Moon, Il-young
(Dept. of Rehabilitation Medicine, Wonju Severance Christian Hospital)
,
Lim, One-bin
(Dept. of Physical & Occupational Therapy, Rehabilitation Hospital, National Rehabilitation Center)
,
Cynn, Heon-seock
(Dept. of Physical Therapy, College of Health Science, Yonsei University)
,
Yi, Chung-hwi
(Dept. of Physical Therapy, College of Health Science, Yonsei University)
Background: Strengthening the supraspinatus is an important aspect of a rehabilitation program for subacromial impingement and tendinopathy. Many authors recommended empty-can (EC), full-can (FC), and prone full-can (PFC) exercises to strengthen the supraspinatus. However, no ultrasonography study h...
Background: Strengthening the supraspinatus is an important aspect of a rehabilitation program for subacromial impingement and tendinopathy. Many authors recommended empty-can (EC), full-can (FC), and prone full-can (PFC) exercises to strengthen the supraspinatus. However, no ultrasonography study has yet investigated supraspinatus muscle architecture (muscle thickness; MT, pennation angle; PA, fiber bundle length; FBL) in relation to supraspinatus strengthening exercises. Objects: The purpose of this study was to compare the architecture (MT, PA, and FBL) of the supraspinatus muscle during three different types of exercises (EC, FC, and PFC) using diagnostic ultrasound. Methods: Participants performed three different exercises: (A) EC; the arm was maintained at $60^{\circ}$ abduction with full internal rotation in the sitting position, (B) FC; the arm was maintained at $60^{\circ}$ abduction with full external rotation in the sitting position, and (C) PFC; the arm was maintained at $60^{\circ}$ abduction with full external rotation in the prone position. Ultrasonography was used to measure the MT, PA and FBL of the supraspinatus. One-way repeated analysis of variance with Bonferroni's post-hoc test was used to compare between the three exercises and the initial position of each exercise. Results: Compared with each initial position, the FC exercise showed the greatest mean difference in muscle architecture properties and the PFC exercise showed the least mean difference. Conclusion: The findings suggest that the FC exercise position may have an advantage in increasing the amount of contractile tissue or producing muscle power and the PFC exercise position may be useful in a rehabilitation program because it offers the advantage of maintaining the muscle architecture properties.
Background: Strengthening the supraspinatus is an important aspect of a rehabilitation program for subacromial impingement and tendinopathy. Many authors recommended empty-can (EC), full-can (FC), and prone full-can (PFC) exercises to strengthen the supraspinatus. However, no ultrasonography study has yet investigated supraspinatus muscle architecture (muscle thickness; MT, pennation angle; PA, fiber bundle length; FBL) in relation to supraspinatus strengthening exercises. Objects: The purpose of this study was to compare the architecture (MT, PA, and FBL) of the supraspinatus muscle during three different types of exercises (EC, FC, and PFC) using diagnostic ultrasound. Methods: Participants performed three different exercises: (A) EC; the arm was maintained at $60^{\circ}$ abduction with full internal rotation in the sitting position, (B) FC; the arm was maintained at $60^{\circ}$ abduction with full external rotation in the sitting position, and (C) PFC; the arm was maintained at $60^{\circ}$ abduction with full external rotation in the prone position. Ultrasonography was used to measure the MT, PA and FBL of the supraspinatus. One-way repeated analysis of variance with Bonferroni's post-hoc test was used to compare between the three exercises and the initial position of each exercise. Results: Compared with each initial position, the FC exercise showed the greatest mean difference in muscle architecture properties and the PFC exercise showed the least mean difference. Conclusion: The findings suggest that the FC exercise position may have an advantage in increasing the amount of contractile tissue or producing muscle power and the PFC exercise position may be useful in a rehabilitation program because it offers the advantage of maintaining the muscle architecture properties.
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가설 설정
This present study aimed to compare the architecture (MT, PA, and FBL) of the supraspinatus muscle during three different types of exercises (EC, FC, and PFC) using diagnostic ultrasound. We hypothesized that EC, FC, and PFC would influence the mean difference of MT, PA, and FBL.
Significant differences among MT, PA, and FBL were observed in the FC exercise position; the PFC exercise position showed the least difference among the three muscle architecture properties. These findings support our hypotheses that these three types of exercises can have an effect on the mean difference of the supraspinatus muscle.
제안 방법
This present study aimed to compare the architecture (MT, PA, and FBL) of the supraspinatus muscle during three different types of exercises (EC, FC, and PFC) using diagnostic ultrasound. We hypothesized that EC, FC, and PFC would influence the mean difference of MT, PA, and FBL.
85, respectively). To ensure the consistency of the measurements, one physical therapist (O.B.L.), who was trained to administer the supraspinatus ultrasound imaging protocol, took all of the images. The mid-point muscle belly and the anterior part of the supraspinatus were imaged in two different positions: relaxed 0° abduction (the arm resting at the side and the palm facing inward or outward) and isometric contracted 60° abduction (Kim et al, 2015).
The one-sample Kolmogorov-Smirnov test was performed to determine if the continuous data approximated a normal distribution; all of the variables were confirmed as normally distributed. A repeated measure one-way analysis of variance was performed for all the measured mean variables (MT, PA, and FBL) to compare the variables among the three different shoulder exercises (EC, FC, and PFC). The statistical significance level was set at α=.
This is the first study to quantify MT, PA, and FBL following three different isometric exercises (EC, FC, and PFC) that are used for supraspinatus rehabilitation. Significant differences among MT, PA, and FBL were observed in the FC exercise position; the PFC exercise position showed the least difference among the three muscle architecture properties.
In contrast, Worrell et al (1992) found the greatest EMG activity in the PFC exercise position, and Reinold et al (2007) showed a similar amount of muscle activity among the three types of exercises. To address the discrepancies of supraspinatus EMG activity, this study chose to examine the glenohumeral elevation angle and the anterior and posterior portions of the supraspinatus. Many EMG studies have viewed the supraspinatus (anterior and posterior) as a whole, and the images in those studies were taken in the 100° horizontal abduction position.
대상 데이터
In the present study, the estimated sample size was 10. Sixteen healthy male subjects participated in the study. Inclusion criteria for this study was active, right-handed participants so as to optimize the data processing time (by asking participants their preferred hand for writing) (de Castro et al, 2014).
성능/효과
This is the first study to quantify MT, PA, and FBL following three different isometric exercises (EC, FC, and PFC) that are used for supraspinatus rehabilitation. Significant differences among MT, PA, and FBL were observed in the FC exercise position; the PFC exercise position showed the least difference among the three muscle architecture properties. These findings support our hypotheses that these three types of exercises can have an effect on the mean difference of the supraspinatus muscle.
Among the three exercise positions, the FC exercise was found to have the greatest increase in MT, while the least increase in MT was observed in the PFC exercise, and a statistically significant difference was found for each of the other exercise positions. MT is commonly used to predict muscle hypertrophy, which is defined by muscle activity (Farthing and Chilibeck, 2003).
The FBL showed a significant decrease in the FC exercise position in comparison to the EC and PFC exercise positions; no significant difference in the FBL was observed between the EC and PFC positions. The mean FBL decreased during isometric training with all of the exercise positions.
Furthermore, the FC exercise showed the greatest increase in MT and PA, and the PFC exercise showed the least increase in MT and PA. The greatest difference in the FBL data was observed for the FC exercise position, which is consistent with our previous data (MT and FBL), and FBL was found to decrease the least in the PFC exercise. From this finding, the FC exercise position may have an advantage in increasing the amount of contractile tissue or producing muscle power, and the PFC exercise position may be useful in a rehabilitation program because it offers the advantage of maintaining the muscle architecture properties.
The present study investigated muscle architecture properties (MT, PA, and FBL) following three different isometric exercises (EC, FC, and PFC). During these three different isometric exercises, the mean difference of MT and PA showed a significant in- crease, and FBL showed a significant decrease. Furthermore, the FC exercise showed the greatest increase in MT and PA, and the PFC exercise showed the least increase in MT and PA.
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