The immediate effects of a shoulder brace on muscle activity and scapular kinematics in subjects with shoulder impingement syndrome and rounded shoulder posture: A randomized crossover design

Yuan-Chun Chiu; Yung-Shen Tsai; Chien-Lung Shen; Tyng-Guey Wang; Jing-Lan Yang; Jiu-Jenq Lin

doi:10.1016/j.gaitpost.2020.04.028

The immediate effects of a shoulder brace on muscle activity and scapular kinematics in subjects with shoulder impingement syndrome and rounded shoulder posture: A randomized crossover design

Gait Posture. 2020 Jun:79:162-169. doi: 10.1016/j.gaitpost.2020.04.028. Epub 2020 May 4.

Authors

Yuan-Chun Chiu¹, Yung-Shen Tsai², Chien-Lung Shen³, Tyng-Guey Wang⁴, Jing-Lan Yang⁵, Jiu-Jenq Lin⁶

Affiliations

¹ School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taiwan.
² Department of Sports Sciences and Institute of Sports Equipment Technology, University of Taipei, Taiwan.
³ Department of Products, Taiwan Textile Research Institute, Taiwan.
⁴ Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taiwan.
⁵ Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taiwan. Electronic address: yangjinglan@gmail.com.
⁶ School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taiwan; Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taiwan. Electronic address: jiujlin@ntu.edu.tw.

PMID: 32416434
DOI: 10.1016/j.gaitpost.2020.04.028

Abstract

Background: Round shoulder posture (RSP) is one of the potential risks for shoulder impingement syndrome (SIS) due to alignment deviation of the scapula. Evidence on how the characteristics of a shoulder brace affecting the degree of RSP, shoulder kinematics, and associated muscle activity during movements is limited.

Research question: The purposes of this study were (1) to compare the effects of a shoulder brace on clinical RSP measurements, muscle activities and scapular kinematics during arm movements in subjects with shoulder impingement syndrome (SIS) and RSP; and (2) to compare the effects of two configurations (parallel and diagonal) and two tensions (comfortable and forced tension) of the brace straps on muscle activities and scapular kinematics during arm movements in subjects with SIS and RSP.

Methods: Twenty-four participants (12 males; 12 females) with SIS and RSP were randomly assigned into 2 groups (comfortable then forced, and forced then comfortable) with 2 strap configurations in each tension condition. The pectoralis minor index (PMI), acromial distance (AD) and shoulder angle (SA) were used to assess the degree of RSP. Three-dimensional electromagnetic motion analysis and electromyography were used to record the scapular kinematics and muscle activity during arm movements.

Results: All clinical measurements with the brace were significantly improved (p < 0.05). Under forced tension, muscle activities were higher with the diagonal configuration than with the parallel configuration in the lower trapezius (LT) (1.2-2.3% MVIC, p < 0.05) and serratus anterior (SA) (2.3% MVIC, p = 0.015). For upward rotation and posterior tilting of the scapula, the diagonal configuration was larger than the parallel configuration (1.5°, p = 0.038; 0.4°-0.5°, p < 0.05, respectively).

Significance: Different characteristics of the straps of the shoulder brace could alter muscle activity and scapular kinematics at different angles during arm movement. Based on the clinical treatment preference, the application of a shoulder brace with a diagonal configuration and forced tension is suggested for SIS and RSP subjects.

Keywords: Electromyography; Round shoulder posture; Scapula motion; Shoulder brace; Shoulder impingement syndrome.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Biomechanical Phenomena
Braces*
Cross-Over Studies
Female
Humans
Male
Muscle, Skeletal / physiology*
Posture*
Range of Motion, Articular
Scapula / physiology*
Shoulder / physiology*
Shoulder Impingement Syndrome / physiopathology
Shoulder Impingement Syndrome / therapy*