Sciascia Aaron, Kuschinsky Nina, Nitz Arthur J, Mair Scott D, Uhl Tim L
The Shoulder Center of Kentucky, Lexington Clinic, Lexington, KY 40504, USA.
Rehabil Res Pract. 2012;2012:783824. doi: 10.1155/2012/783824. Epub 2012 Aug 7.
This study examines if electromyographic (EMG) amplitude differences exist between patients with shoulder instability and healthy controls performing scaption, prone horizontal abduction, prone external rotation, and push-up plus shoulder rehabilitation exercises. Thirty nine subjects were categorized by a single orthopedic surgeon as having multidirectional instability (n = 10), anterior instability (n = 9), generalized laxity (n = 10), or a healthy shoulder (n = 10). Indwelling and surface electrodes were utilized to measure EMG activity (reported as a % of maximum voluntary isometric contraction (MVIC)) in various shoulder muscles during 4 common shoulder exercises. The exercises studied effectively activated the primary musculature targeted in each exercise equally among all groups. The serratus anterior generated high activity (50-80% MVIC) during a push-up plus, while the infraspinatus and teres major generated moderate-to-high activity (30-80% MVIC) during both the prone horizontal and prone external rotation exercises. Scaption exercise generated moderate activity (20-50% MVIC) in both rotator cuff and scapular musculature. Clinicians should feel confident in prescribing these shoulder-strengthening exercises in patients with shoulder instability as the activation levels are comparable to previous findings regarding EMG amplitudes and should improve the dynamic stabilization capability of both rotator cuff and scapular muscles using exercises designed to address glenohumeral joint instability.
本研究旨在探讨肩部不稳定患者与健康对照者在进行前锯肌运动、俯卧水平外展、俯卧外旋以及俯卧撑加肩部康复锻炼时,肌电图(EMG)振幅是否存在差异。39名受试者由一名骨科医生分类为多向不稳定(n = 10)、前向不稳定(n = 9)、全身松弛(n = 10)或肩部健康(n = 10)。在4种常见的肩部运动过程中,使用植入式电极和表面电极测量不同肩部肌肉的肌电活动(报告为最大自主等长收缩(MVIC)的百分比)。所研究的运动在所有组中均有效激活了每个运动中针对的主要肌肉组织。在俯卧撑加运动中,前锯肌产生高活动(50 - 80% MVIC),而在俯卧水平外旋和俯卧外旋运动中,冈下肌和大圆肌产生中度至高活动(30 - 80% MVIC)。前锯肌运动在肩袖和肩胛肌肉组织中均产生中度活动(20 - 50% MVIC)。临床医生在为肩部不稳定患者开这些肩部强化运动处方时应充满信心,因为激活水平与先前关于肌电振幅的研究结果相当,并且使用旨在解决盂肱关节不稳定问题的运动应能提高肩袖和肩胛肌肉的动态稳定能力。