The Effects of Proprioceptive Neuromuscular Facilitation

Biodex System 3 Pro

Isokinetic strength measurement of the shoulder girdle muscles will be performed using a Biodex System 3 Pro isokinetic dynamometer. The measurements will be conducted in a diagonal plane specifically determined to align with scapular patterns, utilizing a concentric-concentric mode at two different angular velocities: 60°/s and 180°/s. For each test, participants will perform three trial sets; the peak torque values obtained from each set will be normalized to body weight (Nm/kg) and averaged for statistical analysis. During the test protocol, participants will be securely positioned using stabilization straps to ensure arm and trunk stability. Prior to the measurements, a device orientation and warm-up session (e.g., three practice/familiarization sets) will be conducted, followed by the actual data collection.

Scapular Isometric Pinch Test

The scapular stabilizer muscles' endurance will be evaluated using the Scapular Isometric Pinch Test. During the test, participants will be asked to maintain the scapula in a bilateral retraction position and will be verbally encouraged to sustain the position for as long as they can maintain a maximal isometric contraction. The endurance time will be recorded in seconds.

The Lateral Scapular Slide Test

The Lateral Scapular Slide Test will be used to evaluate scapular dyskinesis. During the test, the participant will be positioned with their back to the researcher. The assessment will be performed bilaterally in three different upper extremity positions: i) 0° of abduction with the arms in a neutral position, (ii) 45° of abduction with the hands placed on the hips and the thumbs pointing posteriorly, and (iii) 90° of abduction with the shoulders parallel to the floor and the arms held in maximum internal rotation. In all three positions, the scapular position will be determined by measuring the distance between the inferior angle of the scapula and the spinous processes of the thoracic vertebrae.

Disabilities of the Arm, Shoulder, and Hand Questionnaire

The functional status of the upper extremity will be evaluated using the Disabilities of the Arm, Shoulder, and Hand Questionnaire. The Disabilities of the Arm, Shoulder, and Hand Questionnaireis a 30-item self-report scale that measures activities of daily living, symptom severity, and social/role functioning related to the upper extremity. Participants rate each item on a scale from 1 (no difficulty/no symptom) to 5 (unable to do/severe symptoms). The total score is transformed into a 0-100 range based on the item averages; higher scores indicate greater functional impairment.

Short Form-36

Quality of life will be evaluated using the Short Form-36. The Short Form-36 assesses eight distinct health domains categorized under two main component summaries: Physical Functioning, Role Limitations due to Physical Problems, Bodily Pain, General Health Perceptions, Vitality, Social Functioning, Role Limitations due to Emotional Problems, and Mental Health. The scale scores range from 0 (worst health status) to 100 (best health status), with higher scores indicating a better quality of life.