Exercises With Optimal Scapulothoracic Muscle Activation for Individuals With Paraplegia.
exercise
paraplegia
serratus anterior
surface electromyography
trapezius
Journal
Topics in spinal cord injury rehabilitation
ISSN: 1945-5763
Titre abrégé: Top Spinal Cord Inj Rehabil
Pays: United States
ID NLM: 9515174
Informations de publication
Date de publication:
2023
2023
Historique:
pmc-release:
01
03
2024
medline:
29
5
2023
pubmed:
26
5
2023
entrez:
26
5
2023
Statut:
ppublish
Résumé
Individuals with paraplegia and coexisting trunk and postural control deficits rely on their upper extremities for function, which increases the risk of shoulder pain. A multifactorial etiology of shoulder pain includes "impingement" of the supraspinatus, infraspinatus, long head of the biceps tendons, and/or subacromial bursa resulting from anatomic abnormalities, intratendinous degeneration, and altered scapulothoracic kinematics and muscle activation. Targeting serratus anterior (SA) and lower trapezius (LT) activation during exercise, as part of a comprehensive plan, minimizes impingement risk by maintaining optimal shoulder alignment and kinematics during functional activities. To prevent excessive scapular upward translation, minimizing upper trapezius (UT) to SA and LT activation is also important. To determine which exercises (1) maximally activate SA and minimize UT:SA ratio and (2) maximally activate LT and minimize UT:LT ratio. Kinematic and muscle activation data were captured from 10 individuals with paraplegia during four exercises: "T," scaption (sitting), dynamic hug, and SA punch (supine). Means and ratios were normalized by percent maximum voluntary isometric contraction (MVIC) for each muscle. One-way repeated measures analysis of variance determined significant differences in muscle activation between exercises. Exercises were rank ordered: (1) maximum SA activation: SA punch, scaption, dynamic hug, "T"; (2) maximum LT activation: "T," scaption, dynamic hug, SA punch; 3) minimum UT:SA ratio: SA punch, dynamic hug, scaption, "T"; and (4) minimum UT:LT ratio: SA punch, dynamic hug, "T," scaption. Exercise elicited statistically significant changes in percent MVIC and ratios. Post hoc analyses revealed multiple significant differences between exercises ( SA punch produced the greatest SA activation and lowest ratios. Dynamic hug also produced optimal ratios, suggesting supine exercises minimize UT activation more effectively. To isolate SA activation, individuals with impaired trunk control may want to initiate strengthening exercises in supine. Participants maximally activated the LT, but they were not able to minimize UT while upright.
Sections du résumé
Background
UNASSIGNED
Individuals with paraplegia and coexisting trunk and postural control deficits rely on their upper extremities for function, which increases the risk of shoulder pain. A multifactorial etiology of shoulder pain includes "impingement" of the supraspinatus, infraspinatus, long head of the biceps tendons, and/or subacromial bursa resulting from anatomic abnormalities, intratendinous degeneration, and altered scapulothoracic kinematics and muscle activation. Targeting serratus anterior (SA) and lower trapezius (LT) activation during exercise, as part of a comprehensive plan, minimizes impingement risk by maintaining optimal shoulder alignment and kinematics during functional activities. To prevent excessive scapular upward translation, minimizing upper trapezius (UT) to SA and LT activation is also important.
Objectives
UNASSIGNED
To determine which exercises (1) maximally activate SA and minimize UT:SA ratio and (2) maximally activate LT and minimize UT:LT ratio.
Methods
UNASSIGNED
Kinematic and muscle activation data were captured from 10 individuals with paraplegia during four exercises: "T," scaption (sitting), dynamic hug, and SA punch (supine). Means and ratios were normalized by percent maximum voluntary isometric contraction (MVIC) for each muscle. One-way repeated measures analysis of variance determined significant differences in muscle activation between exercises.
Results
UNASSIGNED
Exercises were rank ordered: (1) maximum SA activation: SA punch, scaption, dynamic hug, "T"; (2) maximum LT activation: "T," scaption, dynamic hug, SA punch; 3) minimum UT:SA ratio: SA punch, dynamic hug, scaption, "T"; and (4) minimum UT:LT ratio: SA punch, dynamic hug, "T," scaption. Exercise elicited statistically significant changes in percent MVIC and ratios. Post hoc analyses revealed multiple significant differences between exercises (
Conclusion
UNASSIGNED
SA punch produced the greatest SA activation and lowest ratios. Dynamic hug also produced optimal ratios, suggesting supine exercises minimize UT activation more effectively. To isolate SA activation, individuals with impaired trunk control may want to initiate strengthening exercises in supine. Participants maximally activated the LT, but they were not able to minimize UT while upright.
Identifiants
pubmed: 37235191
doi: 10.46292/sci21-00059
pmc: PMC10208257
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
43-55Informations de copyright
©2023 American Spinal Injury Association.
Déclaration de conflit d'intérêts
Conflicts of Interest The authors declare no conflicts of interest.
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