DOI QR코드

DOI QR Code

Does the Use of Sling Influence Scapular Stabilizers' Activity During Push Up Plus Exercises in Subjects With Scapular Dyskinesis?

  • Lee, Dong-hun (Dept. of Physical Therapy, The Graduate School, Yonsei University) ;
  • Cynn, Heon-seock (Dept. of Physical Therapy, College of Health Science, Yonsei University) ;
  • Yoon, Tae-lim (Department of Physical Therapy, College of Health Science, Cheongju University) ;
  • Lee, Ji-hyun (Dept. of Physical Therapy, The Graduate School, Yonsei University)
  • 투고 : 2016.11.22
  • 심사 : 2017.01.10
  • 발행 : 2017.02.19

초록

Background: Scapular dyskinesis is characterized by altered scapular position and motion. Specifically, excess activation of the Upper trapezius (UT) combined with decreased Lower trapezius (LT) and Serratus anterior (SA) have been observed. The Standard push-up plus exercise (SPP) is considered as a therapeutic exercise for increasing SA activity and maintaining the scapular kinematics. In addition, Using the Sling surface can lead to higher muscle activity. However, the advantage of an unstable surface has been uncertatin. Objects: To compare the activation of the UT, LT, and lower serratus anterior (LSA) muscles during various push-up plus exercises with and without sling in subjects with scapular dyskinesis. Methods: Total 18 male subjects with scapular dyskinesis were recruited. The UT, LT, and LSA electromyographic activities and the UT/LSA and UT/LT EMG activity ratios were measured during three push-up plus exercises with and without sling. Two-way repeated of analysis of variance was used to determine the statistical significance. Results: The UT activity was significantly lower in all postures without sling than that with sling. In addition, the LSA activity was significantly greater without than with sling, and significantly large in SPP, Low back supported push-up plus (LSPP), and Quadruped push-up plus. Additionally, the UT/LSA and UT/LT activity ratios were lower in SPP and LSPP without sling than with the other four push-up plus exercises. Conclusion: The push-up plus without sling were considered to decrease UT and increase LSA activity compared with exercises with sling. Furthermore, SPP without sling seems to be a more effective exercise for increasing LSA activity and lowering the UT/LSA and UT/LT activity ratios in scapular dyskinesis subjects.

키워드

참고문헌

  1. Batista L, Oliveira V, Piraua A, et al. Electromyographic activity of scapular stabilizers muscles during push up exercise variations in subjects with and without shoulder impingement syndrome. Motricidade. 2013;9(3):70-82.
  2. Beach TA, Howarth SJ, Callaghan JP. Muscular contribution to low-back loading and stiffness during standard and suspended push-ups. Hum Mov Sci. 2008;27(3):457-472. https://doi.org/10.1016/j.humov.2007.12.002
  3. Behm DG, Anderson KG. The role of instability with resistance training. J Strength Cond Res. 2006;20(3):716-722. https://doi.org/10.1519/R-18475.1
  4. Cools AM, Dewitte V, Lanszweert F, et al. Rehabilitation of scapular muscle balance which exercises to prescribe? Am J Sports Med. 2007;35(10):1744-1751. https://doi.org/10.1177/0363546507303560
  5. Cools AM, Witvrouw EE, Declercq GA, et al. Scapular muscle recruitment patterns: Trapezius muscle latency with and without impingement symptoms. Am J Sports Med. 2003;31(4):542-549. https://doi.org/10.1177/03635465030310041101
  6. De Mey K, Danneels L, Cagnie B, et al. Shoulder muscle activation levels during four closed kinetic chain exercises with and without redcord slings. J Strength Cond Res. 2014;28(6):1626-1635. https://doi.org/10.1519/JSC.0000000000000292
  7. de Oliveira AS, de Morais Carvalho M, de Brum DP. Activation of the shoulder and arm muscles during axial load exercises on a stable base of support and on a medicine ball. J Electromyogr Kinesiol. 2008;18(3):472-479. https://doi.org/10.1016/j.jelekin.2006.09.009
  8. Decker MJ, Hintermeister RA, Faber KJ, et al. Serratus anterior muscle activity during selected rehabilitation exercises. Am J Sports Med. 1999;27(6):784-791. https://doi.org/10.1177/03635465990270061601
  9. 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
  10. Hermens HJ, Freriks B, Disselhorst-Klug C, et al. Development of recommendations for semg sensors and sensor placement procedures. J Electromyogr Kinesiol. 2000;10(5):361-374. https://doi.org/10.1016/S1050-6411(00)00027-4
  11. Herrington L, Waterman R, Smith L. Electromyographic analysis of shoulder muscles during press-up variations and progressions. J Electromyogr Kinesiol. 2015;25(1):100-106. https://doi.org/10.1016/j.jelekin.2014.10.002
  12. Holtermann A, Mork P, Andersen L, 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. https://doi.org/10.1016/j.jelekin.2009.02.009
  13. Huang JS, Pietrosimone BG, Ingersoll CD, et al. Sling exercise and traditional warm-up have similar effects on the velocity and accuracy of throwing. J Strength Cond Res. 2011;25(6):1673-1679. https://doi.org/10.1519/JSC.0b013e3181da7845
  14. Huang TS, Huang HY, Wang TG, et al. Comprehensive classification test of scapular dyskinesis: A reliability study. Man Ther. 2014;20(3):427-432. https://doi.org/10.1016/j.math.2014.10.017
  15. Huang TS, Ou HL, Huang CY, et al. Specific kinematics and associated muscle activation in individuals with scapular dyskinesis. J Shoulder Elbow Surg. 2015;24(8):1227-1234. https://doi.org/10.1016/j.jse.2014.12.022
  16. Kibler W, Ludewig P, McClure P, et al. Clinical implications of scapular dyskinesis in shoulder injury: The 2013 consensus statement from the 'scapular summit'. Br J Sports Med. 2013;47(14): 877-885. https://doi.org/10.1136/bjsports-2013-092425
  17. Kibler WB, McMullen J. Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg. 2003;11(2):142-151. https://doi.org/10.5435/00124635-200303000-00008
  18. 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
  19. Lear LJ, Gross MT. An electromyographical analysis of the scapular stabilizing synergists during a push-up progression. J Orthop Sports Phys Ther. 1998;28(3):146-157. https://doi.org/10.2519/jospt.1998.28.3.146
  20. Lehman GJ, Gilas D, Patel U. An unstable support surface does not increase scapulothoracic stabilizing muscle activity during push up and push up plus exercises. Man Ther. 2008;13(6):500-506. https://doi.org/10.1016/j.math.2007.05.016
  21. Ludewig PM, Hoff MS, Osowski EE, et al. Relative balance of serratus anterior and upper trapezius muscle activity during push-up exercises. Am J Sports Med. 2004;32(2):484-493. https://doi.org/10.1177/0363546503258911
  22. 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.
  23. Ludewig PM, Phadke V, Braman JP, et al. Motion of the shoulder complex during multiplanar humeral elevation. J Bone Joint Surg. 2009;91(2):378-389. https://doi.org/10.2106/JBJS.G.01483
  24. Lunden JB, Braman JP, Laprade RF, et al. Shoulder kinematics during the wall push-up plus exercise. J Shoulder Elbow Surg. 2010;19(2):216-223. https://doi.org/10.1016/j.jse.2009.06.003
  25. Maenhout A, Van Praet K, Pizzi L, et al. Electromyographic analysis of knee push up plus variations: What is the influence of the kinetic chain on scapular muscle activity? Br J Sports Med. 2010;44(14):1010-1015. https://doi.org/10.1136/bjsm.2009.062810
  26. 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. http://doi.org/10.1519/JSC.0b013e3181660748
  27. McClure P, Tate AR, Kareha S, et al. A clinical method for identifying scapular dyskinesis, part 1: Reliability. J Athl Train. 2009;44(2):160-164. https://doi.org/10.4085/1062-6050-44.2.160
  28. Naughton J, Adams R, Mahr C. Upper-body wobbleboard training effects on the post-dislocation shoulder. Phys Ther Sport. 2005;6(1):31-37. https://doi.org/10.1016/j.ptsp.2004.05.005
  29. Park KM, Cynn HS, Kwon OY, et al. Comparison of pectoralis major and serratus anterior muscle activities during different push-up plus exercises in subjects with and without scapular winging. J Strength Cond Res. 2014;28(9):2546-2551. https://doi.org/10.1519/JSC.0000000000000443
  30. Park SY, Yoo WG. Differential activation of parts of the serratus anterior muscle during push-up variations on stable and unstable bases of support. J Electromyogr Kinesiol. 2011;21(5):861-867. https://doi.org/10.1016/j.jelekin.2011.07.001
  31. Piraua ALT, Pitangui ACR, Silva JP, et al. Electromyographic analysis of the serratus anterior and trapezius muscles during push-ups on stable and unstable bases in subjects with scapular dyskinesis. J Electromyogr Kinesiol. 2014;24(5):675-681. https://doi.org/10.1016/j.jelekin.2014.05.009
  32. Pontillo M, Orishimo KF, Kremenic IJ, et al. Shoulder musculature activity and stabilization during upper extremity weight-bearing activities. Am J Sports Phys Ther: 2007;2(2):90-96.
  33. Tucker WS, Armstrong CW, Gribble PA, et al. Scapular muscle activity in overhead athletes with symptoms of secondary shoulder impingement during closed chain exercises. Arch Phys Med Rehabil. 2010;91(4):550-556. https://doi.org/10.1016/j.apmr.2009.12.021
  34. Uhl TL, Carver TJ, Mattacola CG, et al. Shoulder musculature activation during upper extremity weight-bearing exercise. J Orthop Sports Phys Ther. 2003;33(3):109-117. https://doi.org/10.2519/jospt.2003.33.3.109
  35. Uhl TL, Kibler WB, Gecewich B, et al. Evaluation of clinical assessment methods for scapular dyskinesis. Arthroscopy. 2009;25(11):1240-1248. https://doi.org/10.1016/j.arthro.2009.06.007
  36. Weon JH, Kwon OY, Cynn HS, et al. Real-time visual feedback can be used to activate scapular upward rotators in people with scapular winging: An experimental study. J Physiother. 2011;57(2):101-107. https://doi.org/10.1016/S1836-9553(11)70020-0