Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University Hospital Ghent, Belgium.
J Athl Train. 2020 Apr;55(4):343-349. doi: 10.4085/1062-6050-136-19. Epub 2020 Mar 11.
Scapular rehabilitation exercises should focus on selective activation of weaker muscles and minimal activation of hyperactive muscles. For rehabilitation of overhead athletes, single-plane open chain exercises below 90° of shoulder elevation are often recommended. Moreover, incorporating the kinetic chain in shoulder rehabilitation exercises is advised and has been suggested to influence scapular muscle activity levels.
To study the influence of kinetic chain incorporation during 5 variations of a shoulder-elevation exercise on scapular muscle activity.
Cross-sectional study.
University laboratory.
Thirty-one asymptomatic participants (15 men, 16 women).
MAIN OUTCOME MEASURE(S): The electromyographic activity of the upper (UT), middle (MT), and lower (LT) trapezius, and serratus anterior was determined during 5 variations of bilateral elevation with external rotation: (1) open-hand position (reference exercise), (2) closed-hand position, (3) dynamic bipedal squat, (4) static unipedal squat, and (5) dynamic unipedal squat on the contralateral leg. All data were normalized as a percentage of maximal voluntary isometric contraction (MVIC).
A closed-hand position (exercise 2) instead of an open-hand position (exercise 1) resulted in lower MT (mean difference = 3.44% MVIC) and LT (mean difference = 7.76% MVIC) activity. Incorporating the lower limb (exercises 3-5) increased UT activity when compared with exercise 1 (mean differences = 3.67, 2.68, 5.02% MVIC, respectively), which in general resulted in increased UT : MT ratios. Additionally, LT activity decreased when a dynamic unipedal squat was added (mean difference: 4.90% MVIC). For the serratus anterior, the greatest activity occurred during elevation in a static unipedal squat position (exercise 4, 22.90% MVIC).
Incorporating the kinetic chain during shoulder-elevation exercises influenced scapular muscle activity and ratios. In particular, incorporating the lower limb resulted in more UT activity, whereas the open-hand position increased MT and LT activity.
肩胛骨康复练习应侧重于选择性激活较弱的肌肉，并最大限度地减少过度活跃的肌肉的激活。对于上肢运动员的康复，通常建议在肩关节抬高 90°以下进行单平面开链运动。此外，建议在肩部康复练习中纳入运动链，并已提出这会影响肩胛骨肌肉的活动水平。
研究在 5 种肩部抬高运动的变化中纳入运动链对肩胛骨肌肉活动的影响。
横断面研究。
大学实验室。
31 名无症状参与者（15 名男性，16 名女性）。
在 5 种双侧外旋肩部抬高的变化中，上（UT）、中（MT）和下（LT）斜方肌和前锯肌的肌电图活动，分别为：（1）空手位（参考运动）、（2）握拳位、（3）动态双足蹲、（4）静态单足蹲和（5）对侧腿的动态单足蹲。所有数据均以最大自主等长收缩（MVIC）的百分比进行归一化。
握拳位（运动 2）而不是空手位（运动 1）导致 MT（平均差异=3.44%MVIC）和 LT（平均差异=7.76%MVIC）活动减少。与运动 1 相比，加入下肢（运动 3-5）增加了 UT 活动（平均差异分别为 3.67%、2.68%、5.02%MVIC），通常导致 UT：MT 比值增加。此外，当加入动态单足蹲时，LT 活动减少（平均差异：4.90%MVIC）。对于前锯肌，在静态单足蹲位抬高时活动最大（运动 4，22.90%MVIC）。
在肩部抬高练习中纳入运动链会影响肩胛骨肌肉的活动和比值。特别是，加入下肢会增加 UT 活动，而空手位会增加 MT 和 LT 活动。
