Linda M Riek, Amy Aronson, Kacie Giust, Samantha Putnam, Hannah Froese, Sean Rutherford, Mary Kathryn White
{"title":"针对截瘫患者的肩胛胸肌最佳激活运动。","authors":"Linda M Riek, Amy Aronson, Kacie Giust, Samantha Putnam, Hannah Froese, Sean Rutherford, Mary Kathryn White","doi":"10.46292/sci21-00059","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Individuals with paraplegia and coexisting trunk and postural control deficits rely on their upper extremities for function, which increases the risk of shoulder pain. A multifactorial etiology of shoulder pain includes \"impingement\" of the supraspinatus, infraspinatus, long head of the biceps tendons, and/or subacromial bursa resulting from anatomic abnormalities, intratendinous degeneration, and altered scapulothoracic kinematics and muscle activation. Targeting serratus anterior (SA) and lower trapezius (LT) activation during exercise, as part of a comprehensive plan, minimizes impingement risk by maintaining optimal shoulder alignment and kinematics during functional activities. To prevent excessive scapular upward translation, minimizing upper trapezius (UT) to SA and LT activation is also important.</p><p><strong>Objectives: </strong>To determine which exercises (1) maximally activate SA and minimize UT:SA ratio and (2) maximally activate LT and minimize UT:LT ratio.</p><p><strong>Methods: </strong>Kinematic and muscle activation data were captured from 10 individuals with paraplegia during four exercises: \"T,\" scaption (sitting), dynamic hug, and SA punch (supine). Means and ratios were normalized by percent maximum voluntary isometric contraction (MVIC) for each muscle. One-way repeated measures analysis of variance determined significant differences in muscle activation between exercises.</p><p><strong>Results: </strong>Exercises were rank ordered: (1) maximum SA activation: SA punch, scaption, dynamic hug, \"T\"; (2) maximum LT activation: \"T,\" scaption, dynamic hug, SA punch; 3) minimum UT:SA ratio: SA punch, dynamic hug, scaption, \"T\"; and (4) minimum UT:LT ratio: SA punch, dynamic hug, \"T,\" scaption. Exercise elicited statistically significant changes in percent MVIC and ratios. Post hoc analyses revealed multiple significant differences between exercises (<i>p</i> < .05).</p><p><strong>Conclusion: </strong>SA punch produced the greatest SA activation and lowest ratios. Dynamic hug also produced optimal ratios, suggesting supine exercises minimize UT activation more effectively. To isolate SA activation, individuals with impaired trunk control may want to initiate strengthening exercises in supine. Participants maximally activated the LT, but they were not able to minimize UT while upright.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.4000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208257/pdf/","citationCount":"0","resultStr":"{\"title\":\"Exercises With Optimal Scapulothoracic Muscle Activation for Individuals With Paraplegia.\",\"authors\":\"Linda M Riek, Amy Aronson, Kacie Giust, Samantha Putnam, Hannah Froese, Sean Rutherford, Mary Kathryn White\",\"doi\":\"10.46292/sci21-00059\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Individuals with paraplegia and coexisting trunk and postural control deficits rely on their upper extremities for function, which increases the risk of shoulder pain. A multifactorial etiology of shoulder pain includes \\\"impingement\\\" of the supraspinatus, infraspinatus, long head of the biceps tendons, and/or subacromial bursa resulting from anatomic abnormalities, intratendinous degeneration, and altered scapulothoracic kinematics and muscle activation. Targeting serratus anterior (SA) and lower trapezius (LT) activation during exercise, as part of a comprehensive plan, minimizes impingement risk by maintaining optimal shoulder alignment and kinematics during functional activities. To prevent excessive scapular upward translation, minimizing upper trapezius (UT) to SA and LT activation is also important.</p><p><strong>Objectives: </strong>To determine which exercises (1) maximally activate SA and minimize UT:SA ratio and (2) maximally activate LT and minimize UT:LT ratio.</p><p><strong>Methods: </strong>Kinematic and muscle activation data were captured from 10 individuals with paraplegia during four exercises: \\\"T,\\\" scaption (sitting), dynamic hug, and SA punch (supine). Means and ratios were normalized by percent maximum voluntary isometric contraction (MVIC) for each muscle. One-way repeated measures analysis of variance determined significant differences in muscle activation between exercises.</p><p><strong>Results: </strong>Exercises were rank ordered: (1) maximum SA activation: SA punch, scaption, dynamic hug, \\\"T\\\"; (2) maximum LT activation: \\\"T,\\\" scaption, dynamic hug, SA punch; 3) minimum UT:SA ratio: SA punch, dynamic hug, scaption, \\\"T\\\"; and (4) minimum UT:LT ratio: SA punch, dynamic hug, \\\"T,\\\" scaption. Exercise elicited statistically significant changes in percent MVIC and ratios. Post hoc analyses revealed multiple significant differences between exercises (<i>p</i> < .05).</p><p><strong>Conclusion: </strong>SA punch produced the greatest SA activation and lowest ratios. Dynamic hug also produced optimal ratios, suggesting supine exercises minimize UT activation more effectively. To isolate SA activation, individuals with impaired trunk control may want to initiate strengthening exercises in supine. Participants maximally activated the LT, but they were not able to minimize UT while upright.</p>\",\"PeriodicalId\":46769,\"journal\":{\"name\":\"Topics in Spinal Cord Injury Rehabilitation\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208257/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Topics in Spinal Cord Injury Rehabilitation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.46292/sci21-00059\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/12/30 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Topics in Spinal Cord Injury Rehabilitation","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.46292/sci21-00059","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/30 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
Exercises With Optimal Scapulothoracic Muscle Activation for Individuals With Paraplegia.
Background: Individuals with paraplegia and coexisting trunk and postural control deficits rely on their upper extremities for function, which increases the risk of shoulder pain. A multifactorial etiology of shoulder pain includes "impingement" of the supraspinatus, infraspinatus, long head of the biceps tendons, and/or subacromial bursa resulting from anatomic abnormalities, intratendinous degeneration, and altered scapulothoracic kinematics and muscle activation. Targeting serratus anterior (SA) and lower trapezius (LT) activation during exercise, as part of a comprehensive plan, minimizes impingement risk by maintaining optimal shoulder alignment and kinematics during functional activities. To prevent excessive scapular upward translation, minimizing upper trapezius (UT) to SA and LT activation is also important.
Objectives: To determine which exercises (1) maximally activate SA and minimize UT:SA ratio and (2) maximally activate LT and minimize UT:LT ratio.
Methods: Kinematic and muscle activation data were captured from 10 individuals with paraplegia during four exercises: "T," scaption (sitting), dynamic hug, and SA punch (supine). Means and ratios were normalized by percent maximum voluntary isometric contraction (MVIC) for each muscle. One-way repeated measures analysis of variance determined significant differences in muscle activation between exercises.
Results: Exercises were rank ordered: (1) maximum SA activation: SA punch, scaption, dynamic hug, "T"; (2) maximum LT activation: "T," scaption, dynamic hug, SA punch; 3) minimum UT:SA ratio: SA punch, dynamic hug, scaption, "T"; and (4) minimum UT:LT ratio: SA punch, dynamic hug, "T," scaption. Exercise elicited statistically significant changes in percent MVIC and ratios. Post hoc analyses revealed multiple significant differences between exercises (p < .05).
Conclusion: SA punch produced the greatest SA activation and lowest ratios. Dynamic hug also produced optimal ratios, suggesting supine exercises minimize UT activation more effectively. To isolate SA activation, individuals with impaired trunk control may want to initiate strengthening exercises in supine. Participants maximally activated the LT, but they were not able to minimize UT while upright.
期刊介绍:
Now in our 22nd year as the leading interdisciplinary journal of SCI rehabilitation techniques and care. TSCIR is peer-reviewed, practical, and features one key topic per issue. Published topics include: mobility, sexuality, genitourinary, functional assessment, skin care, psychosocial, high tetraplegia, physical activity, pediatric, FES, sci/tbi, electronic medicine, orthotics, secondary conditions, research, aging, legal issues, women & sci, pain, environmental effects, life care planning