Analysis of arm elevation muscle activity through different movement planes and speeds during in-water and dry-land exercise

作者：Castillo Lozano Romualdo; Cuesta Vargas Antonio^*; Gabel Charles Philip

来源：Journal of Shoulder and Elbow Surgery, 2014, 23(2): 159-165.

DOI：10.1016/j.jse.2013.04.010

• Aquatic therapy
• movement
• muscle
• physical therapy
• shoulder
• surface electromyography

Objective: The objectives of this cross-sectional, analytical inference analysis were to compare shoulder muscle activation at arm elevations of 0 degrees to 90 degrees through different movement planes and speeds during in-water and dry-land exercise and to extrapolate this information to a clinical rehabilitation model. %26lt;br%26gt;Methods: Six muscles of right-handed adult subjects (n = 16; males/females: 50%; age: 26.1 +/- 4.5 years) were examined with surface electromyography during arm elevation in water and on dry land. Participants randomly performed 3 elevation movements (flexion, abduction, and scaption) through 0 degrees to 90 degrees. Three movement speeds were used for each movement as determined by a metronome (30 degrees/sec, 45 degrees/sec, and 90 degrees/sec). Dry-land maximal voluntary contraction tests were used to determine movement normalization. %26lt;br%26gt;Results: Muscle activity levels were significantly lower inwater compared with dry land at 30 degrees/sec and 45 degrees/sec but significantly higher at 90 degrees/sec. This sequential progressive activation with increased movement speed was proportionally higher on transition from gravity-based on-land activity to water-based isokinetic resistance. The pectoralis major and latissimus dorsi muscles showed higher activity during abduction and scaption. %26lt;br%26gt;Conclusions: These findings on muscle activation suggest protocols in which active flexion is introduced first at low speeds (30 degrees/sec) in water, then at medium speeds (45 degrees/sec) in water or on dry land, and finally at high speeds (90 degrees/sec) on dry land before in water. Abduction requires higher stabilization, necessitating its introduction after flexion, with scaption introduced last. This model of progressive sequential movement ensures that early active motion and then stabilization are appropriately introduced. This should reduce rehabilitation time and improve therapeutic goals without compromising patient safety or introducing inappropriate muscle recruitment or movement speed.

• 出版日期2014-2