Establishing Normative Data on Scapulothoracic Musculature Using Handheld Dynamometry

2009 ◽  
Vol 18 (4) ◽  
pp. 502-520 ◽  
Author(s):  
Nichole Turner ◽  
Kristen Ferguson ◽  
Britney W. Mobley ◽  
Bryan Riemann ◽  
George Davies

Context:Scapular strength deficits have been linked to shoulder dysfunction.Objective:To establish normative data on the scapulothoracic musculature in normal subjects using a handheld dynamometer.Design:Descriptive normative data study.Setting:Field research.Subjects:172 subjects with varying levels of overhead activity.Methods:A handheld dynamometer was used to test the upper, middle, and lower trapezius; rhomboids; and serratus anterior.Main Outcome Measures:A 2-factor ANOVA was performed for each of the muscles by activity level and unilateral ratio by activity-level analyses. Post hoc analysis included multiple pairwise comparisons, using the Dunn-Bonferroni correction method.Results:Activity level did not significantly affect the unilateral ratios: Elevation:depression was 2.5:1, upward:downward rotation was 1.5:1, and protraction:retraction was 1.25:1. A rank order from strongest to weakest was established through significant comparisons.Conclusion:The unilateral ratios along with the rank order should be considered when discussing scapular rehabilitation protocols.

2019 ◽  
Vol 23 (3) ◽  
pp. 112-119
Author(s):  
M. Forghani Ozrudi

Purpose: Shoulder girdle muscles are important for stabilizing the scapula and orienting the glenoid for upper-extremity motion in student athletes. Scapular strength deficits have been linked to shoulder dysfunction. Material: study the data of scapulothoracic musculature in student athletes using a handheld dynamometer. Cohort study. 66 subjects with varying levels of overhead activity. A handheld dynamometer was used to test the upper, middle, and lower trapezius, rhomboids, and serratus anterior. A one way-factor ANOVA was performed for each of the muscles by activity level analyses. 2-factor ANOVA was performed for each of the muscles by activity level and unilateral ratio by activity-level analyses. Post hoc analysis included multiple pairwise comparisons, using the Dunn-Bonferroni correction method. Results: Activity level did not significantly affect the unilateral ratios: Elevation: depression was 2.47:1, upward: downward rotation was 1.23:1, and protraction: retraction was 2.35:1. A rank order from strongest to weakest was established through significant comparisons. Conclusions: The unilateral ratios along with the rank order should be considered when discussing scapula rehabilitation protocols. Assessment of the upper and lower trapezius and serratus anterior muscles and should be part of any shoulder examination.


2016 ◽  
Vol 25 (3) ◽  
pp. 273-279 ◽  
Author(s):  
Chang-Hee Ko ◽  
Heon-Seock Cynn ◽  
Ji-Hyun Lee ◽  
Tae-Lim Yoon ◽  
Sil-Ah Choi

Context:Scapular bracing can correct scapular kinematics and restore normal scapular-muscle activity. However, there is little evidence to support the beneficial effects of a figure-8 strap, a type of scapular bracing, on muscle length, scapular alignment, and muscle activity during arm-lifting exercise.Objective:To investigate the immediate effect of a figure-8 strap on pectoralis minor length, scapular alignment, and scapular upward-rotator-muscle activity.Design:Cross-sectional study.Setting:Research laboratory.Participants:Fifteen male participants (age 22.1 ± 1.9 y, weight 68.2 ± 5.7 kg, height 176.2 ± 3.3 cm) with forward shoulder posture (FSP) were examined for pectoralis minor length and scapular alignment with and without the application of a figure-8 strap.Main Outcome Measures:Pectoralis minor length was measured using the Pectoralis Minor Index (PMI), scapular alignment was measured with FSP, and upper trapezius, lower trapezius, and serratus anterior muscle activity were measured using surface electromyography while participants performed an arm-lifting exercise. Data collected with and without applying a figure-8 strap were compared using a paired t-test.Results:Applying a figure-8 strap significantly decreased the PMI (P = .005) and scapular anterior tilting (P = .000). There were no differences in the muscle activity of the upper trapezius (P = .784), lower trapezius (P = .241), and serratus anterior muscles (P = .639).Conclusions:A figure-8 strap resulted in positive changes in pectoralis minor length and scapular alignment. The results support its use as a treatment aid in managing pectoralis minor length and scapular alignment during arm-lifting exercises.


2007 ◽  
Vol 16 (1) ◽  
pp. 50-67 ◽  
Author(s):  
Jennifer L. Lister ◽  
Gianluca Del Rossi ◽  
Fangchao Ma ◽  
Mark Stoutenberg ◽  
Jessica B. Adams ◽  
...  

Context:There are numerous ways to overload the scapular stabilizers.Objectives:To assess scapular stabilizer activity using the Bodyblade® and other traditional training devices.Design:Repeated measures analysis of surface EMG data collected from the upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) during shoulder flexion and abduction using Bodyblade®, cuff weight, and Thera-Band® resistance.Setting:Laboratory.Participants:Thirty collegiate athletes (20.0 ± 1.7 years).Intervention:Participants performed 10 repetitions of shoulder flexion and abduction.Main Outcome Measures:For each movement, normalized root mean square values (NrmsEMG) were computed for each muscle during each repetition under each training condition. Data were analyzed using 3 (condition) × 10 (repetition) repeated measures ANOVAs.Results:During shoulder flexion and abduction, the NrmsEMG of the UT, LT, and SA were significantly greater when using the Bodyblade® than the Thera-Band® or cuff weight.Conclusion:The Bodyblade® produces greater scapular activity than traditional resistance techniques.


Author(s):  
Zoran Z. Sarcevic ◽  
Andreja P. Tepavcevic

BACKGROUND: Subacromial pain (SAP) is a common complaint of young athletes, independently of the sport engaged. The prevalence of SAP in some sports is up to 50%. OBJECTIVE: The study was aimed to investigate some new factors possibly associated to subacromial pain in young athletes. The factors considered were the grade of tightness of the clavicular portion of the pectoralis major, dysfunction of the sternoclavicular joint, and serratus anterior and lower trapezius strength. METHODS: This case-control study included 82 young athletes 9–15 years, 41 with the symptoms of SAP and 41 controls. All participants self-reported whether they had subacromial pain. In addition, Hawkins–Kennedy Test was performed to all the participants to evaluate the subacromial pressure. Main outcome measures were the grade of tightness of the clavicular portion of the pectoralis major, dysfunction of the sternoclavicular joint, and serratus anterior and lower trapezius strength. The grade of tightness of the clavicular portion of the pectoralis major and the dysfunction of the sternoclavicular joint were measured with an inclinometer. Serratus anterior and lower trapezius strength were measured by a handheld dynamometer with external belt-fixation. The data were analyzed using t-test for independent samples, Mann-Whitney U test, contingency coefficients and a stepwise binary logistic regression. RESULTS: Significant statistical difference was observed in the grade of tightness of the clavicular portion of the pectoralis major and in the variable representing the physiological functioning of the sternoclavicular joint, between the cases and the controls. There was no significant difference in serratus anterior and lower trapezius strength between the cases and the controls. Logistic regression analysis showed that the variable representing the physiological functioning of the sternoclavicular joint and the grade of shortening of the clavicular portion of the pectoralis major were good predictors for presence of SAP. CONCLUSIONS: A strong association was determined between subacromial pain in young athletes, clavicular portion of pectoralis major tightness and the dysfunction of the sternoclavicular joint.


2021 ◽  
pp. 1-6
Author(s):  
Guillermo Mendez-Rebolledo ◽  
Ann M. Cools ◽  
Rodrigo Ramirez-Campillo ◽  
Elias Quiroz-Aldea ◽  
Fernanda A.P. Habechian

Context: Knowing the possible association between the isometric strength of the shoulder rotators, scapular muscles, and the Y-balance test upper quarter (YBT-UQ) performance could help identify which indicators of shoulder stability should be considered in this field test. This study aimed to determine whether the isometric strength of the shoulder rotators and scapular muscles is associated with the YBT-UQ performance of the dominant upper limb in amateur volleyball players. Design: Cross-sectional study. Methods: A convenience sample of 22 male and 18 female volleyball players (≥12 h of training/week) between 18 and 26 years of age. The isometric strength of the middle trapezius, lower trapezius, serratus anterior, internal, and external rotator muscles was assessed with a handheld dynamometer. Participants performed the YBT-UQ in the superolateral, medial, and inferolateral directions. The absolute isometric peak force (in Newtons) was normalized to body weight (in Newtons per kilogram) for each muscle test. For each YBT-UQ direction, the distance (in centimeters) was normalized for upper limb length (in percentage). A backward multiple linear regression analysis was used to determine the associations between variables. Results: The analysis revealed that the isometric strength of the lower trapezius (β = 26.82; 95% confidence interval, 21.24–32.40) is associated with inferolateral YBT-UQ performance (adjusted R2 = .706; P < .001). This factor explains 70% of the variability of the YBT-UQ in the inferolateral direction. Conclusions: Lower trapezius isometric strength is associated with inferolateral YBT-UQ performance of the dominant upper limb in amateur volleyball players. These findings could help in the development of more specific training programs and rehabilitation goals according to the performance of the athletes in the test.


2018 ◽  
Vol 6 (11) ◽  
pp. 232596711880745 ◽  
Author(s):  
Kristy A. Pottkotter ◽  
Stephanie L. Di Stasi ◽  
Laura C. Schmitt ◽  
Robert A. Magnussen ◽  
Mark V. Paterno ◽  
...  

Background: The association between quadriceps strength and functional outcomes after anterior cruciate ligament reconstruction (ACLR) is a focus of current research, while evaluations of hamstring strength are limited, despite the frequent use of hamstring autografts. Purpose/Hypothesis: The purpose of this study was to determine the relationship between changes in quadriceps and hamstring strength symmetry and self-reported outcomes before ACLR and at 12 and 24 weeks after surgery. We hypothesized that improvements in quadriceps and hamstring strength symmetry would be correlated with improvements in self-reported outcome measures within the first 6 months after ACLR. Study Design: Cohort study; Level of evidence, 2. Methods: Thirty patients who underwent ACLR with a hamstring autograft were enrolled. Quadriceps and hamstring strength and Knee injury and Osteoarthritis Outcome Score (KOOS) values were assessed before and at 12 and 24 weeks after ACLR; limb symmetry indexes for strength were calculated at each time point. The Friedman and Wilcoxon signed-rank tests were used to analyze changes in KOOS values over time. Spearman rank-order correlations were used to test the relationship between changes in strength and KOOS values between each time point. Results: Hamstring and quadriceps limb symmetry significantly increased with time ( P ≤ .03). Fair correlations were observed between changes in the hamstring index and changes in the KOOS Symptoms subscore from before surgery to 12 weeks postoperatively ( r = 0.48; P ≤ .05). Changes in the quadriceps index (QI) were moderately correlated with changes in the KOOS Sport/Recreation subscore ( r = 0.60; P = .001), and fair correlations were seen between the QI and the KOOS Quality of Life subscore ( r = 0.39; P ≤ .04) from preoperatively to 12 weeks after surgery. Moderate correlations were seen between the QI and the KOOS Sport/Recreation subscore ( r = 0.57; P = .005) from 12 to 24 weeks after surgery. Conclusion: Improvements in quadriceps and hamstring strength symmetry were modestly associated with improvements in athletes’ perceived function in the first 6 months after ACLR. Specifically, improvements in hamstring symmetry were associated with improvements in knee symptoms within the first 12 weeks postoperatively, while improvements in quadriceps symmetry were associated with improvements in self-reported sport function throughout the first 6 months after ACLR. The restoration of strength symmetry within the first 6 months may be a critical component of rehabilitation aimed at maximizing function after ACLR. Further investigation is warranted to comprehensively evaluate whether the timing of strength gains predicts future function, including those who successfully return to their preinjury activity level after ACLR.


2021 ◽  
pp. 1-9
Author(s):  
Germanna M. Barbosa ◽  
Larissa P. Ribeiro ◽  
Ana B. Nasser ◽  
Gretchen D. Oliver ◽  
Paula R. Camargo

Context: Understanding the musculoskeletal adaptations in the shoulder complex of varying ages of tennis athletes may suggest preventive protocols and conditioning and rehabilitation programs to this population. This study aimed to generate a bilateral descriptive profile of shoulder flexibility, scapular and clavicular position, and muscle strength in pediatric and adult amateur tennis athletes. The outcome measures were compared between groups and sides. The number and percentage of athletes “at risk” according to cutoff values for shoulder range of motion (ROM) were also analyzed. Design: Cross-sectional study. Methods: 36 pediatric and 28 adult amateur tennis athletes were tested. Outcome measures were ROM of shoulder flexion, abduction, internal and external rotation, posterior capsule tightness, pectoralis minor index (PMI), scapular upward rotation, clavicular elevation, and strength of the external rotators, serratus anterior, and lower trapezius of the dominant/nondominant sides. Results: Pediatric athletes had greater dominant side external rotation (P = .01) and total ROM (P = .04), increased Low Flexion test (P = .01), and decreased PMI (P = .01) compared with the adults. Bilaterally, the pediatric athletes had greater dominant side external rotation ROM (P < .01) and decreased PMI (P = .002) as compared with their nondominant side, whereas the adults displayed lower values on posterior capsule tightness (P = .01) and decreased PMI (P = .02) on their dominant side compared with their nondominant side. For the remaining outcomes, no interaction effects were observed. The cutoff values for shoulder ROM showed that several athletes were “at risk” of shoulder problems. Conclusion: Upper extremity adaptations at the shoulder are present in both pediatric and adult tennis athletes. These data can assist clinicians in better understanding the biomechanical adaptations in the shoulder of amateur tennis athletes in different age groups.


2020 ◽  
Vol 55 (3) ◽  
pp. 265-273
Author(s):  
Wan-Yu Du ◽  
Tsun-Shun Huang ◽  
Yuan-Chun Chiu ◽  
Szu-Jieh Mao ◽  
Li-Wei Hung ◽  
...  

Context Subacromial impingement syndrome (SIS) is associated with scapular dyskinesis, or imbalanced scapular muscle activity. Evidence has shown that feedback can improve scapular control in patients with SIS. However, it is unknown whether real-time video feedback or electromyography (EMG) biofeedback is optimal for improving scapular kinematics and muscle activity during a functional task. Objective To compare the effects of video and EMG feedback sessions on absolute muscle activity (upper trapezius [UT], lower trapezius [LT], serratus anterior), muscle balance ratios (UT/LT, UT/serratus anterior), and scapular kinematics (anterior-posterior tilt, external-internal rotation, upward rotation) in SIS participants during arm elevation and lowering. Design Randomized controlled clinical trial. Setting Research laboratory. Patients or Other Participants Overhead athletes who were diagnosed with SIS and who also exhibited scapular dyskinesis (N = 41). Main Outcome Measure(s) Three-dimensional kinematics and EMG were recorded before and after feedback training. Results Lower trapezius muscle activity increased (4.2%–18%, P &lt; .011) and UT/LT decreased (0.56–1.17, P &lt; .013) in the EMG biofeedback training group as compared with those in the video feedback training group. Scapular upward rotation during arm elevation was higher in the video group than in the EMG group after feedback training (2.3°, P = .024). Conclusions The EMG biofeedback improved muscle control and video feedback improved the correction of scapular upward rotation in patients with SIS. Trial Registration Number ClinicalTrials.gov: NCT03252444.


2009 ◽  
Vol 18 (4) ◽  
pp. 535-552 ◽  
Author(s):  
Brendon P. McDermott ◽  
Douglas J. Casa ◽  
Susan W. Yeargin ◽  
Matthew S. Ganio ◽  
Rebecca M. Lopez ◽  
...  

Context:Previous field research has not identified sweat rates (SR), fluid consumption (FC), or the efficacy of an educational intervention (EI) for youth during football camp.Objective:To measure hydration status and rehydration performance and examine EI using these data.Design:Observational with EI randomized comparison.Participants:Thirty-three boys (mean ± SD: 12 ± 2 y, 52.9 ± 13.6 kg, 156 ± 12 cm) volunteered during a 5-d camp with 3 (~2-h) sessions per day (WBGT: 25.6 ± 0.5°C).Main Outcome Measures:Hydration status, SR, and FC.Results:Urine osmolality averaged 796 ± 293 mOsm/L for days 2-5. Game SR (1.30 ± 0.57 L/h) was significantly greater than practice SR (0.65 ± 0.35 L/h; P = .002). Subjects dehydrated during free time but matched fluid losses with FC (0.76 ± 0.29 L/h) during football activities.Conclusions:Subjects arrived at camp hypohydrated and maintained this condition. They matched FC and SR during, but dehydrated when not playing, football. This may impair recovery and subsequent performance. Hydration EI seemed to have a positive influence on hydration practices.


2004 ◽  
Vol 41 (3) ◽  
pp. 315-319 ◽  
Author(s):  
Takashi Tachimura ◽  
Yasuko Kotani ◽  
Takeshi Wada

Objective This study was designed to examine whether nasalance score is changed in association with placement of a palatal lift prosthesis (PLP) and whether normative data previously reported are applicable to evaluate the effect of a PLP on velopharyngeal function as it relates to nasality. Design Nasalance scores were obtained as subjects read the Kitsutsuki Passage three times with the PLP in place and then removed. Participants Forty-three children (mean age 9.0 years, SD = 3.6 years) with repaired cleft palate who were treated with a PLP were selected as subjects. Their speech was characterized by nasal emission of air, slight hypernasality without a PLP but within normal limits with a PLP in place, or both. Main Outcome Measures Comparisons were made between normative scores and the average mean nasalance score of subjects with and without the PLP. Results Average values of the mean nasalance score for subjects were 17.3% (SD 7.6%) with the PLP in place and 33.5% (SD 13.3%) without the PLP in place. These scores were greater than the mean score of 9.1% (SD 3.9%) obtained from normal controls previously reported. Conclusion A PLP can decrease nasalance scores for speakers with repaired cleft palate who exhibit velopharyngeal incompetence. It was suggested that the normative score obtained from normal adult speakers is not applicable to evaluate the effect of a PLP to improve velopharyngeal function for children wearing the PLP.


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