Scapula alata: description of a physical therapy program and its effectiveness measured by a shoulder-specific quality-of-life measurement

BACKGROUND: To date, there are no published outcomes-based treatment programs to guide clinicians when managing patients with scapula alata. The purposes of this study were to describe a physical therapy program in patients with scapula alata and to evaluate its effect using a shoulder-specific quality-of-life measurement.

METHODS: In this case series and retrospective study, 22 patients (11 female patients) with a median age of 34 years (interquartile range, 28-44 years), diagnosed with scapula alata caused by injury to the long thoracic nerve, were successively referred as outpatients to a physical therapy program at a university hospital. The program included (1) physical examination, (2) thoracic brace treatment, and (3) muscular rehabilitation. The treatment frequency and duration were determined individually. The effect was evaluated by a shoulder-specific quality-of-life questionnaire, the Western Ontario Rotator Cuff (WORC) Index. The WORC Index is grouped into 5 domains: physical symptoms, sport/leisure time, work, lifestyle, and emotional health.

RESULTS: The results showed a highly significant improvement (P < .001) from pretest to post-test as measured by all 5 domains in the WORC Index.

CONCLUSIONS: This study described in detail a physical therapy program; the program showed significant benefit. Further research is needed before recommending the program as a potential treatment option.