Exercises With Optimal Scapulothoracic Muscle Activation for Individuals With Paraplegia

Top Spinal Cord Inj Rehabil, 2023 · DOI: 10.46292/sci21-00059 · Published: July 1, 2023

Orthopedics Neurorehabilitation Rehabilitation

Simple Explanation

Individuals with paraplegia often rely heavily on their upper bodies, which can lead to shoulder pain. This study looked at which exercises best activate certain shoulder muscles while minimizing others to help reduce this pain. The researchers measured muscle activity during four different exercises to see which ones effectively targeted the serratus anterior (SA) and lower trapezius (LT) muscles while keeping upper trapezius (UT) activation low. The SA punch exercise was found to be the most effective at activating the SA muscle and minimizing the UT:SA ratio. The dynamic hug exercise also produced optimal ratios, suggesting that supine exercises minimize UT activation.

Study Duration

Not specified

Participants

10 individuals with paraplegia

Evidence Level

Cross-sectional observational design study

Key Findings

1
SA punch produced the greatest SA activation and lowest UT:SA ratio.
2
Dynamic hug also produced optimal UT:SA and UT:LT ratios, suggesting that supine exercises are better at minimizing excessive UT activation.
3
LT was activated significantly more in sitting (“T” and scaption) versus either supine exercise.

Research Summary

This study aimed to determine which exercises maximally activate the serratus anterior (SA) and lower trapezius (LT) muscles while minimizing the upper trapezius (UT) activation in individuals with paraplegia to address shoulder pain. The SA punch exercise was found to be the most effective at activating the SA muscle and minimizing the UT:SA ratio, while the dynamic hug exercise also produced optimal ratios. The findings suggest that supine exercises are better at minimizing excessive UT activation, while an upright position may be indicated to maximally activate the LT.

Practical Implications

Exercise Selection

SA punch and dynamic hug exercises may be beneficial for individuals with paraplegia to improve SA activation and minimize UT activation.

Positioning

Supine exercises may be preferred for minimizing excessive UT activation, while upright positions may be indicated to maximally activate the LT.

Individualized Approach

Individuals with more impaired trunk control may initially perform strengthening exercises in supine to more selectively isolate muscle activation.

Study Limitations

1
The study did not include glenohumeral musculature in the investigation.
2
The sample included individuals with paraplegia without shoulder pain, which may affect the results.
3
The interventions focused on non-weightbearing reaching activities and did not target weightbearing mechanisms of impingement.

Your Feedback

Was this summary helpful?

Back to Orthopedics