Analysis of Scapular Musculature Activation During Targeted Abdominal Contraction with Scapular Stabilization Exercises

NCT ID: NCT06261749

Last Updated: 2025-03-13

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 30 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2024-02-15
• Study Completion Date: 2024-08-01

Brief Summary

Muscle activation of the upper trapezius, lower trapezius and serratus anterior muscles will be measured during prone scapular retraction exercises. Then the same exercises will be performed with abdominal contraction using a stabilizer and muscle activity of the same muscles will be measured. A comparison will be made between the two conditions.

Detailed Description

The scapula plays an important role in providing both movement and stability of the shoulder joint. Correct scapular position and movement is achieved through the synchronized firing of muscles to provide optimal length-tension relationships between the scapular stabilizers. During arm elevation, coordinated muscle activation is seen between the serratus anterior (SA) and trapezius to provide controlled scapular upward rotation. Therefore, analyzing the muscle activation rates of these synergistic pairs (upper trapezius/serratus anterior [UT/SA] or upper trapezius/lower trapezius [UT/LT]) helps us understand scapular muscle function and prescribe exercises. Rehabilitation has focused on LT and SA muscle strengthening exercises to treat shoulder dysfunction . From a mechanical point of view, trunk and pelvis stability is required to transmit force and energy to the upper extremities during function or sports activities.

An altered spinal alignment directly affects the movement of the shoulder and scapular muscles, altering scapular position and stability. Coordinated activity of the shoulder and scapular muscles is essential to increase dynamic stability during shoulder movement; therefore, altered muscle activity can produce inappropriate glenohumeral and scapulothoracic joint movement rhythm and cause various shoulder pathologies examined the effect on the surface electromyographic activity of the scapulothoracic (UT, SA and LT) and middle deltoid muscles during isometric contraction in 45° shoulder abduction in the standing scapular plane supported by a pelvic and thoracic belt and reported that it did not significantly increase SA, LT activation, but increased middle deltoid activation and decreased UT electromyography activity observed an increase in the activity of the serratus anterior muscle during crossed shoulder flexion and scaption exercises with voluntary abdominal muscle contraction.

The resistance provided by isotonic exercise depends on gravity and the resistance pattern varies according to changes in the patient's body position (standing, prone, supine). In the prone position, it is often preferred because the scapular muscles can be strengthened in isolation by eliminating the lower extremity and core muscles. In a study in which trapezius muscle activation was examined by performing scapula retraction exercises in the prone position, a higher increase in trapezius muscle activation was reported compared to the standing study . It has been shown that there is a significantly greater increase in muscle activation in all 3 parts of the trapezius muscle in the prone position compared to the side lying and standing positions. It has been reported that this may be due to the fact that exercises performed prone against gravity may give more load to the trapezius muscle than the standing position. Although lower extremity movements are limited in the prone position compared to the standing position, anterior pelvic tilt formation as a result of excessive lumbar spine movements during exercises performed in this position should not be overlooked.

Therefore, our aim in this study was to investigate scapulothoracic muscle activations during open kinetic chain strengthening exercises with scapular stabilizers by providing lumbopelvic stability with voluntary abdominal contraction in the prone position.

Conditions

Scapula; Increased

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Healthy individuals

Inclusion criteria:

18-30 age Physical activity level should be at least 5 according to Tegner activity scale

Voluntary Abdominal Contractions

Intervention Type: OTHER

Abdominal contraction will be taught before exercise. They will be instructed to tighten their abdomen as if they were wearing tight pants and not to hold their breath. The visual biofeedback unit will be placed between the therapy table and the participant's abdominal area and will be used to monitor the contraction of the abdominal muscles. The visual biofeedback inelastic bag will be inflated to 70 mmHg and the participant will be instructed to draw the abdomen in and maintain the position. The participant will be asked to maintain a pressure of 60 mmHg during scapular retraction with visual feedback from an analog pressure gauge. Pressure changes of ± 5 mmHg due to breathing will be allowed. During exercise, the patient will be asked to perform the exercises while maintaining the pressure on the visual biofeedback.

Exercise

Intervention Type: OTHER

Exercises;

1. Scapular retraction with arms next to the trunk

2. Scapular retraction with arms abducted at 45 degrees,

3. Scapular retraction with arms 90 degrees abducted,

4. Scapular retraction exercises with arms 120 degrees abducted The exercises will be performed with the shoulder head off the bed. The exercises will be repeated 3 times with 5 seconds rest between repetitions. To reduce the effect of fatigue, 2 minutes rest will be given between exercises. Each exercise will be performed with 3 seconds of concentric, 3 seconds of isometric and 3 seconds of eccentric contraction and muscle activation of UT-LT and SA muscles will be measured during these phases.

Interventions

Voluntary Abdominal Contractions

Abdominal contraction will be taught before exercise. They will be instructed to tighten their abdomen as if they were wearing tight pants and not to hold their breath. The visual biofeedback unit will be placed between the therapy table and the participant's abdominal area and will be used to monitor the contraction of the abdominal muscles. The visual biofeedback inelastic bag will be inflated to 70 mmHg and the participant will be instructed to draw the abdomen in and maintain the position. The participant will be asked to maintain a pressure of 60 mmHg during scapular retraction with visual feedback from an analog pressure gauge. Pressure changes of ± 5 mmHg due to breathing will be allowed. During exercise, the patient will be asked to perform the exercises while maintaining the pressure on the visual biofeedback.

Intervention Type: OTHER

Exercise

Exercises;

1. Scapular retraction with arms next to the trunk

2. Scapular retraction with arms abducted at 45 degrees,

3. Scapular retraction with arms 90 degrees abducted,

4. Scapular retraction exercises with arms 120 degrees abducted The exercises will be performed with the shoulder head off the bed. The exercises will be repeated 3 times with 5 seconds rest between repetitions. To reduce the effect of fatigue, 2 minutes rest will be given between exercises. Each exercise will be performed with 3 seconds of concentric, 3 seconds of isometric and 3 seconds of eccentric contraction and muscle activation of UT-LT and SA muscles will be measured during these phases.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Healthy individuals between the ages of 18-30
• Physical activity level of at least 5 on the Tegner activity scale.

Exclusion Criteria

• Having pathology of the shoulder and spine
• History of previous upper extremity surgery
• Body mass index greater than 24.9
• Experience with core stability training.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 30 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Hacettepe University

OTHER

Sponsor Role: lead

Responsible Party

Irem Duzgun

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Kübra Çaylan Gürses

Role: PRINCIPAL_INVESTIGATOR

Hacettepe University

İrem Düzgün

Role: STUDY_DIRECTOR

Hacettepe University

Özgün Uysal

Role: PRINCIPAL_INVESTIGATOR

Hacettepe University

Locations

Hacettepe University

Ankara, Ankara, Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

EmgSCAPULA

Identifier Type: -

Identifier Source: org_study_id