Scapular Muscle Recruitment during Therapeutic Exercise
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Proprioceptive neuromuscular facilitation (PNF) patterns have been used to improve muscle strength and may facilitate muscle recruitment patterns typically seen during overhead activities. The purpose of this study is to compare scapula muscle activity during commonly used scapular strengthening exercises. Ten healthy men and twenty healthy women between the ages of 18 and 23 participated in the study (n=30, mean age 23±4 yrs., mean height 1.69±0.16m, mean mass 72.6±15 kg). Prior to enrollment in the study, subjects were screened for inclusion and exclusion criteria, which included no history of shoulder pathology were recruited for this study.Allparticipants performed the following exercises while surface EMG recorded the activity of the scapula muscles: (1) seated row, (2) push-up with a plus, (3) D1 flexion PNF and (4) D2 flexion PNF pattern. The main outcome measures were:average percent maximum voluntary isometric contraction (MVIC) of middle trapezius, lower trapezius, upper trapezius and serratus anterior muscle during each exercise.When performing the D2 PNF exercise, middle trapezius was more active compared to the row (p=0.012) and the D1 PNF exercise (p<0.001). There were no differences in serratus anterior activity (p>
0.05). The ratio between upper trapezius to lower trapezius was higher during the PNF exercises versus the throw (p<0.05). These results suggest that the D2 flexion exercise is most efficient for recruiting the middle trapezius and serratus anterior, but it does not encourage ideal intramuscular activation of the scapular muscles as compared to an overhead activity.