Scapular dyskinesis, i.e., the deviant mobility or function of the scapula, hampers upper limb function in daily life. A typical sign of scapular dyskinesis is a scapula alata—a protrusion of the shoulder blade during arm elevation. While some reversible causes of scapula alata can be treated with therapy, other, irreversible causes require invasive surgical interventions. When surgery is not an option, however, severe limitations arise as standard approaches for assisting the scapula in daily life do not exist. The aim of this study was to quantify functional improvements when external, i.e., non-invasive, scapula assistance is provided. The study was designed as a randomized controlled crossover trial. Eight participants with a scapula alata due to muscular dystrophy performed arm elevations in shoulder flexion and abduction while unassisted (baseline), externally assisted by a trained therapist, and externally assisted by a novel, textile-based scapula orthosis. With therapist assistance, average arm elevation increased by 17.3° in flexion (p < 0.001, 95% confidence interval of the mean $$C{I}_{95\%}=\hspace{0.17em}\left[9.8^\circ , 24.9^\circ \right]$$ ), and by 11.2° in abduction (p < 0.01, $$C{I}_{95\%}=\left[4.7^\circ , 17.7^\circ \right]$$ ), constituting the potential of external scapula assistance. With orthosis assistance, average arm elevation increased by 6.2° in flexion ( $$C{I}_{95\%}=\left[0.4^\circ ,11.9^\circ \right]$$ ) and by 5.8° in abduction ( $$C{I}_{95\%}=\left[3.0^\circ ,8.5^\circ \right]$$ ). Remarkably, in three participants, the orthosis was at least as effective as the therapist. Moreover, orthosis assistance reduced average perceived exertion by 1.25 points (Borg Scale) when elevating a filled bottle during a simulated daily living task. These findings indicate a large potential for future advancements in orthotics. Already now, the textile-based scapula orthosis presented here is a feasible tool for leveraging the benefits of external scapula assistance when a therapist is unavailable, as encountered in daily life scenarios. Trial Registration ClincalTrials.gov (ID NCT04154098). Registered: November 6th 2019, https://clinicaltrials.gov/ct2/show/NCT04154098?term=scapula+orthosis&draw=2&rank=1

中文翻译：

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达到更高：外部肩胛骨辅助可以改善具有不可逆肩胛骨的人的上肢功能

肩胛骨运动障碍，即肩胛骨的异常活动或功能，妨碍日常生活中的上肢功能。肩胛骨运动障碍的典型标志是肩胛骨 - 手臂抬高时肩胛骨的突出。虽然肩胛骨的一些可逆原因可以通过治疗来治疗，但其他不可逆原因需要侵入性手术干预。然而，当手术不是一种选择时，就会出现严重的局限性，因为在日常生活中不存在辅助肩胛骨的标准方法。本研究的目的是量化提供外部（即非侵入性）肩胛骨辅助时的功能改善。该研究被设计为随机对照交叉试验。八名因肌营养不良症而肩胛骨延展的参与者在无辅助（基线）的情况下在肩部屈曲和外展时进行手臂抬高，由训练有素的治疗师外部辅助，并由新型纺织品肩胛骨矫形器外部辅助。在治疗师的帮助下，平均手臂抬高在屈曲时增加了 17.3°（p < 0.001，平均值的 95% 置信区间 $$C{I}_{95\%}=\hspace{0.17em}\left[9.8^\ circ , 24.9^\circ \right]$$ )，外展角 11.2° (p < 0.01, $$C{I}_{95\%}=\left[4.7^\circ , 17.7^\circ \ right]$$ )，构成肩胛骨外辅助的潜力。在矫形器辅助下，平均手臂抬高在屈曲时增加了 6.2° ( $$C{I}_{95\%}=\left[0.4^\circ ,11.9^\circ \right]$$ ) 和 5.8° 在绑架（ $$C{I}_{95\%}=\left[3.0^\circ ,8.5^\circ \right]$$ ）。值得注意的是，在三名参与者中，矫形器至少与治疗师一样有效。此外，在模拟日常生活任务中提升装满瓶子时，矫形辅助可将平均感知用力降低 1.25 分（博格量表）。这些发现表明矫形器的未来发展潜力巨大。现在，这里介绍的基于纺织品的肩胛骨矫形器是一种可行的工具，可在治疗师不可用时利用外部肩胛骨辅助的好处，就像日常生活中遇到的那样。试验注册 ClincalTrials.gov (ID NCT04154098)。注册时间：2019 年 11 月 6 日，https://clinicaltrials.gov/ct2/show/NCT04154098?term=scapula+orthosis&draw=2&rank=1 在模拟日常生活任务中举起装满瓶子的瓶子时获得 25 分（博格量表）。这些发现表明矫形器的未来发展潜力巨大。现在，这里介绍的基于纺织品的肩胛骨矫形器是一种可行的工具，可在治疗师不可用时利用外部肩胛骨辅助的好处，就像日常生活中遇到的那样。试验注册 ClincalTrials.gov (ID NCT04154098)。注册时间：2019 年 11 月 6 日，https://clinicaltrials.gov/ct2/show/NCT04154098?term=scapula+orthosis&draw=2&rank=1 在模拟日常生活任务中举起装满瓶子的瓶子时获得 25 分（博格量表）。这些发现表明矫形器的未来发展潜力巨大。现在，这里介绍的基于纺织品的肩胛骨矫形器是一种可行的工具，可在治疗师不可用时利用外部肩胛骨辅助的好处，就像日常生活中遇到的那样。试验注册 ClincalTrials.gov (ID NCT04154098)。注册时间：2019 年 11 月 6 日，https://clinicaltrials.gov/ct2/show/NCT04154098?term=scapula+orthosis&draw=2&rank=1 这里介绍的基于纺织品的肩胛骨矫形器是一种可行的工具，可在治疗师不可用时利用外部肩胛骨辅助的好处，就像日常生活中遇到的那样。试验注册 ClincalTrials.gov (ID NCT04154098)。注册时间：2019 年 11 月 6 日，https://clinicaltrials.gov/ct2/show/NCT04154098?term=scapula+orthosis&draw=2&rank=1 这里介绍的基于纺织品的肩胛骨矫形器是一种可行的工具，可在治疗师不可用时利用外部肩胛骨辅助的好处，就像日常生活中遇到的那样。试验注册 ClincalTrials.gov (ID NCT04154098)。注册时间：2019 年 11 月 6 日，https://clinicaltrials.gov/ct2/show/NCT04154098?term=scapula+orthosis&draw=2&rank=1