Scapular Exercise Research Articles

The Effectiveness of Exercise Therapy on Scapular Position and Motion in Individuals With Scapular Dyskinesis: Systematic Review Protocol.

BackgroundScapular dyskinesis is an alteration in normal scapular position and motion. Some researchers believe that altered kinematics of the scapula subsequent to dysfunction or weakness of scapular stabilizing muscles contributes to impingement syndrome. Scapular muscle exercises are included in the rehabilitation of patients with subacromial impingement syndrome and scapular dyskinesis because the muscular system is one of the major contributors of scapular positioning both at rest and during shoulder movement, but there is considerable uncertainty relating to the relative effectiveness of such approaches on changing scapular position and motion.ObjectiveThe aim of this systematic review protocol is to evaluate the effectiveness of exercise therapy on scapular position and motion in individuals with scapular dyskinesis.MethodsA systematic review will be conducted using PubMed, Scopus, Web of Science, Elsevier, Ovid, ProQuest, Physiotherapy Evidence Database, and Cochrane Library. The reference lists of articles, other reviews, gray literature, and key journals will be searched for relevant articles. Clinical trials reporting the effect of therapeutic exercises (scapular strengthening exercise, scapular stabilization exercise, scapular muscle stretching) with the aims of changing scapular position and motion in individuals with scapular dyskinesis will be included. Two independent reviewers will select studies, extract data, and assess the quality of primary studies. Any disagreement during the selection of studies will be discussed and decided by the whole team.ResultsThis systematic review began in December 2016 and is currently in progress. The findings will be synthesized to determine the effectiveness of recommended therapeutic exercise on scapular position and motion in individuals with scapular dyskinesis.ConclusionsThis is the first systematic review protocol aiming to assess the effectiveness of exercise therapy in individuals with scapular dyskinesis. The systematic review doesn’t require ethics approval because all data used will be provided from published documents. The results of this study will be published in a peer-reviewed journal.Trial RegistrationPROSPERO CRD42017053923; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=53923 (Archived by WebCite at http://www.webcitation.org/6uzq32T02)

Comparative Effect of Modified Shrug Exercises With and Without Trunk Stabilization Exercise on Scapular Upward Rotator EMG and Thickness in Subjects With Scapular Downward Rotation Syndrome

Background: Scapular downward rotation syndrome (SDRS) is a common scapular alignment impairment that causes insufficient upward rotation and muscle imbalance, shortened levator scapulae (LS) and rhomboid, and lengthened serratus anterior (SA) and trapezius. A modified shrug exercise (MSE), performing a shrug exercise with the shoulders at 150° abduction, is known as an effective exercise to increase scapular stabilizer muscle activation. Previous studies revealed that scapular exercise are more effective when combined with trunk stabilization exercises in decreasing scapular winging and increasing scapular stabilizer muscle activation. Objects: The purpose of our study was to clarify the effect of MSE with or without trunk stabilization exercises in subjects with SDRS. Methods: Eighteen volunteer subjects (male=10, female=8) with SDRS were recruited for this experiment. All subjects performed MSE under 3 different conditions: (1) MSE, (2) MSE with an abdominal draw-in maneuver (ADIM), and (3) MSE with an abdominal expansion maneuver (AEM). The muscle thickness of the lower trapezius (LT) and the SA were measured using an ultrasonography in each condition. Electromyography (EMG) data were collected from the LT, LS, SA, and upper trapezius (UT) muscle activities. Data were statistically analysed using one-way repeated analysis of variance at a significance level of .05. Results: The muscle thickness of the LT and the SA were the significant different in the MSE, MSE with ADIM (MSE+ADIM) and MSE with AEM (MSE+AEM) conditions (p<.05) In both LT and SA, the order of thick muscle thickness was MSE+AEM, MSE+ADIM, and MSE alone. No significant differences were found in the EMG activities of the SA, UT, LS, and LT in all condition. Conclusion: In conclusion, MSE is more beneficial to people with SDRS when combined with trunk stabilization exercises by increased thickness of scapular stabilizer muscles.

Effects of horizontal shoulder abduction and adduction on the activity and strength of the scapular protractors

Increased activity of the serratus anterior (SA) muscle combined with decreased activity of the pectoralis major (PM) muscle during scapular protraction exercise is a widely used method for selective strengthening of the former muscle. However, the role played by the PM during maximal scapular protraction remains unclear. The objective of our study was to investigate the effects of horizontal shoulder abduction (decreasing PM activity) and adduction (increasing activity) on the strength and activity of the scapular protractors (the SA and PM) during maximal protraction. Twenty-nine healthy males performed maximal scapular protraction combined with horizontal shoulder abduction or adduction. The strength and activity of the PM and SA decreased significantly (both p < 0.01) during maximal scapular protraction combined with horizontal shoulder abduction, compared with maximal scapular protraction alone, but increased significantly (both p < 0.01) when maximal scapular protraction was combined with horizontal shoulder adduction. We thus conclude that the PM stabilizes the activated SA during maximal scapular protraction, which effectively increases SA activity and scapular protraction strength in the serratus punch posture.

Specific or general exercise strategy for subacromial impingement syndrome\u2013does it matter? A systematic literature review and meta analysis

BackgroundExercise is frequently suggested as a treatment option for patients presenting with symptoms of subacromial impingement syndrome. Some would argue implementing a specific exercise strategy with special focus on correction of kinematic deficits would be superior to general exercise strategy. There is however a lack of evidence comparing such exercise strategies to determine which is the most effective in the treatment of subacromial impingement syndrome. The aim of this review is to evaluate whether implementing specific exercise strategies involving resistive exercises are more effective than a general exercise strategy for the treatment of patients with subacromial impingement syndrome.MethodsRandomized controlled trials were identified through an electronic search on PubMed/MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science and PEDro. In addition, article reference lists and Clinicaltrials.gov were searched. Studies were considered eligible if they included interventions with resistive specific exercises as compared to general resistance exercise. Four reviewers assessed risk of bias and methodological quality guided by Cochrane recommendations. Results were synthesised qualitatively or quantitatively, where appropriate.ResultsSix randomized controlled trials were included with 231 participants who experienced symptoms of subacromial impingement syndrome. Four studies evaluated the effectiveness of specific scapular exercise strategy and two studies evaluated the effectiveness of specific proprioceptive strategy. Five studies were of moderate quality and one study was of low quality. No consistent statistical significant differences in outcomes between treatment groups were reported in the studies. Standardized mean difference (SMD) for pain was SMD −0.19 (95% CI −0.61, 0.22) and SMD 0.30 (95% CI −0.16, 0.76) for function.ConclusionsThere is insufficient evidence to support or refute the effectiveness of specific resistive exercise strategies in the rehabilitation of subacromial impingement syndrome. More high quality research is needed to accurately assess this. This review provides suggestions on how to improve the methodological design of future studies in this area.

SLAP Yırtığı Şüphesi Olan Hastaların Konservatif Tedavisi

Objective: Outcome following non-operative management of superior labral anterior to posterior (SLAP) lesions has been under reported with little empirical data demonstrating the effectiveness of conservative treatment. Material and Methods: 10 patients, 5 matched pairs, presenting with symptoms consistent with a SLAP lesion performed a standardized phased rehabilitation program completing patient reported outcome (PRO) and pain measures before and following rehabilitation. Physical therapy notes and home exercise logs were reviewed and all exercises were recorded and coded using the phased rehabilitation protocol as a guide. At followup, patients were divided into two groups; responders and non-responders to treatment based on PRO. The volume of exercise and type of exercise performed for each patient were compared using frequency counts. Results: The non-responders did on average 33 more stretching exercises than the responders. The non-responders did on average 21 more scapular orientation exercises than the responders. There were few to no differences in the volume of strengthening exercises between the two groups except responders performed 38 more scapular retraction exercises at shoulder level while non-responders performed 49 more scapular retraction exercises below shoulder level. Conclusions: This case series identified few exercises that were beneficial to patients' responding to conservative intervention but more often identified exercises that were performed that did not facilitate an improved patient outcome. Therapeutic exercises are often the cornerstone of a rehabilitation program, yet limited evidence exists in which specific exercises are beneficial or not beneficial in patients with symptoms consistent with a SLAP lesion.

으쓱 운동과 PNF어깨뼈패턴 시 어깨뼈 안정근의 근활성도

Purpose: The purpose of this study was to compare the intramuscular activation of the scapular stabilizing muscles and the upper trapezius/middle serratus anterior (UT/MSA) ratios during shrug exercise and proprioceptive neuromuscular facilitation (PNF) scapular pattern exercise. Methods: The participants of this study were 13 young adult men who voluntarily consented to participate in this experiment after listening to its purpose and methods. All participants were instructed on maximal voluntary isometric contraction and scapular exercises. The intramuscular activation of the upper trapezius (UT), lower trapezius (LT), middle serratus anterior (MSA), and lower serratus anterior (LSA) muscles while performing scapular exercises in a side-lying position were measured using surface electromyography. To analyze the muscle activation and UT/MSA ratio between the two exercises, a one-way repeated ANOVA was performed. Post-hoc analyses were conducted using Tukey's multiple comparison and analysis. Hamstring flexibility for each group was measured by a passive straight leg raising test. Results: The shrug exercise showed significantly higher UT activation compared to PNF anterior elevation and posterior elevation scapular patterns. The PNF scapular anterior elevation pattern showed significantly higher serratus anterior activation than the shrug exercise. Additionally, the UT/MSA ratios were significantly lower in the PNF scapular anterior elevation pattern than in the two exercises. Conclusion: Although shrug exercise was effective for strengthening UT, the PNF scapular anterior elevation pattern may be effective for strengthening MSA and improving the UT/MSA ratio.

견갑골강화운동이 만성 뇌졸중환자의 견갑골 대칭성 위치와 체간조절 및 균형능력에 미치는 영향

견갑골강화운동이 만성 뇌졸중환자의 견갑골 대칭성 위치와 체간조절 및 균형능력에 미치는 영향

Effects of scapular stability exercise on shoulder stability and rehabilitative ultrasound images in office workers.

[Purpose] To examine the clinical effectiveness of scapular stability exercise on shoulder stability and rehabilitative ultrasound images in office workers. [Subjects and Methods] Thirty-eight subjects were randomly divided into a scapular stability exercise group (n=19) and a manual therapy group (n=19). Subjects in the scapular stability exercise group performed a scapular stability exercise designed to correct the abnormal location of the scapula, at 40 minutes per session, two times per week, for 6 weeks. Forward head horizontal distance, rounded shoulder posture, stability of the upper limb for the shoulder, and rehabilitative ultrasound images were evaluated before and after 6 weeks. [Results] After the intervention, both groups showed significantly decreased forward head horizontal distance and rounded shoulder posture, with significantly improved stability of the upper limb and rehabilitative ultrasound images. Forward head horizontal distance, rounded shoulder posture, stability of the upper limb, and rehabilitative ultrasound images showed greater improvements in the shoulder stability exercise group than in the manual therapy group. [Conclusion] Scapular stability exercise can improve shoulder stability and the thickness of the lower trapezius in rehabilitative ultrasound images of office workers, and could be useful in clinical rehabilitation.

Sports Physical Therapy Section Poster Presentations (Abstracts SPO1–SPO119)

Sports Physical Therapy Section Poster Presentations (Abstracts SPO1–SPO119)

Effect of shoulder flexion angle and exercise resistance on the serratus anterior muscle activity during dynamic hug exercise.

[Purpose] The primary aim of this study was to determine the effect of shoulder flexion angle and exercise resistance on the serratus anterior muscle during dynamic hug exercise. [Subjects] Ten men aged 22–32 years were recruited. [Methods] The subjects performed dynamic hug exercise at different shoulder flexion angles and under resistance weight conditions. Serratus anterior muscle activities were measured by using the surface electromyographic system during the dynamic hug exercises. After performing the exercise, each subject described the exercise intensity by using the Borg rating of perceived exertion (RPE) scale. [Results] The normalized serratus anterior muscle activity increased significantly in the order of Conditions 1 and 4 < Condition 3 < Condition 2. The Borg RPE scale increased significantly in the order of Condition 1 < Condition 2 < Condition 3 < Condition 4. [Conclusion] The results suggest that dynamic hug exercise with the use of a multi-air-cushion biofeedback device is an effective scapular stability exercise.

Acute effect of scapular proprioceptive neuromuscular facilitation (PNF) techniques and classic exercises in adhesive capsulitis: a randomized controlled trial.

[Purpose] The aim of our study was to compare the initial effects of scapular proprioceptive neuromuscular facilitation techniques and classic exercise interventions with physiotherapy modalities on pain, scapular dyskinesis, range of motion, and function in adhesive capsulitis. [Subjects and Methods] Fifty-three subjects were allocated to 3 groups: scapular proprioceptive neuromuscular facilitation exercies and physiotherapy modalities, classic exercise and physiotherapy modalities, and only physiotherapy modalities. The intervention was applied in a single session. The Visual Analog Scale, Lateral Scapular Slide Test, range of motion and Simple Shoulder Test were evaluated before and just after the one-hour intervention in the same session (all in one session). [Results] All of the groups showed significant differences in shoulder flexion and abduction range of motion and Simple Shoulder Test scores. There were statistically significant differences in Visual Analog Scale scores in the proprioceptive neuromuscular facilitation and control groups, and no treatment method had significant effect on the Lateral Scapular Slide Test results. There were no statistically significant differences between the groups before and after the intervention. [Conclusion] Proprioceptive neuromuscular facilitation, classic exercise, and physiotherapy modalities had immediate effects on adhesive capsulitis in our study. However, there was no additional benefit of exercises in one session over physiotherapy modalities. Also, an effective treatment regimen for shoulder rehabilitation of adhesive capsulitis patients should include scapular exercises.

Effect of Shoulder External Rotation on EMG Activity of the Scapular Upward Rotators during Arm Elevation

PURPOSE: The purpose of this study was to determine the effect of shoulder external rotation on muscle activities of the scapular upward rotators during arm elevation. METHODS: Nineteen healthy subjects with no medical history of shoulder pain or upper extremity disorders were recruited for this study. Electromyography (EMG) was used to measure the muscle activities of the serratus anterior (SA), upper trapezius (UP), lower trapezius (LT) and infraspinatus (IS) muscles during arm elevation. The EMG activities were recorded while the subjects performed arm elevation with three different arm positions; palm down (PD), neutral position (NP), and palm up (PU). While seated in a chair, the subject was asked to raise the upper extremity in the sagittal plane in random order. Subjects performed arm elevations in three trials at each arm position. The mean EMG activity normalized by the maximal voluntary isometric contraction was analyzed across three arm positions. Repeated measures one-way ANOVA and the post hoc Bonferroni tests were used to determine the differences in muscle activities among the three arm positions. RESULTS: The EMG activities of the SA and IS were significantly greater in the PU condition than in the other conditions during arm elevation. No significant difference was noted between the NP and PD conditions during arm elevation. CONCLUSION: These results suggest that shoulder external rotation (palm up position) can be used to activate the SA. Therefore, we recommend a scapular protraction exercise in the palm up position for strengthening the SA.

Serratus anterior and lower trapezius muscle activities during multi-joint isotonic scapular exercises and isometric contractions.

Proper scapular function during humeral elevation, such as upward rotation, external rotation, and posterior tilting of the scapula, is necessary to prevent shoulder injury. However, the appropriate intensity of rehabilitation exercise for the periscapular muscles has yet to be clarified. To identify the serratus anterior, lower trapezius, infraspinatus, and posterior deltoid muscle activities during 2 free-motion exercises using 3 intensities and to compare these muscle activities with isometric contractions during quadruped shoulder flexion and external rotation and abduction of the glenohumeral joint. Cross-sectional study. Health Science Laboratory. A total of 16 uninjured, healthy, active, male college students (age = 19.5 ± 1.2 years, height = 173.1 ± 6.5 cm, weight = 68.8 ± 6.6 kg). Mean electromyographic activity normalized by the maximal voluntary isometric contraction was analyzed across 3 intensities and 5 exercises. Intraclass correlation coefficients were calculated for electromyographic activity of the 4 muscles in each free-motion exercise. Significant interactions in electromyographic activity were observed between intensities and exercises (P < .05). The quadruped shoulder-flexion exercise activated all 4 muscles compared with other exercises. Also, the modified robbery free-motion exercise activated the serratus anterior, lower trapezius, and infraspinatus compared with the lawn-mower free-motion exercise. However, neither exercise showed a difference in posterior deltoid electromyographic activity. Three intensities exposed the nature of the periscapular muscle activities across the different exercises. The free-motion exercise in periscapular muscle rehabilitation may not modify serratus anterior, lower trapezius, and infraspinatus muscle activities unless knee-joint extension is limited.

Serratus Anterior and Lower Trapezius Muscle Activities During Multi-Joint Isotonic Scapular Exercises and Isometric Contractions.

Context : Proper scapular function during humeral elevation, such as upward rotation, external rotation, and posterior tilting of the scapula, is necessary to prevent shoulder injury. However, the appropriate intensity of rehabilitation exercise for the periscapular muscles has yet to be clarified. Objective : To identify the serratus anterior, lower trapezius, infraspinatus, and posterior deltoid muscle activities during 2 free-motion exercises using 3 intensities and to compare these muscle activities with isometric contractions during quadruped shoulder flexion and external rotation and abduction of the glenohumeral joint. Design : Cross-sectional study. Setting : Health Science Laboratory. Patients or Other Participants : A total of 16 uninjured, healthy, active, male college students (age = 19.5 ± 1.2 years, height = 173.1 ± 6.5 cm, weight = 68.8 ± 6.6 kg). Main Outcome Measure(s) : Mean electromyographic activity normalized by the maximal voluntary isometric contraction was analyzed across 3 intensities and 5 exercises. Intraclass correlation coefficients were calculated for electromyographic activity of the 4 muscles in each free-motion exercise. Results : Significant interactions in electromyographic activity were observed between intensities and exercises (P < .05). The quadruped shoulder-flexion exercise activated all 4 muscles compared with other exercises. Also, the modified robbery free-motion exercise activated the serratus anterior, lower trapezius, and infraspinatus compared with the lawn-mower free-motion exercise. However, neither exercise showed a difference in posterior deltoid electromyographic activity. Conclusions : Three intensities exposed the nature of the periscapular muscle activities across the different exercises. The free-motion exercise in periscapular muscle rehabilitation may not modify serratus anterior, lower trapezius, and infraspinatus muscle activities unless knee-joint extension is limited.

Immediate Effects of Active Versus Passive Scapular Correction on Pain and Pressure Pain Threshold in Patients With Chronic Neck Pain

ObjectiveThe purpose of this study was to investigate the effect of active vs passive scapular correction on pain and pressure pain threshold at the most symptomatic cervical segment in patients with chronic neck pain. MethodsTwenty-three volunteers with chronic, idiopathic neck pain were recruited (age, 38.9 ± 14.4 years; sex [man/woman], 3/20; Neck Disability Index, 28.1% ± 9.9%). Subjects were randomly allocated to 2 groups: active scapular correction or passive scapular correction. Pressure pain threshold and pain intensity rated on a numerical rating scale during a posteroanterior glide over the most symptomatic cervical segment were measured before and immediately after the active or passive scapular intervention. ResultsOnly the active scapular correction produced a reduction in pain (pre, 6.3 ± 1.2; post, 3.7 ± 2.4; P < .05) and increase in pressure pain threshold (pre, 8.7 ± 4.2 kg/cm2; post, 10.1 ± 3.8 kg/cm2; P < .05) at the most painful cervical segment. ConclusionsAn active scapular correction exercise resulted in an immediate reduction of pain and pressure pain sensitivity in patients with chronic neck pain and scapular dysfunction.

견갑골 안정화 운동이 야구선수의 견갑골 관절가동범위, 근력 및근 활성도에 미치는 영향

견갑골 안정화 운동이 야구선수의 견갑골 관절가동범위, 근력 및근 활성도에 미치는 영향

Maximizing shoulder function after accessory nerve injury and neck dissection surgery: A multicenter randomized controlled trial.

Shoulder pain and dysfunction after neck dissection may result from injury to the accessory nerve. The effect of early physical therapy in the form of intensive scapular strengthening exercises is unknown. A total of 59 neck dissection participants were prospectively recruited for this study. Participants were randomly assigned to either the intervention group (n = 32), consisting of progressive scapular strengthening exercises for 12 weeks, or the control group (n = 29). Blinded assessment occurred at baseline, and at 3, 6, and 12 months. Three-month data were collected on 52 participants/53 shoulders. Per-protocol analysis demonstrated that the intervention group had statistically significantly higher active shoulder abduction at 3 months compared to the control group (+26.6°; 95% confidence interval [CI] 7.28-45.95; p = .007). The intervention is a favorable treatment for maximizing shoulder abduction in the short term. The effect of the intervention compared to usual care is uncertain in the longer term.

Arthroscopic Treatment for Multidirectional Instability

Multidirectional instability (MDI) was first described by Neer and Foster in 1980. Although there has been much confusion over the years with a blending of classifications, the inherent concept of symptomatic inferior instability with associated anterior and posterior instability remains the hallmark of the MDI shoulder. The MDI shoulder may be thought of as one of compensation, where the balance of the scapula and rotator cuff maintain the humeral head in the glenoid. Symptoms are seen when this balance is lost. The anatomical characteristic of the MDI shoulder is increased capsular volume with widening of the critical rotator interval structures (superior glenohumeral ligament and coracohumeral ligament) along with dysfunction of the entire inferior glenohumeral ligament complex. Management centers on nonoperative treatment, with pain control and scapular rebalancing exercises being the key to successful nonoperative management. Surgery is only indicated by a failure of nonoperative treatment and is focused on closing the rotator interval and decreasing capsular volume by shifting both the anterior and posterior capsule superiorly.

Abstract P3-09-12: Effects of acupuncture on rehabilitation after breast cancer surgery - Preliminary results

Abstract Background: The increased incidence of breast cancer and successful treatment result in greater survival of these patients and consequently a greater number of survivors. These patients may have chronic condition of pain in the shoulder and upper limb, including cervical and thoracic spine. This paper seeks, through acupuncture, a new approach in the rehabilitation of these patients. Method: This study was conducted in the Gynecological Department of São Paulo Federal University. The study included women who underwent surgical treatment of breast cancer, radical or conservative, and present pain in the region of the shoulder and upper limb, including cervical and thoracic spine after three months of surgery. Patients older than 18 years and pain level ≥ 3 on the Visual Analog Scale (VAS). We excluded patients with bilateral breast surgery, metastatic disease, vascular disorders and tactile sensitivity, with diabetes mellitus type I and II uncompensated and education level less than four years. The patients were randomly divided into two groups, with 15 patients per group who were treated weekly for 10 weeks, one group treated with kinesiotherapy standard, pre-defined, based on stretching the neck muscles, scapular exercises and upper limb strength lasting 30 minutes and the other group was performed the same protocol described above kinesiotherapy followed by another 30 minutes of Acupuncture using pre-defined points. Acupuncture points used were as follows: CV 3, SP 9, ST 36, KD 7, LV 3 - edema and treat gynecological disorders; VB 21, LI 15, TH 14, LU 5, LI 4, ST 38 and UB 60 - treat pain and difficulty of movement in the upper limb. Patients were evaluated at baseline, after five weeks and at the end of 10 weeks. We used the Visual Analog Scale (VAS) for pain intensity ratings and the DASH questionnaire (Disabilities of the Arm, Shoulder and Hand Questionnaire) assessing functional capacity in diseases of the upper limb, measuring the skills to do certain activities as well as the symptoms. Results: The ANOVA test was used for statistical analysis of pain relief by VAS scale in both groups. Both groups had significant improvement with p&amp;gt; 0.001 and no difference between groups, with p = 0.756. The same analysis of variance was used in the DASH questionnaire, with similar results, both groups improved significantly with p&amp;gt; 0.001 and no difference between groups with p = 0.200. In multiple comparisons all reviews are different from each other showing a gradual improvement. Conclusion: We found that both types of treatment (kinesiotherapy or kinesiotherapy and acupuncture) are effective, and the evolution of the two groups was the same with a gradual improvement. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-09-12.

Neck musculature fatigue affects specific frequency bands of postural dynamics during quiet standing

Proprioceptive input from the neck is important for maintenance of upright standing. Although neck musculature fatigue has been demonstrated to impair standing balance, there is limited understanding of the underlying postural mechanisms. This study aimed to further examine the effects of neck musculature fatigue on standing by using modern analysis of center of pressure (CoP) data. Forty-eight young healthy adults stood quietly on a balance board for 1min before and after performing repeated weight-resisted scapular elevation exercises. In a supplementary study on 20 participants, we examined (i) the effects of visual deprivation and (ii) the test–retest reliability of the traditional and wavelet-based CoP measures. Test–retest reliability of the CoP measures was moderate to good (intraclass correlation coefficients ranged from 0.58 to 0.94). With neck muscle fatigue or without vision, traditional measures of CoP velocity and standard deviation increased monotonically. Wavelet analysis revealed that CoP velocity within the ultralow (<0.10Hz) and moderate (1.56–6.25Hz) frequency bands increased post-fatigue. Without vision, CoP velocity increased in all but the ultralow frequency band. Our data suggest that post-fatigue, vision may be the main compensatory postural mechanism for altered neck proprioception. In conclusion, our findings reveal more nuances than the simple assertion that neck musculature fatigue increased postural sway and they advocate the use of wavelet analysis in examining postural mechanisms associated with neck proprioception.