Trapezius Muscle Activation During Bilateral Scapular Retraction and Shoulder External Rotation Under Kinetic Chain and Unstable Surface Conditions

NCT ID: NCT07000773

Last Updated: 2025-06-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-04-01

Study Completion Date

2024-01-01

Brief Summary

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This study aims to investigate the effects of performing the Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise under kinetic chain involvement and unstable surface conditions on trapezius muscle activation. Surface electromyography (EMG) will be used to assess the activity levels of the upper, middle, and lower trapezius muscles. The goal is to determine whether integrating kinetic chain elements and instability can optimize muscle activation patterns in healthy individuals during a commonly used scapular rehabilitation exercise.

Detailed Description

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Maintaining muscular balance among the scapular stabilizers is crucial for optimal shoulder function. The Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise is frequently used in clinical rehabilitation to activate the lower trapezius while minimizing upper trapezius activity. Although this exercise is widely practiced, the effects of performing it under kinetic chain conditions (such as squat and lunge positions) and on an unstable surface have not been thoroughly explored.

This study will examine how adding kinetic chain involvement and instability influences the electromyographic activity of the upper trapezius (UT), middle trapezius (MT), and lower trapezius (LT) muscles during the BSR-SER exercise. Twenty healthy participants will perform the exercise in various lower extremity positions (standing, squat, lunge) and on both stable and unstable surfaces using a BOSU® ball. EMG data will be collected using a wireless surface EMG system and analyzed in terms of percentage of maximal voluntary isometric contraction (%MVIC).

The results of this study may provide valuable insights into the optimization of scapular stabilization exercises and guide clinicians in designing more effective shoulder rehabilitation programs by incorporating kinetic chain principles and unstable surfaces.

Conditions

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Healthy Volunteers

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

This is a randomized crossover study where each participant performs the Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise under multiple conditions. The exercise is performed on both stable and unstable surfaces and in different lower extremity positions (standing, lunge, and squat). Each participant acts as their own control by completing all exercise conditions in a randomized order. Electromyographic (EMG) activity of the trapezius muscles is measured during each condition to assess muscle activation patterns.
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Standing on Stable Surface

Participants perform the bilateral scapular retraction with shoulder external rotation (BSR-SER) exercise in a standing position on a stable surface using resistance bands.

Group Type EXPERIMENTAL

Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise

Intervention Type BEHAVIORAL

Participants perform the Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise using a resistance band. The exercise is conducted under various conditions including stable and unstable surfaces (using BOSU® balance trainer) and in three different lower limb positions: standing, lunge, and squat. Each condition is randomized, and participants complete all conditions in a crossover design. The intervention aims to evaluate trapezius muscle activation patterns during these exercises using surface electromyography (EMG).

Standing on Unstable Surface

Participants perform the BSR-SER exercise in a standing position on an unstable surface (BOSU®) using resistance bands.

Group Type EXPERIMENTAL

Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise

Intervention Type BEHAVIORAL

Participants perform the Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise using a resistance band. The exercise is conducted under various conditions including stable and unstable surfaces (using BOSU® balance trainer) and in three different lower limb positions: standing, lunge, and squat. Each condition is randomized, and participants complete all conditions in a crossover design. The intervention aims to evaluate trapezius muscle activation patterns during these exercises using surface electromyography (EMG).

Lunge Position on Stable Surface

Participants perform the BSR-SER exercise in a lunge position on a stable surface using resistance bands. Knee and trunk angles are standardized.

Group Type EXPERIMENTAL

Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise

Intervention Type BEHAVIORAL

Participants perform the Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise using a resistance band. The exercise is conducted under various conditions including stable and unstable surfaces (using BOSU® balance trainer) and in three different lower limb positions: standing, lunge, and squat. Each condition is randomized, and participants complete all conditions in a crossover design. The intervention aims to evaluate trapezius muscle activation patterns during these exercises using surface electromyography (EMG).

Lunge Position on Unstable Surface

Participants perform the BSR-SER exercise in a lunge position on an unstable surface (BOSU®) using resistance bands. Knee and trunk angles are standardized.

Group Type EXPERIMENTAL

Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise

Intervention Type BEHAVIORAL

Participants perform the Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise using a resistance band. The exercise is conducted under various conditions including stable and unstable surfaces (using BOSU® balance trainer) and in three different lower limb positions: standing, lunge, and squat. Each condition is randomized, and participants complete all conditions in a crossover design. The intervention aims to evaluate trapezius muscle activation patterns during these exercises using surface electromyography (EMG).

Squat Position on Stable Surface

Participants perform the BSR-SER exercise in a squat position on a stable surface using resistance bands. Knee and trunk angles are standardized.

Group Type EXPERIMENTAL

Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise

Intervention Type BEHAVIORAL

Participants perform the Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise using a resistance band. The exercise is conducted under various conditions including stable and unstable surfaces (using BOSU® balance trainer) and in three different lower limb positions: standing, lunge, and squat. Each condition is randomized, and participants complete all conditions in a crossover design. The intervention aims to evaluate trapezius muscle activation patterns during these exercises using surface electromyography (EMG).

Squat Position on Unstable Surface

Participants perform the BSR-SER exercise in a squat position on an unstable surface (BOSU®) using resistance bands. Knee and trunk angles are standardized.

Group Type EXPERIMENTAL

Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise

Intervention Type BEHAVIORAL

Participants perform the Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise using a resistance band. The exercise is conducted under various conditions including stable and unstable surfaces (using BOSU® balance trainer) and in three different lower limb positions: standing, lunge, and squat. Each condition is randomized, and participants complete all conditions in a crossover design. The intervention aims to evaluate trapezius muscle activation patterns during these exercises using surface electromyography (EMG).

Interventions

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Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise

Participants perform the Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise using a resistance band. The exercise is conducted under various conditions including stable and unstable surfaces (using BOSU® balance trainer) and in three different lower limb positions: standing, lunge, and squat. Each condition is randomized, and participants complete all conditions in a crossover design. The intervention aims to evaluate trapezius muscle activation patterns during these exercises using surface electromyography (EMG).

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Age between 18 and 35 years
* Body Mass Index (BMI) less than 30 kg/m²

Exclusion Criteria

* Engaging in more than 6 hours per week of overhead sports or upper extremity strength training
* History of surgery in the spine, lower extremities, or upper extremities
* Experiencing pain in these regions within the past 6 weeks
* Having a rheumatologic, systemic, or metabolic disease
Minimum Eligible Age

18 Years

Maximum Eligible Age

35 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Gazi University

OTHER

Sponsor Role collaborator

Recep Tayyip Erdogan University

OTHER

Sponsor Role lead

Responsible Party

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Gamze Çobanoğlu Demirkan

Research Assistant, PhD, Physiotherapist, Department of Physiotherapy and Rehabilitation

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Gamze Cobanoglu Demirkan, PhD

Role: PRINCIPAL_INVESTIGATOR

Gazi University

Locations

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Gazi University

Ankara, Çankaya, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Colado JC, Garcia-Masso X, Triplett NT, Calatayud J, Flandez J, Behm D, Rogers ME. Construct and concurrent validation of a new resistance intensity scale for exercise with thera-band(R) elastic bands. J Sports Sci Med. 2014 Dec 1;13(4):758-66. eCollection 2014 Dec.

Reference Type BACKGROUND
PMID: 25435767 (View on PubMed)

Ecemis ZB, Cobanoglu G, Oksuz BS, Kaya B, Guzel NA, Kafa B, Kafa N. Trapezius Muscle Electromyographic Activity in Lawn-Mower Exercise: Standing Versus Quadruped. J Sport Rehabil. 2024 Dec 10;34(4):436-442. doi: 10.1123/jsr.2023-0404. Print 2025 May 1.

Reference Type BACKGROUND
PMID: 39657698 (View on PubMed)

Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol. 2000 Oct;10(5):361-74. doi: 10.1016/s1050-6411(00)00027-4.

Reference Type BACKGROUND
PMID: 11018445 (View on PubMed)

Cobanoglu G, Guzel NA, Ecemis ZB, Demirkan MY. Investigation of muscle activation during kinetic chain based exercises in individuals with and without forward head posture. J Back Musculoskelet Rehabil. 2024;37(6):1537-1549. doi: 10.3233/BMR-230397.

Reference Type BACKGROUND
PMID: 38968043 (View on PubMed)

Kara D, Harput G, Duzgun I. Trapezius muscle activation levels and ratios during scapular retraction exercises: A comparative study between patients with subacromial impingement syndrome and healthy controls. Clin Biomech (Bristol). 2019 Jul;67:119-126. doi: 10.1016/j.clinbiomech.2019.05.020. Epub 2019 May 11.

Reference Type BACKGROUND
PMID: 31103961 (View on PubMed)

Melo ASC, Vilas-Boas JP, Cruz EB, Macedo RM, E Ferreira SB, Sousa AS. The influence of shoulder position during multi-joint exercises in the relative scapular muscles activity in symptomatic and asymptomatic conditions. J Back Musculoskelet Rehabil. 2023;36(4):883-893. doi: 10.3233/BMR-220056.

Reference Type BACKGROUND
PMID: 36776036 (View on PubMed)

Uysal O, Akoglu AS, Kara D, Sezik AC, Calik M, Duzgun I. Theraband Applications for Improved Upper Extremity Wall-Slide Exercises. J Athl Train. 2022 Aug 1;57(8):795-803. doi: 10.4085/1062-6050-0305.21.

Reference Type BACKGROUND
PMID: 36356616 (View on PubMed)

Mendez-Rebolledo G, Morales-Verdugo J, Orozco-Chavez I, Habechian FAP, Padilla EL, de la Rosa FJB. Optimal activation ratio of the scapular muscles in closed kinetic chain shoulder exercises: A systematic review. J Back Musculoskelet Rehabil. 2021;34(1):3-16. doi: 10.3233/BMR-191771.

Reference Type BACKGROUND
PMID: 32831190 (View on PubMed)

Other Identifiers

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Gazi-BSR-SER

Identifier Type: -

Identifier Source: org_study_id

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