1
|
Yassin MM, Saad MN, Khalifa AM, Said AM. Advancing clinical understanding of surface electromyography biofeedback: bridging research, teaching, and commercial applications. Expert Rev Med Devices 2024; 21:709-726. [PMID: 38967375 DOI: 10.1080/17434440.2024.2376699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 07/02/2024] [Indexed: 07/06/2024]
Abstract
INTRODUCTION Expanding the use of surface electromyography-biofeedback (EMG-BF) devices in different therapeutic settings highlights the gradually evolving role of visualizing muscle activity in the rehabilitation process. This review evaluates their concepts, uses, and trends, combining evidence-based research. AREAS COVERED This review dissects the anatomy of EMG-BF systems, emphasizing their transformative integration with machine-learning (ML) and deep-learning (DL) paradigms. Advances such as the application of sophisticated DL architectures for high-density EMG data interpretation, optimization techniques for heightened DL model performance, and the fusion of EMG with electroencephalogram (EEG) signals have been spotlighted for enhancing biomechanical analyses in rehabilitation. The literature survey also categorizes EMG-BF devices based on functionality and clinical usage, supported by insights from commercial sectors. EXPERT OPINION The current landscape of EMG-BF is rapidly evolving, chiefly propelled by innovations in artificial intelligence (AI). The incorporation of ML and DL into EMG-BF systems augments their accuracy, reliability, and scope, marking a leap in patient care. Despite challenges in model interpretability and signal noise, ongoing research promises to address these complexities, refining biofeedback modalities. The integration of AI not only predicts patient-specific recovery timelines but also tailors therapeutic interventions, heralding a new era of personalized medicine in rehabilitation and emotional detection.
Collapse
Affiliation(s)
- Mazen M Yassin
- School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, China
- Biomedical Engineering Department, Faculty of Engineering, Minia University, Minia, Egypt
- Department of Biomedical Engineering, Helwan University, Cairo, Egypt
| | - Mohamed N Saad
- Biomedical Engineering Department, Faculty of Engineering, Minia University, Minia, Egypt
| | - Ayman M Khalifa
- Department of Biomedical Engineering, Helwan University, Cairo, Egypt
| | - Ashraf M Said
- Biomedical Engineering Program, Electrical Engineering Department, Benha Faculty of Engineering, Benha University, Al Qalyubiyah, Egypt
| |
Collapse
|
2
|
Cai S, Lin Y, Chen H, Huang Z, Zhou Y, Zheng Y. Automated analysis of pectoralis major thickness in pec-fly exercises: evolving from manual measurement to deep learning techniques. Vis Comput Ind Biomed Art 2024; 7:8. [PMID: 38625580 PMCID: PMC11021386 DOI: 10.1186/s42492-024-00159-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/22/2024] [Indexed: 04/17/2024] Open
Abstract
This study addresses a limitation of prior research on pectoralis major (PMaj) thickness changes during the pectoralis fly exercise using a wearable ultrasound imaging setup. Although previous studies used manual measurement and subjective evaluation, it is important to acknowledge the subsequent limitations of automating widespread applications. We then employed a deep learning model for image segmentation and automated measurement to solve the problem and study the additional quantitative supplementary information that could be provided. Our results revealed increased PMaj thickness changes in the coronal plane within the probe detection region when real-time ultrasound imaging (RUSI) visual biofeedback was incorporated, regardless of load intensity (50% or 80% of one-repetition maximum). Additionally, participants showed uniform thickness changes in the PMaj in response to enhanced RUSI biofeedback. Notably, the differences in PMaj thickness changes between load intensities were reduced by RUSI biofeedback, suggesting altered muscle activation strategies. We identified the optimal measurement location for the maximal PMaj thickness close to the rib end and emphasized the lightweight applicability of our model for fitness training and muscle assessment. Further studies can refine load intensities, investigate diverse parameters, and employ different network models to enhance accuracy. This study contributes to our understanding of the effects of muscle physiology and exercise training.
Collapse
Affiliation(s)
- Shangyu Cai
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China
| | - Yongsheng Lin
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China
| | - Haoxin Chen
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China
| | - Zihao Huang
- Department of Biomedical Engineering, the Hong Kong Polytechnic University, Hong Kong, 999077, China
| | - Yongjin Zhou
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China.
| | - Yongping Zheng
- Department of Biomedical Engineering, the Hong Kong Polytechnic University, Hong Kong, 999077, China.
| |
Collapse
|
3
|
Yu IY, Ko MJ, Oh JS. The effects of biofeedback training for efficient activation of infraspinatus on proprioception and EMG activity during shoulder external rotation. J Electromyogr Kinesiol 2023; 71:102798. [PMID: 37399603 DOI: 10.1016/j.jelekin.2023.102798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/08/2023] [Accepted: 06/26/2023] [Indexed: 07/05/2023] Open
Abstract
The purpose of this study investigated which biofeedback (BF) training enables efficient activation of the infraspinatus muscle that affect joint position sense (JPS) and force sense (FS) of the shoulder joint. Twenty healthy males participated and performed three external rotation (ER) exercises under three randomly assigned training conditions: 1) non-biofeedback (NBF), 2) BF and 3) force biofeedback (FBF). Each exercise was performed at intervals of one week between training conditions. After performed the ER exercise under each training condition, the relative error (RE) was calculated at shoulder ER 45° and 80°, and then shoulder ER force were measured to determine the JPS error and FS error, respectively. Muscle activity of infraspinatus and posterior deltoid were measured and compared between training conditions. The RE of shoulder ER 45° and 80° were significantly lower under the FBF conditions than other training conditions (P < 0.05). The RE of shoulder ER force were also significantly lower under the FBF conditions compared to those under the other training conditions (P < 0.05). The activity of the infraspinatus muscle was significantly higher under the FBF conditions during all three ER exercises than other training conditions (p < 0.05). We suggest that BF trainings can be useful to improve the proprioception of shoulder joint as well as activation of infraspinatus muscle while performing the ER exercises.
Collapse
Affiliation(s)
- Il-Young Yu
- Department of Rehabilitation Center, Dang Dang Korean Medicine Hospital, Changwon, Republic of Korea.
| | - Min-Joo Ko
- Department of Physical Therapy, INJE university, Gimhae, Republic of Korea.
| | - Jae-Seop Oh
- Department of Physical Therapy, College of Biomedical Science and Engineering, INJE University, Gimhae, Republic of Korea.
| |
Collapse
|
4
|
Hayek R, Gottlieb U, Gutman I, Springer S. Peroneal muscle response to single-leg drop-jump and unexpected leg-drop in young and middle-aged adults before and after one session of neuromuscular training. Eur Rev Aging Phys Act 2023; 20:11. [PMID: 37330500 DOI: 10.1186/s11556-023-00321-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 06/11/2023] [Indexed: 06/19/2023] Open
Abstract
BACKGROUND Changes in neuromuscular ability in middle age (MA) may lead to deterioration of postural control. The aim of this study was to investigate the anticipatory response of the peroneus longus muscle (PL) to landing after a single-leg drop-jump (SLDJ), and its postural response after an unexpected leg-drop in MA and young adults. A second aim was to investigate the influence of neuromuscular training on PL postural responses in both age groups. METHODS Twenty-six healthy MA (55.3 ± 4 years) and 26 healthy young adults (26.3 ± 3.6 years) participated in the study. Assessments were performed before (T0) and after (T1) PL EMG biofeedback (BF) neuromuscular training. Subjects performed SLDJ, and PL EMG activity in preparation for landing (% of flight time) was calculated. To measure PL time to activation onset and time to peak activation in response to an unexpected leg-drop, subjects stood on a customized trapdoor device that produced a sudden 30° ankle inversion. RESULTS Before training, the MA group showed significantly shorter PL activity in preparation for landing compared to the young adults (25.0% vs. 30.0%, p = 0.016), while after training there was no difference between the groups (28.0% vs. 29.0%, p = 0.387). There were no differences between groups in peroneal activity after the unexpected leg-drop before and after training. CONCLUSIONS Our results suggest that automatic anticipatory peroneal postural responses are decreased at MA, whereas reflexive postural responses appear to be intact in this age group. A short PL EMG-BF neuromuscular training may have an immediate positive effect on PL muscle activity at MA. This should encourage the development of specific interventions to ensure better postural control in this group. TRIAL REGISTRATION ClinicalTrials.gov NCT05006547.
Collapse
Affiliation(s)
- Roee Hayek
- Faculty of Health Sciences, Department of Physical Therapy, The Neuromuscular & Human Performance Laboratory, Ariel University, Medicine and Health Science Building, Rm 30, 40700, Ariel, Israel
| | - Uri Gottlieb
- Faculty of Health Sciences, Department of Physical Therapy, The Neuromuscular & Human Performance Laboratory, Ariel University, Medicine and Health Science Building, Rm 30, 40700, Ariel, Israel
| | - Itai Gutman
- Faculty of Health Sciences, Department of Physical Therapy, The Neuromuscular & Human Performance Laboratory, Ariel University, Medicine and Health Science Building, Rm 30, 40700, Ariel, Israel
| | - Shmuel Springer
- Faculty of Health Sciences, Department of Physical Therapy, The Neuromuscular & Human Performance Laboratory, Ariel University, Medicine and Health Science Building, Rm 30, 40700, Ariel, Israel.
| |
Collapse
|
5
|
Futami K, Seki T, Murao K. Unconscious load changer: Designing method to subtly influence load perception by simply presenting modified myoelectricity sensor information. FRONTIERS IN COMPUTER SCIENCE 2022. [DOI: 10.3389/fcomp.2022.914525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Systems of presenting myoelectricity sensor information allow users to understand the body's load for various purposes, such as medical rehabilitation and sports training. If there is a method to create the psychological phenomenon of unconsciously increasing or decreasing a user's load perception simply by changing how to present the myoelectricity sensor values, it will help design a more effective system. Therefore, we propose a method to manipulate load perception by presenting modified myoelectricity sensor information. The proposed method aims to induce higher or lower load perception by modifying the actual myoelectric value to a higher or lower value. We implemented a prototype system and evaluated our method for the two types of load perception of weight perception and fatigue perception when handling objects. The result showed that most subjects unconsciously increased or decreased their load perception to match the presented myoelectric value, while the minority subjects got the opposite response from the majority subjects. This result indicates the feasibility of user assistance systems that use this phenomenon for a good purpose, such as systems that slightly reduce the load perception during physical activity. On the other hand, this result also indicates the feasibility of systems that use this phenomenon for a bad purpose, such as systems that increase user's fatigue to harm user's activity. This study provides helpful findings for designing and using sensor information presentation systems considering the psychological phenomenon.
Collapse
|
6
|
Riek LM, Pfohl K, Zajac J. Using biofeedback to optimize scapular muscle activation ratios during a seated resisted scaption exercise. J Electromyogr Kinesiol 2022; 63:102647. [DOI: 10.1016/j.jelekin.2022.102647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 02/13/2022] [Accepted: 02/18/2022] [Indexed: 10/19/2022] Open
|
7
|
Huang ZH, Ma CZH, Wang LK, Wang XY, Fu SN, Zheng YP. Real-Time Visual Biofeedback via Wearable Ultrasound Imaging Can Enhance the Muscle Contraction Training Outcome of Young Adults. J Strength Cond Res 2022; 36:941-947. [PMID: 35319000 PMCID: PMC8936156 DOI: 10.1519/jsc.0000000000004230] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Huang, Z-H, Ma, CZ-H, Wang, L-K, Wang, X-Y, Fu, S-N, and Zheng, Y-P. Real-time visual biofeedback via wearable ultrasound imaging can enhance the muscle contraction training outcome of young adults. J Strength Cond Res 36(4): 941-947, 2022-Real-time ultrasound imaging (RUSI) can serve as visual biofeedback to train deep muscle contraction in clinical rehabilitative settings. However, its effectiveness in resistance training in sports/fitness fields remains unexplored. This article introduced a newly developed wearable RUSI system that provided visual biofeedback of muscle thickening and movement and reported its effectiveness in improving the training outcomes of muscle thickness change (%) during dynamic contraction. Twenty-five healthy young men participated and performed pec fly exercise both with and without RUSI biofeedback. Statistical analysis was conducted to examine the reliability of the measurements and the immediate effects of (a) RUSI biofeedback of muscle contraction and (b) training intensity (50 vs. 80% of 1-repetition maximum [1RM]) on the pectoralis major (PMaj) thickness change measured by ultrasound images. In addition to significantly high inter-contraction reliability (ICC3,1 > 0.97), we observed significantly increased PMaj thickness change for both training intensities upon receiving biofeedback in subjects, compared with without biofeedback (p < 0.001). We also observed significantly larger PMaj thickness change at 80% of 1RM compared with 50% of 1RM (p = 0.023). The provision of visual biofeedback using RUSI significantly enlarged the magnitude of PMaj thickness change during pec fly exercises, potentially indicating that RUSI biofeedback could improve the ability of targeted muscle contraction of PMaj in healthy young adults. To our knowledge, this study has pioneered in applying RUSI as a form of biofeedback during weight training and observed positive effectiveness. Future iterations of the technique will benefit more subject groups, such as athletes and patients with neuromuscular disorders.
Collapse
Affiliation(s)
- Zi-Hao Huang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Christina Z.-H. Ma
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Li-Ke Wang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Xiao-Yun Wang
- Guangdong Work Injury Rehabilitation Center, Guangzhou, China; and
| | - Siu-Ngor Fu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| |
Collapse
|
8
|
Broilo C, Schuster RC, Dhein W. Análise eletromiográfica de músculos do complexo do ombro durante exercícios de rotação externa com faixa elástica. FISIOTERAPIA E PESQUISA 2019. [DOI: 10.1590/1809-2950/19004126032019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
RESUMO Na artrocinemática do ombro, o manguito rotador atua estabilizando a cabeça umeral em contato com a cavidade glenoidal, enquanto realiza a translação inferior para contrabalancear a força rotacional promovida principalmente pelo deltoide. Exercícios de rotação externa (RE) vêm sendo utilizados na reabilitação de pacientes com disfunções no complexo do ombro buscando restaurar a artrocinemática. Porém, poucos estudos abordam a utilização da faixa elástica e a avaliação dos músculos da cintura escapular, determinantes para uma cinemática adequada. O objetivo deste estudo é comparar a atividade eletromiográfica (EMG) de músculos do complexo do ombro durante exercícios de rotação externa com faixa elástica. Participaram 11 sujeitos do sexo masculino que foram avaliados durante os movimentos de (1) RE em ortostase; (2) RE com abdução de ombro; (3) RE em decúbito lateral (DL). Os músculos avaliados pela EMG foram: (1) trapézio superior (TS); (2) deltoide médio (DM); (3) deltoide posterior (DP); e (4) infraespinal (IN). A resistência foi determinada por uma faixa elástica cinza calibrada com carga de 5% do peso corporal. A análise dos dados foi realizada no software Biomec-SAS e as estatísticas foram calculadas por meio da Anova de medidas repetidas no software SPSS v20.0. Pôde-se constatar que os músculos TS e DM obtiveram maior atividade EMG durante o exercício de RE com abdução de ombro, o músculo DP durante a RE com abdução de ombro e RE em decúbito lateral, enquanto o IN a obteve durante a RE em ortostase e RE em decúbito lateral.
Collapse
|
9
|
Effects of 3 Infraspinatus Muscle Strengthening Exercises on Isokinetic Peak Torque and Muscle Activity. J Sport Rehabil 2019; 28:229-235. [PMID: 28952870 DOI: 10.1123/jsr.2017-0110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
CONTEXT The infraspinatus muscle plays a particularly important role in producing primary external rotation (ER) torque and dynamic stability of the shoulder joint. Previous studies have reported that prone external rotation with horizontal abduction (PER), side-lying wiper exercise (SWE), and standing external rotation (STER) were effective exercises for strengthening the infraspinatus. However, we do not have enough knowledge about changes in muscle strength and dynamic muscle activity in each exercise under dynamic conditions. OBJECTIVE To compare the ER muscle strength, muscle activity among exercise methods and between muscle contraction types during 3 different exercises. DESIGN Repeated measures design in which ER muscle strength and muscle activities data were collected from subjects under 3 exercise conditions. SETTING Outpatient clinic. PARTICIPANTS A total of 15 healthy men with no shoulder, neck, or upper-extremity pain were participated. INTERVENTION The subjects performed 3 different exercises randomly in concentric and eccentric using a Biodex dynamometer at an angular velocity of 60°/s. MAIN OUTCOME MEASURES The ER peak torque (PT) data was collected and surface electromyography was used to measure the activity of the infraspinatus and posterior deltoid muscles and infraspinatus to posterior deltoid muscle activity ratio. RESULTS There was significant main effect for muscle contraction type in ER PT (P < .05). The concentric PT was greater during PER (P < .05) and SWE (P < .05) compared with eccentric. The main effect for exercise was found in ER PT and muscle activity (P < .05). The ER PT and infraspinatus muscle activity were the largest increased during PER whereas the lowest during STER in both concentric and eccentric (P < .05). CONCLUSION The results of this study suggest that PER is an exercise for strengthening the infraspinatus muscle effectively.
Collapse
|
10
|
Forbush SW, Bandy WD, Garrison MK, Graves LC, Roberts R. TESTING INFRASPINATUS AND DELTOID MUSCLES WITH NEW TECHNIQUE TO DECREASE DELTOID ACTIVITY DURING TESTING USING EMG ANALYSIS. Int J Sports Phys Ther 2018; 13:896-904. [PMID: 30276022 PMCID: PMC6159494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Muscle strength testing of an injured infraspinatus muscle (IM) is confounded by actions of synergistic muscles such as the posterior deltoid (PD). HYPOTHESIS/PURPOSE The purpose of this study was to describe a condition for testing of the IM that results in less EMG activity of the PD musculature. The researchers hypothesized that greater inhibition of the PD could be achieved through active adduction (AA), creating reciprocal inhibition of the PD. STUDY DESIGN Prospective cohort descriptive study. METHODS Thirty-four (19 females and 15 males) right-handed subjects between the ages of 22- 31 (mean 24.2 years + /- 6.2) with no previous history of shoulder surgery or pathology participated. Surface electrodes were placed over the muscle bellies of the IM and PD of the right shoulder along with a ground electrode over the C7 spinous process. EMG activity was recorded during resisted external rotation in four different testing conditions (seated active and passive adduction, and side-lying active and passive adduction). The order of test positions was randomly assigned, and each subject completed all four positions with appropriate rest. During AA conditions, subjects were asked to adduct the humerus against a sphygmomanometer (using 80% maximum force output) while maximal effort external rotation was manually resisted. RESULTS PD activity was significantly less during AA than with no AA (p<0.05) in both test positions. No significant difference occurred between IM EMG activity in the various test conditions. CONCLUSION The results of this study suggest that clinicians can reduce activity of the PD without reducing activity of the IM by using AA of the humerus before applying manual resistance to test the IM during manual muscle testing. LEVELS OF EVIDENCE 1b.
Collapse
|
11
|
Yu IY, Choo YK, Kim MH, Oh JS. The effects of pressure biofeedback training on infraspinatus muscle activity and muscle thickness. J Electromyogr Kinesiol 2018; 39:81-88. [DOI: 10.1016/j.jelekin.2018.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/30/2017] [Accepted: 01/17/2018] [Indexed: 11/30/2022] Open
|
12
|
Jaggi A, Alexander S. Rehabilitation for Shoulder Instability - Current Approaches. Open Orthop J 2017; 11:957-971. [PMID: 28979601 PMCID: PMC5611703 DOI: 10.2174/1874325001711010957] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 10/24/2016] [Accepted: 10/28/2016] [Indexed: 11/22/2022] Open
Abstract
Background: The shoulder relies predominantly on dynamic muscular control to provide stability. Successful treatment is highly dependent upon the correct clinical diagnosis, identification of anatomical structural defects and abnormal movement patterns so that rehabilitation programs can be designed accordingly and individualised to the patient. Method: A systematic outline is provided to guide the clinician on how to identify muscular insufficiencies both local to the shoulder joint and global muscles that can influence shoulder instability. Management is based on expert experience and current literature. Results: The Stanmore classification helps to correctly diagnose the type of instability and prioritise management. Symptom modification tests can help to guide management, however assessing individual muscle groups local to glenohumeral control is also recommended. Conclusion: Physical and psychosocial factors can influence motor control in the presence of pain and injury. A multi-disciplinary approach is required to avoid recurrence of symptoms with rehabilitation focusing on kinetic chain, scapular and gleno-humeral control.
Collapse
Affiliation(s)
- Anju Jaggi
- RNOHT - Therapies Dept Brockley Hill Stanmore Middlesex Stanmore HA7 4LP United Kingdom
| | - Susan Alexander
- RNOHT - Therapies Dept Brockley Hill Stanmore Middlesex Stanmore HA7 4LP United Kingdom
| |
Collapse
|
13
|
Kim DH, Kim TH. Effect of axial shoulder external rotation exercise in side-lying using visual feedback on shoulder external rotators. J Phys Ther Sci 2017; 29:1723-1725. [PMID: 29184277 PMCID: PMC5683998 DOI: 10.1589/jpts.29.1723] [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: 05/17/2017] [Accepted: 06/26/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to determine effectiveness of axial side-lying wiper exercise using the visual feedback with a laser pointer on infraspinatus and posterior deltoid muscles. [Subjects and Methods] The subjects were 22 healthy adults (18 males, 4 females) in their 20s who consented to participate in the present study. Surface Electromyography was used to measure the infraspinatus and posterior deltoid muscle activity before and after an intervention. The intervention consisted of performing side-lying wiper exercise with a 1-kg dumbbell and a ruled paper for 30 minutes. [Results] The infraspinatus illustrated significantly increased muscle activity after intervention. The posterior deltoid also showed increased activity after intervention but it was not significant. [Conclusion] Axial side-lying wiper exercise using the visual feedback has the therapeutic effectiveness for the selective infraspinatus muscle strengthening. Therefore it can be useful to provide shoulder movements with stability.
Collapse
Affiliation(s)
- Dong Hyun Kim
- Department of Physical Therapy, College of Rehabilitation Sciences, Daegu University: 201 Daegudae-ro, Gyeongsan-si, Gyeongsangbuk-do 38453, Republic of Korea
| | - Tae Ho Kim
- Department of Physical Therapy, College of Rehabilitation Sciences, Daegu University: 201 Daegudae-ro, Gyeongsan-si, Gyeongsangbuk-do 38453, Republic of Korea
| |
Collapse
|
14
|
Mehlhorn AT, Walther M, Yilmaz T, Gunst L, Hirschmüller A, Südkamp NP, Schmal H. Dynamic plantar pressure distribution, strength capacity and postural control after Lisfranc fracture-dislocation. Gait Posture 2017; 52:332-337. [PMID: 28043054 DOI: 10.1016/j.gaitpost.2016.11.043] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 11/22/2016] [Accepted: 11/27/2016] [Indexed: 02/02/2023]
Abstract
Substantial progress has been made in the operative treatment of Lisfranc fractures, however, the prognosis remains poor. We hypothesized that Lisfranc injuries change the postural control and muscle strength of the lower limb. Both are suggested to correlate with the clinical outcome and quality of life. 17 consecutive patients suffering from a Lisfranc fracture dislocation were registered, underwent open reduction and internal fixation and were followed-up for 50.5±25.7months (Mean±SDM). Biomechanical analysis of muscle strength capacities, postural control and plantar pressure distribution was assessed >6 month postoperatively. Results were correlated to clinical outcome (AOFAS, FFI, Pain, SF-36). The isokinetic assessment revealed a significant reduction in plantar flexor and dorsal extensor peak torque of the injured limb compared to the uninjured limb. The dorsal extensor peak torque thereby correlated well with clinical outcome. Altered postural control was evident by a significant reduction in unilateral stance time, from which we calculated a strong correlation between stance time and the isokinetic strength measurement. Plantar pressure measurements revealed a significant reduction in peak pressure under the midfoot and of Force-Time Integral beneath the second metatarsal. Sufficient rehabilitation is crucial to the clinical outcome following anatomical open reduction of Lisfranc fracture-dislocation. The present study supports a rehabilitation approach focussing on restoring proprioception and calf muscular strength including isometric exercises of the dorsal extensors.
Collapse
Affiliation(s)
- Alexander T Mehlhorn
- Department of Orthopedic and Trauma Surgery, University Medical Center, Hugstetterstraße 55, 79106, Freiburg, Germany; Center of Foot and Ankle Surgery, Schön Klinik München Harlaching, Harlachingerstraße 51, 81547, Munich, Germany.
| | - Markus Walther
- Center of Foot and Ankle Surgery, Schön Klinik München Harlaching, Harlachingerstraße 51, 81547, Munich, Germany
| | - Tayfun Yilmaz
- Department of Orthopedic and Trauma Surgery, University Medical Center, Hugstetterstraße 55, 79106, Freiburg, Germany
| | - Lennart Gunst
- Department of Orthopedic and Trauma Surgery, University Medical Center, Hugstetterstraße 55, 79106, Freiburg, Germany
| | - Anja Hirschmüller
- Department of Orthopedic and Trauma Surgery, University Medical Center, Hugstetterstraße 55, 79106, Freiburg, Germany
| | - Norbert P Südkamp
- Department of Orthopedic and Trauma Surgery, University Medical Center, Hugstetterstraße 55, 79106, Freiburg, Germany
| | - Hagen Schmal
- Department of Orthopedic and Trauma Surgery, University Medical Center, Hugstetterstraße 55, 79106, Freiburg, Germany; Department of Orthopedics and Traumatology, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Sdr. Boulevard 29, 500 Odense C, Denmark
| |
Collapse
|
15
|
Jo ME, Lee SM, Jang JH, Lee SY. The influence of various resistance loads on the ratio of activity of the external rotator muscles of the shoulder and the anterior gliding of the humeral head during external rotation exercise. J Phys Ther Sci 2015; 27:3241-3. [PMID: 26644683 PMCID: PMC4668174 DOI: 10.1589/jpts.27.3241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 07/23/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To quantify the ratio of activation of the infraspinatus and posterior deltoid muscles and the anterior gliding motion of the humeral head during external rotation (ER) motions of the shoulder performed in prone position against different external resistance loads. [Subjects] Twenty healthy women between the ages of 20 and 30 years. [Methods] Activity ratio was quantified as the difference in the root mean square of the smoothed electromyography signal (EMG) of the posterior deltoid to the infraspinatus muscle, and anterior gliding pressure of the humeral head using a pressure biofeedback unit (PBU), for three resistance loads: 0, 1 and 2 kg. [Results] There was a significant correlation among all three variables (load, ratio, and pressure). Anterior gliding pressure correlated with the activity ratio, with activity of the posterior deltoid increasing with the magnitude of the resistance load. [Conclusion] There was a positive association between the magnitude of resistance load, activity of the posterior deltoid and anterior gliding pressure of the humeral head. The PBU could be used to facilitate the recruitment of the infraspinatus muscle at higher loads to improve glenohumeral joint stability during ER exercise against higher resistance.
Collapse
Affiliation(s)
- Marg-Eun Jo
- Department of Physical Therapy, Graduate School of Clinical Pharmacy and Health, Kyungsung University, Republic of Korea
| | - Seung-Min Lee
- Department of Physical Therapy, Graduate School of Clinical Pharmacy and Health, Kyungsung University, Republic of Korea
| | - Jun-Hyeok Jang
- Department of Physical Therapy, Haeundae Jaseng Hospital of Oriental Medicine, Republic of Korea
| | - Sang-Yeol Lee
- Department of Physical Therapy, College of Health Science, Kyungsung University, Republic of Korea
| |
Collapse
|
16
|
Feeley BT. CORR Insights(®): What is the Best Clinical Test for Assessment of the Teres Minor in Massive Rotator Cuff Tears? Clin Orthop Relat Res 2015; 473:2967-8. [PMID: 26100259 PMCID: PMC4523546 DOI: 10.1007/s11999-015-4420-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 06/16/2015] [Indexed: 01/31/2023]
Affiliation(s)
- Brian T Feeley
- Department of Orthopaedic Surgery, University of California, San Francisco, 1500 Owens Street, San Francisco, CA, 94158, USA,
| |
Collapse
|