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Tomoki Oshikawa, Gen Adachi, Hiroshi Akuzawa, Yu Okubo, and Koji Kaneoka

Context: The quadratus lumborum (QL) is expected to contribute to segmental motor control of the lumbar spine to prevent low back pain. It has different layers (anterior [QL-a] and posterior [QL-p] layers), whose functional differences are becoming apparent. However, the difference between the QL-a and QL-p activities during bridge exercises utilized in rehabilitation is unclear. Objective: To compare QL-a and QL-p activities during bridge exercises. Design: Repeated-measurement design was used to assess electromyographic activity of trunk muscles recorded during 14 types of bridge exercises. Setting: University laboratory. Participants: A total of 13 healthy men with no history of lumbar spine disorders participated. Intervention: The participants performed 14 types of bridge exercises (3, 3, and 8 types of side bridge, back bridge, and front bridge [FB], respectively). Main Outcome Measures: Fine-wire electromyography was used for QL-a and QL-p activity measurements during bridge exercises. Results: Both QL-a and QL-p showed the highest activity during the side bridge with hip abduction  (47.3% [29.5%] and 43.0% [32.9%] maximal voluntary isometric contraction, respectively). The activity of the QL-a was significantly higher than that of the QL-p during back bridge with ipsilateral leg lift and FB elbow–toe with ipsilateral arm and contralateral leg lift (P < .05). With regard to the QL-p, the activity of the FB hand–knee with contralateral arm and ipsilateral leg lift, the FB elbow–knee with contralateral arm and ipsilateral leg lift, and the FB elbow–toe with contralateral arm and ipsilateral leg lift were significantly higher than that of the FB elbow–knee and FB elbow–toe (P < .05). Conclusion: This study indicates different regional activities; the QL-a activated during the back bridge with ipsilateral leg lift and FB with ipsilateral arm lift, and the QL-p activated during the FB with ipsilateral leg lift. These results have implications for the rehabilitation of low back pain or lumbar scoliosis patients based on QL recruitment.

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Takao Mise, Yosuke Mitomi, Saki Mouri, Hiroki Takayama, Yoshitomo Inoue, Mamoru Inoue, Hiroshi Akuzawa, and Koji Kaneoka

Context: The range of shoulder rotation is associated with shoulder pain in young male and female swimmers. However, the association between shoulder pain and shoulder complex mobility of the scapulothoracic and acromioclavicular joints has not yet been examined. Moreover, shoulder pain occurs more frequently in females than in males, but only a few studies have examined the relationship between shoulder pain and sex as a risk factor. This study aims to determine the association between shoulder complex mobility and shoulder pain in young male and female swimmers. Design: Prospective cohort design. Methods: The participants were competitive swimmers (n = 76; 37 males and 39 females) with a mean age of 14 years in Japan. The shoulder rotation width, which was the index of shoulder complex mobility, shoulder internal and external rotation range, and middle finger distance of the back-scratch test were measured. An examiner regularly visited the swimming clubs to evaluate the development of shoulder pain and swimming distance. Logistic regression analysis was used to determine the physical characteristics related to the overall development of shoulder pain in both female and male swimmers. The cutoff value was calculated using receiver operating characteristic curves. Results: Sixteen participants, composed of 8 males and 8 females, developed shoulder pain. The overall swimming distance of the male (odds ratio [OR]: 1.0007, P = .01) and female (OR: 1.0018, P = .02) swimmers and the shoulder rotation width of the male (OR: 1.0952, P = .04) and female (OR: 0.888, P = .03) swimmers were identified as risk factors for shoulder pain. The cutoff value for swimming distance was 6000 m. Shoulder rotation width was more than 88 cm in males and <54 cm in females. Conclusions: Hypomobility and hypermobility of the shoulder complex were identified as risk factors for shoulder pain in male and female swimmers, respectively.