Shoulder Exercises Research Articles

Changes in Shoulder and Lumbar Injury Incidence in Swimmers After Physical Examination and Exercise Programs.

Previous injury and physical examination data collected by a physiotherapist were reviewed to investigate the causes of injury among competitive swimmers. Each swimmer received an injury improvement exercise program based on their injury history and physical examination findings. The purpose of this study was to identify trends in the number of shoulder and lumbar injuries and discern the effectiveness of exercise programs in swimmers. The authors hypothesize that these efforts would decrease injury rates. Observational Cohort study. Thirty-one male high school and college student swimmers underwent a physical examination. Previous injury was considered as pain that lasted for > three weeks or that caused the participant to stop practicing. A questionnaire was administered to all swimmers at the beginning of the study and one year later. The questionnaire assessed the number of injuries sustained and the daily practice hours over the previous year. The injury rate at the first examination and one-year followup was calculated as the number of injury incidents divided by the total number of player hours (1 h of practice is equivalent to 1) for one year, multiplied by 1,000 to obtain the injury rate per 1,000 hours (1000 player hours: 1,000 ph). Shoulder and hip exercise programs were prescribed based on measurement results and previous research. The numbers of injuries seen in the group were 12 shoulder and six lumbar at the first examination, and two shoulder and one lumbar at the one-year followup. The 1,000 ph (95% confidence interval) values were 0.32 (0.13-0.50) and 0.16 (0.03-0.29) at the first examination and 0.05 (0.00-0.12) and 0.03 (0.00-0.07) at the one-year followup for the shoulder and lumbar areas, respectively. The results indicates that exercise programs prescribed after a physical examination may reduce the incidence of injuries in male swimmers over the course of a year. Level 3.

Efficacy of Marma Chikitsa and Shoulder Exercises in the management of Avabahuka (Frozen Shoulder) - A Case Study

Avabahuka is one among the 80 Vatavyaadhis mentioned in Samhitas. The disease known as Avabahuka is characterized by Dushita Vata Dosha, which is localized in the Ansa Pradesha and results in shoulder dysfunction as well as Akunchan of Sira at this site. It is correlated with Adhesive Capsulitis that is Frozen Shoulder. The prevalence of frozen shoulder is 3% to 5% in general population and upto 20% in those with diabetes. Allopathy medicines have limitations giving short term relief in pain and surgeries which carries risk. Marma therapy being a non pharmaceutical technique is a hidden treasure of Ayurveda. It is ancient Neuromodulation therapy which offers deep sense of relief in pain and stiffness of muscles. A 32 year aged women who has already diagnosed with frozen shoulder since 3 years approached to Pt. Khushilal Sharma Ayurveda Hospital and was treated with Marma Chikitsa and Shoulder Exercises. The treatment was continued for 15 days in which day wise improvement was analyzed. The range of movements improved from 30° to 120° for abduction, 105° to 160° for flexion, 35° to 45° for extension and 55° to 65° for external rotation. Pain is assessed using VAS score which also improved after the treatment. Thus, Marma therapy and Shoulder exercises gives highly remarkable relief in both range of movement as well as pain in Avabahuka. Nonetheless, a large-scale population study was recommended.

Effectiveness of micro-electrolysis associated with exercises versus exercises alone on pain intensity and disability in individuals with chronic rotator cuff tendinopathy: A randomized clinical trial

ObjectiveTo compare the effectiveness of intratissue percutaneous micro-electrolysis (IPM) in addition to shoulder exercise program on pain intensity and disability in individuals with rotator cuff tendinopathy. Study designTwo parallel arms, single blind superiority randomized control clinical trial. SiteOutpatient clinic (Alcides Carneiro University Hospital) Participants42 individuals with rotator cuff tendinopathy were randomly allocated (1:1) into 2 groups: IPM associated with exercises (IPM+Ex) and exercises only (Ex). InterventionsBoth groups underwent a therapeutic exercise program (6 in-person sessions) conducted by a physiotherapist, but only the IPM+Ex group received additional treatment with IPM (6 sessions). Linear mixed models were used to compare groups. Main outcome measuresPain intensity was measured with the Numerical Pain Rating Scale (NPRS) and shoulder disability with the Shoulder Pain and Disability Index (SPADI). The outcomes were evaluated (blinded assessor) at baseline and 8 weeks after the intervention protocol. Secondary outcomes: adverse effects, frequency of the weekly home exercises, and overall perceived effect. ResultsForty individuals completed the 8-week follow-up. There were statistically significant within-group changes in both IPM+Ex and Ex for pain (IPM+Ex: mean difference -3.19; 95% CI:-4.45 to -1.94; Ex: mean difference: -3.99; 95% CI:- 5.27 to -2.72) and disability (IPM+Ex: mean difference -35.76; 95% CI:-47.77 to -23.76; Ex: mean difference: -38.26; 95% CI:-50.45 to -26.07). We found no between-group significant differences in either pain (mean difference: -1.23; 95% CI: -2.54, 0.07) or disability (mean difference 7.17; 95% CI:-7.02, 21.35). We found no differences between the groups (p < 0.05) regarding adverse effects, frequency of the weekly home exercises, and overall perceived effect. ConclusionApplying IPM along with therapeutic exercises does not have additional effects on pain intensity and disability in individuals with rotator cuff tendinopathy.

Effectiveness of hydrotherapy on pain and functional status of shoulder joint among individuals undergone intra-articular injections

BackgroundThe shoulder complex with its varied pathology responds differently from patient to patient and so, the best option for progression is a choice of rehabilitation. In the present post-COVID scenario, many patients are referred to acute and sub-acute shoulder pain and dysfunction. It is very difficult to predict the outcome of therapy. Some patients recover even without any modalities. Recurrent or adverse symptoms are also possible. Gender, other demographic features, physiological response, and progressive outcome need to be considered in rehabilitation. This study is intended to evaluate the short-term effects of hydrotherapy post-intra-articular injections of shoulder dysfunctions.Aims and objectivesTo evaluate the effectiveness of hydrotherapy during early rehabilitation of individuals who have undergone intra-articular injections of shoulder joint on pain and function.Materials and methodsIn this prospective study, we have studied a total of 59 cases within the age group of 40–70 years with idiopathic frozen shoulder, acromio-clavicular joint dysfunction, and grade-1 untreated rotator cuff injuries. Group A patients were treated with conventional shoulder exercises and group B patients were treated in a hydrotherapy pool. The chief aim was to obtain earlier pain relief with controlled movement patterns and earlier relief from functional disability. The Constant-Murley score (CMS–100 points scale) composing pain and functional parameters was the outcome measure.ResultsAfter confounding all the demographic factors, it was found that the experimental group B treated by hydrotherapy revealed a statistically extremely significant difference (p value < 0.0001) at the end of the first week as compared to the conventional group. The treatment protocol was continued for 5 weeks. More than 90% of patients in the hydrotherapy group felt it easier and exercise participation progression was best. Better progression and improvement of shoulder function were achieved in the hydrotherapy group compared to the conventional group.ConclusionFrom this study, we conclude that hydrotherapy during early management of shoulder dysfunctions post-intra-articular injections is safer and provides excellent relief from pain as early as the first week. Functional progression is better and avoids complications related to mobilization.

3D-printed shoulder and elbow exercise device for stroke patients- A pilot study

Upper limb movements are essential in everyday life; hand paralysis caused by post-stroke affects the regular lives of patients. To regain hand mobility and motor function, we must perform repetitive exercises. Nowadays, rehabilitation devices are essential to help post-stroke victims exercise and recover from paralysis more quickly. The proposed research developed a 3D-printed portable rehabilitative device for elbow and shoulder movements. This device assists patients with hand impairments in performing repetitive elbow flexion and internal/external rotation of the shoulder. Twenty post-stroke patients (each group of 10) were randomly assigned to the traditional training group or rehabilitation device training group. This study compared the outcomes of the two groups before and after eight weeks of training. Following the therapy, the patient's performance was evaluated using standard clinical tests such as the Fugl-Meyer Assessment (FMA) and Active Range of Motion (AROM) of the elbow and shoulder. The results of the RDT (Rehabilitation Device Training) group were greater than those of the TT (Traditional Training) group, and the p values (p ​< ​0.05) show a significant improvement. The proposed device is a simple, low-cost, portable structure that improves muscular strength and mobility in the shoulder and elbow.

Should I prescribe exercise to a patient with an immobilized shoulder? An electromyographic study in patients with unilateral shoulder pain and healthy volunteers.

There is limited evidence about exercise performance during postoperative immobilization. This study aimed to quantify the muscle activity in the immobilized shoulder girdle in an abduction and neutral rotation position during a battery of contralateral activities and ipsilateral exercises of the upper limb in healthy volunteers and patients with unilateral shoulder pain (USP). Thirty participants were included and grouped as without (N = 17) or with USP (N = 13). Muscle activity (percentage of maximum voluntary isometric contraction (%MVIC)) of the serratus anterior (SA), upper trapezius (UT), lower trapezius (LT) and infraspinatus muscles was assessed during five contralateral activities (during comfortable speed, fast speed and comfortable speed with additional load) and seven ipsilateral exercises. No differences in % MVIC were found between healthy volunteers and patients with USP on immobilized upper limb exercises and with the contralateral shoulder girdle. General muscle activity was low (<15% MVIC) to moderate (21-40% MVIC). This similarity was maintained at different speeds and with additional load. Adapted lawnmower exercise showed a favorable UT/LT activation ratio. The study results support the use of all evaluated shoulder exercises, as they have shown low muscle activity, which is important for early rehabilitation phases.

The Effect of a Combined Scapula and Shoulder Exercise Program with Kinesio Tape on Pain, Shoulder Proprioception, and Upper Limb Function in Swimmers with Shoulder Impingement Syndrome

The Effect of a Combined Scapula and Shoulder Exercise Program with Kinesio Tape on Pain, Shoulder Proprioception, and Upper Limb Function in Swimmers with Shoulder Impingement Syndrome

EFisioTrack System for Monitoring Therapeutic Exercises in Patients with Shoulder Orthopedic Injuries in a Hospital Setting: A Pilot Feasibility Study.

To assess the effects of the eFisioTrack monitoring system on clinical variables in patients with prescribed physiotherapy for shoulder injuries, twenty-four adult patients with shoulder orthopaedic injuries who underwent physical therapy treatment in a hospital setting participated in the study (twelve in the experimental group and twelve as controls). Clinical outcome measures were shoulder function and pain (Constant-Murley Score and Disabilities of the Arm, Shoulder, and Hand or DASH score). Each variable was measured by a blinded physiotherapist at baseline and at one month follow-up. Patients performed the prescribed exercises either supervised by the physiotherapist (control group) or in a separate room without therapist supervision (experimental group). There were no statistically significant differences between groups before treatment or at follow-up for any outcomes (p ≥ 0.05). There was a statistically significant decrease (p ≤ 0.05) of at least 10 points in both groups for the DASH score at follow-up. Differences in the total score and subjective components of the Constant-Murley were also evidenced within groups. The use of the eFisioTrack system showed similar results in clinical measures compared to those performed under the direct supervision of the physiotherapist. This approach might be suitable for providing an effective shoulder exercise program at home.

Effects of isolated shoulder versus core-shoulder chain exercises on motor control and isokinetic torque in baseball pitchers with shoulder impingement syndrome: A single-blinded randomized controlled trial

ABSTRACT Recent biomechanical evidence suggests that shoulder impingement syndrome (SIS) is closely linked with altered core-shoulder kinetic chain, resulting pain, altered external shoulder muscle activation, and external muscle weakness. We aimed to compare the effects of conventional isolated shoulder exercise (ISE) and core-shoulder chain exercises (CCE) during isokinetic shoulder rotation in baseball pitchers with SIS. Forty male college baseball pitchers with SIS were randomly allocated to ISE and CCE groups and they performed the exercises 3 times a week for 6 weeks. The standardised numerical pain rating scale (NPRS), shoulder pain and disability index (SPADI), electromyography (EMG) amplitude, and concentric (CON) and eccentric (ECC) torques were measured. Substantial improvements in NPRS and SPADI scores were observed after CCE compared to ISE (p ≤ 0.046). Internal oblique/transversus abdominis, rectus abdominis, external oblique, serratus anterior, and infraspinatus muscle activation were significantly higher after CCE than ISE (p ≤ 0.033). CON and ECC torques were higher after CCE than ISE (p ≤ 0.002). The present findings demonstrated superior therapeutic effects of CCE in improving pain, disability level, shoulder muscle activation, and torque (muscle strength) in baseball pitchers with SIS compared to the conventional ISE, highlighting the importance of the chain exercise concept.

Voluntary Contraction of the Abdominal Muscles During Shoulder Exercises Increases Scapular Muscle Activation: A Critically Appraised Topic.

The fascial relationship between scapular muscles and abdominal muscles has been documented from previous studies. However, it is not yet clear whether voluntary abdominal contraction has a beneficial effect on scapular muscle activity during shoulder exercises. Do scapulothoracic muscle activation levels increase if shoulder exercises are performed with voluntary abdominal activation? Summary of Key Finding: After the literature review, 4 cross-sectional studies met the inclusion criteria and were included in this critically appraised topic. There is moderate evidence to support dynamic shoulder exercises with voluntary abdominal contraction can increase trapezius and serratus anterior muscle activation level in asymptomatic shoulders. Strength and Recommendation: Findings from 4 cross-sectional trials indicate that there is moderate evidence supporting that dynamic shoulder exercises performed with voluntary abdominal contraction can increase scapular muscle activity.

Effect of Combined Neck, Shoulder and Hand Exercises with Conventional Physiotherapy Treatment on Hand Grip Strength and Hand Function in Patients with Unilateral Cervical Radiculopathy: a Comparative Study

Effect of Combined Neck, Shoulder and Hand Exercises with Conventional Physiotherapy Treatment on Hand Grip Strength and Hand Function in Patients with Unilateral Cervical Radiculopathy: a Comparative Study

The Feasibility and Efficacy of Remote App-Guided Home Exercises for Frozen Shoulder: A Pilot Study.

Home exercise programs are beneficial in managing frozen shoulder (FS), yet adherence remains challenging. This pilot study introduces the remote app, Defrozen, designed for home exercises and assesses its feasibility and clinical outcomes in FS patients undergoing intra-articular and sub-acromial corticosteroid treatment. Over a four-week period, patients used the Defrozen-app, engaging in guided exercises. The feasibility of the intervention was assessed through several measurement scales, including adherence, the Technology Acceptance Model 2 (TAM2), the System Usability Scale (SUS), and User Satisfaction and Engagement (USE). Clinical outcomes included pain scale, Oxford Shoulder Score (OSS), Quick Disability of the Arm, Shoulder, and Hand (QuickDASH) Score, and passive range of motion. The TAM2 results indicated high perceived usefulness (4.5/5), ease of use (4.8/5), and intention to use (4.4/5); the SUS score was high at 81.7/100, complemented by USE scores reflecting ease of learning (4.9/5) and satisfaction (4.3/5). Clinical outcomes showed significant pain reduction, improved shoulder function, reduced shoulder-related disability, and increased shoulder range of motion. These findings suggest the Defrozen-app as a promising solution for FS, significantly improving adherence and showing potential to enhance clinical outcomes. However, these clinical outcome results are preliminary and necessitate further validation through a large-scale randomized controlled trial to definitively confirm efficacy and assess long-term benefits.

Building a Bridge to Community: A Pragmatic Randomized Trial Examining a Combined Physical Therapy and Resistance Exercise Intervention for People after Head and Neck Cancer.

Established barriers to general exercise and physical activity among individuals with head and neck cancer include dry mouth, difficulty eating, weight loss, fear of injury, comorbidities, and treatment-related symptoms of pain and fatigue. A 12-week pragmatic randomized controlled trial was conducted followed by an optional supported exercise transition phase. Eligible participants were individuals with head and neck cancers who had undergone surgery and/or radiation therapy to lymph node regions in the neck. Participants were randomized to a comparison group involving a shoulder and neck physiotherapeutic exercise protocol, or to a combined experimental group comprising the shoulder and neck physiotherapeutic exercise protocol and lower-body resistance exercise training. The primary outcome of this study was fatigue-related quality of life. Sixty-one participants enrolled, 59 (97%) completed the randomized trial phase, 55 (90%) completed the 24-week follow-up, and 52 (85%) completed the one-year follow-up. Statistically significant between-group differences were found in favor of the combined experimental group for the fatigue-related quality of life, fitness outcomes, and overall physical activity. Paired comparisons confirmed significant within-group improvements for both groups from baseline to one-year follow-up across most outcomes. A group-based combined physiotherapeutic and lower-body resistance exercise program was feasible and effective. Findings are limited to individuals who had undergone a surgical neck dissection procedure. Given the complexity of head and neck cancer, further pragmatic interdisciplinary research is warranted.

Effects of Shoulder Exercises with and Without Cervical Exercises on Pain and Function in the Patients with Cervical Spondylosis: Randomized Controlled Trial

Background: Cervical spondylosis is a chronic, degenerative, progressive disease of osteocartilagenous component of cervical spine that is usually age related and more common in men than in women, with a peak incidence between the ages of 40 and 60 years for both men and women.Objective: The aim of the study is to determine effects of shoulder exercises with and without cervical exercises on pain and function in patients with cervical spondylosis.Methods: Sixty eight diagnosed cervical spondylosis patients with 30-60 years of age were selected and randomly allocated in experimental and control groups, 34 in each group. The study was conducted in the physical therapy department of WAPDA hospital, Lahore. All participants were following the 6 weeks supervised exercise program, 4 sessions per week. Experimental group received shoulder exercises with cervical exercises while the control group received cervical exercises. Clinical outcomes were measured with visual analog scale for pain and neck disability index for function.Results: Analysis of final 61 patients were included, 31 in experimental and 30 in control (3 and 4 patients did not follow the study completely). Mean aged for experimental and control group was 49.39 ±7.022 and 49.23 ±6.704 respectively. Results showed that there was statically and clinically significance difference that as observed in from of reduction of pain P=0.001 and improvement of function P= 0.01Conclusion: Overall improvement was observed in both groups, results of study shows that shoulder exercises with cervical isometric exercises were more beneficial for outcomes of pain and function in experimental group. So we can conclude that shoulder exercise should be an integral part of treatment for cervical spondylosis patients.

Deep learning model for classifying shoulder pain rehabilitation exercises using IMU sensor

BackgroundArtificial intelligence is being used for rehabilitation, including monitoring exercise compliance through sensor technology. AI classification of shoulder exercise wearing an IMU sensor has only been reported in normal (i.e. painless) subjects. To prove the feasibility of monitoring exercise compliance, we aimed to classify 11 types of shoulder rehabilitation exercises using an AI (artificial intelligence) algorithm in patients with shoulder pain. We had the patients wear an IMU-based sensor, collected data during exercise, and determined the accuracy of exercise classification.MethodsData were collected from 58 patients (27 males, 31 females, age range 37–82 years) diagnosed with shoulder diseases such as adhesive capsulitis and rotator cuff disease. 11 types of shoulder pain rehabilitation exercise programs were developed and repeated each exercise ten times per session while wearing an IMU sensor. The study applied the Rectified Linear Unit (ReLU) and the SoftMax as the activation function for hidden layers, the output layer.ResultsThe acquired data was used to train a DNN model using the multilayer perceptron algorithm. The trained model was used to classify 11 types of shoulder pain rehabilitation exercises. The training accuracy was 0.975 and the test accuracy was 0.925.ConclusionThe study demonstrates that IMU sensor data can effectively classify shoulder pain rehabilitation exercises, providing more appropriate feedback for patients. The model can be utilized to establish a system for remotely monitoring patients’ exercise performance. The use of deep learning in patient monitoring and rehabilitation has significant potential to bring innovative changes to healthcare service delivery.

One-year effectiveness of high-load compared with low-load strengthening exercise on self-reported function in patients with hypermobile shoulders: a secondary analysis from a randomised controlled trial

ObjectivesTo investigate the long-term effectiveness of high-load versus low-load strengthening exercise on self-reported function in patients with hypermobility spectrum disorder (HSD) and shoulder symptoms.MethodsA secondary analysis of a superiority, parallel-group,...

To allow or avoid pain during shoulder rehabilitation exercises for patients with chronic rotator cuff tendinopathy-Study protocol for a randomized controlled trial (the PASE trial)

BackgroundRotator cuff (RC) tendinopathy is the most reported shoulder disorder in the general population with highest prevalence in overhead athletes and adult working-age population. A growing body of evidence support exercise therapy as an effective intervention, but to date there are no prospective randomized controlled trials addressing pain as an intervention variable.MethodsA single-site, prospective, pragmatic, assessor-blinded randomized controlled superiority trial. Eighty-four patients aged 18–55 years with chronic (symptom duration over 3 months) RC tendinopathy are randomized 1:1 to receive shoulder exercise during which pain is either allowed or avoided. The intervention period lasts 26 weeks. During that period, participants in both groups are offered 8 individual on-site sessions with an assigned sports physiotherapist. Participants perform home exercises and are provided with a pain and exercise logbook and asked to report completed home-based exercise sessions and reasons for not completing sessions (pain or other reasons). Patients are also asked to report load and the number of sets and repetitions per sets for each exercise session. The logbooks are collected continuously throughout the intervention period. The primary and secondary outcomes are obtained at baseline, 6 weeks, 26 weeks, and 1 year after baseline. The primary outcome is patient-reported pain and disability using the Shoulder PAin and Disability Index (SPADI). Secondary outcomes are patient-reported pain and disability using Disability Arm Shoulder and Hand short-form (Quick DASH), and shoulder pain using Numeric Pain Rating Scale. Objective outcomes are shoulder range of motion, isometric shoulder muscle strength, pain sensitivity, working ability, and structural changes in the supraspinatus tendon and muscle using ultrasound.DiscussionThe results of this study will contribute knowledge about the treatment strategies for patients with RC tendinopathy and help physiotherapists in clinical decision-making. This is the first randomized controlled trial comparing the effects of allowing pain versus avoiding pain during shoulder exercises in patients with chronic RC tendinopathy. If tolerating pain during and after exercise proves to be effective, it will potentially expand our understanding of “exercising into pain” for this patient group, as there is currently no consensus.Trial registrationClinicalTrials.gov NCT05124769. Registered on August 11, 2021.

Rehabilitation protocols in neonates undergoing primary nerve surgery for upper brachial plexus palsy: A scoping review.

Surgical management is recommended in patients with severe neonatal brachial plexus palsy (NBPP) within the first 6 months of age to regain best possible function. Rehabilitation post-surgery remains relatively unexplored. This is a scoping review that explores, which rehabilitation modalities exist and how they vary for different microsurgical approaches in NBPP. A systematic search was conducted to include articles about upper trunk obstetric brachial plexus nerve microsurgery in pediatric patients that made mention of rehabilitation protocols. The aims of rehabilitation modalities varied and were grouped: "passive" movement to prevent joint contracture or stiffness, "active" or task-oriented movement to improve motor function, or "providing initial motor recovery". Surgical approach was described as either exploration of the brachial plexus (EBP) or nerve transfer without root exploration (NTwoRE). Technique was categorized into transfers and non-transfers. Thirty-six full-text articles were included. Initiation of rehabilitation was 22.26 days post-surgery. Twenty-eight studies were EBP, and six were NTwoRE. Of studies classifiable by aims, nine were "passive", nine were "active", and five were "providing initial motor recovery". Only 27.7% of EBP studies mentioned active therapy, while 75.0% of NTwoRE studies mentioned active therapy. The average age of patients in the EBP procedure category was 7.70 months, and NTwoRE was 17.76 months. Within transfers, the spinal accessory to suprascapular group was more likely to describe an active shoulder exercise therapy, whereas contralateral C7 group was more likely to describe "initial motor recovery", especially through the use of electrostimulation. All articles on electrostimulation recommended 15-20-minute daily treatment. Information on rehabilitation is limited post-nerve surgery in NBPP. However, when mentioned, the aims of these therapies vary with respect to surgical approach and technique. The type of therapy to employ may be a multifaceted decision, involving factors such as patient age, initial deformity, and goals of the care team.

Effect of Adding Shoulder Stabilization Exercises to the Rehabilitation of Postoperative Hand Injuries in Young Adult Patients.

Hand injuries are common and could have an impact on all upper limb functions. Engaging shoulder muscle training during the rehabilitation protocol postoperatively could have a significant impact on regaining all upper limb function. The purpose of this study was to assess the effect of adding shoulder stabilization exercise to hand rehabilitation postoperatively. Forty patients were randomly assigned to 2 equal groups. Group A received a standard physical therapy program plus shoulder exercise protocol and group B received only a standard physical therapy protocol for hand rehabilitation. Outcome measures were pain intensity; grip strength; Arabic modified Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire; and range of motion (ROM). All outcome measures were assessed before and after treatment. Statistical analysis revealed that both groups, the experimental and control, showed significant improvement in all outcome measures, but experimental group A showed significant improvement than the control group B posttreatment for hand grip strength, ROM, and QuickDASH questioners (P < .001). Adding shoulder stabilizer muscle training to the hand rehabilitation protocol postoperatively has a significant impact on hand function outcomes.

The effect of dynamic neuromuscular stabilization on trapezius muscle activation during shoulder exercises in individuals with rounded shoulder posture: a pilot study

Aims: The aim of this pilot study is to investigate the impact of dynamic neuromuscular stabilization (DNS) technique on the activation of the upper, middle, and lower parts of the trapezius muscle during commonly used shoulder exercises in individuals with rounded shoulder posture. Methods: The study was conducted with 15 individuals exhibiting rounded shoulder posture. The determination of rounded shoulder posture was based on measuring the distance in centimeters between the posterior corner of the lateral acromion prominence and the bed in a supine position. If this distance was 2.5 cm or more, it was considered as rounded shoulder posture. Participants were taught three different shoulder exercises and the DNS respiratory technique, a component of Dynamic Neuromuscular Stabilization. The exercises were randomly performed with and without DNS, and the activation of the upper (UT), middle (MT), and lower (LT) parts of the trapezius muscle was measured separately using an 8-channel surface electromyography (EMG) system (Noraxon Ultium, Scottsdale, USA). Results: The activation of all parts of the trapezius muscle was found to be higher when exercises were performed with DNS compared to without DNS (p&lt;0.05). Additionally, the UT/MT and UT/LT activation ratios were compared during the exercises with and without DNS. It was observed that only during the 1st exercise, the UT/LT activation ratio was higher when exercises were performed with DNS (p&lt;0.05), while in all other cases, it was similar (p&gt;0.05). Conclusion: The primary findings of the study suggest that the activation of all parts of the trapezius muscle is higher when exercises are performed with DNS. This implies that DNS may contribute to more effective exercise performance in terms of the activation of the relevant muscle group, indicating potential positive effects of DNS in rehabilitation programs. However, the participant profile in our study is limited to individuals with rounded shoulder posture. Further research in different populations is needed to generalize the obtained results.