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http://dx.doi.org/10.21598/JKPNFA.2021.19.3.401

The Effect of the Lower Trapezius Strengthening Exercise using PNF on Pain, Range of Motion, and Disability in Patients with Frozen Shoulder  

Kang, Tae-Woo (Department of Physical Therapy, College of Health and Welfare, Woosuk University)
Song, Gui-Bin (Department of Physical Therapy, PT Rehabilitation and Education Center)
Kim, Beom-Ryong (Department of Physical Therapy, Design Hospital)
Publication Information
PNF and Movement / v.19, no.3, 2021 , pp. 401-412 More about this Journal
Abstract
Purpose: The study aimed to determine the effect of the proprioceptive neuromuscular facilitation (PNF) lower trapezius muscle strengthening exercise on pain, shoulder range of motion, and shoulder pain and disability index (SPADI) in patients with frozen shoulder. Methods: Following baseline measurements, 30 subjects (n=30) with frozen shoulder were randomized into two groups: the PNF group (n=15), which received PNF strength training of the lower trapezius muscles, and the control group (n=15), which received gentle palpation of the skin. Each group participated in the intervention for 30 minutes, three times per week, for six weeks. The visual analogue scales for pain, range of motion, and SPADI of both groups were recorded at both pre- and post-intervention. Paired t-tests were used to determine significant changes in the post-intervention period compared with pre-intervention, and independent t-tests were used to analyze differences in the dependent variables between the two groups. Results: After the six-week intervention, both groups experienced significantly decreased pain and SPADI (p < 0.05) and significantly increased shoulder flexion, abduction, internal rotation, and external rotation range of motion (p < 0.05). The PNF group that received the PNF strength exercise of the lower trapezius muscles showed greater improvements in pain and range of motion than those of the control group (p < 0.05). Conclusion: These results suggest that the PNF lower trapezius strengthening exercise reduces shoulder pain and disability levels and enhances shoulder range of motion in patients with frozen shoulder.
Keywords
Frozen shoulder; Range of motion; Strengthening exercise; Trapezius;
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1 Sahrmann SA. Diagnosisand treatment of movement impairment syndromes. St Louis. Mosby. 2001.
2 Adler SS, Beckers D, Buck, M. PNF in practice: an illustrated guide. Berlin. Springer. 2007.
3 Arlotta M, LoVasco G, McLean L. Selective recruitment of the lower fibers of the trapezius muscle. Journal of Electromyography and Kinesiology. 2011;21(3): 403-410.   DOI
4 Bae SS, Lee HO, Goo BO, et al. Change and development of proprioceptive neuromuscular facilitation. PNF and Movement. 2003;1(1):27-32.
5 Kang MS. Psychosomatic nature of pain and a critical consideration of clinical concept of pain. Philosophy of Medicine. 2010;10(1):61-80.
6 Kim BR, Lee HJ. Effects of proprioceptive neuromuscular facilitation-based abdominal muscle strengthening training on pulmonary function, pain, and functional disability index in chronic low back pain patients. Journal of Exercise Rehabilitation. 2017;13(4): 486-490.   DOI
7 Kim BR, Yi DH, Yim JE. Effect of the combined isotonic technique for proprioceptive neuromuscular facilitation and taping on pain and grip strength in patients with lateral epicondylitis: a randomized clinical trial. Journal of Exercise Rehabilitation. 2019;15(2):316-321.   DOI
8 Do JH. Effects of a physical therapy program on quality of life, and neck and shoulder disability in patients with head and neck cancer. Physical Therapy Korea. 2013;20(1):36-46.
9 Mun YR, Kim SY. The immediate effects of functional taping on pain, muscle strength, and range of motion of the shoulder after surgery in patients with rotator cuff tears. Physical Therapy Kore. 2017;24(1):19-29.
10 Park SH, Lee MM. Effects of lower trapezius strengthening exercises on pain, dysfunction, posture alignment, muscle thickness and contraction rate in patients with neck pain: randomized controlled trial. Medical Science Monitor. 2020;26(1):1-9.
11 Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Physical Therapy. 2000;83(3):276-291.   DOI
12 Kolber MJ, Saltzman SB, Beekhuizen KS, et al. Reliability and minimal detectable change of inclinometric shoulder mobility measurements. Physiotherapy Theory and Practice. 2009;25(8):572-581.   DOI
13 Lim WS, Shin HS, Kim IS, et al. The effects of scapular pattern and hold-relax technique of PNF on the ROM and VAS in frozen shoulder patients. The Journal of Korean Physical Therapy. 2002;14(1):15-26.
14 Lin JJ, Wu YT, Wang SF, et al. Trapezius muscle imbalance in individual suffering from froen shoulder syndrome. Clinical Rheumatology. 2005;24(6):569-575.   DOI
15 Pietrobon R, Coeytaux RR, Carey TS, et al. Standard scales for measurement of functional outcome for cervical pain or dysfunction: a systematic review. Spine. 2002;27(5):515-522.   DOI
16 Song MJ, K ang TW. The effect of a four-week s capular stabilization exercise program using PNF technique on scapular symmetry and range of flexion motion, pain, function, and quality of life in post-mastectomy women with breast cancer. PNF and Movement. 2021;19(1):19-29.   DOI
17 Song GB, Kim JJ, Kim KR, et al. The effects of neck stabilization exercise and proprioceptive neuromuscular facilitation on neck alignment, NDI, and static balance in adults with forward-head posture in a sitting position. PNF and Movement. 2020;18(1):11-22.
18 Yoon SH. Effects of scapular combined exercise and posture correction on neck pain, cervical curvature and improving posture in forward head posture. Korea National Sport University. Dissertation of Master's Degree. 2014.
19 Kolber MJ, Vega Jr F, Widmayer K, et al. The reliability and minimal detectable change of shoulder mobility measurements using a digital inclinometer. Physiotherapy Theory and Practice. 2011;27(2): 176-184.   DOI
20 Yong JH, Weon JH. Comparison of the EMG activities of scapular upward rotators and other scapular muscles among three lower trapezius strengthening exercises. Physical Therapy Korea. 2013;20(3):27-35.   DOI
21 Jayson MI. Frozen shoudler: adhesive capsulitis. BMJ. 1981;283(6298):1005-1006.   DOI
22 Choi JY, Jang JH, Oh JS. Effects of passive scapular alignment on electromyographic activity of trapezius in people with shortness of pectoralis monor muscle. Physical Therapy Korea. 2012;19(2):12-19.   DOI
23 Barry M, Jenner J. ABC of rheumatology: pain in neck, shoulder, and arm. BMJ. 1995;310(6973):183-186.   DOI
24 Chester R, Smith TO, Hooper L, et al. The impact of subacromial impingement syndrome on muscle activity patterns of the shoulder complex: systematic review of electromyographic studies. BMC Musculoskelet Disord. 2010;11(1):45.   DOI
25 Choi YJ, Hwang R. Effect of cervical and thoracic stretching and strengthening exercise program on forward head posture. The Journal of the Korea Contents Association. 2011;11(10):293-300.   DOI
26 Codine P, Bernard P, Pocholle M, et al. Influence of sports discipline on shoulder rotator cuff balance. Medicine & Science in Sports & Exercise. 1997;29(11): 1400-1405.   DOI
27 Cohen J. Statistical power analysis for the behavioral sciences. New York. Academic Press. 2013.
28 Elhamed abd HB, Koura GM, Hamada HA, et al. Effect of strengthening lower trapezius on scapular tipping in patients with diabetic frozen shoulder: a randomized controlled study. Biomedical Research. 2018;29(3): 442-447.
29 Hahm SC, Kim IB. Effects of static stretching and hold-relax on recovering range of motion and reducing pain of patients with frozen shoulder. Journal of Korean Physical Therapy Science. 2012;19(3):39-47.
30 Ha SM, Kwon OY, Yi CH, et al. Effects of passive correction of scapular position on pain, proprioception, and range of motion in neck-pain patients with bilateral scapular downward-rotation syndrome. Manual Therapy. 2011;16(6):585-589.   DOI
31 Lingjaerde O, Foreland AR. Direct assessment of improvement in winter depression with a visual analogue scale: high reliability and validity. Psychiatry Research. 1998;81(3):387-392.   DOI
32 Ki HS, Kwon OY, Yi CH, et al. Effects of the scapular taping on the muscle activity of the scapula rotators and pain in subjects with upper trapezius pain. Physical Therapy Korea. 2010;17(1):77-85.
33 Klein DA, Stone WJ, Phillips WT, et al. PNF training and physical function in assisted-living older adults. Journal of Aging and Physical Activity. 2002;10(4): 476-488.   DOI
34 Krekoukias G, Gelalis ID, Xenakis T, et al. Spinal mobilization vs conventional physiotherapy in the management of chronic low back pain due to spinal disk degeneration: a randomized controlled trial. Journal of Manual & Manipulative Therapy. 2017;25(2): 66-73.   DOI
35 Roy JS, MacDermid JC, Woodhouse LJ. Measuring shoulder function: a systematic review of four questionnaires. Arthritis Care & Research. 2009;61(5):623-632.   DOI
36 Tepper M, Vollenbroek-Hutten MMR, Hermens HJ, et al. The effect of an ergonomic computer device on muscle activity of the upper trapezius muscle during typing. Applied Ergonomics. 2003;34(2):125-130.   DOI
37 Kang TW. The effect of proprioceptive neuromuscular facilitation rehabilitation exercise on range of motion, pain, and function of breast cancer patients after surgery. PNF and Movement. 2018;16(1):133-141.