Selective Muscle Activation With Visual Electromyographic Biofeedback During Scapular Posterior Tilt Exercise in Subjects With Round-Shoulder Posture원문보기
The purpose of this study was to investigate the effects of visual electromyography (EMG) biofeedback on the EMG activity of the lower trapezius (LT), serratus anterior (SA), and upper trapezius (UT) muscles, the LT/UT and SA/UT EMG activity ratios, and the scapular upward rotation angle during scap...
The purpose of this study was to investigate the effects of visual electromyography (EMG) biofeedback on the EMG activity of the lower trapezius (LT), serratus anterior (SA), and upper trapezius (UT) muscles, the LT/UT and SA/UT EMG activity ratios, and the scapular upward rotation angle during scapular posterior tilting exercise (SPTE). Twenty-four subjects with round-shoulder posture participated in this study. The EMG activities of the LT, SA, and UT were collected during SPTE both without and with visual EMG biofeedback. The scapular upward rotation angle was measured at the baseline, after SPTE without visual EMG biofeedback, and after SPTE with visual EMG biofeedback. The LT, SA, and UT EMG activities, and the LT/UT and SA/UT EMG activity ratios were analyzed by paired t-test. The scapular upward rotation angle was statistically analyzed using one-way repeated analysis of variance. If a significant difference was found, a Bonferroni correction was performed (p=.05/3=.017). The EMG activities of LT and SA significantly increased, and the EMG activity of UT significantly decreased during SPTE with visual EMG biofeedback compared to SPTE without visual EMG biofeedback (p<.05). In addition, the LT/UT and SA/UT EMG activity ratios significantly increased during SPTE with visual EMG biofeedback compared to SPTE without visual EMG biofeedback (p<.05). Significant increases were found in the scapular upward rotation angle after SPTE without and with visual EMG biofeedback compared to baseline (p<.017), and no significant differences were observed in the scapular upward rotation angle between SPTE without and with visual EMG biofeedback. In conclusion, SPTE using visual EMG biofeedback may be an effective method for increasing LT and SA activities while reducing UT activity.
The purpose of this study was to investigate the effects of visual electromyography (EMG) biofeedback on the EMG activity of the lower trapezius (LT), serratus anterior (SA), and upper trapezius (UT) muscles, the LT/UT and SA/UT EMG activity ratios, and the scapular upward rotation angle during scapular posterior tilting exercise (SPTE). Twenty-four subjects with round-shoulder posture participated in this study. The EMG activities of the LT, SA, and UT were collected during SPTE both without and with visual EMG biofeedback. The scapular upward rotation angle was measured at the baseline, after SPTE without visual EMG biofeedback, and after SPTE with visual EMG biofeedback. The LT, SA, and UT EMG activities, and the LT/UT and SA/UT EMG activity ratios were analyzed by paired t-test. The scapular upward rotation angle was statistically analyzed using one-way repeated analysis of variance. If a significant difference was found, a Bonferroni correction was performed (p=.05/3=.017). The EMG activities of LT and SA significantly increased, and the EMG activity of UT significantly decreased during SPTE with visual EMG biofeedback compared to SPTE without visual EMG biofeedback (p<.05). In addition, the LT/UT and SA/UT EMG activity ratios significantly increased during SPTE with visual EMG biofeedback compared to SPTE without visual EMG biofeedback (p<.05). Significant increases were found in the scapular upward rotation angle after SPTE without and with visual EMG biofeedback compared to baseline (p<.017), and no significant differences were observed in the scapular upward rotation angle between SPTE without and with visual EMG biofeedback. In conclusion, SPTE using visual EMG biofeedback may be an effective method for increasing LT and SA activities while reducing UT activity.
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문제 정의
However, there are few previous studies documenting selective activation with visual EMG biofeedback for individuals with RSP during exercises to activating of the LT and SA. Therefore, the purpose of this study was to investigate LT, SA, and UT muscle activity, LT/UT and SA/UT ratio, and the scapular upward rotation angle during SPTE without and with visual EMG biofeedback in subjects with RSP. We hypothesized that SPTE with visual EMG biofeedback would increase LT and SA activities while reducing UT activity.
가설 설정
Therefore, the purpose of this study was to investigate LT, SA, and UT muscle activity, LT/UT and SA/UT ratio, and the scapular upward rotation angle during SPTE without and with visual EMG biofeedback in subjects with RSP. We hypothesized that SPTE with visual EMG biofeedback would increase LT and SA activities while reducing UT activity. And the LT/UT and SA/UT activity ratios would increase during STPE with visual EMG biofeedback.
제안 방법
The UT electrodes were attached midway between the spinous process of the 7th cervical vertebra and the posterior tip of the acromion process (Criswell, 2011). During the investigation, EMG signals were collected at 1,000 ㎐; the raw signal was filtered using a bandpass filter (Lancosh FIR) between 10 and 450 ㎐, and 60 ㎐ and 120 ㎐ notch filters were used to reduce noise. EMG data were processed into root mean square values, which was calculated from 300 ㎳ data points of windows.
The current study has several limitations. First, the current study investigated the immediate effects of visual EMG biofeedback on EMG activities in the LT, SA and UT and the scapular upward rotation angle during SPTE. We do not know the maintenance of the effects of biofeedback training and changes in the motor control.
After practice, the subjects were given a 5-min rest period. The subjects performed three trials with 2-min rest periods between trials to prevent muscle fatigue (Ha et al, 2012).
The variables (EMG values and scapular upward rotation angles) satisfied the normal distribution. Therefore, parametric tests were used to analyze the variables. The paired t-test was used to analyze the EMG activities (LT, SA, and UT) and the EMG activity ratios (LT/UT and SA/UT).
However, contrary to the hypothesis in the current study, scapular upward rotation angles between without and with visual EMG biofeedback condition were not significantly different. This finding may have been due to the immediate effect of visual EMG biofeedback because the current study was a cross-sectional study. Thus, a longitudinal study is warranted to determine the long-term effect of visual EMG biofeedback on changes in scapular upward rotation angle.
This study investigated whether visual EMG biofeedback could increase the LT and SA activities while reducing UT activity during SPTE and changes in scapular upward rotation angles in subjects with RSP. The results of this study partially supported the hypotheses.
Although the study by Huang et al (2013) that used visual EMG biofeedback to reduce the UT activity did not set an EMG activity threshold, the current study needed an EMG activity threshold to simultaneously control the LT, SA and UT. Thus, current study used the mean values of the EMG activities of LT, SA, and UT in SPTE without visual EMG biofeedback to define the EMG activity thresholds. The examiner instructed the subjects to decrease the UT EMG activity below the threshold and increase the LT and SA EMG activities above the threshold during the SPTE by watching the computer display screen (Huang et al, 2013; Jeon et al, 2011; Lim et al, 2014).
대상 데이터
05. The estimated sample size was 16 and 24 subjects (15 males and 9 females) with RSP participated in this study. The general characteristics of the subjects are presented in Table 1.
데이터처리
Therefore, parametric tests were used to analyze the variables. The paired t-test was used to analyze the EMG activities (LT, SA, and UT) and the EMG activity ratios (LT/UT and SA/UT). One-way repeated measures analysis of variance was used to analyze scapular upward rotation angles for the three conditions (baseline and after performing SPTE without and with visual EMG biofeedback), and the Bonferroni correction was used for clarification of the differences among the three conditions (.
이론/모형
A one-sample Kolmogorov-Smirnov test was used to define the normality of distribution. The variables (EMG values and scapular upward rotation angles) satisfied the normal distribution.
성능/효과
The EMG activities of LT and SA significantly increased with visual EMG biofeedback compared to without visual EMG biofeedback (LT without visual EMG biofeedback: 55.55±16.38 %MVIC; LT with visual EMG biofeedback: 58.90±19.66 %MVIC; SA without visual EMG biofeedback: 24.77±13.34 %MVIC; SA with visual EMG biofeedback: 38.01±18.85%MVIC; p<.05).
The results of this study partially supported the hypotheses. The LT and SA activities significantly increased while the UT activity reduced during SPTE with visual EMG biofeedback compared to SPTE without visual EMG biofeedback. EMG activity ratios (LT/UT and SA/UT) significantly increased in SPTE with visual EMG biofeedback compared to SPTE without visual EMG biofeedback.
The LT/UT and SA/UT EMG activity ratios significantly increased with visual EMG biofeedback compared to without visual EMG biofeedback (LT/UT without visual EMG biofeedback: 2.00±.97 %MVIC; LT/UT with visual EMG biofeedback: 3.02±1.90 %MVIC; SA/UT without visual EMG biofeedback: .95±.62%MVIC; SA/UT with visual EMG biofeedback:1.84±1.25 %MVIC; p<.05) (Figure 5).
The results of the current study are partially similar to the previous study that showed significantly reduced the UT activity using visual EMG biofeedback. Holtermann et al (2009) investigated selective activation within the trapezius muscles and suggested that independent activation between the LT and UT is related to the selective innervation of the fine cranial and main branch of the spinal accessory nerve to the LT and UT.
The results of the current study support the hypothesis that there would be an increase in both LT/UT and SA/UT activity ratios during SPTE with visual EMG biofeedback. The LT/UT and SA/UT activity ratios mean relative use of the LT and SA compared to the UT.
후속연구
Third, we investigated EMG values only in the isometric contraction phase. It is recommended that further studies investigate EMG values in the concentric and eccentric contraction phases with muscle recruitment patterns. Finally, we did not investigate scapular posterior tilt.
We do not know the maintenance of the effects of biofeedback training and changes in the motor control. Thus, further studies are needed to determine the long-term effects in EMG activities as well as motor control and postural changes. In addition, the retention of the effects of feedback training should be investigated.
참고문헌 (27)
Arlotta M, Lovasco G, McLean L. Selective recruitment of the lower fibers of the trapezius muscle. J Electromyogr Kinesiol. 2011;21(3):403-410. http://dx.doi.org/10.1016/j.jelekin.2010.11.006
Cools AM, Declercq GA, Cambier DC, et al. Trapezius activity and intramuscular balance during isokinetic exercise in overhead athletes with impingement symptoms. Scand J Med Sci Sports. 2007a;17(1):25-33.
Cools AM, Dewitte V, Lanszweert F, et al. Rehabilitation of scapular muscle balance: Which exercises to prescribe? Am J Sports Med. 2007b;35(10):1744-1751.
Ha SM, Kwon OY, Cynn HS, et al. Comparison of electromyographic activity of the lower trapezius and serratus anterior muscle in different arm -lifting scapular posterior tilt exercises. Phys Ther Sport. 2012;13(4):227-232. http://dx.doi.org/10.1016/j.ptsp.2011.11.002
Holtermann A, Mork PJ, Andersen LL, et al. The use of EMG biofeedback for learning of selective activation of intra-muscular parts within the serratus anterior muscle: A novel approach for rehabilitation of scapular muscle imbalance. J Electromyogr Kinesiol. 2010;20(2):359-365. http://dx.doi.org/10.1016/j.jelekin.2009.02.009
Holtermann A, Roeleveld K, Mork PJ, et al. Selective activation of neuromuscular compartments within the human trapezius muscle. J Electromyogr Kinesiol. 2009;19(5):896-902. http://dx.doi.org/10.1016/j.jelekin.2008.04.016
Huang HY, Lin JJ, Guo YL, et al. EMG biofeedback effectiveness to alter muscle activity pattern and scapular kinematics in subjects with and without shoulder impingement. J Electromyogr Kinesiol. 2013;23(1):267-274. http://dx.doi.org/10.1016/j.jelekin.2012.09.007
Jeon YJ, Choung SD, Kim SH, et al. Selective activation of serratus anterior using electromyography biofeedback during push-up plus. Phys Ther Korea. 2011;18(1):1-8.
Kendall FP, McCreary EK, Provance PG. Muscles: Testing and function with posture and pain. 5th ed. Baltimore, Williams & Wilkins, 2005:330-335.
Lee JH, Cynn HS, Yoon TL, et al. The effect of scapular posterior tilt exercise, pectoralis minor stretching, and shoulder brace on scapular alignment and muscles activity in subjects with round-shoulder posture. J Electromyogr Kinesiol. 2015;25(1):107-114. http://dx.doi.org/10.1016/j.jelekin.2014.10.010
Lim OB, Kim JA, Song SJ, et al. Effect of selective muscle training using visual EMG biofeedback on infraspinatus and posterior deltoid. J Hum Kinet. 2014;44:83-90. http://dx.doi.org/10.2478/hukin-2014-0113
Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther. 2000;80(3):276-291.
Ludewig PM, Reynolds JF. The association of scapular kinematics and glenohumeral joint pathologies. J Orthop Sports Phys Ther. 2009;39(2):90-104. http://dx.doi.org/10.2519/jospt.2009.2808
Nijs J, Roussel N, Vermeulen K, et al. Scapular positioning in patients with shoulder pain: A study examining the reliability and clinical importance of 3 clinical tests. Arch Phys Med Rehabil. 2005;86(7):1349-1355.
Page P, Frank C, Lardner R. Assessment and Treatment of Muscle Imbalance: The janda approach. 1st ed. Champaign, IL, Human Kinetics, 2010:67, 199-208.
Reinold MM, Escamilla RF, Wilk KE. Current concepts in the scientific and clinical rationale behind exercises for glenohumeral and scapulothoracic musculature. J Orthop Sports Phys Ther. 2009;39(2):105-117. http://dx.doi.org/10.2519/jospt.2009.2835
Sahrmann. Diagnosis and Treatment of Movement Impairment Syndromes. 1st ed. St Louis, MO, Mosby, 2002:193-217.
Thigpen CA, Padua DA, Michener LA, et al. Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. J Electromyogr Kinesiol. 2010;20(4):701-709. http://dx.doi.org/10.1016/j.jelekin.2009.12.003
Wong CK, Coleman D, diPersia V, et al. The effects of manual treatment on rounded-shoulder posture, and associated muscle strength. 2010;14(4):326-333. http://dx.doi.org/10.1016/j.jbmt.2009.05.001
Yano Y, Hamada J, Tamai K, et al. Different scapular kinematics in healthy subjects during arm elevation and lowering: Glenohumeral and scapulothoracic patterns. J Shoulder Elbow Surg. 2010;19(2):209-215. http://dx.doi.org/10.1016/j.jse.2009.09.007
Yoshizaki K, Hamada J, Tamai K, et al. Analysis of the scapulohumeral rhythm and electromyography of the shoulder muscles during elevation and lowering: Comparison of dominant and nondominant shoulders. J Shoulder Elbow Surg. 2009;18(5):756-763. http://dx.doi.org/10.1016/j.jse.2009.02.021
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