Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey.
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kırıkkale University, Kırıkkale, Turkey.
J Back Musculoskelet Rehabil. 2024;37(6):1537-1549. doi: 10.3233/BMR-230397.
The Band Pull-Apart (BPA) exercise is used to strengthen the periscapular muscles. It was recently stated that the lower extremity and trunk movements should be included in the shoulder rehabilitation programs to optimize an effective energy transfer throughout the kinetic chain.
The aim of this study is to investigate the effects of kinetic chain based BPA exercise on the muscle activations of the sternocleidomasteideous (SCM) and the trapezius muscles in individuals with and without forward head posture (FHP).
Eighteen individuals with FHP and 18 individuals without FHP were included. Photographic measurements were made to identify individuals with FHP. The muscle activations of SCM, Upper Trapezius (UT), Middle Trapezius (MT), and Lower Trapezius (LT) were measured with surface EMG. BPA exercise was performed in the standing, unipedal standing, squat, unipedal squat, and Bulgarian split squat (BSS).
There was no Group × Exercise interaction for the SCM, UT, MT, LT muscle activations, or for the UT/MT and UT/LT ratios (p> 0.05). While there was a difference in the activation of all muscles between individuals with and without FHP (p< 0.05), both ratios were similar (p> 0.05). There was a statistically significant difference between exercises for SCM, MT, and LT muscle activations (p< 0.000 for these muscles), UT/MT (p< 0.000) and UT/LT ratios (p= 0.004). SCM muscle activation in squat was lower than activation in standing (Mean Difference (MD) = 2.5% Maximal Voluntary Isometric Contractions (MVIC); p= 0.004) and in unipedal standing (MD = 2.1% MVIC; p= 0.002). MT muscle activation in squat was higher than activation in standing (MD = 9.7% MVIC), unipedal standing (MD = 7.8% MVIC), unipedal squat (MD = 6.9% MVIC) and BSS (MD = 9.4% MVIC; p< 0.000 for these positions). LT muscle activation in the squat was higher than activation in the standing (MD = 8.5% MVIC) and unipedal squat (MD = 8.1% MVIC; p< 0.004 for these positions). UT/MT ratio in the squat was lower than standing (MD = 0.3), unipedal standing (MD = 0.2) and BSS (MD = 0.3; p< 0.000 for these positions). UT/LT ratio in squat was lower than unipedal squat (MD = 0.5) and BSS (MD = 0.6; p= 0.002; for these positions).
Performing the BPA exercise in the squat position is suggested in cases where lower SCM and UT muscle activation, lower UT/MT, and UT/LT ratios and higher MT and LT muscle activations are needed for individuals with and without FHP.
Band Pull-Apart（BPA）练习用于增强肩胛带肌肉。最近有人指出，为了优化整个运动链中的有效能量传递，应将下肢和躯干运动纳入肩部康复计划中。
本研究旨在探讨基于运动链的 BPA 练习对存在和不存在前伸头姿势（FHP）的个体的胸锁乳突肌（SCM）和斜方肌的肌肉激活的影响。
纳入 18 名存在 FHP 的个体和 18 名不存在 FHP 的个体。拍照测量用于识别存在 FHP 的个体。使用表面肌电图测量 SCM、上斜方肌（UT）、中斜方肌（MT）和下斜方肌（LT）的肌肉激活。BPA 练习在站立、单足站立、深蹲、单足深蹲和保加利亚分裂深蹲（BSS）中进行。
对于 SCM、UT、MT 和 LT 肌肉激活，以及 UT/MT 和 UT/LT 比值，组间无交互作用（p>0.05）。虽然存在 FHP 个体和无 FHP 个体之间所有肌肉的激活差异（p<0.05），但两个比值相似（p>0.05）。对于 SCM、MT 和 LT 肌肉激活（这些肌肉的 p<0.000）、UT/MT（p<0.000）和 UT/LT 比值（p=0.004），运动之间存在统计学显著差异。深蹲中的 SCM 肌肉激活低于站立（平均差异（MD）=2.5%最大自主等长收缩（MVIC）；p=0.004）和单足站立（MD=2.1%MVIC；p=0.002）。深蹲中的 MT 肌肉激活高于站立（MD=9.7%MVIC）、单足站立（MD=7.8%MVIC）、单足深蹲（MD=6.9%MVIC）和 BSS（MD=9.4%MVIC；这些位置的 p<0.000）。深蹲中的 LT 肌肉激活高于站立（MD=8.5%MVIC）和单足深蹲（MD=8.1%MVIC；这些位置的 p<0.004）。深蹲中的 UT/MT 比值低于站立（MD=0.3）、单足站立（MD=0.2）和 BSS（MD=0.3；这些位置的 p<0.000）。深蹲中的 UT/LT 比值低于单足深蹲（MD=0.5）和 BSS（MD=0.6；p=0.002；这些位置）。
对于存在和不存在 FHP 的个体，当需要降低 SCM 和 UT 肌肉的激活、降低 UT/MT 和 UT/LT 比值以及增加 MT 和 LT 肌肉的激活时，建议在深蹲位进行 BPA 练习。
