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Supine scapular punch: An exercise for early phases of shoulder rehabilitation?

  • Leonardo Intelangelo
    Correspondence
    Corresponding author at: Musculoskeletal Research Unit - UIM, University Center for Assistance, Teaching and Research - CUADI, University of Gran Rosario – UGR, Corrientes 1245, Rosario CP 2000, Santa Fe, Argentina.
    Affiliations
    Musculoskeletal Research Unit, University Center for Assistance, Teaching and Research, University of Gran Rosario, Corrientes 1245, Rosario, Argentina
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  • Lassaga Ignacio
    Affiliations
    Musculoskeletal Research Unit, University Center for Assistance, Teaching and Research, University of Gran Rosario, Corrientes 1245, Rosario, Argentina
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  • Cristian Mendoza
    Affiliations
    Musculoskeletal Research Unit, University Center for Assistance, Teaching and Research, University of Gran Rosario, Corrientes 1245, Rosario, Argentina
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  • Diego Bordachar
    Affiliations
    Musculoskeletal Research Unit, University Center for Assistance, Teaching and Research, University of Gran Rosario, Corrientes 1245, Rosario, Argentina
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  • Daniel Jerez-Mayorga
    Affiliations
    Faculty of Rehabilitation Sciences, Universidad Andres Bello, Fernández Concha 700, Las Condes, Santiago de Chile, Chile
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  • Alexandre Carvalho Barbosa
    Affiliations
    Department of Physical Therapy, Musculoskeletal Research Group - NIME, Federal University of Juiz de Fora, Av. Dr. Raimundo Monteiro Rezende, 330, Centro, Governador Valadares, Brazil
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      Highlights

      • Supine Scapular Punch demonstrated moderate-high levels of serratus anterior muscle activity.
      • Supine Scapular Punch showed low levels of upper trapezius and infraspinatus muscle activity.
      • Additional load-induced similar muscle activity in healthy volunteers and with shoulder pain.
      • The exercise could be used in early stage of rehabilitation.
      • This exercise helps to reverse the alterations in the upper trapezius/serratus anterior rate.

      Abstract

      Background

      Serratus anterior strengthening generally appears in shoulder rehabilitation protocols. This study's aim was to measure electromyographic activity of the serratus anterior, upper trapezius, and infraspinatus muscles during the Supine Scapular Punch exercise in healthy volunteers and those with unilateral shoulder pain.

      Methods

      Fifty-four participants were included and grouped as without (n = 34, age = 25.8 years) or with unilateral shoulder pain (n = 20, age = 26.3 years, visual analogue scale = 4.15 cm). Electromyographic activity of the serratus anterior, upper trapezius, and infraspinatus muscles was assessed during Supine Scapular Punch (four phases: P1 = press up concentric, P2 = Supine Scapular Punch concentric, P3 = Supine Scapular Punch eccentric, P4 = press up eccentric) performed under two conditions, with and without additional load.

      Findings

      Overall muscle activity during P1 and P4 was negligible (< 10% maximal voluntary isometric contractions). During P2 and P3, no statistically significant differences in serratus anterior and upper trapezius muscle activity were found between groups, with moderate to high serratus anterior activity (28.94% to 44.3%) and very low upper trapezius activity (< 6%). Upper trapezius/serratus anterior activity ratios ranged from 0.09 to 0.18. Overall infraspinatus muscle activity was always very low (< 10%).

      Interpretation

      The Supine Scapular Punch induces moderate to high serratus anterior muscle activity with very low upper trapezius and infraspinatus activation. Based on these results, the Supine Scapular Punch is a safe exercise that can be used in the early phases of shoulder rehabilitation.

      Keywords

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