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Effects of Exercise and Neuromuscular Electrical Stimulation on Lower Trapezius Muscle Activity in Individuals with Round Shoulder Posture

  • Jeong Pyo Seo (Department of Physical Therapy, College of Health and Welfare Sciences, Dankook University) ;
  • Heun-Jae Ryu (Department of Public Health Sciences, Graduate School, Dankook University)
  • 투고 : 2024.03.25
  • 심사 : 2024.04.26
  • 발행 : 2024.04.30

초록

Purpose: The prolonged use of digital devices has led to the widespread adoption of poor postures, particularly rounded shoulder posture (RSP), associated with shoulder impingement and pain. This study investigates the effects of neuromuscular electrical stimulation (NMES) on RSP in healthy adults. Methods: Thirty adults with RSP were randomly assigned to NMES only, exercise only, or NMES with exercise groups. NMES was applied to the lower trapezius, which was the target muscle in this study, for a total of 2 weeks, 5 times per week, 20 minutes per session. The exercise program included pectoralis minor stretching, wall-slide exercise, dynamic hug exercise with band, and Brugger stretching for upper body with band, which were performed for a total of 2 weeks, 5 times per week, 20 minutes per session. Outcome measures, including the Supine Method (SM) for posture and surface electromyography (EMG) of the lower trapezius for muscle activity, were assessed before the intervention, after 5 sessions, and after 10 sessions. Results: All the groups showed significant changes in the SM and % maximal voluntary isometric contraction (%MVIC) over time (p<0.05). The NMES group had significantly reduced SM at 1 week, while the exercise and combined groups had reduced SM at 2 weeks (p<0.017). All the groups had increased %MVIC at 2 weeks (p<0.017), with no significant differences observed between groups. Conclusion: NMES alone can be as effective as exercise in improving RSP. NMES combined with exercise also showed positive outcomes, thus offering diverse treatment options for this condition.

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참고문헌

  1. Mol N, Abeeshna A, Kumar D et al. Upper crossed syndrome: trends and recent advances in the physiotherapy treatment a narrative review. J Pharm Res Int. 2021;33:359-67.
  2. Muscolino J. Upper crossed syndrome. J Aust Tradit Med Soc. 2015;21(2).
  3. Roshani S, Yousefi M, Sokhtezari Z et al. The effect of a corrective exercise program on upper crossed syndrome in a blind person. J Rehabil Sci Res. 2019;6(3):148-52.
  4. Javazi F, Sedaghati P, Daneshmandi H. The effect of selected corrective exercises with physioball on the posture of female computer users with upper crossed syndrome. J Sport Biomech. 2019;5(2):112-23.
  5. Hasan S, Iqbal A, Alghadir AH et al. The combined effect of the trapezius muscle strengthening and pectoralis minor muscle stretching on correcting the rounded shoulder posture and shoulder flexion range of motion among young saudi females: a randomized comparative study. Healthcare (Basel). 2023;11(4):500.
  6. Rosa DP, Borstad JD, Pires ED et al. Reliability of measuring pectoralis minor muscle resting length in subjects with and without signs of shoulder impingement. Braz J Phys Ther. 2016;20:176-83.
  7. Choi SA, Cynn HS, Lee JH et al. Relationships between rounded shoulder posture and biceps brachii muscle length, elbow joint angle, pectoralis muscle length, humeral head anterior translation, and glenohumeral range of motion. Phys Ther Korea. 2017;24(2):48-57.
  8. Ekstrom RA, Donatelli RA, Soderberg GL. Surface electromyographic analysis of exercises for the trapezius and serratus anterior muscles. J Orthop Sports Phys Ther. 2003;33(5):247-58.
  9. Ahn SJ, Choi EH, Kim MK et al. The effects of kinesiology taping and pectoralis minor self-stretching on posture change and muscle tone in adults with rounded shoulder posture. J Korean Soc Phys Med. 2019;14(4):81-91.
  10. Kang JH, Park TS. Effect of shoulder brace design on round shoulder posture. PNF & Mov. 2022;20(3):391-7.
  11. Sahrmann S. Diagnosis and treatment of movement impairment syndromes-e-book. Elsevier Health Sciences. 2001:193-256.
  12. Sahrmann S, Azevedo DC, Van Dillen L. Diagnosis and treatment of movement system impairment syndromes. Braz J Phys Ther. 2017;21(6):391-9.
  13. Bdaiwi AH, Mackenzie TA, Herrington L et al. Acromiohumeral distance during neuromuscular electrical stimulation of the lower trapezius and serratus anterior muscles in healthy participants. J Athl Train. 2015;50(7):713-8.
  14. Spector P, Laufer Y, Gabyzon ME et al. Neuromuscular electrical stimulation therapy to restore quadriceps muscle function in patients after orthopaedic surgery: a novel structured approach. J Bone Joint Surg Am. 2016;98(23):2017-24.
  15. Gondin J, Brocca L, Bellinzona E et al. Neuromuscular electrical stimulation training induces atypical adaptations of the human skeletal muscle phenotype: a functional and proteomic analysis. 2011;110(2):433-50.
  16. Decker MJ, Hintermeister RA, Faber KJ et al. Serratus anterior muscle activity during selected rehabilitation exercises. Am J Sports Med. 1999;27(6):784-91.
  17. Page P, Frank CC, Lardner R. Assessment and treatment of muscle imbalance. Champaign, IL, Human Kinetics, 2010:99-100.
  18. Park HK, Yang BI. Effects of quadruped exercise and wall slide exercise on shoulder height and muscle activity of university students with rounded shoulders. J Korean Acad Orthop Man Phys Ther. 2020;24:39-45.
  19. Yang KH, An PT, Ms SSL. The effects of intensive serratus anterior and lower trapezius muscle training with thera-band on muscle activation, height of shoulder in people with rounded shoulder. Phys Ther Korea. 2021;25(1):25-30.
  20. Kara D, Harput G, Duzgun I. Trapezius muscle activation levels and ratios during scapular retraction exercises: a comparative study between patients with subacromial impingement syndrome and healthy controls. Clin Biomech (Bristol, Avon). 2019;67:119-26.
  21. Lee E, Choi WJ, Jung DI et al. A randomized controlled trial on posture improvement and trunk muscle strength by round shoulder posture improvement exercise. Int J E Health Med Commun. 2018;9(4):1-10.
  22. Park SW, Lee HS. Effects of posture correction exercise on muscle activity and onset time during arm elevation in subject with forward head and rounded shoulder posture. J Korean Soc Phys Med. 2020;15(3):29-41.
  23. Lin JJ, Wu YT, Wang SF et al. Trapezius muscle imbalance in individuals suffering from frozen shoulder syndrome. Clin Rheumatol. 2005;24:569-75.
  24. Westgaard RH, Vasseljen O, Holte KA. Trapezius muscle activity as a risk indicator for shoulder and neck pain in female service workers with low biomechanical exposure. Ergonomics. 2001;44(3):339-53.
  25. Cools AM, Dewitte V, Lanszweert F et al. Rehabilitation of scapular muscle balance: which exercises to prescribe? Am J Sports Med. 2007;35(10):1744-51.
  26. Kang M. Arm lifting exercises for lower trapezius muscle activation. J Int Acad Phys Ther Res. 2019;10(4):1868-72.
  27. Camargo PR, Neumann DA. Kinesiologic considerations for targeting activation of scapulothoracic muscles-part 2: trapezius. Braz J Phys Ther. 2019;23(6):467-75.
  28. Kinney E, Wusthoff J, Zyck A et al. Activation of the trapezius muscle during varied forms of Kendall exercises. Phys Ther Sport. 2008;9(1):3-8.
  29. McCabe RA, Orishimo KF, McHugh MP et al. Surface electromygraphic analysis of the lower trapezius muscle during exercises performed below ninety degrees of shoulder elevation in healthy subjects. N Am J Sports Phys Ther. 2007;2(1):34.
  30. Doucet BM, Lam A, Griffin L. Neuromuscular electrical stimulation for skeletal muscle function. Yale J Biol Med. 2012;85(2):201.
  31. Trimble MH, Enoka RM. Mechanisms underlying the training effects associated with neuromuscular electrical stimulation. Phys Ther. 1991;71(4):273-80.
  32. Martimbianco ALC, Torloni MR, Andriolo BN et al. Neuromuscular electrical stimulation (NMES) for patellofemoral pain syndrome. Cochrane Database Syst Rev. 2017(12):CD011289.