Electromyographic analysis of selected shoulder muscles during a series of exercises commonly used in patients with symptomatic degenerative rotator cuff tears

Cools, Ann; Tongel, Alexander Van; Berckmans, Kelly; Spanhove, Valentien; Plaetevoet, Tibo; Rosseel, Jonas; Soen, Jasper; Levy, Ofer; Maenhout, Annelies

doi:10.1016/j.jse.2020.03.019

Cited by 12 publications

(9 citation statements)

References 21 publications

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“…Conversely, in this present study, forward movement was generated preferentially by the shoulder, similar to that by Gaunt et al, 13 which may explain the reason for the larger mean %MVICs in the supraspinatus, and also for the infraspinatus and subscapularis. The mean %MVIC of the anterior deltoid and middle deltoid produced similar MVICs to those observed in the study by Cools et al 23 (11% and 11.9%, respectively).…”

Section: Discussionsupporting

confidence: 88%

“…It has been suggested this exercise, also known as the wall slide or wall walk, is more appropriately used in later stages of rehabilitation once the patient can actively elevate the arm to at least 130° without pain, to build endurance for active elevation rather than as an assist for improving elevation ROM. 5 Mean %MVICs observed for the anterior and middle deltoid were similar to those observed in the study by Cools et al 23 (11% and 11.9%, respectively). Dowels and pulleys are often used by patients to actively assist forward flexion motion so as not to place excessive stress on an early cuff repair.…”

Section: Discussionsupporting

confidence: 87%

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Electromyographic Evaluation of Early-Stage Shoulder Rehabilitation Exercises Following Rotator Cuff Repair

Edwards¹,

Kwong²,

Ackland³

et al. 2021

International Journal of Sports Physical Therapy

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BackgroundElectromyography (EMG) is frequently used as a guide for exercise rehabilitation progression following rotator cuff repair. Knowledge of EMG activity during passive and active-assisted exercises may help guide clinicians when considering exercise prescription in the early post-operative period. PurposeThe purpose of this study was to investigate EMG activity of the rotator cuff and deltoid musculature during passive and active-assisted shoulder range of motion (ROM) exercises commonly performed in post-operative rehabilitation. Study DesignDescriptive cohort laboratory study using healthy subjects. MethodsIn sixteen active healthy volunteers, surface and fine-wire EMG activity was measured in the supraspinatus, infraspinatus, subscapularis, and anterior, middle and posterior deltoid muscles during eight common ROM exercises. Mean %MVIC values and 95% confidence intervals were used to rank exercises from the least to the most amount of muscular activity generated during the exercises. ResultsStandard pendulum exercises generated low levels of EMG activity in the supraspinatus and infraspinatus (≤15% MVIC), while active-assisted table slides, and the upright wall slide generated low levels of EMG activity in only the supraspinatus. No exercises were found to generate low levels of muscular activation (≤15% MVIC) in the subscapularis. ConclusionThis study found no clear distinctions between the EMG activity of the supraspinatus or the infraspinatus occurring during common passive and active-assisted ROM exercises. Subdividing ROM exercises based on muscle activity, may not be necessary to guide progression of exercises prior to commencing active motion after rotator cuff repair.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 87%

Electromyographic Evaluation of Early-Stage Shoulder Rehabilitation Exercises Following Rotator Cuff Repair

Edwards¹,

Kwong²,

Ackland³

et al. 2021

International Journal of Sports Physical Therapy

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“…Theoretically, one may provoke or avoid pain during exercises by changing various contextual factors [ 69 , 70 ]. When the chosen comparison is pain level during and after exercise, the best way to develop 2 exercise programs in which pain is the intervention variable is to consider the assumed tendon load, combined with pain experience during the exercise.…”

Section: Interventionsmentioning

confidence: 99%

To allow or avoid pain during shoulder rehabilitation exercises for patients with chronic rotator cuff tendinopathy-Study protocol for a randomized controlled trial (the PASE trial)

Kjær,

Cools,

Johannsen

et al. 2024

Trials

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Background Rotator cuff (RC) tendinopathy is the most reported shoulder disorder in the general population with highest prevalence in overhead athletes and adult working-age population. A growing body of evidence support exercise therapy as an effective intervention, but to date there are no prospective randomized controlled trials addressing pain as an intervention variable. Methods A single-site, prospective, pragmatic, assessor-blinded randomized controlled superiority trial. Eighty-four patients aged 18–55 years with chronic (symptom duration over 3 months) RC tendinopathy are randomized 1:1 to receive shoulder exercise during which pain is either allowed or avoided. The intervention period lasts 26 weeks. During that period, participants in both groups are offered 8 individual on-site sessions with an assigned sports physiotherapist. Participants perform home exercises and are provided with a pain and exercise logbook and asked to report completed home-based exercise sessions and reasons for not completing sessions (pain or other reasons). Patients are also asked to report load and the number of sets and repetitions per sets for each exercise session. The logbooks are collected continuously throughout the intervention period. The primary and secondary outcomes are obtained at baseline, 6 weeks, 26 weeks, and 1 year after baseline. The primary outcome is patient-reported pain and disability using the Shoulder PAin and Disability Index (SPADI). Secondary outcomes are patient-reported pain and disability using Disability Arm Shoulder and Hand short-form (Quick DASH), and shoulder pain using Numeric Pain Rating Scale. Objective outcomes are shoulder range of motion, isometric shoulder muscle strength, pain sensitivity, working ability, and structural changes in the supraspinatus tendon and muscle using ultrasound. Discussion The results of this study will contribute knowledge about the treatment strategies for patients with RC tendinopathy and help physiotherapists in clinical decision-making. This is the first randomized controlled trial comparing the effects of allowing pain versus avoiding pain during shoulder exercises in patients with chronic RC tendinopathy. If tolerating pain during and after exercise proves to be effective, it will potentially expand our understanding of “exercising into pain” for this patient group, as there is currently no consensus. Trial registration ClinicalTrials.gov NCT05124769. Registered on August 11, 2021.

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“…The highest recorded muscle activity was used for normalization. The procedure of measuring the MVIC for each muscle was adapted from a previous study [26] and is described in Table 2. EMG activity was recorded at 2 weeks and 4 weeks after the exercises were performed, in the same positions for both groups, except that manual resistance was not performed.…”

Section: Outcome Measurementmentioning

confidence: 99%

Effects of Pseudo-Weight Resistance Training Using Mixed-Reality Technology on Muscle Activation in Healthy Adults: A Preliminary Study

Nekar,

Lee,

Hong

et al. 2023

Applied Sciences

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The present study investigated the feasibility and effectiveness of pseudo-weight resistance training using mixed-reality (MR) technology for shoulder muscle activation in healthy individuals. Thirty-two healthy students aged 20~35 years participated in this preliminary study and were divided into two groups. Participants in the MR group received 30 min of training three times a week for 4 weeks using a customized MR-based pseudo-weight resistance training system. Those in the control group performed the same exercises using a conventional training program. Muscle activation of the deltoids, upper trapezius, infraspinatus, and supraspinatus were measured before and after the intervention. There was a statistically significant difference in middle deltoid, upper trapezius, and supraspinatus muscle activation in the MR group (p < 0.05), while the control group showed a significant difference in the anterior and middle deltoid, upper trapezius, and supraspinatus (p < 0.05). Regarding the between-group comparison, no statistically significant difference was observed for all six muscles (p > 0.05). Without any superiority of physical weight resistance training in the pseudo-weight training program, an MR-based pseudo-weight resistance training system can potentially be used for muscle-strengthening training, especially for early rehabilitation programs. However, further study using a large sample size with a long experimental duration is needed for more evidence of the presented technology and its use in home training.

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Electromyographic analysis of selected shoulder muscles during a series of exercises commonly used in patients with symptomatic degenerative rotator cuff tears

Cited by 12 publications

References 21 publications

Electromyographic Evaluation of Early-Stage Shoulder Rehabilitation Exercises Following Rotator Cuff Repair

Electromyographic Evaluation of Early-Stage Shoulder Rehabilitation Exercises Following Rotator Cuff Repair

To allow or avoid pain during shoulder rehabilitation exercises for patients with chronic rotator cuff tendinopathy-Study protocol for a randomized controlled trial (the PASE trial)

Effects of Pseudo-Weight Resistance Training Using Mixed-Reality Technology on Muscle Activation in Healthy Adults: A Preliminary Study

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