key":"ref_54","unstructured":"Duarte, A. (2002). Valida\u00e7\u00e3o intercultural do Shoulder Pain and Disability Index\u2014SPADI, Escola Superior de Tecnologia da Sa\u00fade de Coimbra."},{"key":"ref_55","unstructured":"Leal, S. (2001). Constant Score e Shoulder Pain and Disability Index (SPADI)\u2014Adapta\u00e7\u00e3o cultural e lingu\u00edstica, Escola Superior de Tecnologia da Sa\u00fade de Coimbra."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1002\/art.24396","article-title":"Measuring shoulder function: A systematic review of four questionnaires","volume":"61","author":"Roy","year":"2009","journal-title":"Arthritis Rheum."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.bjpt.2020.08.001","article-title":"Scapular movement training versus standardized exercises for individuals with chronic shoulder pain: Protocol for a randomized controlled trial","volume":"25","author":"Kamonseki","year":"2021","journal-title":"Braz. J. Phys. Ther."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"117","DOI":"10.26603\/001c.31727","article-title":"Current Views of Scapular Dyskinesis and its Possible Clinical Relevance","volume":"17","author":"Sciascia","year":"2022","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_59","unstructured":"Norkin, C.C., and White, D.J. (2016). Measurement of Joint Motion: A Guide to Goniometry, FA Davis."},{"key":"ref_60","first-page":"98","article-title":"Evaluating change in clinical status: Reliability and measures of agreement for the assessment of glenohumeral range of motion","volume":"5","author":"Muir","year":"2010","journal-title":"N. Am. J. Sports Phys. Ther."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"90","DOI":"10.3389\/fnbot.2019.00090","article-title":"Muscle Contributions to Upper-Extremity Movement and Work From a Musculoskeletal Model of the Human Shoulder","volume":"13","author":"Seth","year":"2019","journal-title":"Front. Neurorobot."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1115\/1.1351892","article-title":"Dynamic measurements of three-dimensional scapular kinematics: A validation study","volume":"123","author":"Karduna","year":"2001","journal-title":"J. Biomech. Eng."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1177\/0363546507303560","article-title":"Rehabilitation of scapular muscle balance: Which exercises to prescribe?","volume":"35","author":"Cools","year":"2007","journal-title":"Am. J. Sports Med."},{"key":"ref_64","first-page":"13","article-title":"European recommendations for surface electromyography","volume":"8","author":"Hermens","year":"1999","journal-title":"Roessingh Res. Dev."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/j.jelekin.2004.09.006","article-title":"Normalization procedures using maximum voluntary isometric contractions for the serratus anterior and trapezius muscles during surface EMG analysis","volume":"15","author":"Ekstrom","year":"2005","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/S1050-6411(00)00033-X","article-title":"Use of surface electromyography to estimate neck muscle activity","volume":"10","author":"Sommerich","year":"2000","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/BF02110752","article-title":"The effect of head position on scapular orientation and muscle activity during shoulder elevation","volume":"6","author":"Ludewig","year":"1996","journal-title":"J. Occup. Rehabil."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.jelekin.2018.09.011","article-title":"Application of MR-derived cross-sectional guideline of cervical spine muscles to validate neck surface electromyography placement","volume":"43","author":"Alizadeh","year":"2018","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"235","DOI":"10.2519\/jospt.2004.34.5.235","article-title":"Comparing the function of the upper and lower parts of the serratus anterior muscle using surface electromyography","volume":"34","author":"Ekstrom","year":"2004","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1016\/j.jelekin.2011.07.001","article-title":"Differential activation of parts of the serratus anterior muscle during push-up variations on stable and unstable bases of support","volume":"21","author":"Park","year":"2011","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Ijspeert, J., Kerstens, H.C.J.W., Janssen, R.M.J., Geurts, A.C.H., van Alfen, N., and Groothuis, J.T. (2019). Validity and reliability of serratus anterior hand held dynamometry. BMC Musculoskelet. Disord., 20.","DOI":"10.1186\/s12891-019-2741-7"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/j.jbmt.2021.03.016","article-title":"Changes in electromyographic activity of deltoid muscles in women with shoulder pain during a functional task","volume":"27","author":"Rufo","year":"2021","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.bjpt.2017.09.007","article-title":"Normalization of the trapezius sEMG signal\u2014A reliability study on women with and without neck-shoulder pain","volume":"22","author":"Cid","year":"2018","journal-title":"Braz. J. Phys. Ther."},{"key":"ref_74","unstructured":"Donatelli, R.A. (2011). Physical Therapy of the Shoulder, Elsevier Health Sciences. [5th ed.]."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1002\/jor.20675","article-title":"Standard maximum isometric voluntary contraction tests for normalizing shoulder muscle EMG","volume":"26","author":"Boettcher","year":"2008","journal-title":"J. Orthop. Res."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1743-0003-6-2","article-title":"Movement variability in stroke patients and controls performing two upper limb functional tasks: A new assessment methodology","volume":"6","author":"Thies","year":"2009","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/1743-0003-3-18","article-title":"Three-dimensional kinematic motion analysis of a daily activity drinking from a glass: A pilot study","volume":"3","author":"Murphy","year":"2006","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/j.jelekin.2014.04.011","article-title":"Co-activation of upper limb muscles during reaching in post-stroke subjects: An analysis of the contralesional and ipsilesional limbs","volume":"24","author":"Silva","year":"2014","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1016\/j.apmr.2007.07.016","article-title":"Effects of robot-aided bilateral force-induced isokinetic arm training combined with conventional rehabilitation on arm motor function in patients with chronic stroke","volume":"88","author":"Chang","year":"2007","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1186\/s12984-015-0090-9","article-title":"On the analysis of movement smoothness","volume":"12","author":"Balasubramanian","year":"2015","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_81","unstructured":"GitHub (2023, January 25). Smoothness.py Code. Available online: https:\/\/github.com\/siva82kb\/SPARC\/blob\/master\/scripts\/smoothness.py."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"e15025","DOI":"10.14814\/phy2.15025","article-title":"The impact of experimental pain on shoulder movement during an arm elevated reaching task in a virtual reality environment","volume":"9","author":"Dupuis","year":"2021","journal-title":"Physiol. Rep."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1097\/JSM.0b013e318160c05d","article-title":"Scapular muscular activity with shoulder impingement syndrome during lowering of the arms","volume":"18","year":"2008","journal-title":"Clin. J. Sport. Med."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1007\/s00296-019-04486-3","article-title":"Investigating the Patient Acceptable Symptom State cut-offs: Longitudinal data from a community cohort using the Shoulder Pain and Disability Index","volume":"40","author":"Tran","year":"2019","journal-title":"Rheumatol. Int."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1136\/bjsports-2018-099450","article-title":"Self-efficacy and risk of persistent shoulder pain: Results of a Classification and Regression Tree (CART) analysis","volume":"53","author":"Chester","year":"2019","journal-title":"Br. J. Sports Med."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/B978-0-444-63954-7.00037-9","article-title":"Neuromuscular adaptations in shoulder function and dysfunction","volume":"158","author":"Kibler","year":"2018","journal-title":"Handb. Clin. Neurol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/S0167-9457(02)00166-5","article-title":"Practice effects on coordination and control, metabolic energy expenditure, and muscle activation","volume":"21","author":"Lay","year":"2002","journal-title":"Hum. Mov. Sci."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"e11","DOI":"10.1016\/j.jse.2012.06.010","article-title":"Motor control retraining exercises for shoulder impingement: Effects on function, muscle activation, and biomechanics in young adults","volume":"22","author":"Worsley","year":"2013","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1093\/ptj\/86.8.1075","article-title":"Shoulder function and 3-dimensional scapular kinematics in people with and without shoulder impingement syndrome","volume":"86","author":"McClure","year":"2006","journal-title":"Phys. Ther."},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"De Baets, L., Vanbrabant, S., Dierickx, C., van der Straaten, R., and Timmermans, A. (2020). Assessment of Scapulothoracic, Glenohumeral, and Elbow Motion in Adhesive Capsulitis by Means of Inertial Sensor Technology: A Within-Session, Intra-Operator and Inter-Operator Reliability and Agreement Study. Sensors, 20.","DOI":"10.3390\/s20030876"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1177\/1545968310370748","article-title":"Kinematic variables quantifying upper-extremity performance after stroke during reaching and drinking from a glass","volume":"25","author":"Murphy","year":"2011","journal-title":"Neurorehabilit. Neural Repair"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.clinbiomech.2013.12.013","article-title":"Kinematic analysis of upper extremity movement during drinking in hemiplegic subjects","volume":"29","author":"Kim","year":"2014","journal-title":"Clin. Biomech."},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Longo, U.G., Risi Ambrogioni, L., Candela, V., Berton, A., Lo Presti, D., and Denaro, V. (2023). Scapular Kinematics and Patterns of Scapular Dyskinesis in Rotator Cuff Tears: A Prospective Cohort Study. J. Clin. Med., 12.","DOI":"10.3390\/jcm12113841"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/s00221-010-2405-1","article-title":"Movement timing and reach to reach variability during a repetitive reaching task in persons with chronic neck\/shoulder pain and healthy subjects","volume":"206","author":"Lomond","year":"2010","journal-title":"Exp. Brain Res."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1016\/j.jelekin.2012.05.003","article-title":"Reliability and minimal detectable change in scapulothoracic neuromuscular activity","volume":"22","author":"Seitz","year":"2012","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"663","DOI":"10.2165\/00007256-200939080-00004","article-title":"Shoulder muscle activity and function in common shoulder rehabilitation exercises","volume":"39","author":"Escamilla","year":"2009","journal-title":"Sports Med."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.humov.2019.01.005","article-title":"Effects of scapular retraction\/protraction position and scapular elevation on shoulder girdle muscle activity during glenohumeral abduction","volume":"64","author":"Contemori","year":"2019","journal-title":"Hum. Mov. Sci."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.bjpt.2019.01.011","article-title":"Kinesiologic considerations for targeting activation of scapulothoracic muscles\u2014Part 2: Trapezius","volume":"23","author":"Camargo","year":"2019","journal-title":"Braz. J. Phys. Ther."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.jht.2016.06.006","article-title":"Effects of a stretching protocol for the pectoralis minor on muscle length, function, and scapular kinematics in individuals with and without shoulder pain","volume":"30","author":"Rosa","year":"2017","journal-title":"J. Hand Ther."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.bjpt.2019.01.008","article-title":"Kinesiologic considerations for targeting activation of scapulothoracic muscles\u2014Part 1: Serratus anterior","volume":"23","author":"Neumann","year":"2019","journal-title":"Braz. J. Phys. Ther."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.apmr.2014.09.029","article-title":"Visual scapular dyskinesis: Kinematics and muscle activity alterations in patients with subacromial impingement syndrome","volume":"96","author":"Lopes","year":"2015","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1152\/jn.00147.2013","article-title":"Reorganization of muscle synergies during multidirectional reaching in the horizontal plane with experimental muscle pain","volume":"111","author":"Muceli","year":"2014","journal-title":"J. Neurophysiol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1007\/s00421-014-3059-7","article-title":"Influence of shoulder pain on muscle function: Implications for the assessment and therapy of shoulder disorders","volume":"115","author":"Struyf","year":"2015","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"1820","DOI":"10.1016\/j.apmr.2015.06.004","article-title":"Optimal Normalization Tests for Muscle Activation of the Levator Scapulae, Pectoralis Minor, and Rhomboid Major: An Electromyography Study Using Maximum Voluntary Isometric Contractions","volume":"96","author":"Castelein","year":"2015","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1080\/10669817.2019.1622896","article-title":"Dynamic scapular recognition exercise improves scapular upward rotation and shoulder pain and disability in patients with adhesive capsulitis: A randomized controlled trial","volume":"28","author":"Mohamed","year":"2020","journal-title":"J. Man. Manip. Ther."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1016\/j.jse.2008.02.009","article-title":"A cadaveric study of the serratus anterior muscle and the long thoracic nerve","volume":"17","author":"Hamada","year":"2008","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"536","DOI":"10.3389\/fphys.2019.00536","article-title":"Eccentric Muscle Contractions: Risks and Benefits","volume":"10","author":"Hody","year":"2019","journal-title":"Front. Physiol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1007\/s11517-009-0485-5","article-title":"Scapular muscle activation and co-activation following a fatigue task","volume":"47","author":"Szucs","year":"2009","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.1016\/j.jse.2016.04.010","article-title":"Relative scapular muscle activity ratios are altered in subacromial pain syndrome","volume":"25","author":"Michener","year":"2016","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/j.humov.2011.07.004","article-title":"Measuring scapular kinematics during arm lowering using the acromion marker cluster","volume":"31","author":"Warner","year":"2012","journal-title":"Hum. Mov. 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