Rhomboideus Research Articles

Getting more from standard rotator cuff strengthening exercises.

A simple modification to standard rotator cuff exercises using an additional resistance band around the scapula has been recommended in the clinical setting, postulated to encourage activation of the posterior scapular stabilisers and increase rotator cuff activation. The aim of this clinical laboratory study was to compare scapular and rotator cuff muscle activation between standard and modified exercises. Electromyographic data were collected from 10 healthy adults via surface and intramuscular electrodes from the scapular and rotator cuff muscles. Internal and external rotation exercises of the shoulder with the arm abducted to 0°, 45° and 90° were performed using one handheld resistance band (standard) or two bands with the additional band applied to the scapula (modified). Activation of the trapezii and rhomboid muscles during the modified exercises at 0° and 45° of abduction was significantly greater when compared to the standard exercises (P < 0.05). No significant differences were found in rotator cuff muscle activation. Applying resistance to the posterior scapula increases activation of some scapular stabilising muscles particularly in lower ranges of abduction. This study provides preliminary evidence that this simple modification can elicit greater scapular muscle activity, potentially producing enhanced exercise outcomes with minimal additional effort.

Thoracic Spine Manipulation on Pressure Pain Sensitivity of Active Myofascial Trigger Points in Rhomboid Muscle

Thoracic Spine Manipulation on Pressure Pain Sensitivity of Active Myofascial Trigger Points in Rhomboid Muscle

Skeletal muscle proteome of piglets is affected in a muscle-dependent manner by a limiting total sulfur amino acid supply.

A total sulfur amino acid (TSAA) deficient diet can affect the amino acid composition of skeletal muscles. However, it is unknown how the different muscle proteins are affected by the TSAA deficiency. The proteomic profiles of the fast-twitch glycolytic longissimus (LM) and the slow-twitch oxidative rhomboideus (RM) muscles were compared in 42-day-old piglets fed either a 28% deficient (TSAA-) or a sufficient (TSAA+) diet in TSAA for 10 days. Differentially regulated proteins were identified and submitted to Gene Ontology Pathways Analysis to identify biological processes affected by TSAA deficiency. A total of 36 proteins in LM and 24 proteins in RM differed in abundance between the two dietary treatments. In both muscles, an increased oxidative energy metabolism was observed in TSAA- piglets. However, a greater mitochondrial oxidation of pyruvate generated from glycolysis was observed in LM of TSAA- piglets, whereas fatty acid β-oxidation and glycogen sparing were favored in RM. This suggests a muscle-specific reorientation of energy metabolism in response to a TSAA- deficiency. In both muscles, the protein abundance and enzyme activity of superoxide dismutase were increased in TSAA- piglets. Other enzymes involved in antioxidant defense, heat shock proteins coping with cellular stress, and annexins involved in the regulation of apoptosis were generally found to be more expressed in the LM of TSAA- piglets, with no or minor changes in RM. Skeletal muscle proteome in young growing piglets was modulated in a muscle-dependent manner by a deficient TSAA supply, with accentuated changes in fast-twitch glycolytic muscle.

Neck Muscle Changes Following Long-Duration Spaceflight.

The effects of long-duration spaceflight on crewmember neck musculature have not been adequately studied. The purpose of this study was to evaluate the changes in the neck musculature on pre-flight and post-flight magnetic resonance imaging (MRI) examinations of six crewmembers on 4- to 6-month missions equipped with the advanced resistive exercise device (aRED). The MRI images were resliced to remove variations in spinal curvature, the cross-sectional area (CSA), and muscle fat infiltration (MFI) of neck musculature at the C1-C2, C4-C5, C7-T1, and T1-T2 intervertebral disc levels were measured bilaterally. Percent changes in the neck muscle CSA and fatty infiltration following spaceflight were calculated, and mixed models were used to assess significance of these changes. Crewmembers on missions equipped with the aRED experienced an average 25.1% increase in CSA for the trapezius muscle at C6-C7, an average 11.5% increase in CSA for the semispinalis capitis muscle at C4-C5, an average 9.0% increase in CSA for the sternocleidomastoid muscle at C4-C5, and an average 23.1% increase in CSA for the rhomboid minor at T1-T2. There were no significant changes in the CSA of the levator scapulae, splenius capitis, rectus capitis posterior major, scalenus anterior, scalenus posterior, scalenus medius, longissimus capitis, or obliquus capitis inferior muscles at the locations measured. None of the muscles analyzed experienced statistically significant changes in fatty infiltration with spaceflight. Our study indicates that long-duration spaceflight conditions are associated with preservation of CSA in most neck muscles and significant increases in the CSAs of the trapezius, semispinalis capitis, sternocleidomastoid, and rhomboid minor muscles. This may indicate that cervical muscles are not subjected to the same degradative effects microgravity imparts on the majority of muscles.

Expansion of 1 mL of Solution by Ultrasound-Guided Injection Between the Trapezius and Rhomboid Muscles: A Cadaver Study.

An ultrasound-guided interfascial injection, which targets the space between the epimysia, is often performed for myofascial neck and shoulder pain. However, the relationship between the injection volume and clinical effectiveness has been controversial. We conducted an anatomical study with cadavers to measure the distribution of a small amount of pigment solution injected into the interfascial space. An experimental cadaveric study. An institutional clinical anatomy laboratory. We performed 20 ultrasound-guided injections with pigment solutions of 1.0 mL each into the space between the trapezius muscle and rhomboid muscle bilaterally on 10 cadaver specimens. Cadavers were then dissected and macroscopically evaluated for pigment distribution on the fascia of the muscular surfaces. The pigment distribution area of each injection site was visually confirmed and calculated using automatic area calculation software. Pigment solution exclusively within the interfascial space was visually confirmed in 95% (19/20) of injection sites. The median pigmented surface area (interquartile range) was 24.50 (16.17-30.76) cm2 on the deep side of the trapezius muscle and 18.82 (13.04-24.79) cm2 on the superficial side of rhomboid muscle; these measurements were statistically significantly different (P = 0.033). A pigment solution comprising as little as 1.0 mL injected under ultrasound guidance separated two adjacent muscles and spread to the wide area within the interfascial space. The difference in the pigment distribution area between the two adjacent muscles can be explained by the path made by the injection needle and several layers of fascia between the epimysium.

Comparison of radial shockwave and dry needling therapies in the treatment of myofascial pain syndrome

Background/Aims Myofascial pain syndrome is a frequent problem in the musculoskeletal system. As a method of treatment for myofascial pain syndrome, dry needling therapy is an effective and convenient treatment for patients because they do not need to be treated every day. However, as patients often have post-needle soreness or some patients are afraid of needles, there are limitations to this treatment. The purpose of this study is to compare the effectiveness of radial shockwave therapy with dry needling therapy to treat myofascial pain. Methods A total of 42 patients attending the rehabilitation department with at least one myofascial pain trigger point in their upper back muscles, were randomly assigned to receive radial shockwave therapy or dry needling therapy. Treatment was performed once a week for 3 weeks in both groups. Participants' pain pressure threshold, measured using an algometer, and pain levels, measured using a numeric pain scale, were assessed before the designated treatment was applied each week. Each patient also performed upper trapezius, rhomboid and infraspinatus muscle stretches twice a day throughout the study period. Results There was no difference in pain pressure threshold at the three trigger points before treatment with the different modalities commenced. At the end of the study, the radial shockwave therapy group had a significant improvement in trapezius pain pressure threshold, increasing from 11.7 at baseline to 14.8 at the end of study. There was no significant between-group difference in pain level (P=3.4 vs P=2.6) at the end of the study. Both treatments significantly reduced pain levels: from 7.2 to 3.4 in the radial shockwave group (P&lt;0.001) and from 6.8 to 2.6 in the dry needling therapy group (P&lt;0.001). Conclusions Dry needling and radial shock wave therapies are effective in reducing myofascial pain syndrome originating in the upper back muscles. Participants' pain pressure threshold increased after 3 weeks of treatment with both therapies. Radial shock therapy can be used as an alternative to dry needling in the treatment of myofascial pain syndrome in patients who have trouble attending daily physical therapy or in whom dry needling therapy is contraindicated.

O-39 High resolution ultrasound of scapula alata – A prospective case control study

Scapulae alatae (SA) is a rare but also underreported disorder caused by neuromuscular disturbance in the scapulothoracic stabilizer muscles. The study is a single-blinded, prospective, controlled multi-center-study. We recruited 27 patients and 41 healthy-subjects. A standardized clinical examination was performed, electrodiagnostic-tests(EDx) were performed according to the department’s guidelines, and a Siemens ACUSON S1000 device with a high-frequency linear array transducer (18L6HD) used. The serratus anterior (SAM), trapezius and rhomboid muscles and the long thoracic (LTN), dorsal scapular, and accessory nerves were scanned bilaterally at predefined standardized sites. Muscle-thickness and nerve-diameter were measured. A reliability study in ten subjects was performed. Twenty patients showed a medial winging, seven patients showed a lateral winging and one patient had a lateral winging on the static examination but a medial winging on the dynamic examination. EDx were normal in 11 (40%) out of 27 patients. In patients with medial winging, the ratio of muscle thickness of SAM between the symptomatic side and the asymptomatic side differed significantly from the ratio in healthy-subjects: upper SAM (p-value: 0.007), lower SAM (p-value: 0.003), but no difference found for middle SAM (p-value: 0.051). Comparing difference in LTN diameter between the symptomatic and asymptomatic side in the patients with the difference between sides in the healthy-subjects, we found significant difference in two of three scanning-sites in the neck. The diagnosis of SA patients can be difficult and EDx are often normal. Our study shows that ultrasound of the neck/ shoulder may be used as a supplement in the diagnostic work-up.

Efficacy of rhomboid intercostal block for analgesia after thoracotomy.

Regional anesthesia, including central and plane blocks (serratus anterior plane block and erector spinae block), are used for post-thoracotomy pain. The rhomboid intercostal block (RIB) is mainly performed by injection to the upper intercostal muscle plane below the rhomboid muscle. It has been reported to provide analgesia at the T3–T9 levels. The RIB was performed on 5 patients who had been scheduled for thoracotomy. The catheter was advanced in the area under the rhomboid muscle between the intercostal muscles. Postoperative visual analog scale (VAS) scores were observed and each patient’s resting VAS score remained below 3 for 48 hours. The RIB has been observed to be a convenient plane block for post-thoracotomy analgesia. We believe that further information from detailed studies is required.

Widespread Pressure Pain Sensitivity and Referred Pain from Trigger Points in Patients with Upper Thoracic Spine Pain.

The presence of trigger points (MTrPs) and pressure pain sensitivity has been well documented in subjects with neck and back pain; however, it has yet to be examined in people with upper thoracic spine pain. The purpose of this study was to investigate the presence of MTrPs and mechanical pain sensitivity in individuals with upper thoracic spine pain. Seventeen subjects with upper thoracic spine pain and 17 pain-free controls without spine pain participated. MTrPs were examined bilaterally in the upper trapezius, rhomboid, iliocostalis thoracic, levator scapulae, infraspinatus, and anterior and middle scalene muscles. Pressure pain thresholds (PPTs) were assessed over T2, the C5-C6 zygapophyseal joint, the second metacarpal, and the tibialis anterior. The numbers of MTrPs between both groups were significantly different (P < 0.001) between patients and controls. The number of MTrPs for each patient with upper thoracic spine pain was 12.4 ± 2.8 (5.7 ± 4.0 active TrPs, 6.7 ± 3.4 latent TrPs). The distribution of MTrPs was significantly different between groups, and active MTrPs within the rhomboid (75%), anterior scalene (65%), and middle scalene (47%) were the most prevalent in patients with upper thoracic spine pain. A higher number of active MTrPs was associated with greater pain intensity and longer duration of pain history. This study identified active MTrPs and widespread pain hypersensitivity in subjects with upper thoracic spine pain compared with asymptomatic people. Identifying proper treatment strategies might be able to reduce pain and improve function in individuals with upper thoracic spine pain. However, future studies are needed to examine this.

Positive association between the cross-sectional area of the rhomboid muscle, and the range of shoulder abduction after neck dissection surgery.

To evaluate the association between the cross-sectional area of selected shoulder and scapular muscles and the range of shoulder abduction, early after neck dissection surgery. Twenty-seven patients (contributing 34 upper limbs), who had undergone neck dissection surgery for head and neck malignancy, were enrolled into the study. Loss of strength of the trapezius muscle at 1-month post-surgery was quantified by the change in active range of shoulder abduction (%A-ROM), measured by hand-held goniometry in a standing position, from baseline, before surgery. The cross-sectional area of the following muscles were measured on unenhanced computed tomography images after surgery: trapezius, rhomboid, serratus anterior, pectoralis major, deltoid, and biceps brachii. There was a significant positive correlation between the %A-ROM and the cross-sectional area of the rhomboid muscle. Greater active shoulder abduction early after surgery is associated with a greater cross-sectional area of the rhomboid muscle. This muscle should be included in intensive programs for rehabilitation of upper limb movement after neck dissection surgery.

Conventional MRI to detect the differences between mass-like tuberculosis and lung cancer.

The aim of this study was to investigate differences in the imaging features of mass-like tuberculosis and lung cancer on conventional MR sequences to improve the diagnostic ability for pulmonary masses. Thirty patients with suspicious pulmonary lesions were enrolled and diagnosed with tuberculosis by pathology or comprehensive clinical diagnoses. Twenty-six cases of lung cancer were retrospectively analyzed. Transverse fat-suppressed T2-weighted (T2W) imaging and T1-weighted (T1W) imaging were obtained at 1.5 Tesla. The imaging characteristics of lesions on the T2W and T1W images were compared between the two groups. The imaging features of enlarged mediastinal lymph nodes on T2W images were studied and compared. On T2W images, there was a higher percentage of lesions containing hypointensity in the tuberculosis group (GTB) than in the lung cancer group (GLC) (P=0.004).The incidence of lesions demonstrating heterogeneous intensity was significantly greater in the GTB than in the GLC (70.0% vs. 7.7%, P=0.001). Approximately 92.3% of the lung cancer cases showed hyperintensity, a proportion substantially greater than that in the GTB (6.7%). On T1W images, more cases showed hyperintensity in the GTB than in the GLC (43.3% vs. 7.7%, P=0.003). The signal intensity ratios (SIRs) of the lesion to rhomboid muscle on T2W and T1W images were significantly different between the two groups. The mean intrasubject standard deviation (SD) of lesions in the GTB was markedly greater than that in the GLC on both T2W and T1W images. Benign mediastinal lymph nodes in the GTB showed a variety of signals on T2W images, whereas 80% of metastatic mediastinal lymph nodes displayed slight homogeneous hyperintensity, and this difference between the two groups was statistically significant. Conventional MR sequences can reveal the essential differences between mass-like tuberculosis and lung cancer and may be helpful for discriminating pulmonary masses.

Correlation of scapulo-thoracic muscle strength, neck pain and the functional status of information technology professionals

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The cross-sectional study was to correlate scapulo-thoracic muscle strength, neck pain and the functional status of Information Technology (IT) professionals. IT professionals have long working hours in a seated position which can lead to neck pain and decrease in the scapulo-thoracic muscle strength. This could hinder the person’s capability to perform daily functional activities.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The study was conducted in an IT- company from November 2017- December 2017. FET was used to assess the scapulo-thoracic muscle strength. Neck pain and functional status of the IT professional was evaluated by the two scales–Neck Disability Index and Orebro Pain Rating Questionnaire respectively. For the statistical analysis–Spearman’s correlation and SPSS software was used. All subjects, male and female, with neck pain and having worked for more than 2 years were included. Subjects with diagnosed orthopaedic condition and having a history of trauma were excluded. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; For the IT professionals, a moderate correlation was established between the neck pain and strength of serratus anterior muscle R(r=0.32) L(r=0.4) and rhomboid muscles R(r=0.37) L(r=0.4). Further, it was seen that the functional status was not hampered due to neck pain and scapulo-thoracic muscle strength.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The study shows that there is a moderate correlation between the neck pain and scapula-thoracic muscle strength of IT professionals. In addition, there is a weak correlation between neck pain, scapulo-thoracic muscle strength with respect to the functional status.&lt;/p&gt;

An Unusual Back Muscle Identified Bilaterally: Case Report

Most muscular structures in the human body are named based on their function, origin/insertion, or shape. During routine dissection of the back, an unusual muscle was found deep to the rhomboid muscles. The details of this case and a review of the extant literature are provided.

Electrodiagnostic findings in postoperative C5 palsy after cervical laminectomy and fusion

Abstract Proximal upper extremity weakness is a poorly understood complication of cervical spine surgery. The cause of this complication is unknown, although most patients recover completely over weeks to months with conservative treatment. We present two cases of postoperative, transient clinical C5 palsy after laminectomy and fusion as well as pre- and postoperative electrodiagnostic (EDX) examinations which demonstrate C6 nerve root involvement. EDX studies performed after surgery revealed active denervation of the deltoid and biceps muscles on the symptomatic side. In contrast, the ipsilateral rhomboid muscles appeared unaffected. We suggest that the current models of postoperative C5 palsy pathogenesis may be inadequate to explain our findings and propose an alternative theory of watershed ischemia distal to the origin of the dorsal scapular nerve as a contributing factor to the etiology of this surgical complication. EDX studies may be used to assist with diagnosis, confirm involved root levels, estimate prognosis, to follow recovery or to offer clues into the pathophysiology of the condition.

Expression of cationic amino acid transporters in pig skeletal muscles during postnatal development.

The cationic amino acid transporter (CAT) protein family transports lysine and arginine in cellular amino acid pools. We hypothesized that CAT expression changes in pig skeletal muscles during rapid pig postnatal development. We aimed to investigate the tissue distribution and changes in the ontogenic expression of CATs in pig skeletal muscles during postnatal development. Six piglets at 1, 12, 26, 45, and 75days old were selected from six litters, and their longissimus dorsi (LD), biceps femoris (BF), and rhomboideus (RH) muscles, and their stomach, duodenum, jejunum, ileum, colon, liver, kidney, heart, and cerebrum were collected. CAT-1 was expressed in all the 12 tissues investigated. CAT-2 (CAT-2A isoform) expression was highest in the skeletal muscle and liver and lowest in the jejunum, ileum, kidney, and heart. CAT-3 was expressed mainly in the colon and detected in the jejunum, ileum, and cerebrum. The CAT-1 expression was higher in the skeletal muscle of day 1 pigs than in that of older pigs (P<0.05). The CAT-2 mRNA level was lowest at day 1, but increased with postnatal development (P<0.05). There was no significant change in CAT-1 expression among the LD, BF, and RH during postnatal development (P>0.05); however, there was a change in CAT-2 expression. The CAT-2 expression was highest in the LD of 12-, 26-, 45-, and 75-day-old pigs, followed by the BF and RH (P<0.05). These results suggest that CAT-1 and CAT-2 play different roles in pig skeletal muscles during postnatal development.

Sprengel's Deformity Associated with Omovertebral bar between Inferior angle of the scapula and the Cervical spine: A Case Report

Background; Sprengel's deformity is a rare congenital anomaly of the shoulder girdle. The deformity is due to failure of descent of the scapula in intrauterine life. Case Presentation;We report a case of unilateral Sprengel's deformity Sprengel's Deformity Associated with omovertebral bar between inferior angle of the scapula and the cervical spine ,absence of rhomboid major and rhomboid minor muscles, weakness of trapezius and serratus anterior in a 10- year-old boy.Conclusion;Sprengel's deformity can be associated with omovertebral bar between inferior angle of the scapula and the cervical spine with other musculoskeletal abnormalities.

The hypaxial origin of the epaxially located rhomboid muscles

In vertebrates, skeletal muscles of the body are made up of epaxial and hypaxial muscles based on their innervation and relative position to the vertebral column. The epaxial muscles are innervated by the dorsal branches of the spinal nerves and comprise the intrinsic (deep) back muscles, while the hypaxial muscles are innervated by the ventral branches of the spinal nerves including the plexus and consist of a heterogeneous group of intercostal, abdominal, and limb as well as girdle muscles. The canonical view holds that the epaxial muscles are derived from the medial halves of the somites, whereas the hypaxial muscles are all derived from the lateral somitic halves. The rhomboid muscles are situated dorsal to the vertebral column and therefore in the domain typically occupied by epaxial muscles. However, they are innervated by a ventral branch of the brachial plexus called the N. dorsalis scapulae. Due to the apparent inappropriate position of the muscle in relation to its innervation we investigated its origin to help clarify this issue. To study the embryonic origin of the rhomboid muscles, we followed derivatives of the medial and lateral somite halves using quail-chick chimeras. Our results showed that the rhomboid muscles are made up of cells derived mainly from the lateral portion of the somite. Therefore the rhomboid muscles which lie within the epaxial domain of the body, originate from the hypaxial domain of the somites. However their connective tissue is derived from both medial and lateral somites.

Ultrasound Verification Of Safe Needle Examination Of The Rhomboid Major Muscle.

Palpation of a thoracic rib is a common method for reducing the risk of pneumothorax during electromyographic examination of the rhomboid major muscle, but its accuracy is unknown. Two physicians palpated healthy subjects to attempt to identify the center of a rib located beneath the rhomboid major muscle. The identified location was examined with ultrasonography to examine its accuracy and the subject's anatomical depths. Forty-four subjects (88 ribs) were studied. Palpation demonstrated a 66.3% accuracy rate, with significantly more incorrect palpations seen with greater muscle thickness (P = 0.004) and body mass index (P = 0.037), but not adipose thickness, age, or skin thickness (P > 0.05). Palpation of the ribs in an attempt to avoid inadvertent pneumothorax while examining the rhomboid major may be inaccurate, primarily in patients with large muscle bulk. We suggest a brief ultrasound evaluation before electromyography to gauge correct needle depth. Muscle Nerve 57: 61-64, 2018.

Effects of pulling direction on upper trapezius and rhomboid muscle activity.

[Purpose] This study examined the activation of the rhomboid muscle according to the angle of the arm. [Subjects and Methods] The current study was conducted on 15 healthy males. The participants performed the pulling exercise in 5 conditions. The surface electromyography system was used to measure the muscle activities of the rhomboid and upper trapezius. [Results] The activity of the upper trapezius in condition 5 was significantly increased compared to that in condition 4. The activity of the rhomboid in condition 4 was significantly increased compared to that in conditions 1 and 5. [Conclusion] This study showed that performing a pulling exercise with the arms raised above the head (shoulder flexion at 120°) is more effective for reducing upper trapezius tension, while also selectively strengthening the rhomboid muscle.

Nitrite Embedded Vacuum Packaging Improves Retail Color and Oxidative Stability of Bison Steaks and Patties

Bison meat is prone to rapid discoloration under traditional aerobic retail packaging conditions. The aim of this study was to determine if the color stability of bison steaks and burger patties could be improved through packaging meat with a vacuum-sealed film containing embedded sodium nitrite. Bison bulls (n = 40) were slaughtered and the longissimus lumborum (LL) and rhomboideus (RH) were removed. Following a postmortem aging period of 6, 13, or 20 d steaks were obtained from the LL. RH muscles aged 6 d were ground (85:15 lean to fat) and formed into 140 g patties. One steak and two burger patties from each carcass side were placed into either a polystyrene tray overwrapped with oxygen permeable polyvinyl chloride film (CONT) or a polyethylene tray vacuum sealed with film coated in sodium nitrite (113 mg × m–2; NIT); meat was placed under simulated retail conditions for 4 d. A 3-way interaction was observed between packaging type, whole muscle aging and time in retail display for objective (L*, Chroma, and Hue) and subjective (lean color score and proportion of surface discoloration) color measures from steaks (P &lt; 0.0001). The CONT packaged meat showed an increased area of discoloration and in metmyoglobin after 4 d in retail display (P &lt; 0.0001); NIT meats did not show a higher area of discoloration or metmyoglobin after retail display. Additionally, NIT packaged steaks and burger patties lightened (higher L*) and became redder over the course of the retail display period. Thiobarbituric acid reactive substances (products of lipid peroxidation) did not increase in NIT packaged burger patties after 4 d under retail conditions, however, there was a significant increase observed for CONT packaged burger patties (P &lt; 0.0001). NIT packaging appears to effectively improve the color stability of bison meat under retail conditions, making this packaging strategy well suited to address the issue of rapid discoloration.