Background:

During nonoperative or postoperative rehabilitation after sports injuries, exercise selection is often based on minimal load on the injured/repaired glenohumeral structures, while optimally activating scapulothoracic muscles. Previous research explored scapular muscle activity during rehabilitation exercises using surface electromyography (EMG). However, limited information exists about the deeper lying muscle activity, measured with fine-wire electrodes, even more in combination with 3-dimensional scapular kinematics.

Purpose:

To report scapular kinematics synchronously with surface and fine-wire EMG during specific shoulder exercises for early rehabilitation.

Study Design:

Descriptive laboratory study.

Methods:

A total of 23 healthy male patients were recruited. Three-dimensional scapular kinematics were measured combined with EMG recording of 8 muscles during 4 commonly used shoulder exercises (inferior glide, low row, lawnmower, and robbery). Upper (UT), middle (MT), and lower (LT) trapezius and serratus anterior muscle activities were measured with bipolar surface electrodes. Intramuscular electrodes were placed in the levator scapulae (LS), rhomboid major (RM), pectoralis minor (Pm), and infraspinatus (IS) muscles. All data were normalized as a percentage of maximal voluntary isometric contraction (%MVIC). A linear mixed model with Bonferroni correction was applied for statistical analysis.

Results:

Scapular kinematics revealed an anterior tilt position during the inferior glide, low row, and robbery (P < .05). An upward rotation position between 20° and 30° was reached in all exercises except low row. Inferior glide (31°) and low row (42°) represented a significantly increased internal rotation position compared with lawnmower and robbery. Lawnmower and robbery showed significantly (P < .05) more MT (lawnmower, 36% MVIC; robbery, 39% MVIC) and RM (lawnmower, 59% MVIC; robbery, 66% MVIC) activation compared with inferior glide and low row. Lawnmower and robbery showed significantly (P < .05) less Pm activation (9.5%-12% MVIC). LS was significantly more active during robbery (58% MVIC) compared with inferior glide and low row (27%-36% MVIC) (P < .05). IS showed moderate activity (24%-37% MVIC) for all exercises, except low row (13% MVIC).

Conclusion/Clinical Relevance:

This study provides new insights about scapular positions and activation of the deeper layer muscles during 4 commonly used shoulder rehabilitation exercises. The lawnmower showed a favorable position of the scapula with less Pm activity in contrast to the low row. The inferior glide, lawnmower, and robbery should not be implemented in early phases of shoulder rehabilitation because of their moderate muscle activity.

中文翻译：

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肩部运动期间使用细线电极分析肩cap运动学和肌肉活动。

背景：

运动损伤后的非手术或术后康复过程中，运动选择通常基于对受伤/修复的盂肱体结构的最小负荷，同时最佳地激活肩or孔肌。先前的研究使用表面肌电图（EMG）探索了康复锻炼过程中的肩cap肌活动。但是，有关使用细线电极测量的更深层肌肉活动的信息有限，甚至与3维肩cap运动学结合使用时，信息还很少。

目的：

在特定的肩部锻炼过程中，与表面和细线肌电图同步报告肩cap运动，以进行早期康复。

学习规划：

描述性实验室研究。

方法：

总共招募了23名健康男性患者。在4种常用的肩部锻炼（下滑行，低行，割草机和抢劫）中，测量了三维肩cap运动学并结合EMG记录了8条肌肉。使用双极表面电极测量上斜方肌（UT），中斜方肌（MT）和下斜肌（LT）和锯齿肌的前肌活动。肌内电极放置在肩提肌（LS），大菱形（RM），小胸大肌（Pm）和鼻下肌（IS）肌肉中。所有数据均以最大自愿等距收缩百分比（％MVIC）标准化。具有Bonferroni校正的线性混合模型用于统计分析。

结果：

肩cap运动学显示在下滑行，低行和抢劫期间前倾位置（P <.05）。除低排以外，所有练习都达到20°至30°的向上旋转位置。与割草机和抢劫相比，下滑行（31°）和低行（42°）表示内部旋转位置明显增加。割草机和抢劫的MT（割草机，MVIC为36％;抢劫，39％MVIC）和RM（割草机，59％MVIC;抢劫，66％MVIC）与下滑道和低排滑道相比，活化显着（P <.05）。割草机和抢劫案显示Pm活化显着降低（P <.05）（9.5％-12％MVIC）。与下滑行和低排（27％-36％MVIC）相比，抢劫期间LS的活跃度更高（MVIC为58％）（P <.05）。除低排（13％MVIC）外，所有锻炼的IS均显示中等活动度（24％-37％MVIC）。

结论/临床意义：

这项研究提供了关于4种常用肩关节康复运动期间肩骨位置和深层肌肉激活的新见解。与低排相比，割草机显示出肩the骨的有利位置，Pm活性较低。下滑行，割草机和抢劫不宜在肩部康复的早期阶段进行，因为它们的肌肉活动中等。