Effects of Scapular Interventions on Pain and Disability in Subjects with Neck Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Background: Musculoskeletal neck pain is the fourth common cause of disability worldwide. Scapula dysfunction can subsequently lead to neck pain. Previous literature could not establish the effectiveness of scapular stabilization exercises on neck pain due to the different definitions used for exercise in different studies. There is a need for quality evidence examining the effectiveness of scapular interventions on pain and disability in patients with neck pain. Data Sources: PubMed, EMBASE, Scopus, Cochrane, OVID, and PEDro were searched from 1 April 2011 to 31 March 2022. Methods: We included randomized controlled trials that focused on scapular interventions and other active strategies in the management of neck pain. The following outcomes were assessed: pain, disability, and quality of life. PEDro scale was used to assess the risk of bias and the data pooled was analyzed using standardized mean difference. Results: The 5 trials included in the review assessed (116 participants) the effects of scapular interventions in patients with chronic nonspecific neck pain. Risk of bias for one study was low and that for the others was moderate. The metaanalysis showed that there was a significant difference between the combined effect of neck and scapula interventions and only neck interventions group (Standardized mean difference -1.51, 95% CI [-2.79, -0.23], z=2.32, p=0.02). On assessing the effect of scapula interventions on disability, the results revealed that there was no significant (p=0.40) impact. Conclusion: Moderate quality evidence was found for the combined effect of scapular and neck interventions in reducing pain in patients with neck pain. However, it was not effective in improving the disability.