Department of Rehabilitation, Orthopedic Hokushin Hospital, Sapporo, Japan.
Department of Rehabilitation, Orthopedic Hokushin Hospital, Sapporo, Japan.
J Shoulder Elbow Surg. 2023 Aug;32(8):1718-1727. doi: 10.1016/j.jse.2023.01.006. Epub 2023 Jan 31.
Isometric horizontal abduction loading has been applied to improve imbalanced scapular muscle activities during shoulder exercises; however, the effect on glenohumeral joint muscle activity remains unclear. The purpose of this study was to investigate the changes in electromyographic activity of shoulder muscles during forward flexion with isometric horizontal abduction loading in healthy participants.
Thirteen healthy men were recruited for this study. Participants performed shoulder forward flexion with isometric horizontal abduction loading using an elastic band (Flex-band condition) and forward flexion without shoulder loading (Normal-flex condition). Muscle activities were evaluated while maintaining shoulder flexion at 60°, 90°, 120°, and 150° (static task) and during active shoulder flexion from 0° to maximum elevation (dynamic task). Surface electrodes were placed on the deltoid, pectoralis major, infraspinatus, and teres minor muscles to measure the activities of the shoulder muscles during each task. The muscle activities during the static task were compared using a 2-way analysis of variance with repeated measures of the 2 factors, loading condition and flexion position, and a paired t test was used for comparisons between the 2 conditions during the dynamic task (significance level set at P < .05).
For the static task, the Flex-band condition significantly increased the deltoid middle and posterior activities by 2-15 times and the infraspinatus and teres minor activities by 2-3 times compared with the Normal-flex condition at all positions. In contrast, the Flex-band condition significantly decreased (by about half) the activities of the deltoid anterior (at 120° and 150°) and pectoralis major (at all positions) compared with the Normal-flex condition. For the dynamic task, the Flex-band condition significantly increased the deltoid middle, deltoid posterior, infraspinatus, and teres minor activities by 2-7 times and decreased the deltoid anterior activity by approximately two-thirds.
Applying isometric horizontal abduction loading during shoulder forward flexion may be useful in improving the imbalanced muscle activities of the glenohumeral joint, such as excessive activity of the deltoid anterior and pectoralis major and dysfunction of the deltoid middle, deltoid posterior, and shoulder external rotator muscles. Shoulder forward flexion with horizontal abduction loading could be available for exercise in patients who have massive rotator cuff tears or who have undergone rotator cuff repair and shoulder arthroplasty.
等长水平外展负荷已被应用于改善肩部运动中不平衡的肩胛骨肌肉活动,但对盂肱关节肌肉活动的影响仍不清楚。本研究的目的是探讨健康参与者进行前屈运动时,等长水平外展负荷对肩部肌肉肌电图活动的影响。
本研究招募了 13 名健康男性。参与者使用弹性带(Flex-band 条件)进行肩部前屈等长水平外展加载,并用肩部前屈(Normal-flex 条件)进行无肩部加载。在维持肩部 60°、90°、120°和 150°的前屈(静态任务)和从 0°到最大抬高的主动肩部前屈(动态任务)期间,评估肌肉活动。在每个任务中,将表面电极放置在三角肌、胸大肌、冈下肌和小圆肌上,以测量肩部肌肉的活动。使用 2 因素重复测量的 2 方式方差分析比较静态任务中的肌肉活动,2 个条件之间的比较使用配对 t 检验(显著性水平设置为 P <.05)。
在静态任务中,与 Normal-flex 条件相比,Flex-band 条件在所有位置下均显著增加三角肌中、后束活动 2-15 倍,冈下肌和小圆肌活动 2-3 倍。相反,Flex-band 条件在 120°和 150°时显著降低(约一半)三角肌前束(在所有位置)和胸大肌的活动。在动态任务中,Flex-band 条件显著增加三角肌中、后束、冈下肌和小圆肌活动 2-7 倍,三角肌前束活动减少约三分之二。
在肩部前屈时施加等长水平外展负荷可能有助于改善盂肱关节的不平衡肌肉活动,如三角肌前束和胸大肌活动过度,三角肌中、后束和肩外旋肌功能障碍。肩部前屈伴水平外展负荷可用于肩袖撕裂或肩袖修复和肩关节置换术后患者的运动。