Exercises With Optimal Scapulothoracic Muscle Activation for Individuals With Paraplegia.

Background: Individuals with paraplegia and coexisting trunk and postural control deficits rely on their upper extremities for function, which increases the risk of shoulder pain. A multifactorial etiology of shoulder pain includes "impingement" of the supraspinatus, infraspinatus, long head of the biceps tendons, and/or subacromial bursa resulting from anatomic abnormalities, intratendinous degeneration, and altered scapulothoracic kinematics and muscle activation. Targeting serratus anterior (SA) and lower trapezius (LT) activation during exercise, as part of a comprehensive plan, minimizes impingement risk by maintaining optimal shoulder alignment and kinematics during functional activities.

Using biofeedback to optimize scapular muscle activation ratios during a seated resisted scaption exercise.

Impairments in muscle activation have been linked to increased risk of developing shoulder pathologies such as subacromial impingement syndrome (SIS) and associated rotator cuff injuries. Individuals with SIS have demonstrated increased upper trapezius (UT) muscle activation and reduced serratus anterior (SA) and lower trapezius (LT) muscle activation, which can be collectively represented as ratios (UT/SA and UT/LT). Targeted exercise is an important component of shoulder rehabilitation programs to re-establish optimal muscle activation and ratios.

Automatic Identification of Upper Extremity Rehabilitation Exercise Type and Dose Using Body-Worn Sensors and Machine Learning: A Pilot Study.

Background: Prior studies suggest that participation in rehabilitation exercises improves motor function poststroke; however, studies on optimal exercise dose and timing have been limited by the technical challenge of quantifying exercise activities over multiple days.

Objectives: The objectives of this study were to assess the feasibility of using body-worn sensors to track rehabilitation exercises in the inpatient setting and investigate which recording parameters and data analysis strategies are sufficient for accurately identifying and counting exercise repetitions.

Methods: MC10 BioStampRC® sensors were used to measure accelerometer and gyroscope data from upper extremities of healthy controls ( = 13) and individuals with upper extremity weakness due to recent stroke ( = 13) while the subjects performed 3 preselected arm exercises.

Validity of Visual Assessment of Sit to Stand After Hip Fracture.

Background And Purpose: When treating older adults post-hip fracture, physical therapists routinely assess the sit-to-stand (STS) task using observational analysis. Studies have demonstrated that significant movement asymmetries in ground reaction force production of the fractured lower limb persist during STS, even though individuals may rise independently. To date, the validity of therapist judgments of lower limb force during STS has not been addressed.

Improving Shoulder Kinematics in Individuals With Paraplegia: Comparison Across Circuit Resistance Training Exercises and Modifications in Hand Position.

Background: Circuit resistance training (CRT) should promote favorable kinematics (scapular posterior tilt, upward rotation, glenohumeral or scapular external rotation) to protect the shoulder from mechanical impingement following paraplegia. Understanding kinematics during CRT may provide a biomechanical rationale for exercise positions and exercise selection promoting healthy shoulders.

Objective: The purposes of this study were: (1) to determine whether altering hand position during CRT favorably modifies glenohumeral and scapular kinematics and (2) to compare 3-dimensional glenohumeral and scapular kinematics during CRT exercises.

How "healthy" is circuit resistance training following paraplegia? Kinematic analysis associated with shoulder mechanical impingement risk.

The purpose of the study was to determine whether wheelchair-based circuit resistance training (CRT) exercises place the shoulder at risk for mechanical impingement. Using a novel approach, we created a mechanical impingement risk score for each exercise by combining scapular and glenohumeral kinematic and exposure data. In a case series design, 18 individuals (25-76 yr old) with paraplegia and without substantial shoulder pain participated.

Effect of shoulder pain on shoulder kinematics during weight-bearing tasks in persons with spinal cord injury.

Objective: To assess 3-dimensional scapulothoracic and glenohumeral kinematics between subjects with spinal cord injury and disease (SCI/D) with and without shoulder pain during a weight-relief raise and transfer task.

Design: Case-control, repeated-measures analysis of variance.

Setting: Movement analysis laboratory.