[논문]Effects of Posture Correction Exercise on Muscle Activity and Onset Time during Arm Elevation in Subject with Forward Head and Rounded Shoulder Posture

Park, Sun-Wook; Lee, Han-Suk

doi:10.13066/kspm.2020.15.3.29

Effects of Posture Correction Exercise on Muscle Activity and Onset Time during Arm Elevation in Subject with Forward Head and Rounded Shoulder Posture 원문보기

대한물리의학회지 = Journal of the korean society of physical medicine, v.15 no.3, 2020년, pp.29 - 41

Park, Sun-Wook (Department of Physical Therapy, Samsung Medical Center) , Lee, Han-Suk (Department of Physical Therapy, Eulji university)

Abstract ▼ AI-Helper

PURPOSE: The aim of this study was to provide evidence for the treatment of Forward Head and Rounded Shoulder Posture (FHRSP) using posture correction exercises by comparing muscle activity and onset time around the neck and shoulder area during an arm elevation task. METHODS: The subjects were divided into FHRSP (21 persons) and non-FHRSP (19 persons) groups to measure muscle activity and onset time of muscle contraction. Wireless surface electromyography was used to assess the muscle activity and onset time of the right and left sternocleidomastoid (SCM), splenius capitis, anterior deltoid, middle deltoid, serratus anterior, upper trapezius, pectoralis major, and infraspinatus during an arm elevation task. After the pre-measurement, the participants performed the postural correction exercises, and then the post-measurement was conducted. RESULTS: After the posture correction exercises, there were significant differences in the muscle activity and onset time of all muscles in the FHRSP group. The results of the comparison of the muscle onset time during an arm elevation task demonstrated that after the postural correction exercises, the muscle onset time was significantly reduced in the right and left SCM and left splenius capitis, but there were no significant changes in the onset time of other muscles. CONCLUSION: The results of this study help us understand the change in muscle activities and muscle contraction onset time in a person with FHRSP when lifting the arm and suggest the relevant basis to apply the posture correction exercise in clinical settings.

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문제 정의

The purpose of this study was to provide a basis for the treatment of FHRSP by comprehensively analyzing changes in muscle activity and onset time of muscle contraction during functional arm lifting through FHRSP correction.
The results of this study help us understand the change in muscle activities of each muscle when lifting the arm and suggest the relevant basis to apply the posture correction exercise in clinical settings. This study also confirmed that the muscle contraction onset time changes in some muscles during arm-lifting movement after the posture correction exercise.
This study demonstrated that the posture correction exercise can positively affect the activity of the muscles around the neck and shoulders during functional arm lifting in a person with FHRSP. The results of this study help us understand the change in muscle activities of each muscle when lifting the arm and suggest the relevant basis to apply the posture correction exercise in clinical settings.

가설 설정

In this study, we compared the onset time of muscle contraction during functional arm lifting after FHRSP correction and found that it was faster in all muscles. In particular, the right and left SCM and splenius capitis accelerated the onset time of muscle contraction.
In this study, we hypothesized that the muscle activity of subjects with FHRSP after the posture correction exercise in the functional arm-lifting task would be reduced compared with that before the correction exercise. As a result, all the eight muscles, except for the pectoralis major muscle, had decreased muscle activity after the posture correction exercise.

제안 방법

First, the therapist taught the pelvic anterior–posterior tilt exercise in the sitting position, and the subject moved accordingly.
However, the activity of the pectoralis major muscle increased significantly after posture correction. In this study, the clavicle head portion of the pectoralis major muscle was measured, and this area was the most active muscle at the beginning of arm flexion.
Measurements were carried out in a sitting position, and the subjects were measured at a knee angle of 90° using a chair with adjustable height.
Moreover, in this study, muscle activity was measured while placing objects on the shelf at eye level. In the FHRSP group, the relative height of the shelf was higher due to the bent posture, and as the angle of the arm was increased, the muscle activity decreased in the clavicle head portion of the pectoralis major muscle.
The measurement arm was selected as the arm that the subject mainly used to throw a ball. The subjects performed the action of placing the object on the shelf at the level of the iliac crest and at eye level (Fig. 1).
This study had a case control design. The subjects were divided into FHRSP (21 persons) and non-FHRSP (19 persons) groups to measure muscle activity and onset time of muscle contraction. After the pre-measurement, a physical therapist with 10 years’ experience performed the posture correction exercise for 10 min.
The lower cervical segment, which is relatively moved forward, was pulled slightly backward. The therapist placed the fingers in the cervical spinous process and guided the movement to give the subject a specific understanding of the cervical spine that had to move. The subjects repeatedly practiced this until they could maintain their correct postures.
This study had a case control design. The subjects were divided into FHRSP (21 persons) and non-FHRSP (19 persons) groups to measure muscle activity and onset time of muscle contraction.

대상 데이터

Among them, muscles that are difficult to measure with surface electromyography equipment were excluded [1,16,21-26]. In this study, a total of nine muscles were used: the right and left sternocleidomastoid (SCM), splenius capitis, anterior and middle deltoid, upper trapezius, serratus anterior, pectoralis major, and infraspinatus; the specific locations of attachment are shown in Table 1. EMG signals were collected at a sampling rate of 1,000 Hz using MR-XP 1.
The subjects of this study were 40 men in their 20s in the Seoul Gyeonggi area. The subject selection criteria were as follows: (1) no neck injury, such as herniated intervertebral disc, spondylosis, radiculopathy, chronic headache, torticollis, deformity, strain or whiplash; (2) no shoulder injury or surgical history, such as subacromial impingement syndrome, rotator cuff injury, bursitis, instability, dislocation or adhesive capsulitis; (3) a person who could raise their arm more than 90° without pain; (4) no neck fractures or spine fractures; and (5) no functional or structural scoliosis [16-18].
This study had a total of 40 subjects: 21 in the FHRSP group and 19 in the non-FHRSP group. All subjects were men and right handed (Table 2).

데이터처리

The paired t-test was used to compare differences in muscle activity and onset time of muscle contraction of the FHRSP and non-FHRSP groups before and after the posture correction, and analysis of covariance (ANCOVA) was used to compare the muscle activity between the two groups. All statistical data were processed using SPSS 18.
To investigate the differences in the activity of the neck and shoulder muscles between the non-FHRSP and FHRSP groups during functional arm lifting after the posture correction exercise, ANCOVA was used to measure the pre-test scores as covariates and the post-test scores as dependent variables. As a result, after posture correction, except for the right SCM and infraspinatus muscles, all the other muscles showed significant differences (p < .

이론/모형

For FHRSP measurements, the Bodystyle s-8.0 (LU trading, Korea), a body-somatotype measuring system, was used. Markers were attached to the tragus, acromion, and C7 spinous process, and the FHA and FSA were measured on the coronal plane.

성능/효과

Previous studies[34-37] have focused on the ipsilateral SCM muscle of the same side of the arm. In this study, we measured both SCMs and found that the activity of the left SCM of the FHRSP group was significantly lower than that of the non-FHRSP group after the posture correction exercise. Therefore, the results of this study suggest that SCM muscle activity related to the arm-lifting movement should include both muscles.
First, it is difficult to generalize the results of this study because the number of subjects is small and is limited to men in their 20s. Second, we did not measure muscle activity for deep neck and shoulder muscles such as suboccipital muscles, levator scapular muscle, and supraspinatus muscle because we used surface EMG for muscle activity measurement.

후속연구

This study demonstrated that the posture correction exercise can positively affect the activity of the muscles around the neck and shoulders during functional arm lifting in a person with FHRSP. The results of this study help us understand the change in muscle activities of each muscle when lifting the arm and suggest the relevant basis to apply the posture correction exercise in clinical settings. This study also confirmed that the muscle contraction onset time changes in some muscles during arm-lifting movement after the posture correction exercise.

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