Electromyographic analysis during pull, forward punch, elevation and overhead throw after conservative treatment or capsular shift at patient with multidirectional shoulder joint instability

Illyés, Árpád; Kiss, János; Kiss, Rita M.

doi:10.1016/j.jelekin.2008.09.008

Cited by 45 publications

(47 citation statements)

References 38 publications

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“…Both activation ratios and individual muscle-activation amplitudes were different among the exercises tested. Whereas unexpected, the lack of group differences in our study in relation to activation ratios and individual muscle amplitude is consistent with the findings of others 23,34 and can be explained by examining the profile of our GH injury group, as well as how the exercises in our study were executed.…”

Section: Discussionsupporting

confidence: 92%

“…In both studies, the multiplanar, multijoint exercises were performed in a controlled manner without load, which also may explain the lack of group differences in muscleactivation ratios and individual muscle amplitudes. Other researchers 23,34,37 have suggested that if activation amplitudes are affected by injuries, differences are more apparent when the shoulder complex is challenged, which occurs when movements are performed with more dynamic speed or load. The trend toward higher UT:MT activation ratios during the lawnmower and a main effect for higher UT:LT in the GH injury group, supported by moderate to strong effect sizes (0.74 and 2.2, respectively; Table 2), suggest that compensations of UT hyperactivity and decreased MT and LT activity as reported by Cools et al 14 may occur.…”

Section: Discussionmentioning

confidence: 99%

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Scapular Muscle-Activation Ratios in Patients With Shoulder Injuries During Functional Shoulder Exercises

Moeller

Bliven

Valier

2014

Journal of Athletic Training

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Context: Alterations in scapular muscle activation, which are common with glenohumeral (GH) injuries, affect stability and function. Rehabilitation aims to reestablish activation between muscles for stability by progressing to whole-body movements.Objective Design: Cross-sectional study. Setting: Laboratory.Patients or Other Participants: Thirty-nine participants who had GH injuries (n ¼ 20; age ¼ 23.6 6 3.2 years, height ¼ 170.7 6 11.5 cm, mass ¼ 74.7 6 13.1 kg) or were healthy (n ¼ 19; age ¼ 24.4 6 3.3 years, height ¼ 173.6 6 8.6 cm, mass ¼ 74.7 6 14.8 kg) were tested.Intervention(s): Clinical examination confirmed each participant's classification as GH injury or healthy control. Participants performed 4 exercises (bow and arrow, external rotation with scapular squeeze, lawnmower, robbery) over 3 seconds with no load while muscle activity was recorded.Main Outcome Measure(s): We used surface electromyography to measure UT, MT, LT, and SA muscle activity. Scapular muscle-activation ratios (UT:MT, UT:LT, and UT:SA) were calculated (normalized mean electromyography of the UT divided by normalized mean electromyography of the MT, LT, and SA). Exercise 3 group analyses of variance with repeated measures were conducted.Results: No group differences for activation ratios or individual muscle activation amplitude were found (P . .05). Similar UT:MT and UT:LT activation ratios during bow-andarrow and robbery exercises were seen (P . .05); both had greater activation than external-rotation-with-scapular-squeeze and lawnmower exercises (P , .05). The bow-and-arrow exercise elicited the highest activation from the UT, MT, and LT muscles; SA activation was greatest during the externalrotation-with-scapular-squeeze exercise.Conclusions: Scapular muscle activation was similar between participants with GH injuries and healthy control participants when performing the unloaded multiplanar, multijoint exercises tested. High activation ratios during the bow-andarrow exercise indicate UT hyperactivity or decreased MT, LT, and SA activity. Our GH injury group may be comparable to high-functioning injured athletes. Study results may assist clinicians in selecting appropriate exercises for scapular muscle activation when caring for injured athletes.Key Words: force couple, glenohumeral joint, rehabilitation, serratus anterior muscle, trapezius muscle Key PointsMuscle balance to promote scapular upward rotation, as indicated by muscle-activation ratios, was present and similar between participants with glenohumeral injuries and healthy control participants when performing 4 unloaded multiplanar, multijoint functional exercises. Clinicians should use caution when prescribing the bow-and-arrow exercise because it produced high scapular muscle-activation ratios, indicating upper trapezius hyperactivity and decreased middle trapezius, lower trapezius, and serratus anterior activity. Exercises that promote activation of the middle trapezius, lower trapezius, and serratus anterior muscles while minimizing upper trapezius hyperactivity are ...

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Scapular Muscle-Activation Ratios in Patients With Shoulder Injuries During Functional Shoulder Exercises

Moeller

Bliven

Valier

2014

Journal of Athletic Training

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“…There are several studies dealing with the conservative rehabilitative treatment in patients with multidirectional shoulder instability [15][16][17][18][19][20][21]; however, there is not a common agreement on the use of conservative treatment with a rehabilitative program for patients with traumatic anterior shoulder dislocation. Therefore, we performed a case series study that aimed to evaluate the efficacy of a well-defined rehabilitative approach to restoring stability, range of motion (ROM), and function of the shoulder joint in nonoperated adults presenting a first episode of traumatic anterior shoulder dislocation.…”

Section: Introductionmentioning

confidence: 99%

Conservative treatment of traumatic shoulder instability: a case series study

et al. 2015

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“…Strengthening of the rotator cuff may improve concavity compression with improved humeral head centering, leading to a functional reduction of instability. 8 Proprioceptive exercise programs, scapulothoracic training, and core stability are the main columns of nonsurgical management. Motivated patients with appropriate protocols typically respond well and may not need further management.…”

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confidence: 99%