Effect of Isometric Hip Abduction on Foot and Ankle Muscle Activity and Medial Longitudinal Arch During Short-Foot Exercise in Individuals With Pes Planus.

CONTEXT: The improvement of hip joint stability can significantly impact knee and rearfoot mechanics. Individuals with pes planus have a weak abductor hallucis (AbdH), and the tibialis anterior (TA) may activate to compensate for this. As yet, no studies have applied isometric hip abduction (IHA) for hip stability during short-foot exercise (SFE). OBJECTIVE: To compare the effects of IHA on the muscle activity of the AbdH, TA, peroneus longus (PL), and gluteus medius (Gmed), as well as the medial longitudinal arch (MLA) angle during sitting and standing SFE. DESIGN: Two-way repeated analyses of variance were used to determine the statistical significance of AbdH, TA, PL, and Gmed electromyography activity, as well as the change in MLA angle. SETTING: University research laboratory. PARTICIPANTS: Thirty-two participants with pes planus. INTERVENTION(S): The participants performed SFE with and without isometric hip abduction in sitting and standing positions. MAIN OUTCOME MEASURES: Surface electromyography was used to measure the activity of the AbdH, TA, PL, and Gmed muscles, and Image J was used to measure the MLA angle. RESULTS: Significant interactions between exercise type and position were observed in terms of the PL muscle activity and in the change in MLA angle only, while other muscles showed significant main effects. The IHA during SFE significantly increased the AbdH muscle activity, while the TA muscle activity was significantly lower. The muscle activity of Gmed and PL was significantly increased in the standing position compared with sitting, but there was no significant difference with or without IHA. The change in the MLA angle was significantly greater in SFE with IHA in a standing position than in the other SFE conditions. CONCLUSIONS: IHA may be an effective method for reducing compensatory TA activity and increasing AbdH muscle activity during SFE for individuals with pes planus.

Validity and Reliability of an Inertial Measurement Unit-based 3-Dimensional Angular Measurement of Cervical Range of Motion.

OBJECTIVE: This study aimed to assess the reliability and validity of an inertial measurement unit (IMU)-based 3-dimensional (3D) angular measurement system for evaluating cervical range of motion. METHODS: Thirty-three healthy participants (21.9 ± 2.1 years; 162.0 ± 6.0 cm; 55.8 ± 9.0 kg; 21.2 ± 2.4 kg/m2) were evaluated. Kinematic data of the cervical joints were simultaneously obtained using the IMU 3D angular, goniometer, and photographic measurements during cervical flexion (0°, 30°, and 50°), extension (30°, 50°), side-bending (0°, 20°, 40°), and rotation (45°). Test-retest reliability was investigated in each measurement method. Concurrent validity was assessed with the direct comparison between the IMU 3D angular measurement and other methods. RESULTS: The IMU 3D angular measurement showed mostly good to high test-retest reliability with relatively small standard error of measurement and the minimal detectable change values. The concurrent validity of IMU 3D angular measurements in the cervical range of motion was mostly reasonable. However, the measurement bias between the 2 methods tended to be larger at the end range of each plane. CONCLUSION: Using the IMU 3D angular measurement in cervical spine is recommended because of its mostly good to high reliability and reasonable validity. However, using the IMU 3D angular measurement at the end range of each plane should be carefully considered owing to the poorer validity.

Effective Treatment for Chronic Ankle Instability During Lateral Step-Down-Kinesiology Tape, Resistance Exercise, or Both Accompanied With Heel Raise-Lower Exercise?

CONTEXT: Kinesiology tape (KT), multidirectional resistance exercise, and interventions for decreased ankle dorsiflexion range of motion are gaining popularity in the treatment of patients with chronic ankle instability (CAI). However, there is limited evidence of the effectiveness of combined interventions in patients with CAI. OBJECTIVES: To compare the effects of KT alone, KT with resistance exercise (KT + resistance), and KT with resistance and heel raise-lower exercise (KT + resistance + heel) on the results of the dynamic balance test (star excursion balance test [SEBT]), functional performance (lateral step-down test), and ankle muscle activation in patients with CAI. DESIGN AND SETTING: This study used a repeated-measures design in a laboratory setting. MAIN OUTCOME MEASURES: The participants completed 3 different interventions with a 24-hour rest period between interventions. The SEBT, lateral step-down test, and ankle muscle activation results were used as the outcome measures. All outcomes were assessed before and immediately after the 3 interventions. RESULTS: The results of the SEBT-anteromedial direction significantly increased with KT + resistance (78.61 [16.11] cm, P = .01, ES = 0.50) and KT + resistance + heel (76.94 [16.00] cm, P = .03, ES = 0.33) in comparison with the baseline values (73.68 [12.84] cm). Additionally, the result of the SEBT-anteromedial direction was significantly greater with KT + resistance (78.61 [16.11] cm) than with KT alone (76.00 [14.90] cm, P = .05, ES = 0.18). The number of errors during the lateral step-down test was significantly lower for the KT alone (2.16 [0.90] errors, P = .02, ES = 0.46), KT + resistance (2.10 [0.79] errors, P = .01, ES = 0.54), and KT + resistance + heel (2.03 [0.75] errors, P = .003, ES = 0.61) interventions than the baseline values (2.55 [0.85] errors). CONCLUSIONS: Patients with CAI should be encouraged to perform KT + resistance to improve balance.

Figure-8 Strap Application: Immediate Alteration of Pectoralis Minor Length and Scapular Alignment During Arm-Lifting Exercise in Participants With Forward Shoulder Posture.

CONTEXT: Scapular bracing can correct scapular kinematics and restore normal scapular-muscle activity. However, there is little evidence to support the beneficial effects of a figure-8 strap, a type of scapular bracing, on muscle length, scapular alignment, and muscle activity during arm-lifting exercise. OBJECTIVE: To investigate the immediate effect of a figure-8 strap on pectoralis minor length, scapular alignment, and scapular upward-rotator-muscle activity. DESIGN: Cross-sectional study. SETTING: Research laboratory. PARTICIPANTS: Fifteen male participants (age 22.1 ± 1.9 y, weight 68.2 ± 5.7 kg, height 176.2 ± 3.3 cm) with forward shoulder posture (FSP) were examined for pectoralis minor length and scapular alignment with and without the application of a figure-8 strap. MAIN OUTCOME MEASURES: Pectoralis minor length was measured using the Pectoralis Minor Index (PMI), scapular alignment was measured with FSP, and upper trapezius, lower trapezius, and serratus anterior muscle activity were measured using surface electromyography while participants performed an arm-lifting exercise. Data collected with and without applying a figure-8 strap were compared using a paired t-test. RESULTS: Applying a figure-8 strap significantly decreased the PMI (P = .005) and scapular anterior tilting (P = .000). There were no differences in the muscle activity of the upper trapezius (P = .784), lower trapezius (P = .241), and serratus anterior muscles (P = .639). CONCLUSIONS: A figure-8 strap resulted in positive changes in pectoralis minor length and scapular alignment. The results support its use as a treatment aid in managing pectoralis minor length and scapular alignment during arm-lifting exercises.

Comparison of pectoralis major and serratus anterior muscle activities during different push-up plus exercises in subjects with and without scapular winging.

To examine the differences between men with and without scapular winging in the electromyographic (EMG) amplitude and activity ratio between the pectoralis major (PM) and serratus anterior (SA) during 3 push-up plus exercises: (a) the standard push-up plus (SPP), (b) the knee push-up plus (KPP), and (c) the wall push-up plus (WPP), and to determine which exercise induced the lowest PM/SA ratio in each group. Twenty-eight men participated in this study (13 scapular winging group: age, 21.8 ± 2.1 years; 15 control group: age, 23.3 ± 2.0 years). Surface EMG of the PM, SA, and activity ratio between the PM and SA were collected during 3 push-up plus exercises, and the EMG data were expressed as a percentage of the reference voluntary contraction (%RVC). The normalized PM activity for subjects in the scapular winging group was significantly greater than that in the control group (79.16 ± 6.65 %RVC vs. 39.66 ± 6.19 %RVC, p ≤ 0.05). The normalized SA activity was significantly lower in the scapular winging group compared with the control group (39.80 ± 4.09 %RVC vs. 56.28 ± 3.81 %RVC, p ≤ 0.05) and was significantly decreased in the following order: SPP > KPP > WPP; 77.09 ± 5.12 %RVC > 39.48 ± 3.38 %RVC > 27.55 ± 3.07 %RVC, p < 0.016). The PM/SA EMG ratio was significantly greater in the scapular winging group compared with that in the control group across all exercises and was significantly lower during SPP than that during KPP and WPP in both groups (1.13 ± 0.58 vs. 0.53 ± 0.25 for SPP, 3.50 ± 2.07 vs. 0.92 ± 0.63 for KPP, 4.04 ± 3.13 vs. 1.19 ± 0.66 for WPP, p < 0.016). Greater PM activity was found in the scapular winging group, and the SPP is an optimal exercise for subjects with scapular winging, where maximum SA activation with minimal PM activation is desired.

Effects of different hip rotations on gluteus medius and tensor fasciae latae muscle activity during isometric side-lying hip abduction.

CONTEXT: Gluteus medius (Gmed) weakness is associated with some lower-extremity injuries. People with Gmed weakness might compensate by activating the tensor fasciae latae (TFL). Different hip rotations in the transverse plane may affect Gmed and TFL muscle activity during isometric side-lying hip abduction (SHA). OBJECTIVES: To compare Gmed and TFL muscle activity and the Gmed:TFL muscle-activity ratio during SHA exercise with 3 different hip rotations. DESIGN: The effects of different hip rotations on Gmed, TFL, and the Gmed:TFL muscle-activity ratio during isometric SHA were analyzed with 1-way, repeated-measures analysis of variance. SETTING: University research laboratory. PARTICIPANTS: 20 healthy university students were recruited in this study. INTERVENTIONS: Participants performed isometric SHA: frontal SHA with neutral hip (frontal SHAN), frontal SHA with hip medial rotation (frontal SHA-MR), and frontal SHA with hip lateral rotation (frontal SHA-LR). MAIN OUTCOME MEASURES: Surface electromyography measured the activity of the Gmed and the TFL. A 1-way repeated-measures analysis of variance assessed the statistical significance of Gmed and TFL muscle activity. When there was a significant difference, a Bonferroni adjustment was performed. RESULTS: Frontal SHA-MR showed significantly greater Gmed muscle activation than frontal SHA-N (P = .000) or frontal SHA-LR (P = .015). Frontal SHA-LR showed significantly greater TFL muscle activation than frontal SHA-N (P = .002). Frontal SHA-MR also resulted in a significantly greater Gmed:TFL muscle-activity ratio than frontal SHA-N (P = .004) or frontal SHA-LR (P = .000), and frontal SHA-N was significantly greater than frontal SHA-LR (P = .000). CONCLUSIONS: Frontal SHA-MR results in greater Gmed muscle activation and a higher Gmed:TFL muscle ratio.

Effect of Using an 8-Figure Shoulder Brace on Posture and Muscle Activities during the Performance of Dental Hygiene Procedures.

The incidence of work-related musculoskeletal disorders (MSDs) among dental workers has been increasing. Many ergonomic devices and accessories have been introduced. The aim of this study was to investigate the effects of an 8-figure shoulder brace on posture-related muscle activities in dental hygiene practitioners during scaling procedures. In this study, 33 participants (age: 21.9 ± 2.1 years, height: 162.0 ± 6.0 cm, weight: 55.8 ± 9.0 kg, body mass index: 21.2 ± 2.4 kg/m2) performed the scaling procedure with and without the 8-figure shoulder brace in a randomized order. The normalized electromyography activity in the amplitude probability distribution function and joint angles (cervical, thoracic, lumbar, and shoulder joints) were simultaneously recorded during scaling. A paired t test was used to compare the differences in muscle kinematics, with the alpha level set at 0.05. The dental hygienists who wore the 8-figure shoulder brace during scaling showed thoracic and lumbar extension, improved sitting postures, and reduced shoulder joint abduction. However, we also observed an unintended increase in internal rotation. Use of the 8-figure shoulder brace could prevent work-related MSDs in lumbar and thoracic regions by reducing the effort exerted by the upper trapezius and deltoid muscles, despite the increased muscular effort of the cervical erector spinae.

Effects of different heel-raise-lower exercise interventions on the strength of plantarflexion, balance, and gait parameters in stroke survivors.

The objective of this study was to investigate the effects of Heel-Raise-Lower Exercise (HRLE) interventions on the strength of plantarflexion, balance, and gait parameters in people with stroke. Specifically, this study compared the two different HRLEs to identify whether heels raise-lower with forefoot on a block (HRB) is more effective or ineffective to enhance strength and functional capacities than heels raise-lower on a level floor (HRL) exercise in people with stroke. Repetitive heel raise-lower is a common exercise for improving the strength and power of ankle plantarflexors. It is a simple movement, requires no equipment, and can be performed at home. Each group of 10 people with stroke was given either HRB training or HRL training. The subjects performed the exercise 100 times per day, 5 days per week for 6 weeks. The strength of plantarflexors, static/dynamic balance, and gait parameters were measured using the manual muscle test (MMT), a Biodex Balance System (BBS) SD, and the GAITRite system. After 6 weeks of treatment, there were significant increases in the plantarflexors strength in both groups: by 34% in the HRB group and by 21% in the HRL group. Static and dynamic balance and gait speed also increased significantly in both groups. However, cadence, the paretic side single limb support period (SLSP), paretic side step length, and paretic side stride length significantly increased only in the HRB group. The HRB improved significantly the plantar flexor strength of the paretic side, gait speed, and cadence compared to the HRL.

Different weight bearing push-up plus exercises with and without isometric horizontal abduction in subjects with scapular winging: A randomized trial.

The aim of the present study was to determine whether the application of isometric horizontal abduction (IHA) differentially affected two weight-bearing push-up plus exercises by examining activation of the scapulothoracic muscles in subjects with scapular winging. Fifteen male subjects performed standard push-up plus (SPP) and wall push-up plus (WPP), with and without IHA. Two-way analyses of variance using two within-subject factors were used to determine the statistical significance of observed differences in upper trapezius (UT), pectoralis major (PM), and serratus anterior (SA) muscle activities and UT/SA and PM/SA muscle activity ratios. UT and SA muscle activities were greater during SPP than WPP. PM muscle activity was lower with IHA application. The UT/SA and PM/SA muscle activity ratios were lower during SPP than WPP. The PM/SA muscle activity ratio was lower with IHA application. The results suggest that IHA application using a Thera-Band can effectively reduce PM muscle activity during SPP and WPP exercises. Moreover, the SPP exercise can be used to increase UT and SA muscle activity and reduce the UT/SA and PM/SA muscle activity ratios in subjects with scapular winging.

Wearable tubing assistive walking device immediately enhances gait parameters in subjects with stroke: A randomized controlled study.

BACKGROUND: Stroke patients develop compensatory movements due to limitations of ankle dorsiflexion and knee flexion. To solve the limitations, there are many adjustable walking assistive devices such as robotic devices, ankle-foot orthoses, and functional electric stimulation in rehabilitation session. However, these assistive devices have some disadvantages, including expense and discomforts. Therefore, the development of a new assistive device for stroke patients is needed to assist ankle dorsiflexion and knee flexion. OBJECTIVE: This study investigated the effects of a wearable tubing assistive walking device (WTAWD) on gait parameters (gait speed, cadence, and step length and stride length on affected and less affected sides) in patients with stroke. METHODS: Gait parameters were measured using the GAITRite system. One-way repeated measures analysis of variance was used to determine gait differences under three conditions (WTAWD, barefoot, and conventional elastic band orthosis). RESULTS: Gait speed, cadence, and step length and stride length on both affected and less affected sides were significantly greater with WTAWD, compared to barefoot and conventional elastic band orthosis conditions. CONCLUSION: WTAWD could be effective for patients with stroke.

Stretching position can affect levator scapular muscle activity, length, and cervical range of motion in people with a shortened levator scapulae.

OBJECTIVES: Levator scapulae (LS) muscle stretching exercises are a common method of lengthening a shortened muscle; however, the appropriate stretching position for lengthening the LS in people with a shortened LS remains unclear. The purpose of this study was to compare the effects of different stretching exercise positions on the LS and introduce effective stretching exercise methods to clinicians. PARTICIPANTS: Twenty-four university students (12 men, 12 women) with a shortened LS were recruited. METHODS: LS muscle activity, LS index (LSI), and cervical range of motion (ROM) were measured pre (baseline) and post three different stretching exercise positions (sitting, quadruped, and prone). RESULTS: The LSI and cervical ROM exceeded the minimal detectable change and had significant changes. The LSI was greater in the sitting position than at the baseline (p = 0.01), quadruped position (p < 0.01); the LSI in the prone position presented a higher increase than the quadruped position (p = 0.01). The cervical ROM increased in the sitting position when compared to the baseline (p < 0.01) and quadruped position (p < 0.01). CONCLUSIONS: Stretching the LS in the sitting position was the most effective exercise for improving LS muscle length and cervical ROM.

Differences in the angle of the medial longitudinal arch and muscle activity of the abductor hallucis and tibialis anterior during sitting short-foot exercises between subjects with pes planus and subjects with neutral foot.

BACKGROUND AND OBJECTIVES: Excessive activity of the tibialis anterior muscle may be a causal mechanism in overuse injuries such as stress fracture in pes planus patients. However, information about this relationship is limited. In this study, we compared the angle of the medial longitudinal arch, the activities of the abductor hallucis and tibialis anterior muscles, and the activity ratio of tibialis anterior/abductor hallucis in individuals with pes planus and those with a neutral foot position during short-foot exercises conducted while sitting. METHODS: Differences between the groups were analyzed using an independent t-test. In all, 28 university students participated in this study (14 subjects in each group). RESULTS: The activity of the abductor hallucis muscle was significantly lower (p < 0.001), and the activity ratio of tibialis anterior/abductor hallucis was significantly greater (p = 0.012) in the pes planus group than in the neutral foot group during the exercise. CONCLUSIONS: Clinicians should recognize that pes planus patients may compensate for reduced activation of the abductor hallucis to maintain the angle of the medial longitudinal arch during the sitting short-foot exercise.

Various shrug exercises can change scapular kinematics and scapular rotator muscle activities in subjects with scapular downward rotation syndrome.

Scapular dyskinesis, characterized by scapular downward rotation syndrome (SDRS) affects scapula-humeral rhythm and results in shoulder dysfunction. Previous study has led to the recommendation of standard shrug exercise to contend with SDRS and strengthen the upper trapezius (UT) muscle. However, few researchers have examined which shrug exercise is most effective. The aim of this research was to compare scapular kinematic changes and scapular rotator muscles activity across three different shrug exercises in SDRS. The amounts of scapular downward rotation were measured by a caliper and the scapular upward rotation angle was measured using two digital inclinometers. Surface electromyography was used to measure EMG amplitude from the UT, lower trapezius (LT), serratus anterior (SA), and levator scapula (LS). Seventeen subjects with SDRS were recruited for this study. The subjects performed three shrug exercises with 30° shoulder abduction (preferred shrug, frontal shrug, and stabilization shrug). The stabilization shrug showed a significantly greater scapular upward rotation angle compared with the preferred shrug (P=0.004) and frontal shrug (P=0.006). The UT activity was significantly greater in the frontal shrug than in the preferred shrug (P=0.002). The UT/LS muscle activity ratio was also significantly greater in the frontal shrug than in the preferred shrug (P=0.004). The stabilization shrug should be preferred to enhance the upward rotation angle. In addition, the frontal shrug can be used as an effective method to increase UT activity and to decrease LS activity in SDRS.

Reliability of levator scapulae index in subjects with and without scapular downward rotation syndrome.

OBJECTIVES: The objective of this study was to introduce levator scapulae (LS) measurement using a caliper and the levator scapulae index (LSI) and to investigate intra- and interrater reliability of the LSI in subjects with and without scapular downward rotation syndrome (SDRS). DESIGN: Two raters measured LS length twice in 38 subjects (19 with SDRS and 19 without SDRS). MAIN OUTCOME MEASURES: For reliability testing, intraclass correlation coefficients (ICCs), standard error of measurement (SEM), and minimal detectable change (MDC) were calculated. RESULTS: Intrarater reliability analysis resulted with ICCs ranging from 0.94 to 0.98 in subjects with SDRS and 0.96 to 0.98 in subjects without SDRS. These results represented that intrarater reliability in both groups were excellent for measuring LS length with the LSI. Interrater reliability was good (ICC: 0.82) in subjects with SDRS; however, interrater reliability was moderate (ICC: 0.75) in subjects without SDRS. Additionally, SEM and MDC were 0.13% and 0.36% in subjects with SDRS and 0.35% and 0.97% in subjects without SDRS. In subjects with SDRS, low dispersion of the measurement errors and MDC were shown. CONCLUSIONS: This study suggested that the LSI is a reliable method to measure LS length and is more reliable for subjects with SDRS.

Effect of the craniocervical brace on craniocervical angle, thoracic kyphosis angle, and trunk extensor muscle activity during typing in subjects with forward head posture.

BACKGROUND: The relationship between forward head posture (FHP) and thoracic kyphosis has been a subject of interest in the rehabilitation field for visual display terminal workers. OBJECTIVE: The aim of this study was to investigate the immediate effects of the craniocervical brace use on craniocervical angle (CCA), thoracic kyphosis angle (TKA), and trunk extensor muscle activity. METHODS: Twelve young male subjects with forward head posture (21.6±1.9 years) participated in this study. We compared CCA & TKA and trunk extensor muscle activity between with and without application of the craniocervical brace during visual display terminal work. RESULTS: When wearing the craniocervical brace, the subjects demonstrated significantly greater CCA at the start and the end of the task and less change in CCA during the task (p < 0.05). While non-significantly less TKA was seen at the start of the task, significantly less TKA was observed at the end of the task when using the craniocervical brace (p < 0.05). The craniocervical brace use also led to significantly less change in TKA (p < 0.05). There was no significant difference in the trunk extensor muscle activity. CONCLUSIONS: Use of the craniocervical brace decreased FHP immediately, lessened thoracic kyphosis over time, and prevented the worsening of FHP and thoracic kyphosis during visual display terminal work.

Predictor variables for forward scapular posture including posterior shoulder tightness.

The purpose of this study was (1) to determine the relationships between the degree of forward scapular posture and the pectoralis minor index, the strength of the serratus anterior, the thoracic spine angle, and posterior shoulder tightness, and (2) to identify predictors of forward scapular posture, including posterior shoulder tightness. The study recruited eighteen subjects with forward scapular posture and objectively measured the acromion distance, the pectoralis minor index, and the strength of the serratus anterior muscle of each participant. The amount of glenohumeral horizontal adduction and internal rotation were evaluated to measure posterior shoulder tightness. There were high intra-rater reliabilities in all measurements. The measurement results showed a statistically strong negative correlation between the degree of forward scapular posture and the pectoralis minor index. They also revealed a moderate positive correlation between the degree of forward scapular posture and the thoracic spine angle and a moderate negative relationship between the degree of forward scapular posture and the amount of the glenohumeral horizontal adduction. A multiple regression analysis indicated that a total multiple regression model explained 93% of the amount of forward scapular posture. All predictor variables, including posterior shoulder tightness, should be considered while assessing, managing, and preventing forward scapular posture.

The effect of scapular posterior tilt exercise, pectoralis minor stretching, and shoulder brace on scapular alignment and muscles activity in subjects with round-shoulder posture.

BACKGROUND: There are various methods for rehabilitating round-shoulder posture (RSP), including strengthening exercises, stretching, and using a shoulder brace or taping to correct the altered posture. However, no study has determined which intervention is the most effective of the three methods to decrease RSP (intervention #1: scapular posterior tilting exercise alone [hereafter, SPT], intervention #2: the scapular posterior tilting exercise after PM stretching [PM stretch+SPT], and intervention #3: the scapular posterior tilting exercise with use of a shoulder brace [SPT+brace]). OBJECTIVES: The purpose of this study was to compare the SPT, PM stretch+SPT, and SPT+brace on RSP, PM index (PMI), and lower trapezius (LT) and serratus anterior (SA) activity in subjects with RSP. METHODS: In total, fifteen young men with RSP, participated in the study (21.46 ± 2.30 years old). RSP was confirmed using a caliper measure. Surface electromyography (SEMG) data for LT and SA activity were collected during the three interventions, and the SEMG data are expressed as a percentage of the maximal voluntary isometric contraction (%MVIC). RESULTS: RSP was significantly less in the PM stretch+SPT and SPT+brace than in the SPT (P<0.05). PMI was significantly greater in the PM stretch+SPT and SPT+brace than in the SPT (P<0.05). LT activity was significantly greater in the PM stretch+SPT than in the SPT or SPT+brace in subjects with RSP (P<0.05). CONCLUSIONS: The PM stretching exercise and application of a shoulder brace may help correct RSP and restore the length of the PM. The posterior tilting exercise after PM stretching was the most effective method for eliciting greater LT muscle activation among the interventions tested.

Isometric hip abduction using a Thera-Band alters gluteus maximus muscle activity and the anterior pelvic tilt angle during bridging exercise.

The purpose of this study was to investigate the effects of bridging with isometric hip abduction (IHA) using the Thera-Band on gluteus maximus (GM), hamstring (HAM), and erector spinae (ES) muscle activity; GM/HAM and GM/ES ratios; and the anterior pelvic tilt angle in healthy subjects. Twenty-one subjects participated in this study. Surface EMG was used to collect EMG data of GM, HAM, and ES muscle activities, and Image J software was used to measure anterior pelvic tilt angle. A paired t-test was used to compare GM, HAM, and ES muscle activity; the GM/HAM and GM/ES ratios; and the anterior pelvic tilt angle with and without IHA during the bridging exercise. GM muscle activity increased significantly and the anterior pelvic tilt angle decreased significantly during bridging with IHA using the Thera-Band (p < 0.05). However, there were no significant differences in the activity of the HAM and ES and the GM/HAM and GM/ES ratios between bridging with and without IHA (p > 0.05). The results of this study suggest that bridging with IHA using the Thera-Band can be implemented as an effective method to facilitate GM muscle activity and reduce the anterior pelvic tilt angle.

Comparison of scapular posterior tilting exercise alone and scapular posterior tilting exercise after pectoralis minor stretching on scapular alignment and scapular upward rotators activity in subjects with short pectoralis minor.

OBJECTIVES: To compare scapular posterior tilting exercise alone and scapular posterior tilting exercise after pectoralis minor (PM) stretching on the PM index (PMI), scapular anterior tilting index, scapular upward rotation angle, and scapular upward rotators' activity in subjects with a short PM. PARTICIPANTS: Fifteen subjects with a short PM participated in this study. MAIN OUTCOME MEASURES: The PMI, scapular anterior tilting index, and scapular upward rotation angle were measured after scapular posterior tilting exercise alone and scapular posterior tilting exercise after PM stretches. Scapular upward rotators' activities were collected during scapular posterior tilting exercise alone and scapular posterior tilting exercise after PM stretches. RESULTS: The PMI and scapular upward rotation angle, as well as the activity of the upper trapezius, lower trapezius, and serratus anterior muscles, were significantly greater for scapular posterior tilting exercise after PM stretching and the scapular anterior tilting index was significantly lower for scapular posterior tilting exercise after PM stretching than the scapular posterior tilting exercise alone. CONCLUSIONS: Scapular posterior tilting exercise after PM stretching in subjects with a short PM could be an effective method of modifying scapular alignment and scapular upward rotator activity.

Shrug exercises combined with shoulder abduction improve scapular upward rotator activity and scapular alignment in subjects with scapular downward rotation impairment.

The aim of this research was to investigate which shoulder abduction angle (30°, 90°, 150°) during shrug exercise is superior for (1) activating the scapular upward rotators and (2) improving scapular and clavicular position in subjects with scapular downward rotation impairment. Twenty subjects performed shrug exercises at three different shoulder abduction angles (30°, 90°, 150°) which were obtained and maintained actively. Surface EMG data were collected from the levator scapulae (LS), upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) during shrug exercises. Scapular downward rotation index (SDRI) and clavicular tilt angle (CTA) were measured immediately after each shrug exercise. Oneway repeated-measures analysis of variance was used to determine the significance. UT muscle activity was greater at 90° and 150° than at 30° of shoulder abduction. UT/LS muscle activity ratio was greater at 90° than at 30°. LT and LT/LS increased as shoulder abduction angle increased. SA was greater at 150° than at 30° or 90°. SA/LS was greater at 150° than at 30°. SDRI was lower at 90° and 150° than at 30°. CTA was greater at 90° and 150° than at 30°. In conclusion, shrug exercises at 90° or 150° of shoulder abduction angle may be advocated to activate scapular upward rotators, decrease SDRI, and increase CTA in patients with scapular downward rotation impairment.