[논문]Comparative Study of Infraspinatus and Posterior Deltoid Muscle Activation According to Angle of External Rotation of Glenohumeral Joint

Yang, Dongseok; Choi, Wonho

doi:10.20540/jiaptr.2020.11.2.2071

Comparative Study of Infraspinatus and Posterior Deltoid Muscle Activation According to Angle of External Rotation of Glenohumeral Joint 원문보기

Journal of international academy of physical therapy research, v.11 no.2, 2020년, pp.2071 - 2076

Yang, Dongseok (Department of Physical Therapy, Daegu Hospital of Korea) , Choi, Wonho (Department of Physical Therapy, Gachon University of Korea)

Abstract ▼ AI-Helper

Background: Based on the understanding of the muscle activation relationship between the infraspinatus and posterior deltoid muscles to according to the angle of motion during external rotation on glenohumeral joint, effective shoulder joint strengthening exercise for the prevention and rehabilitation of shoulder injury due to muscle strength imbalance can be performed by achieving the ideal muscle activity ratio during exercise. Objectives: To compare and analyze the muscle activation changes and activity ratio of the infraspinatus and posterior deltoid muscles according to the glenohumeral external rotation angle. Design: Quasi-randomized trial. Methods: The study included 48 healthy male and female adults who provided informed consent for participation in the study. All the subjects performed isometric glenohumeral external rotation by setting the angle of motion to 30°, 45°, and 60° using a 5 kg resistance weight pulley. On surface electromyography, the differences in muscle activation and activity ratio between the infraspinatus and posterior deltoid muscles were investigated. Results: A significant difference in muscle activation was found in the comparison between the infraspinatus and posterior deltoid muscles according to the glenohumeral external rotation angle (P<.05). The muscle activation levels of the infraspinatus and posterior deltoid muscles were highest at the external rotation angles of 30° and 60°, respectively. The muscle activity ratio between the infraspinatus and posterior deltoid muscles also showed a significant difference (P<.05) and was highest at the shoulder external rotation angle of 30°. Conclusion: The findings of this study suggest that muscle activity is the highest at the shoulder external rotation angle of 30° in healthy individuals.

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문제 정의

The purpose of this study was to investigate the change in muscle activation between IS and PD according to glenohumeral external rotation angle. On the basis of the previous studies, the glenohumeral joint angles were set to 30°, 45°, and 60° in the adduction position, and a resistance of 5-kg was applied.
Therefore, on the basis of the assumption of a close correlation between the changes in the joint angles and muscle activation during glenohumeral external rotation in healthy adults, this study aimed to determine the optimal joint angle during glenohumeral external rotation and to investigate the difference in the muscle activity ratio between the IS and PD. With the findings of this study, we aim to propose an effective exercise method for patients with shoulder injuries such as rotator cuff muscle imbalance and impingement syndrome.
Therefore, on the basis of the assumption of a close correlation between the changes in the joint angles and muscle activation during glenohumeral external rotation in healthy adults, this study aimed to determine the optimal joint angle during glenohumeral external rotation and to investigate the difference in the muscle activity ratio between the IS and PD. With the findings of this study, we aim to propose an effective exercise method for patients with shoulder injuries such as rotator cuff muscle imbalance and impingement syndrome.

가설 설정

The limitations of this study were as follows: 1) the study subjects were all of young age, so the interpretation of the study results cannot be generalized to the general population; 2) manual resistance could not be applied objectively during the measurement of MVIC; 3) because the study was conducted with healthy adults without shoulder pain, trial discontinuation due to pain and fatigue showed individual differences, and the study results cannot be applied to patients with shoulder pain; and 4) as the study was conducted in the side-down position, the compensatory movement of the muscles of the opposite side could not be restricted.

제안 방법

As for the starting position, the subject assumed a side-down position with the elbow in 90° flexion and the glenohumeral joint in 0° adduction.
Each exercise posture was maintained for 5 seconds, and the examination posture was set with a joint angle measurement system so that all the subjects can perform the exact motions. The investigator gave oral instructions. To minimize muscle fatigue, which may affect the results of this study, a 2-minute rest time was allowed between each motion performance.
The study was designed as a randomized controlled trial. In the study, 48 healthy male and female adults were randomly assigned into three groups by using the random number table of the Microsoft Excel 2010 Program.
To analyze the differences in the muscle activation and muscle activity ratio between the IS and PD muscles according to the joint angle during glenohumeral external rotation, normality was confirmed using the Shapiro-Wilk test, and one-way ANOVA was performed. Then, a post hoc Scheffe test was performed. All statistical analyses were performed with the significance level set at P<.

대상 데이터

The study was designed as a randomized controlled trial. In the study, 48 healthy male and female adults were randomly assigned into three groups by using the random number table of the Microsoft Excel 2010 Program. The joint angles during glenohumeral external rotation were set to 30°, 45°, and 60° on a flat mirror, and the error range was reduced using a baseline inclinometer (AcuAngle Inc, USA).
The study experiment was conducted for 10 weeks, from January to March 2018, after approval by the institutional review board of Gachon University (1044396-201804-HR-100-01). The subjects were 48 healthy male and female adults residing in D city.
The study experiment was conducted for 10 weeks, from January to March 2018, after approval by the institutional review board of Gachon University (1044396-201804-HR-100-01). The subjects were 48 healthy male and female adults residing in D city. Before the experiment, all the subjects fully understood the contents of the study and signed the consent form.
This study was conducted in 48 healthy male and female adults (n=30 and n=18, respectively), and those who were left-hand dominant were excluded from the study. The characteristics of the study participants were as follows (Table 1).

데이터처리

For all the subjects, normal distribution was confirmed using the Shapiro-Wilk normality test. A chi-square test and one-way analysis of variance (ANOVA) were performed to compare the general characteristics of the subjects and to test the homogeneity between the groups. To analyze the differences in the muscle activation and muscle activity ratio between the IS and PD muscles according to the joint angle during glenohumeral external rotation, normality was confirmed using the Shapiro-Wilk test, and one-way ANOVA was performed.
A chi-square test and one-way analysis of variance (ANOVA) were performed to compare the general characteristics of the subjects and to test the homogeneity between the groups. To analyze the differences in the muscle activation and muscle activity ratio between the IS and PD muscles according to the joint angle during glenohumeral external rotation, normality was confirmed using the Shapiro-Wilk test, and one-way ANOVA was performed. Then, a post hoc Scheffe test was performed.

이론/모형

0 was used for data processing in this study, and the measured values of all the variables were calculated as the mean and standard deviation. For all the subjects, normal distribution was confirmed using the Shapiro-Wilk normality test. A chi-square test and one-way analysis of variance (ANOVA) were performed to compare the general characteristics of the subjects and to test the homogeneity between the groups.

성능/효과

As a result of the post hoc test, the muscle activation of the IS according to the glenohumeral external rotation angle was significantly higher at the joint angle of 30° and 45° than at 60° (P<.001), but no significant difference was found between the 30° and 45° joint angles.
In this study, the glenohumeral external rotation angle was comparatively analyzed. The IS muscle showed the highest muscle activation level at the joint angles of 30° and 45°, whereas the PD muscle showed the lowest muscle activation at the joint angle of 30°.
The analysis of the muscle activation of the PD muscle according to the glenohumeral external rotation angle revealed significant differences in the mean (±SD) muscle activation level in the order of 53.72±16.69, 62.87±12.24, and 70.94±11.38 for the 30°, 45°, and 60° angles of motion, respectively (P<.05).
The analysis of the muscle activity ratio between the IS and PD muscles according to the glenohumeral external rotation angle revealed significant differences in mean (±SD) muscle activity ratio in the order of 1.57±.36, 1.35±.53, and .96±.63 for the 30°, 45°, and 60° angles of motion (P<.05).

후속연구

Furthermore, the muscle activity ratio analysis between the IS and PD muscles revealed the highest values at the joint angle of 30°. From the findings of this study, which was conducted in healthy adults, we propose that further studies on muscle activities should be conducted by broadening the types of subjects to include those with rotator cuff disease, athletes, and various age groups.
As a result, significant changes in joint angle were identified in the IS and PD muscles during shoulder external rotation. Therefore, to promote the muscle activity of the IS without excessive muscle activity of the PD muscle during shoulder external rotation, the findings of this study will provide a basis for obtaining clinically useful information in the future. Additionally, in this study the intensity of resistance was applied to all subjects at 5-kg.

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