DOI QR코드

DOI QR Code

3차원적 어깨재활운동 시 도수 저항의 강도에 따른 어깨안정근의 활성도 및 비율

Activation and Ratio of Shoulder Stabilizer Muscles on Variations of Manual Resistance during Three Dimensional Shoulder Rehabilitation Exercises

  • 손민혁 (부산가톨릭대학교 대학원) ;
  • 노현빈 (부산가톨릭대학교 대학원) ;
  • 박두진 (부산가톨릭대학교 물리치료학과)
  • Min-Hyeok Son (Department of Physical Therapy, Graduate School, Catholic University of Pusan) ;
  • Hyun-Been Roh (Department of Physical Therapy, Graduate School, Catholic University of Pusan) ;
  • Du-Jin Park (Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan)
  • 투고 : 2024.08.06
  • 심사 : 2024.08.16
  • 발행 : 2024.08.31

초록

Purpose: The aim of this study was to compare the activation of shoulder stabilizer muscles to variations of manual resistance during three-dimensional shoulder rehabilitation exercises. Methods: A total of 13 participants were included in this study. To normalize each muscle's activity, a maximal isometric voluntary contraction was performed by all participants. After receiving 30 minutes of training in three-dimensional shoulder rehabilitation exercises, participants randomly performed PNF arm and scapular patterns according to the intensities of manual resistance. The activities of the upper trapezius, lower trapezius, and serratus anterior were measured during these patterns. All exercises were performed for five seconds, and the average of three seconds, excluding the first and last seconds, was used for data analysis. Results: Lower trapezius activity was significant among manual resistance intensities. In both the PNF arm and scapular patterns, using 80% manual resistance of maximum resistance showed higher activity of the lower trapezius muscle compared to 20% of the maximum resistance. Conclusion: It is expected that PNF arm and scapular patterns, with varying intensities of manual resistance, can be used for early rehabilitation of patients with shoulder impingement syndrome.

키워드

과제정보

본 연구는 2023년 (재)보건장학회의 지원으로 수행되었음.

참고문헌

  1. Adler SS, Beckers D, Buck M. PNF in Practice: An Illustrated Guide, 4th ed. Berlin Heidelberg, Germany. Springer. 2014.
  2. AlAnazi A, Alghadir AH, Gabr SA. Handgrip strength exercises modulate shoulder pain, function, and strength of rotator cuff muscles of patients with primary subacromial impingement syndrome. BioMed Research International. 2022:9151831.
  3. Baskurt Z, Baskurt F, Gelecek N, et al. The effectiveness of scapular stabilization exercise in the patients with subacromial impingement syndrome. Journal of Back and Musculoskeletal Rehabilitation. 2011;24(3):173-179. https://doi.org/10.3233/BMR-2011-0291
  4. Choo YK. Effects of mobilization with movement combined with Exercise(EMWM) on ADH, ROM and functional performance in patients with impingement syndrome of the shoulder. Journal of The Korean Society of Integrative Medicine. 2019;7(2):153-163. https://doi.org/10.15268/KSIM.2019.7.2.153
  5. Cigercioglu NB, Unuvar E, Hazimoglu P, et al. Proprioceptive neuromuscular facilitation training improves scapular muscle strength and pectoralis minor length in individuals with scapular dyskinesis. Journal of Basic and Clinical Health Sciences. 2022;6(1):238-246. https://doi.org/10.30621/jbachs.1000917
  6. Cools A, Declercq G, Cambier D, et al. Trapezius activity and intramuscular balance during isokinetic exercise in overhead athletes with impingement symptoms. Scandinavian Journal of Medicine and Science in Sports. 2007;17(1):25-33. https://doi.org/10.1111/j.1600-0838.2006.00570.x
  7. Ekstrom RA, Donatelli RA, Soderberg GL. Surface electromyographic analysis of exercises for the trapezius and serratus anterior muscles. Journal of Orthopaedic and Sports Physical Therapy. 2003;33(5):247-258. https://doi.org/10.2519/jospt.2003.33.5.247
  8. Garving C, Jakob S, Bauer I, et al. Impingement syndrome of the shoulder. Deutsches Ärzteblatt International. 2017;114(45):765-776. https://doi.org/10.3238/arztebl.2017.0765
  9. Hermens HJ, Freriks B, Disselhorst-Klug C, et al. Development of recommendations for SEMG sensors and sensor placement procedures. Journal of Electromyography and Kinesiology. 2000;10(5):361-374. https://doi.org/10.1016/S1050-6411(00)00027-4
  10. Hindle KB, Whitcomb TJ, Briggs WO, et al. Proprioceptive neuromuscular facilitation (PNF): its mechanisms and effects on range of motion and muscular function. Journal of Human Kinetics. 2012;31:105-113. https://doi.org/10.2478/v10078-012-0011-y
  11. Hislop H, Avers D, Brown M. Daniels and worthingham's muscle testing, 9th ed. St. Louis, USA. Saunders. 2013.
  12. Johnson G, Bogduk N, Nowitzke A, et al. Anatomy and actions of the trapezius muscle. Clinical Biomechanics. 1994;9(1):44-50. https://doi.org/10.1016/0268-0033(94)90057-4
  13. Jung JC, An DI, Yoon SH, et al. The immediate effects of electromyographic biodfeedback training on muscle activity of trapezius in patients with subacromial impingement syndrome. PNF and Movement. 2020;18(1):107-116. https://doi.org/10.21598/JKPNFA.2020.18.1.107
  14. Kendall FP, McCreary EK, Provance PG, et al. Muscles: testing and function, with posture and pain. 5th ed. Baltimore, USA. Lippincott Williams and Wilkins. 2005.
  15. Kibler WB, McMullen J. Scapular dyskinesis and its relation to shoulder pain. Journal of the American Academy of Orthopaedic Surgeons. 2003;11(2):142-151. https://doi.org/10.5435/00124635-200303000-00008
  16. Kim BR, Lee HJ. Effects of proprioceptive neuromuscular facilitation-based abdominal muscle strengthening training on pulmonary function, pain, and functional disability index in chronic low back pain patients. Journal of Exercise Rehabilitation. 2017;13(4):486-490. https://doi.org/10.12965/jer.1735030.515
  17. Kim BR, Yi DH, Yim JE. Effect of the combined isotonic technique for proprioceptive neuromuscular facilitation and taping on pain and grip strength in patients with lateral epicondylitis: a randomized clinical trial. Journal of Exercise Rehabilitation. 2019;15(2):316-321. https://doi.org/10.12965/jer.1938078.039
  18. Kim YH, Park DJ. Effects of three-week contract-relax interventions with and without reinforcement using temporal summation for flexibility and balance ability in young people with hamstring shortening. PNF and Movement. 2022;20(3):383-390. https://doi.org/10.21598/JKPNFA.2022.20.3.383
  19. Kisner C, Colby LA, Borstad J. Therapeutic exercise: Foundations and Techniques, 7th ed. Philadelphia, USA. F.A. Davis Company. 2017.
  20. Klein DA, Stone WJ, Phillips WT, et al. PNF training and physical function in assisted-living older adults. Journal of Aging and Physical Activity. 2002;10(4):476-488. https://doi.org/10.1123/japa.10.4.476
  21. Kwak DH, Ryu YU. Applying proprioceptive neuromuscular facilitation stretching: optimal contraction intensity to attain the maximum increase in range of motion in young males. Journal of Physical Therapy Science. 2015;27(7):2129-2132. https://doi.org/10.1589/jpts.27.2129
  22. Littlewood C, Ashton J, Mawson S, et al. A mixed methods study to evaluate the clinical and cost-effectiveness of a self-managed exercise programme versus usual physiotherapy for chronic rotator cuff disorders: protocol for the SELF study. BMC Musculoskeletal Disorders. 2012;13:62.
  23. Luque-Suarez A, Navarro-Ledesma S, Petocz P, et al. Short term effects of kinesiotaping on acromiohumeral distance in asymptomatic subjects: a randomised controlled trial. Manual Therapy. 2013;18(6):573-577. https://doi.org/10.1016/j.math.2013.06.002
  24. Maicki T, Bilski J, Szczygiel E, et al. PNF and manual therapy treatment results of patients with cervical spine osteoarthritis. Journal of Back and Musculoskeletal Rehabilitation. 2017;30(5):1095-1101. https://doi.org/10.3233/BMR-169718
  25. Michener LA, Subasi Yesilyaprak SS, Seitz AL, et al. Supraspinatus tendon and subacromial space parameters measured on ultrasonographic imaging in subacromial impingement syndrome. Knee Surgery, Sports Traumatology, Arthroscopy. 2015;23(2):363-369. https://doi.org/10.1007/s00167-013-2542-8
  26. Moreira R, Lial L, Teles Monteiro MG, et al. Diagonal movement of the upper limb produces greater adaptive plasticity than sagittal plane flexion in the shoulder. Neuroscience Letter. 2017;643:8-15. https://doi.org/10.1016/j.neulet.2017.02.022
  27. Myers JB, Wassinger CA, Lephart SM. Sensorimotor contribution to shoulder stability: effect of injury and rehabilitation. Manual Therapy. 2006;11(3):197-201. https://doi.org/10.1016/j.math.2006.04.002
  28. Neumann DA. Kinesiology of the musculoskeletal system, 3rd ed. St. Louis, USA. Elsevier. 2016.
  29. Page P. Shoulder muscle imbalance and subacromial impingement syndrome in overhead athletes. International Journal of Sports Physical Therapy. 2011;6(1):51-58.
  30. Park SY, Park DJ. Comparison of muscular activities between subjects with and without scapular downward rotation impairment during diagonal pattern of exercises. Journal of Bodywork and Movement Therapies. 23(1):59-64.
  31. Ravichandran H, Janakiraman B. Assessment and rehabilitation of scapular dyskinesis: a case study. Archives of Medicine and Health Sciences. 2016;4(2):244-247. https://doi.org/10.4103/2321-4848.196205
  32. Roh HB. A Comparison of activity and ratio of scapular muscles during 3 dimensional scapular exercises. Catholic University of Pusan. Master's Degree. 2023.
  33. Roy JS, Moffet H, Hebert LJ, et al. Effect of motor control and strengthening exercises on shoulder function in persons with impingement syndrome: a single-subject study design. Manual Therapy. 2009;14(2):180-188. https://doi.org/10.1016/j.math.2008.01.010
  34. Samir MG, Wallace FB, Felipe ST. Effects of strength training on scapular dyskinesia: A systematic review. Journal of Health Sciences. 2019;21(4):403-413.
  35. Sheard PW, Paine TJ. Optimal contraction intensity during proprioceptive neuromuscular facilitation for maximal increase of range of motion. Journal of Strength and Conditioning Research. 2010;24(2): 416-421. https://doi.org/10.1519/JSC.0b013e3181c50a0d
  36. Shin SS. Immediate effects of various contract-relax techniques on the peak force and range of motion of knee extension. -A Pilot Study- PNF and Movement. 2018;16(2):229-238.
  37. Wang DM, Li C, Hatchard N, et al. Lower trapezius muscle function in people with and without shoulder and neck pain: a systematic review. Journal of Osteopathic Medicine. 2022;123(2):73-89. https://doi.org/10.1515/jom-2022-0056
  38. Witt D, Talbott N, Kotowski S. Electromyographic activity of scapular muscles during diagonal patterns using elastic resistance and free weights. International Journal of Sports Physical Therapy. 2011;6(4):322-332.
  39. Worsley P, Warner M, Mottram S, et al. Motor control retraining exercises for shoulder impingement: effects on function, muscle activation, and biomechanics in young adults. Journal of Shoulder and Elbow Surgery. 2013;22(4):e11-9. https://doi.org/10.1016/j.jse.2012.06.010
  40. Yong JH, Weon JH. Comparison of the EMG activities of scapular upward rotators and other scapular muscles among three lower trapezius strengthening exercises. Physical Therapy Korea. 2013;20(3):27-35. https://doi.org/10.12674/ptk.2013.20.3.027