Analysis of Scapular Kinematics and Muscle Activity by Use of Fine-Wire Electrodes During Shoulder Exercises

Berckmans, Kelly; Castelein, Birgit; Borms, Dorien; Palmans, Tanneke; Parlevliet, Thierry; Cools, Ann

doi:10.1177/0363546520908604

Cited by 14 publications

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“…More recently, the activation patterns of the deep scapular stabilizers, such as the levator scapulae (LS), rhomboid major (RM), and pectoralis minor (Pm) muscles, were explored with fine-wire EMG during rehabilitation exercises. 2,7,8,10 Exploring the activation of these muscles gives a new dimension of information that may influence the clinicians' exercise choice. Moreover, knowledge about the optimal muscle activation ratio (the relative activity of one muscle in perspective to another, rather than absolute levels of activity) may be of importance for improving scapular muscle strength and balance.…”

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confidence: 99%

Rehabilitation Exercises for Dysfunction of the Scapula: Exploration of Muscle Activity Using Fine-Wire EMG

et al. 2021

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Background: Scapular muscle activity during shoulder exercises has been explored with surface electromyography (EMG). However, knowledge about the activity of deeper-layer scapular muscles is still limited. Purpose: To investigate EMG activation of the deeper-layer scapular stabilizers (levator scapulae [LS], rhomboid major [RM], pectoralis minor [Pm] muscles) together with superficial muscle activity (upper [UT], middle [MT], and lower trapezius [LT] and serratus anterior [SA]) during 4 exercises often used for training scapular function. Based on the amplitude EMG of the deeper-layer muscles, scapular muscle activation ratios for the 4 exercises were calculated, hereby providing knowledge of the optimal muscle balance. Study Design: Descriptive laboratory study. Methods: A total of 26 healthy participants performed 4 shoulder exercises (side-lying external rotation [ER], side-lying forward flexion, prone horizontal abduction with ER, and prone extension) while simultaneously measuring scapular muscle activity. Intramuscular electrodes were used for the deeper layer, in contrast to surface electrodes for the superficial muscles. All data were normalized to percentage of maximal voluntary isometric contraction (%MVIC), and the activation ratios (the muscle activity of the deeper layer relative to the other muscles) were calculated. A 1-way analysis of variance with Bonferroni correction was applied for statistical analysis. Results: Moderate activity was found in all exercises for the LS and RM (25%-45% MVIC). The Pm resulted in low activity during both side-lying exercises (13%-18% MVIC). Ratios involving LS or RM showed values >1 for all exercises (1.28-12.41) except for LS/MT, LS/LT, and LS/RM (0.85-0.98) during side-lying ER, and LS/MT, RM/MT and RM/LS (0.85-0.99) during side-lying forward flexion. Likewise, values <1 were found when MT (0.85) and LS (0.99) were involved with RM in the numerator during side-lying forward flexion. Ratios with Pm in the numerator showed values <1, apart from the ratios with UT and SA in the denominator. Conclusion: The study provides extended knowledge about the deeper-layer scapular muscle activity and related ratios during the 4 shoulder exercises mentioned here. Putting theory into practice, based on our results, we advise both side-lying exercises to be performed to strengthen LT and MT, even in case of hyperactivity of the Pm. However, the 4 exercises should be given carefully to patients with hyperactivity in the LS and/or RM. Clinical Relevance: The findings of this study may assist clinical decision making in exercise selection for restoring scapular function.

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Rehabilitation Exercises for Dysfunction of the Scapula: Exploration of Muscle Activity Using Fine-Wire EMG

et al. 2021

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“…In our study, Rhom activity was not significantly different between the exercises. Moseley et al 33 and Berckmans et al 4 reported that the main function of the Rhom was scapular retraction. The scapular external rotation movement in scapular retraction increases with trunk rotation.…”

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confidence: 99%

“… 47 Rhom muscle activity increases with increased scapular external rotation movement. 4 Exercises in the limb position parallel to the direction of the muscle fibers results in higher muscle activity. 32 , 37 In this study, the trunk rotation exercise, which required trunk rotation motion, and the A-exercise, in which the direction of movement was close to the direction of the oblique Rhom muscle fibers, were expected to show higher muscle activity, but no significant difference was found between the exercises.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have investigated Rhom activity in exercises using dumbbells, rubber tubing, and early phase rehabilitation activities. 3,4,7,33,34 These studies reported that Rhom activity was high in exercises involving scapular retraction and external rotation of the glenohumeral joint. The Rhom activity required during the baseball throwing motion was shown to be moderate in the early cocking phase (35% maximal manual muscle test [MMT]) and late cocking phase (41% MMT), 14 which was similar to the muscle activity levels during the exercises in this study.…”

Section: Discussionmentioning

confidence: 99%

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Muscle Activity During Scapular Muscle Exercises With Multijoint Compound Movement: Analysis Using Fine-Wire and Surface Electrodes

Adachi¹,

Oshikawa

Akuzawa

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Improvements in motor control of the scapular muscles are important for the prevention and rehabilitation of shoulder and elbow injuries in overhead athletes. Purpose: To clarify scapular muscle activity during multijoint compound movement exercises using fine-wire and surface electrodes. Study Design: Descriptive laboratory study. Methods: Sixteen healthy men performed 5 types of exercises (cat and dog, trunk rotation, A-exercise, T-exercise, and Y-exercise). Muscle activity was measured as percentage of maximum voluntary isometric contraction (%MVIC) by using fine-wire electrodes in the rhomboid major (Rhom) and using surface electrodes in the upper (UT), middle (MT), and lower (LT) trapezius and serratus anterior (SA) muscles. The Rhom/UT, MT/UT, LT/UT, and SA/UT muscle activity ratios were calculated. One-way analysis of variance was used to compare the %MVIC and muscle activity ratios between exercises. Results: There was no significant difference in Rhom activity between the exercises (34.6-54.2%MVIC; P = .25). LT activity was significantly greater in the trunk rotation (58.0 ± 24.6%MVIC) and Y-exercise (63.2 ± 40.1%MVIC) than in the cat and dog scapular retraction (19.6 ± 9.3%MVIC) and A-exercise (28.2 ± 14.2%MVIC) ( P < .05). SA activity was significantly greater in the cat and dog scapular protraction (26.7 ± 11.0%MVIC) and Y-exercise (25.6 ± 19.3%MVIC) than in the other exercises ( P < .05). The SA/UT activity ratio in the cat and dog scapular protraction exercise (9.64 ± 8.48) was significantly higher than in the other exercises ( P < .05). Conclusion: All the exercises were effective for activating the Rhom. The trunk rotation and Y-exercise were effective for activating the LT, and the cat and dog scapular protraction exercise was effective for activating the SA while suppressing the UT. Clinical Relevance: These results enable exercise selection based on muscle activity characteristics (moderate [20%-50%MVIC] and high [>50%MVIC] levels contribute to muscle activation) to prevent and rehabilitate shoulder and elbow injuries.

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“…Finally, a standardized method to assess the sensorimotor function of the shoulder is yet to be determined. Other commonly used methods are the joint position sense and kinesthesia examinations [26][27][28][29][30][31].…”

Section: Discussionmentioning

confidence: 99%

Center of pressure (COP) measurement in patients with confirmed successful outcomes following shoulder surgery show significant sensorimotor deficits

Ehmann

Berthold

Reuter

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose To determine the sensorimotor and clinical function of patients with confirmed successful outcome after either undergoing acromioclavicular joint (ACJ) stabilization, Bankart repair (BR), or rotator cuff repair (RC), and to compare these measures to the contralateral, healthy side without history of previous injuries or surgeries of the upper extremity. It was hypothesized that patients of each interventional group would have inferior sensorimotor function of the shoulder joint compared to the contralateral, healthy side, while presenting with successful clinical and functional outcomes. Methods Three intervention groups including ten patients who had confirmed successful clinical and functional outcomes after either undergoing ACJ stabilization, BR, or RC were evaluated postoperatively at an average follow-up of 31.7 ± 11.6 months. Additionally, a healthy control group (CG) of ten patients was included. Clinical outcomes were assessed using the Constant–Murley (CM) and American Shoulder and Elbow Surgeons (ASES) Score. Pain was evaluated using the visual analogue scale (VAS). Sensorimotor function was assessed by determining the center of pressure (COP) of the shoulder joint in a one-handed support task in supine position on a validated pressure plate. Results Each interventional group demonstrated excellent clinical outcome scores including the CM Score (ACJ 83.3 ± 11.8; BR 89.0 ± 10.3; RC 81.4 ± 8.8), ASES Score (ACJ 95.5 ± 7.0; BR 92.5 ± 9.6; RC 96.5 ± 5.2), and VAS (ACJ 0.5 ± 0.9; BR 0.5 ± 0.8; RC 0.5 ± 0.8). Overall, the CG showed no significant side-to-side difference in COP, whereas the ACJ-group and the BR-group demonstrated significantly increased COP compared to the healthy side (ACJ 103 cm vs. 98 cm, p = 0.049; BR: 116 cm vs. 102 cm, p = 0.006). The RC-group revealed no significant side-to-side difference (120 cm vs. 108 cm, n.s.). Conclusion Centre of pressure measurement detected sensorimotor functional deficits following surgical treatment of the shoulder joint in patients with confirmed successful clinical and functional outcomes. This may indicate that specific postoperative training and rehabilitation protocols should be established for patients who underwent surgery of the upper extremity. These results underline that sensorimotor training should be an important component of postoperative rehabilitation and physiotherapeutic activities to improve postoperative function and joint control. Level of evidence IV.

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Analysis of Scapular Kinematics and Muscle Activity by Use of Fine-Wire Electrodes During Shoulder Exercises

Cited by 14 publications

References 18 publications

Rehabilitation Exercises for Dysfunction of the Scapula: Exploration of Muscle Activity Using Fine-Wire EMG

Rehabilitation Exercises for Dysfunction of the Scapula: Exploration of Muscle Activity Using Fine-Wire EMG

Muscle Activity During Scapular Muscle Exercises With Multijoint Compound Movement: Analysis Using Fine-Wire and Surface Electrodes

Center of pressure (COP) measurement in patients with confirmed successful outcomes following shoulder surgery show significant sensorimotor deficits

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