1
|
Swanson BT, Hagenbruch M, Lapaan B, Skipalskiy K. Combined Effects of Glenohumeral Mobilization, Stretching, and Thoracic Manipulation on Shoulder Internal Rotation Range of Motion. Int J Sports Phys Ther 2024; 19:394-409. [PMID: 38699673 PMCID: PMC11065457 DOI: 10.26603/001c.95040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/07/2024] [Indexed: 05/05/2024] Open
Abstract
Background/purpose Interventions including posterior glenohumeral mobilizations (PGM), sleeper stretches, and thoracic manipulation are commonly used to address posterior shoulder tightness. The purpose of this study was to assess the effects of adding thoracic manipulation to PGM and sleeper stretches on passive range of motion (PROM), joint mobility, and infraspinatus electromyographic (EMG) activity in shoulders with decreased internal rotation (IR) PROM. Design Randomized Sequential Intervention Laboratory Study. Methods Forty individuals with clinically significant IR loss attended two study sessions. Participants were randomized to receive five 30 seconds bouts of either grade III PGM or sleeper stretching. Following a seven-day washout period, all participants attended a second session and received a prescriptive supine HVLA manipulation targeting the T3-4 segment, followed by the previously randomized intervention. Outcome measures included internal rotation PROM, horizontal adduction PROM, posterior glenohumeral joint translation assessed via ultrasound imaging, and EMG activity of the infraspinatus during a PGM. All outcome measures were assessed pre- and immediately post-intervention and compared statistically. Results There were significant within-group, but not between-group, differences for IR and horizontal adduction PROM following a single session of PGM or sleeper stretch. When combined with thoracic manipulation, significantly smaller within session changes of IR PROM were observed for both PGM (mean difference 4.4, p=0.017) and sleeper stretches (mean difference 6.4, p=0.0005). There were no significant between group differences for horizontal adduction PROM, humeral head translation, or EMG activity across all time points. Discussion Both GH posterior mobilizations and sleeper stretches improved IR and horizontal adduction PROM in a single session. The addition of thoracic manipulation prior to local shoulder interventions resulted in smaller gains of both IR and horizontal adduction ROM. Level of evidence Level 2.
Collapse
|
2
|
Zhu X, Pang Y, Li L, Sun W, Ding L, Song Q, Shen P. Standard isometric contraction has higher reliability than maximum voluntary isometric contraction for normalizing electromyography during level walking among older adults with knee osteoarthritis. Front Bioeng Biotechnol 2024; 12:1276793. [PMID: 38433819 PMCID: PMC10904509 DOI: 10.3389/fbioe.2024.1276793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/26/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction: Electromyography (EMG) normalization often relies on maximum voluntary isometric contraction (MVIC), which may not be suitable for knee osteoarthritis (KOA) patients due to difficulties in generating maximum joint torques caused by pain. This study aims to assess the reliability of standard isometric contraction (SIC) for EMG normalization in older adults with KOA, comparing it with MVIC. Methods: We recruited thirty-five older adults with KOA and collected root mean square EMG amplitudes from seven muscles in the affected limb during level walking, SIC, and MVIC tests. EMG data during level walking were normalized using both SIC and MVIC methods. This process was repeated after at least 1 week. We calculated intra-class correlation coefficients (ICCs) with 95% confidence intervals to evaluate between- and within-day reliabilities. Results: SIC tests showed higher between- (ICC: 0.75-0.86) and within-day (ICC: 0.84-0.95) ICCs across all seven muscles compared to MVIC tests. When normalized with SIC, all seven muscles exhibited higher between- (ICC: 0.67-0.85) and within-day (ICC: 0.88-0.99) ICCs compared to MVIC normalization. Conclusion: This study suggests that SIC may offer superior movement consistency and reliability compared to MVIC for EMG normalization during level walking in older adults with KOA.
Collapse
Affiliation(s)
- Xiaoxue Zhu
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Yaya Pang
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Li Li
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA, United States
| | - Wei Sun
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Lijie Ding
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Qipeng Song
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Peixin Shen
- College of Sports and Health, Shandong Sport University, Jinan, China
| |
Collapse
|
3
|
Azevedo KP, Bastos JAI, de Sousa Neto IV, Pastre CM, Durigan JLQ. Different Cryotherapy Modalities Demonstrate Similar Effects on Muscle Performance, Soreness, and Damage in Healthy Individuals and Athletes: A Systematic Review with Metanalysis. J Clin Med 2022; 11:jcm11154441. [PMID: 35956058 PMCID: PMC9369651 DOI: 10.3390/jcm11154441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background: There are extensive studies focusing on non-invasive modalities to recover physiological systems after exercise-induced muscle damage (EIMD). Whole-body cryotherapy (WBC) and Partial-body cryotherapy (PBC) have been recommended for recovery after EIMD. However, to date, no systematic reviews have been performed to compare their effects on muscle performance and muscle recovery markers. Methods: This systematic review with metanalysis compared the effects of WBC and PBC on muscle performance, muscle soreness (DOMS), and markers of muscular damage following EIMD. We used Pubmed, Embase, PEDro, and Cochrane Central Register of Controlled Trials as data sources. Two independent reviewers verified the methodological quality of the studies. The studies were selected if they used WBC and PBC modalities as treatment and included muscle performance and muscle soreness (DOMS) as the primary outcomes. Secondary outcomes were creatine kinase and heart rate variability. Results: Six studies with a pooled sample of 120 patients were included. The methodological quality of the studies was moderate, with an average of 4.3 on a 0–10 scale (PEDro). Results: Both cryotherapy modalities induce similar effects without difference between them. Conclusion: WBC and PBC modalities have similar global responses on muscle performance, soreness, and markers of muscle damage.
Collapse
Affiliation(s)
- Klaus Porto Azevedo
- Rehabilitation Sciences Program, Physical Therapy Division, University of Brasilia, Brasília 72220-275, Brazil; (K.P.A.); (J.A.I.B.)
| | - Júlia Aguillar Ivo Bastos
- Rehabilitation Sciences Program, Physical Therapy Division, University of Brasilia, Brasília 72220-275, Brazil; (K.P.A.); (J.A.I.B.)
| | | | - Carlos Marcelo Pastre
- Physical Therapy Department, Paulista State University, Presidente Prudente 19060-900, Brazil;
| | - Joao Luiz Quagliotti Durigan
- Rehabilitation Sciences Program, Physical Therapy Division, University of Brasilia, Brasília 72220-275, Brazil; (K.P.A.); (J.A.I.B.)
- Correspondence: ; Tel.: +55-(61)-31078401
| |
Collapse
|
4
|
Cid MM, Januario LB, Moreira RDFC, Côté JN, Madeleine P, Oliveira AB. Does sEMG normalization change results on sex differences in the activation of the shoulder girdle muscles during a simulated work task? APPLIED ERGONOMICS 2020; 85:103044. [PMID: 31932265 DOI: 10.1016/j.apergo.2020.103044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 11/26/2019] [Accepted: 01/03/2020] [Indexed: 06/10/2023]
Abstract
The aim was to investigate if the method of normalizing surface electromyography (sEMG) can change results on sex differences in the muscular activation of the shoulder girdle muscles during a simulated work task. sEMG was recorded in 36 asymptomatic participants (17 females, 19 males) from four parts of trapezius and from serratus anterior muscles during a simulated work task. Four normalization methods, one involving maximal voluntary contractions (MVCs) and three involving submaximal voluntary contractions were applied. Sex differences in absolute and normalized amplitude of sEMG were analyzed. The normalization method had a significant influence on the observed sex differences. Females only showed higher sEMG amplitude than males when the sEMGs were normalized to MVC and to a submaximal contraction based on 20% of MVC for the upper trapezius (acromial fibers). Researchers and practitioners should be aware of the impact of the sEMG normalization method in sex differences investigation.
Collapse
Affiliation(s)
- Marina Machado Cid
- Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy, Federal University of São Carlos, Rodovia Washington Luís, km 235, SP-310, São Carlos, São Paulo, Brazil
| | - Leticia Bergamin Januario
- Department of Occupational Health Sciences and Psychology, Centre for Musculoskeletal Research, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden; Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy, Federal University of São Carlos, Rodovia Washington Luís, km 235, SP-310, São Carlos, São Paulo, Brazil
| | - Roberta de Fátima Carreira Moreira
- Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy, Federal University of São Carlos, Rodovia Washington Luís, km 235, SP-310, São Carlos, São Paulo, Brazil
| | - Julie N Côté
- McGill University, Department of Kinesiology and Physical Education, 475 Pine Avenue West, Montreal, Quebec, H2W 1S4, Canada
| | - Pascal Madeleine
- Laboratory for Ergonomics and Work-related Disorders, Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 12, 9220, Aalborg East, Denmark
| | - Ana Beatriz Oliveira
- Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy, Federal University of São Carlos, Rodovia Washington Luís, km 235, SP-310, São Carlos, São Paulo, Brazil.
| |
Collapse
|
5
|
Normalization of the trapezius sEMG signal - a reliability study on women with and without neck-shoulder pain. Braz J Phys Ther 2017; 22:110-119. [PMID: 29033217 PMCID: PMC5883997 DOI: 10.1016/j.bjpt.2017.09.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 08/01/2017] [Indexed: 12/19/2022] Open
Abstract
Objective To evaluate within- and between-days reliability of two normalization methods of surface electromyography (sEMG) recordings of the trapezius muscle. Methods Nineteen women were allocated into 2 groups (healthy and with neck-shoulder pain). The sEMG was recorded in two sessions with 7 days in between sessions. The four portions of the trapezius muscle (the clavicular and acromial fibers of the upper trapezius, the middle and the lower trapezius) were evaluated during maximal and submaximal isometric voluntary contractions. The within- and between-days reliability of both maximal and submaximal contractions were assessed through Intraclass Correlation Coefficient (ICC(2,1) was used for within-day analyses of both maximal and submaximal contractions, and for between-days analyses of maximal contractions while ICC(2,3) was used for between-days analyses of submaximal contractions), Coefficient of Variation, Standard Error of Measurement, and Bland–Altman analysis. Results In general, submaximal contractions presented higher within-day reliability, with higher ICC values (e.g., middle trapezius – mean of 0.97), smaller Coefficient of Variation and Standard Error of Measurement ranges compared to maximal contractions (ICC values, e.g. for middle trapezius – mean of 0.94) in both groups. The same pattern was observed for between-days analyses, with submaximal contractions presenting higher ICC values (e.g., middle trapezius – mean of 0.84), smaller Coefficient of Variation and Standard Error of Measurement ranges than maximal contractions (ICC values, e.g. for middle trapezius – mean of 0.73) in both groups. Conclusion Submaximal contractions are recommended for normalization procedures of trapezius sEMG, in both subjects with neck-shoulder pain and healthy individuals.
Collapse
|
6
|
Mullaney MJ, Perkinson C, Kremenic I, Tyler TF, Orishimo K, Johnson C. EMG OF SHOULDER MUSCLES DURING REACTIVE ISOMETRIC ELASTIC RESISTANCE EXERCISES. Int J Sports Phys Ther 2017; 12:417-424. [PMID: 28593096 PMCID: PMC5455191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Traditionally, shoulder isometrics are introduced in the early stages of shoulder rehabilitation. A patient's isometric torque output is based on a subjective perception of force generation. By utilizing elastic resistance elongation (strain) to standardize force output, clinicians could prescribe shoulder therapeutic isometrics based on % maximum voluntary contraction (%MVC). PURPOSE/HYPOTHESIS The purpose of this study was to measure electromyographic (EMG) activity and determine the %MVC during shoulder flexion, external rotation and abduction isometrics at varying lengths of TheraBand® elastic resistance. It was hypothesized that increased elongation of progressive resistance bands would proportionately increase the %MVC of the shoulder musculature. STUDY DESIGN Laboratory design using healthy subjects. METHODS Eight healthy subjects (16 shoulders) (5 females, 3 males; avg. age 29.2) were tested. Surface EMG electrodes were placed over the anterior deltoid, middle deltoid, and infraspinatus muscles. A force transducer was anchored to a stable surface with its corresponding end in series with an extremity strap securely holding the elastic band. Subjects were asked to maintain shoulder position for the proper isometric contraction (flexion, abduction and external rotation) while taking incremental steps away from the anchored elastic resistance, to the beat of a metronome to clearly marked distances on the floor (50, 100, 150, 200 and 250% of band elongation). This was repeated with yellow, red, green, and blue TheraBand® resistance levels. Maximum voluntary contractions for both force and EMG were collected for each subject in all three test positions. EMG data were normalized and expressed as a %MVC. RESULTS For external rotation and flexion, the infraspinatus and anterior deltoid activity increased with band elongation (p<0.01) and progressive colors (p<0.01). The increases in EMG activity with elongation plateaued with the yellow and red bands but continued to increase with the green and blue bands (p<0.01). The increase in infraspinatus and anterior deltoid EMG activity with progressive band color was more apparent for green and blue bands compared with yellow and red band (p<0.01). For the abduction exercise, middle deltoid activity increased with band elongation (p<0.01) and progressive color (p<0.01). In all three exercises, there was an increase in force exerted by the band with increasing length and band color (p < 0.001). However, while there were clear increases in force from red to green to blue, there was no difference in force between yellow and red regardless of elongation (p<0.01). CONCLUSION Isometric flexion, external rotation and abduction muscle activity can be accurately prescribed clinically by adjusting the elongation and resistance associated with progressive colors of resistance bands. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- Michael J. Mullaney
- Nicholas Institute of Sports Medicine and Athletic Trauma Lenox Hill Hospital, New York, NY, USA
| | - Christine Perkinson
- Nicholas Institute of Sports Medicine and Athletic Trauma Lenox Hill Hospital, New York, NY, USA
| | - Ian Kremenic
- Nicholas Institute of Sports Medicine and Athletic Trauma Lenox Hill Hospital, New York, NY, USA
| | - Timothy F. Tyler
- Nicholas Institute of Sports Medicine and Athletic Trauma Lenox Hill Hospital, New York, NY, USA
| | - Karl Orishimo
- Nicholas Institute of Sports Medicine and Athletic Trauma Lenox Hill Hospital, New York, NY, USA
| | - Christopher Johnson
- Nicholas Institute of Sports Medicine and Athletic Trauma Lenox Hill Hospital, New York, NY, USA
| |
Collapse
|
7
|
Alizadehkhaiyat O, Hawkes DH, Kemp GJ, Frostick SP. Electromyographic Analysis of the Shoulder Girdle Musculature During External Rotation Exercises. Orthop J Sports Med 2015; 3:2325967115613988. [PMID: 26740950 PMCID: PMC4687830 DOI: 10.1177/2325967115613988] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Implementation of overhead activity, a key component of many professional sports, requires an effective and balanced activation of the shoulder girdle muscles, particularly during forceful external rotation (ER) motions. Purpose: To identify activation strategies of 16 shoulder girdle muscles/muscle segments during common shoulder ER exercises. Study Design: Descriptive laboratory study. Method: Thirty healthy subjects were included in this study, and 16 shoulder girdle muscles/muscle segments were investigated (surface electrode: anterior, middle, and posterior deltoid; upper, middle, and lower trapezius; serratus anterior; teres major; upper and lower latissimus dorsi; and upper and lower pectoralis major; fine wire electrodes: supraspinatus, infraspinatus, subscapularis, and rhomboid major) using a telemetric electromyography (EMG) system. Five ER exercises (standing ER at 0° and 90° of abduction, with underarm towel roll, prone ER at 90° of abduction, side-lying ER with underarm towel) were studied. Exercise EMG amplitudes were normalized to EMG at maximum ER force in a standard position. Univariate analysis of variance and post hoc analysis applied on EMG activity of each muscle were used to assess the main effect of the exercise condition. Results: Muscular activity differed significantly among the ER exercises (P < .05 to P < .001). The greatest activation for anterior and middle deltoid, supraspinatus, upper trapezius, and serratus anterior occurred during standing ER at 90° of abduction; for posterior deltoid, middle trapezius, and rhomboid during side-lying ER with underarm towel; for lower trapezius, upper and lower latissimus dorsi, subscapularis, and teres major during prone ER at 90° of abduction; and for the clavicular and sternal part of the pectoralis major during standing ER with underarm towel. Conclusion: Key glenohumeral and scapular muscles can be optimally activated during specific ER exercises, particularly in positions that stimulate athletic overhead motions. Clinical Relevance: These results enable sports medicine professionals to target specific muscles during shoulder rehabilitation protocols while minimizing the effect of others, providing a foundation for optimal evidence-based exercise prescription. They also provide information for tailored muscle training and injury prevention in overhead sports.
Collapse
Affiliation(s)
| | - David H Hawkes
- Musculoskeletal Science Research Group, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Graham J Kemp
- Department of Musculoskeletal Biology II, Institute of Ageing & Chronic Disease, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Simon P Frostick
- Musculoskeletal Science Research Group, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| |
Collapse
|
8
|
Alizadehkhaiyat O, Hawkes DH, Kemp GJ, Frostick SP. ELECTROMYOGRAPHIC ANALYSIS OF SHOULDER GIRDLE MUSCLES DURING COMMON INTERNAL ROTATION EXERCISES. Int J Sports Phys Ther 2015; 10:645-654. [PMID: 26491615 PMCID: PMC4595918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND High level throwing performance requires the development of effective muscle activation within shoulder girdle muscles particularly during forceful internal rotation (IR) motions. STUDY DESIGN Controlled Laboratory Descriptive Study. PURPOSE To investigate activation pattern of 16 shoulder girdle muscles/muscle sub-regions during three common shoulder IR exercises. METHODS EMG was recorded in 30 healthy subjects from 16 shoulder girdle muscles/muscle sub-regions (surface electrode: anterior, middle and posterior deltoid, upper, middle and lower trapezius, serratus anterior, teres major, upper and lower latissimus dorsi, upper and lower pectoralis major; fine wire electrodes: supraspinatus, infraspinatus, subscapularis and rhomboid major) using a telemetric EMG system. Three IR exercises (standing IR at 0° and 90° of Abduction, and IR at Zero-Position) were studied. EMG amplitudes were normalized to EMGmax (EMG at maximal IR force in a standard position) and compared using one-way repeated-measures analysis of variance (ANOVA). RESULTS There were significant differences in muscles' activation across IR exercises (p<0.05-p<0.001). Rotator cuff and deltoid muscles were highly activated during IR at 90° of Abduction. Latissimus dorsi exhibited markedly higher activation during IR at Zero-Position. While upper trapezius had the highest activation during IR at Zero-Position, middle and lower trapezius were activated at highest during IR at 90° of Abduction. The highest activation of serratus anterior and rhomboid major occurred in IR at Zero-Position and IR at 90° of Abduction, respectively. CONCLUSIONS Studied exercises have the potential to effectively activate glenohumeral and scapular muscles involved in throwing motions. Results provide further evidence for developing rehabilitation, injury prevention, and training strategies. LEVEL OF EVIDENCE 4, Controlled laboratory study.
Collapse
Affiliation(s)
- Omid Alizadehkhaiyat
- School of Health Sciences (Sport and Exercise Science), Liverpool Hope University, Liverpool, UK
| | - David H. Hawkes
- Musculoskeletal Science Research Group, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Graham J. Kemp
- Department of Musculoskeletal Biology II, Institute of Ageing & Chronic Disease, Faculty of Health & Life Sciences, University of Liverpool, UK
| | - Simon P. Frostick
- Musculoskeletal Science Research Group, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| |
Collapse
|