Objectives: The purpose of this study was to investigate the effects of additional 6-week scapular stabilization training in patients with nonspecific neck pain (NNP). Materials and Methods: A total of 30 patients with NNP were randomly allocated to the study. Fifteen participants in the intervention group received neck-focused exercise and scapular stabilization training, whereas 15 participants in the control group received neck-focused exercise training. All groups were evaluated at baseline and after 6 weeks of rehabilitation. The pain intensity on the neck was measured with the visual analog scale (VAS). The self-reported disability status was measured with the neck disability index (NDI). Three-dimensional scapular kinematics were recorded during dynamic shoulder elevation trials using an electromagnetic tracking device, and data were further analyzed at 30°, 60°, 90°, and 120° of humerothoracic elevations. Results: Comparisons revealed that, regardless of the received treatment, after 6 weeks of training both groups showed significant improvements in VAS (P < .001) and NDI (P < .001) scores. Both VAS and NDI outcomes have a large effect size (r = .618 and r = .619, respectively). For scapular kinematics, there were no group differences, especially for scapular upward–downward rotation and anterior–posterior tilt (P > .05). However, in the intervention group, the scapula was more externally rotated at 120° humerothoracic elevation (P = .04). Conclusion: Findings of this study showed that both manual therapy and active interventions, including neck-focused exercise and scapular stabilization training, are effective in decreasing pain and disability level in patients with NNP. More comprehensive studies with longer follow-up durations are needed to better understand the potential effects of scapular stabilization training in patients with NNP.
Taha Ibrahim Yildiz, Elif Turgut, and Irem Duzgun
Elif Turgut, Irem Duzgun, and Gul Baltaci
Context: Increasing soft tissue flexibility and joint mobility is one of the important aims of studies to treat subacromial impingement syndrome (SIS). Objective: The aim of this study was to investigate the effects of a stretching program on posterior capsule tightness, pectoralis minor tightness, pain severity, and disability status in SIS. Design: Single-group pretest posttest design. Setting: University outpatient clinic. Participants: 18 participants diagnosed with SIS (34.8±9.4 y, symptoms duration 5.8±4.9 months) were included in the study. Intervention: The 6-week self-stretching program for pectoralis minor, posterior capsule, levator scapula, and latissimus dorsi was performed. Main Outcome Measures: Posterior capsule tightness, pectoralis minor tightness, pain severity (visual analog scale), and self-reported shoulder-related pain and disability status (Shoulder Pain and Disability Index) were used to assess changes in flexibility and symptoms. Results: Comparisons showed that there was significantly less posterior capsule and pectoralis minor tightness, less pain severity on activity and at night, and a lower disability score reported after the 6-week stretching program (P < 0.05). There was no statistically significant difference in pain severity at rest after the 6-week stretching program (P > 0.05). Conclusions: The findings of the study showed that flexibility, pain severity, and disability gains can be achieved with a 6-week stretching exercise training for participants with SIS. Therefore, shoulder girdle stretching exercises should be recommended early in shoulder rehabilitation program.
Hande Guney-Deniz, Gulcan Harput, Ugur Toprak, and Irem Duzgun
Context: The scapular retraction exercises are widely used among clinicians to balance the activity of the scapular muscles as well as the rotator cuff muscles in different shoulder abduction positions. Objectives: The aim of this study was to investigate the relationship between scapular (middle and upper trapezius) and shoulder muscles (middle deltoid and infraspinatus) activation level differences and acromiohumeral distance changes during shoulder abduction with scapular retraction. Design: Cross-sectional study. Setting: University research laboratory. Participants: Nineteen asymptomatic individuals were included (mean [SD]: age = 22.4 [1.8] y). Main Outcome Measure: The acromiohumeral distance was measured at 0° and 90° shoulder abduction when the scapula was in nonretracted and retracted position with ultrasound imaging. The relationship between muscle activation level changes and acromiohumeral distance difference was analyzed with the Pearson correlation test. Results: Middle trapezius muscle activity change correlated with acromiohumeral distance difference (r = .55, P = .02) from 0° to 90° shoulder abduction when scapula was retracted. For both nonretracted and retracted scapular positions, no correlations were found between middle deltoid, infraspinatus, and upper trapezius muscle activity changes with acromiohumeral distance differences during shoulder abduction (P > .05). Conclusions: Active scapular retraction exercise, especially focusing on the middle trapezius muscle activation, seems to be an effective treatment option to optimize the acromiohumeral distance during shoulder abduction.
Derya Ozer Kaya, Irem Duzgun, Gul Baltaci, Selma Karacan, and Filiz Colakoglu
To assess and compare the effects of 6 mo of Pilates and calisthenics on multijoint coordination and proprioception of the lower limbs at the 3rd and 6th mo of training.
Randomized, controlled, assessor-blinded, repeated-measures.
University research laboratory.
Participants and Intervention:
Healthy, sedentary, female participants age 25–50 y were recruited and randomly divided into 3 groups: a calisthenic exercise group (n = 34, mean age ± SD 40 ± 8 y, body-mass index [BMI] 31.04 ± 4.83 kg/m2), a Pilates exercise group (n = 32, mean age ± SD 37 ± 8 y, BMI 31.04 ± 4.83 kg/m2), and a control group (n = 41, mean age ± SD 41 ± 7 y, BMI 27.09 ± 4.77 kg/m2). The calisthenics and Pilates groups underwent related training programs for 6 mo, while the controls had no specific training.
Main Outcome Measures:
Coordination and proprioception of the lower extremities with concentric and eccentric performances in the closed kinetic chain assessed with the monitored rehab functional squat system at baseline and at the 3rd and 6th mo of training.
For the within-group comparison, coordinative concentric and eccentric deviation values were significantly decreased for both dominant and nondominant lower limbs at pretraining and at the 3rd and 6th mo posttraining in the calisthenics group (P < .05). In contrast, there was no improvement in the Pilates group throughout the training. However, for comparisons between groups, the baseline values of coordinative concentric and eccentric deviations were different in the calisthenics group than in Pilates and the controls (P < .05). There were no differences in the proprioception values of either visible or nonvisible movement in any group throughout the training (P > .05).
It seems that calisthenic exercises are more likely to improve coordination of the lower extremity after 3 and 6 mo of training than Pilates exercises. Calisthenic exercises may be useful for individuals who require improved coordination.
Irem Duzgun, Gul Baltaci, Filiz Colakoglu, Volga Bayrakci Tunay, and Derya Ozer
To investigate the effect of a 12-wk weighted-jump-rope training program on shoulder strength.
Pretest to posttest experimental design.
University sports physiotherapy laboratory.
24 healthy volleyball players age 13-16 y.
Group 1 took weighted-rope training (n = 9), group 2 took unweighted-rope training (n = 8), and group 3 did not train with any specific program (n = 7).
Main Outcome Measures:
Players’ strength determined with an isokinetic dynamometer (Isomed 2000) at 180 and 60°/s on external and internal rotators, supraspinatus peak torque, and total work of the dominant shoulder. Kruskal–Wallis and Mann–Whitney U tests were used to determine the difference among the groups.
At pretraining evaluation, there were no significant differences in the test scores of the isokinetic test of full can and empty can between the groups at 60 and 180°/s. There was no statistically significant difference for 60 and 180°/s between pretraining and posttraining assessment (P > .05) except that total eccentric work increased in groups 1 and 3 but decreased in group 2 at 180°/s during the full can (P < .05). There was no significant difference among the groups between the pretraining and posttraining testing at both 180 and 60°/s for the empty can (P > .05). Internal-rotation values at 60 and 180°/s decreased for both peak torque and total work for all groups. External-rotation peak torque and total work at 60°/s increased for group 1. External-rotation peak torque and total work at 180°/s increased for all groups.
The results indicate that a jump-rope training program is a good conditioning method for overhead athletes because of its potential benefits to shoulder strength.