A comparative study on the recruitment of shoulder stabilizing muscles and types of exercises

The effect of various therapeutic exercises on forward head posture, rounded shoulder, and hyperkyphosis among people with upper crossed syndrome: a systematic review and meta-analysis

OBJECTIVES

This review study aimed to evaluate the impact of therapeutic exercises on Upper-Crossed Syndrome (UCS). The study utilized a systematic review and meta-analysis approach to investigate the effects of various therapeutic exercises on forward head posture, rounded shoulders, and hyperkyphosis associated with upper crossed syndrome.

METHODS

The study identified relevant keywords for each independent and dependent variable and conducted a search in scientific databases, including PubMed, Web of Science, Scopus, and Google Scholar, without any time limitations until 12 August 2023. Overall, 4625 articles were found in the selected databases, which were reduced to 1085 after being entered into the EndNote software and removing duplicate data. The full texts of 30 remaining studies were reviewed; ten articles meeting the criteria were included. Additionally, 12 studies from the Google Scholar database were included, resulting in 22 studies. Using Comprehensive meta-analysis software (CMA ver 3), data heterogeneity was measured with I2 and the Q tests. The Funnel Plot and Egger test methods were utilized to determine the possibility of publication bias. The JBI checklist was used to assess the quality of the studies.

RESULTS

The results of the meta-analysis showed that therapeutic exercises were effective in improving forward head, rounded shoulders, and thoracic kyphosis angles (CI 95% = -1.85-1.161, P = 0.001, P = 0.001, CI95%=-1.822-1.15, and P = 0.001, CI 95%= -1.83-1.09, respectively).

CONCLUSION

Based on the results, it appears that performing therapeutic exercises in the form of strength exercises, stretching, shoulder-based exercises, and incredibly comprehensive exercises that target all muscles may be effective in reducing forward head, rounded shoulders, thoracic kyphosis, and overall UCS.

LEVEL OF EVIDENCE: 1

Electromyographic signals analysis to assess the response of a proprioceptive neuromuscular facilitation pattern execution

Proprioceptive Neuromuscular Facilitation is a rehabilitation technique that consists of the stimulation of a healthy muscle in one extremity of the body to produce an activation effect of a damaged muscle in another extremity, laterally or contralaterally. The use of the analysis of the electromyographic response during the process allows us to describe and evaluate if the damaged muscle produces an activation. This paper presents the progress of the results of a clinical protocol where PNF is explored in healthy subjects, manipulating the upper limb, and recording the electromyographic response of the lower limbs in three different muscles in both inferior limbs. Four activation patterns (movement sequence) with three different stages with different intensities of resistance are considered. Lateral plane video recording analysis is performed to extract the trajectory of the manipulated limb and correlate this information with electromyography signals. The electromyography signals are analyzed in their temporal response by integrating the rectified and smoothed signal according to the beginning and end of the trajectory of the manipulated superior limb. Additionally, the spectrogram analysis of the signals is performed. The partial results of the protocol allow us to establish that the response in the most distal muscles to the manipulated upper limb has been non-significant for the subjects, compared to the response of the proximal muscles, where a relationship with activation and trajectory of the arm is observed. particularly in the process with greater resistance. The observed changes in signal frequency across the spectrogram correspond to low-frequency changes in the 15 to 20Hz band.Clinical Relevance- This work presents a strategy to assess the rehabilitation process based on proprioceptive neuromuscular facilitation by analyzing the time and time-frequency response of the electromyographic signal.

The Effects of Elastic Band Exercises with PNF on Shooting Speed and Accuracy in Ball Hockey Players during the COVID-19 Pandemic

The coronavirus pandemic has affected life and left one of the strongest negative effects on sport. The aim of our study was to evaluate how a simple exercise performed with elastic resistance during the COVID-19 pandemic, when athletes cannot train, affects the basic shooting characteristics of ball hockey players. Extra-league ball hockey players (N = 30, age 19-37 years) were randomly divided into an experimental group, which performed elastic resistance exercises with Proprioceptive Neuromuscular Facilitation (PNF) elements for eight weeks, and a control group, which did not perform any exercises. Before the start of the experiment and after it was completed, the speed and accuracy of shooting were measured. In experimental group, there was no decrease after 8 weeks in the shooting speed, and in the control group, there was a statistically significant decrease. There was a deterioration in the accuracy of shooting in both groups; however, in the experimental group, the deterioration was not significant. The results show that even three simple exercises with elastic resistance according to the PNF concept performed 10 times per day for eight weeks can maintain the level of basic skills of ball hockey players-the speed and accuracy of shooting-even when no other training is performed.