Physical Therapy Korea (한국전문물리치료학회지)

Korean Research Society of Physical Therapy (한국전문물리치료학회)
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Comparative Effect of Modified Shrug Exercises With and Without Trunk Stabilization Exercise on Scapular Upward Rotator EMG and Thickness in Subjects With Scapular Downward Rotation Syndrome

  • Kim, Ji-hyun (Dept. of physical therapy, The Graduate School, Yonsei University) ;
  • Yoon, Hyeo-bin (Dept. of physical therapy, The Graduate School, Yonsei University) ;
  • Park, Joo-hee (Dept. of physical therapy, The Graduate School, Yonsei University) ;
  • Jeon, Hye-seon (Dept. of Physical Therapy, College of Health Science, Yonsei University)
  • Received : 2017.10.02
  • Accepted : 2017.11.05
  • Published : 2017.11.19
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Abstract

Background: Scapular downward rotation syndrome (SDRS) is a common scapular alignment impairment that causes insufficient upward rotation and muscle imbalance, shortened levator scapulae (LS) and rhomboid, and lengthened serratus anterior (SA) and trapezius. A modified shrug exercise (MSE), performing a shrug exercise with the shoulders at $150^{\circ}$ abduction, is known as an effective exercise to increase scapular stabilizer muscle activation. Previous studies revealed that scapular exercise are more effective when combined with trunk stabilization exercises in decreasing scapular winging and increasing scapular stabilizer muscle activation. Objects: The purpose of our study was to clarify the effect of MSE with or without trunk stabilization exercises in subjects with SDRS. Methods: Eighteen volunteer subjects (male=10, female=8) with SDRS were recruited for this experiment. All subjects performed MSE under 3 different conditions: (1) MSE, (2) MSE with an abdominal draw-in maneuver (ADIM), and (3) MSE with an abdominal expansion maneuver (AEM). The muscle thickness of the lower trapezius (LT) and the SA were measured using an ultrasonography in each condition. Electromyography (EMG) data were collected from the LT, LS, SA, and upper trapezius (UT) muscle activities. Data were statistically analysed using one-way repeated analysis of variance at a significance level of .05. Results: The muscle thickness of the LT and the SA were the significant different in the MSE, MSE with ADIM (MSE+ADIM) and MSE with AEM (MSE+AEM) conditions (p<.05) In both LT and SA, the order of thick muscle thickness was MSE+AEM, MSE+ADIM, and MSE alone. No significant differences were found in the EMG activities of the SA, UT, LS, and LT in all condition. Conclusion: In conclusion, MSE is more beneficial to people with SDRS when combined with trunk stabilization exercises by increased thickness of scapular stabilizer muscles.

Keywords

References

  1. Basmajian JV, Blumen R. Electrode Placement in Electromyographic Biofeedback. Biofeedback Principles and Practice for Clinicians. 1983.
  2. Burkhead Wz Jr, Rockwood CA Jr. Treatment of instability of the shoulder with an exercise program. J Bone Joint Surg Am. 1992;74(6):890-896. https://doi.org/10.2106/00004623-199274060-00010
  3. Caldwell C, Sahrmann S, Van Dillen L, et al. use of a movement system impairment diagnosis for physical therapy in the examination and treatment of a patient with shoulder pain. J Ortho Sports PhysTher. 2007;37(9):551-563. https://doi.org/10.2519/jospt.2007.2283
  4. Choi WJ, Cynn HS, Lee CH, et al. Shrug exercises combined with shoulder abduction improve scapular upward rotator activity and scapular alignment in subjects with scapular downward rotation impairment. J Electromyogr Kinesiol. 2015;25(2):363-370. https://doi.org/10.1016/j.jelekin.2014.12.001
  5. Criswell E. Cram's Introduction to Surface Electromyography 2nd ed. Sudbury, Jones and Bartlett Publishers, 2010:268-298
  6. Cuadros CL, Driscoll CL, Rothkopf DM. The anatomy of the lower serratus anterior muscle: A fresh cadaver study. Plas Reconstr Surg. 1995;95(1):93-97. https://doi.org/10.1097/00006534-199501000-00014
  7. Day JM, Uhl T. Thickness of the lower trapezius and serratus anterior using ultrasound imaging during a repeated arm lifting task. Man Ther. 2013;18(6):588-593. https://doi.org/10.1016/j.math.2013.07.003
  8. Ekstrom RA, Donatelli RA, Soderberg GL. Surface electromyographic analysis of exercises for the trapezius and serratus anterior muscles. J Orthop Sports Phys Ther. 2003;33(5):247-258. https://doi.org/10.2519/jospt.2003.33.5.247
  9. Hintermeister RA, Lange GW, Schultheis JM, et al. Electromyographic activity and applied load during shoulder rehabilitation exercises using elastic resistance. Am J Sports Med. 1998;26(2):210-220. https://doi.org/10.1177/03635465980260021001
  10. Kanik ZH, Pala OO, Gunaydin G, et al. Relationship between scapular muscle and core endurance in healthy subjects. J Back Musculoskelet Rehabil. 2017;30(4):811-817. https://doi.org/10.3233/BMR-150497
  11. Kendall FP. Muscles Testing and Function. 3rd ed. Lippincott Williams and Wilkins, 1983:222-228.
  12. Kim DE, Shin AR, Lee JH, et al. Effect of the abdominal drawing-in maneuver on the scapular stabilizer muscle activities and scapular winging during push-up plus exercise in subjects with scapular winging. Physi Ther Korea. 2017;24(1):61-70. https://doi.org/10.12674/ptk.2012.19.4.038
  13. Kim KS, Lim OB, Yi CH, et al. Comparisons of trunk muscle activity during arm lift in prone and standing positions with and without abdominal drawing-in maneuver. Phys Ther Korea. 2012;19(4):38-45. https://doi.org/10.12674/ptk.2012.19.4.038
  14. LEE HJ, KIM SY. Comparison of the effects of abdominal draw-in and expansion maneuvers on trunk stabilization in patients with low back pain and lumbar spine instability. Phys Ther Korea. 2015;22(1):37-48. https://doi.org/10.12674/ptk.2015.22.1.037
  15. Lee JH, Cynn HS, Choi WJ, et al. Various shrug exercises can change scapular kinematics and scapular rotator muscle activities in subjects with scapular downward rotation syndrome. Hum Mov Sci. 2016;45:119-129. https://doi.org/10.1016/j.humov.2015.11.016
  16. Ludewig PM, Cook TM, Nawoczenski DA. Three-dimensional scapular orientation and muscle activity at selected positions of humeral elevation. J Orthop Sports Phys Ther. 1996;24(2):57-65. https://doi.org10.2519/jospt.1996.24.2.57
  17. Macedo LG, Maher CG, Latimer J, et al. Motor control exercise for persistent, nonspecific low back pain: A systematic review. Phys Ther. 2009;89(1):9-25.https://doi.org/10.2522/ptj.20080103
  18. Moseley JB Jr, Jobe FW, Pink M, et al. EMG analysis of the scapular muscles during a shoulder rehabilitation program. Am J Sports Med. 1992;20(2):128-134. https://doi.org/10.1177/036354659202000206
  19. Myers TW. Anatomy Trains: Myofascial meridians for manual and movement therapist, 3rd ed. Edinburg, Elsevier, 2009:159-175.
  20. O'sullivan C, Bentman S, Bennett K, et al. Rehabilitative ultrasound imaging of the lower trapezius muscle: Technical description and reliability. J Orthop Sports Phys Ther. 2007;37(10):620-626. https://doi.org/10.2519/jospt.2007.2446
  21. Pizzari T, Wickham J, Balster S, et al. Modifying a shrug exercise can facilitate the upward rotator muscles of the scapula. Clin Biomech. 2014;29(2):201-205. https://doi.org/10.1016/j.clinbiomech.2013.11.011
  22. Sahrmann S. Diagnosis and Treatment of Movement Impairment Syndromes. 1st ed. St. Louis, Mosby, 2002:199-252
  23. Smith J, Padgett DJ, Kaufman KR, et al. Rhomboid muscle electromyography activity during 3 different manual muscle tests. Arch Phys Med Rehabil. 2004;85(6):987-992. https://doi.org/10.1016/S0003-9993(03)00618-X
  24. Vleeming A, Schuenke MD, Danneels L, et al. The functional coupling of the deep abdominal and paraspinal muscles: The effects of simulated paraspinal muscle contraction on force transfer to the middle and posterior layer of the thoracolumbar fascia. J Anat. 2014;225(4):447-462. https://doi.org/10.1111/joa.12227
  25. Willard FH, Vleeming A, Schuenke MD, et al. The thoracolumbar fascia: Anatomy, function and clinical considerations. J Anat. 2012;221(6):507-536. https://doi.org/10.1111/j.1469-7580.2012.01511.x
  26. Yoon MR, Choi HS, Shin WS. Effects of the abdominal drawing-in maneuver and the abdominal expansion maneuver on grip strength, balance and pulmonary function in stroke patients. J Korean Phys Ther. 2015;27(3):147-153. https://doi.org/10.18857/jkpt.2015.27.3.147

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