DOI QR코드

DOI QR Code

Effect of the Abdominal Drawing-in Maneuver on the Scapular Stabilizer Muscle Activities and Scapular Winging During Push-up Plus Exercise in Subjects With Scapular Winging

  • Kim, Da-eun (Dept. of Physical Therapy, The Graduate School, Yonsei University) ;
  • Shin, A-reum (Dept. of Physical Therapy, The Graduate School, Yonsei University) ;
  • Lee, Ji-hyun (Dept. of Physical Therapy, The Graduate School, Yonsei University) ;
  • Cynn, Heon-seock (Dept. of Physical Therapy, College of Health Science, Yonsei University)
  • 투고 : 2017.01.09
  • 심사 : 2017.02.09
  • 발행 : 2017.02.19

초록

Background: Scapular winging is a prominence of the entire scapular medial border, mainly caused by insufficient activity of the serratus anterior (SA) and imbalance of scapulothoracic muscles. Push-up plus (PUP) exercise has been commonly used to increase SA muscle activity. The facilitation of abdominal muscle may affect scapular muscle activity by myofascial connections. Thus, the sequential activation of the turnk muscles is suggested to facilitate the transition of proper force from upper limb and restore force couple of scapular muscles. The abdominal drawing-in maneuver (ADIM) has been effective in improving activation of the deep trunk muscles during movement. Objects: The aim of this study was to determine the effect of ADIM on the activity of the upper trapezius (UT), lower trapezius (LT), and SA during PUP exercises in subjects with scapular winging. Methods: Fourteen men with scapular winging (determined as a of distance between the scapular medial border and thoracic wall over 3 cm) volunteered for our study. The subjects performed the PUP exercise with and without ADIM. Surface electromyography was used to collect the electromyography data of the UT, LT, and SA. A scapulometer was used to measure the amount of scapular winging. Results: SA activity was significantly greater and scapular winging significantly lower during the PUP exercise with ADIM than during those without ADIM. Conclusion: PUP exercise with ADIM can be used as an beneficial method to improve SA activation and to reduce the amount of scapular winging in subjects with scapular winging.

키워드

참고문헌

  1. Bang MD, Deyle GD. Comparison of supervised exercise with and without manual physical therapy for patients with shoulder impingement syndrome. J Orthop Sports Phys Ther. 2000;30(3):126-137. https://doi.org/10.2519/jospt.2000.30.3.126
  2. Choi WJ, Yoon TL, Choi SA, et al. Different weight bearing push-up plus exercises with and without isometric horizontal abduction in subjects with scapular winging: A randomized trial. J Bodyw Mov Ther. 2016:1-7.
  3. 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. 2007;17(1):25-33. https://doi.org/10.1111/j.1600-0838.2006.00570.x
  4. Criswell E. Cram's Introduction to Surface Electromyography. 2nd ed. Sudbury, Jones & Bartlett Learning, 2010:289-299.
  5. Decker MJ, Hintermeister RA, Faber KJ, et al. Serratus anterior muscle activity during selected rehabilitation exercises. AmJ Sports Med. 1999;27(6):784-791. https://doi.org/10.1177/03635465990270061601
  6. Ekstrom RA, Soderberg GL, Donatelli RA. Normalization procedures using maximum voluntary isometric contractions for the serratus anterior and trapezius muscles during surface emg analysis. J Electromyogr Kinesiol. 2005;15(4):418-428. https://doi.org/10.1016/j.jelekin.2004.09.006
  7. Hardwick DH, Beebe JA, McDonnell MK, et al. A comparison of serratus anterior muscle activation during a wall slide exercise and other traditional exercises. J Orthop Sports Phys Ther. 2006;36(12):903-910. https://doi.org/10.2519/jospt.2006.2306
  8. Henry SM, Westervelt KC. The use of real-time ultrasound feedback in teaching abdominal hollowing exercises to healthy subjects. J Orthop Sports Phys Ther. 2005;35(6):338-345. https://doi.org/10.2519/jospt.2005.35.6.338
  9. Hides JA, Miokovic T, Belavy DL, et al. Ultrasound imaging assessment of abdominal muscle function during drawing-in of the abdominal wall: An intrarater reliability study. J Orthop Sports Phys Ther. 2007;37(8):480-486. https://doi.org/10.2519/jospt.2007.2416
  10. Hirashima M, Kadota H, Sakurai S, et al. Sequential muscle activity and its functional role in the upper extremity and trunk during overarm throwing. J Sports Sci. 2002;20(4):301-310. https://doi.org/10.1080/026404102753576071
  11. Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain: A motor control evaluation of transversus abdominis. Spine (Phila Pa 1976). 1996;21(22):2640-2650. https://doi.org/10.1097/00007632-199611150-00014
  12. Hodges PW, Richardson CA. Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds. Arch Phys Med Rehabil. 1999;80(9):1005-1012. https://doi.org/10.1016/S0003-9993(99)90052-7
  13. Jang HJ, Kim SY, Oh DW. Effects of augmented trunk stabilization with external compression support on shoulder and scapular muscle activity and maximum strength during isometric shoulder abduction. J Electromyogr Kinesiol. 2015;25(2): 387-391. https://doi.org/10.1016/j.jelekin.2014.12.005
  14. Kendall FP, McCreary EK, Provance PG, et al. Muscles: Testing and function with posture and pain. 5th ed. Baltimore, Williams & Wilkins, 2005:330-332.
  15. Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med. 2006;36(3):189-198 https://doi.org/10.2165/00007256-200636030-00001
  16. Kibler WB, Sciascia A. Current concepts: Scapular dyskinesis. Br J Sports Med. 2010;44(5):300-305. https://doi.org/10.1136/bjsm.2009.058834
  17. Kim KS, Lim OB, Yi CH, et al. Comparisons of trunk muscle activity during arm lift in prone and standing positions with and without abdominal drawing-in maneuver. Phys Ther Korea. 2012;19(4):38-45. https://doi.org/10.12674/ptk.2012.19.4.038
  18. Maenhout A, Van Praet K, Pizzi L, et al. Electromyographic analysis of knee push up plus variations: What's the influence of the kinetic chain on scapular muscle activity? Br J Sports Med. 2009;44(14):1010-1015. https://doi.org/10.1136/bjsm.2009.062810
  19. Magarey ME, Jones MA. Dynamic evaluation and early management of altered motor control around the shoulder complex. Man Ther. 2003;8(4):195-206. https://doi.org/10.1016/S1356-689X(03)00094-8
  20. Martin RM, Fish DE. Scapular winging: Anatomical review, diagnosis, and treatments. Curr Rev Musculoskelet Med. 2008;1(1):1-11. https://doi.org/10.1007/s12178-007-9000-5
  21. Martins J, Tucci HT, Andrade R, et al. Electromyographic amplitude ratio of serratus anterior and upper trapezius muscles during modified push-ups and bench press exercises. J Strength Cond Res. 2008;22(2):477-484. https://doi.org/10.1519/JSC.0b013e3181660748
  22. Misuri G, Colagrande S, Gorini M, et al. In vivo ultrasound assessment of respiratory function of abdominal muscles in normal subjects. Eur Respir J. 1997;10(12):2861-2867. https://doi.org/10.1183/09031936.97.10122861
  23. Moseley JB, Jobe FW, Pink M, et al. EMG analysis of the scapular muscles during a shoulder rehabilitation program. Am J Sports Med. 1992;20(2):128-134. https://doi.org/10.1177/036354659202000206
  24. Myers TW. Anatomy Trains: Myofascial meridians for manual and movement therapists. 3rd ed. Edinburgh, Churchill Livingstone, 2009:159-175.
  25. Neumann DA. Kinesiology of the Musculoskeletal System: Foundations for rehabilitation. 2nd ed. St Louis Mosby, 2013:161-164.
  26. O'sullivan PB. Lumbar segmental 'instability': Clinical presentation and specific stabilizing exercise management. Man Ther. 2000;5(1):2-12. https://doi.org/10.1054/math.1999.0213
  27. Park JS, Jeon HS, Kwon OY. A comparison of the shoulder stabilizer muscle activities during push-up plus between persons with and without winging scapular. Phys Ther Korea. 2007;14(2):44-52.
  28. Park KM, Cynn HS, Yi CH, et al. Effect of isometric horizontal abduction on pectoralis major and serratus anterior emg activity during three exercises in subjects with scapular winging. J Electromyogr Kinesiol. 2013;23(2):462-468. https://doi.org/10.1016/j.jelekin.2012.11.013
  29. Richardson CA, Snijders CJ, Hides JA, et al. The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain. Spine (Phila Pa 1976). 2002;27(4):399-405. https://doi.org/10.1097/00007632-200202150-00015
  30. Ries JD, Echternach JL, Nof L, et al. Test-retest reliability and minimal detectable change scores for the timed "up & go" test, the six-minute walk test, and gait speed in people with Alzheimer disease. Phys Ther. 2009;89(6):569-579. https://doi.org/10.2522/ptj.20080258
  31. Rogol IM, Ernst G, Perrin DH. Open and closed kinetic chain exercises improve shoulder joint reposition sense equally in healthy subjects. J Athl Train. 1998;33(4):315-318.
  32. Sahrmann SA. Diagnosis and treatment of movement impairment syndromes. 1st ed. St. Louis, Mosby, 2002:199-252.
  33. Suehiro T, Mizutani M, Watanabe S, et al. Comparison of spine motion and trunk muscle activity between abdominal hollowing and abdominal bracing maneuvers during prone hip extension. J Bodyw Mov Ther. 2014;18(3):482-488. https://doi.org/10.1016/j.jbmt.2014.04.012
  34. Toro ASV, Cools AM, de Oliveira AS. Instruction and feedback for conscious contraction of the abdominal muscles increases the scapular muscles activation during shoulder exercises. Man Ther. 2016;25:11-18. https://doi.org/10.1016/j.math.2016.05.331
  35. Vera-Garcia FJ, Moreside JM, McGill SM. MVC techniques to normalize trunk muscle emg in healthy women. J Electromyogr Kinesiol. 2010;20(1):10-16. https://doi.org/10.1016/j.jelekin.2009.03.010
  36. Warner JJ, Allen AA, Marks PH, et al. Arthroscopic release of postoperative capsular contracture of the shoulder. J Bone Joint Surg Am. 1997;79(8):1151-1158. https://doi.org/10.2106/00004623-199708000-00006