Exercise therapy may affect scapular position and motion in individuals with scapular dyskinesis: a systematic review of clinical trials Afsun Nodehi Moghadam, PhD a , Leila Rahnama, PhD a,b, *, Shohreh Noorizadeh Dehkordi, PhD c , Shima Abdollahi, MSc d a Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran b Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran c Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran d Sajad Physiotherapy Clinic, Tehran, Iran Background: Therapeutic exercise for scapular muscles is suggested to be effective in reducing shoulder pain in patients with rotator cuff disorders, whereas its effectiveness on scapular position and motion has remained unclear. Therefore, the aim of this systematic review was to investigate whether exercise ther- apy improves scapular position and motion in individuals with scapular dyskinesis. Methods: This study is a wide systematic review including any type of clinical trial in which the effect of any type of therapeutic exercise, including scapular muscle strengthening, stretching, and scap- ular stabilization exercise, is investigated in adult participants. Results: Twenty studies were included in this systematic review. Studies were categorized on the basis of the techniques they used to measure scapular position and motion and the included participants. Methodologic quality of the studies was assessed by the Cochrane tool of assessing the risk of bias. Eight studies used 3-dimensional techniques for measuring scapular motions. Among them, 5 studies showed significant effects of exercise on scapular motion, of which 3 studies investigated individuals with subacromial impingement syndrome (SIS). The other 12 studies used 2-dimensional measurement techniques, of which 8 studies reported significant effects of exercise on scapular position and motion both in SIS patients and in asymptomatic individuals. However, their methodologic quality was debatable. Therefore, there was conflicting evidence for the effect of exercise on scapular dyskinesis. Conclusion: There is a lack of evidence for beneficial effects of exercise in improving scapular position and motion in individuals with scapular dyskinesis. However, exercise is beneficial in reducing pain and disability in individuals with SIS. Level of evidence: Level IV; Systematic Review Ó 2019 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved. Keywords: Exercise therapy; scapula; dyskinesis; motion; systematic review; scapular position The Research Ethics Committee, University of Social Welfare and Reha- bilitation Sciences, approved this study. All participants gave written informed consent before data collection began. *Reprint requests: Leila Rahnama, PhD, Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Kodakyar Ave., Daneshjo Blvd., Evin, Post code: 1985713871, Tehran, Iran. E-mail address: l.rahnama@uswr.ac.ir (L. Rahnama). J Shoulder Elbow Surg (2020) 29, e29–e36 www.elsevier.com/locate/ymse 1058-2746/$ - see front matter Ó 2019 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved. https://doi.org/10.1016/j.jse.2019.05.037