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Updated: Jun 15, 2026

Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers
Published on: October 29, 2021
Electromyographical assessment of passive, active assistive, and active shoulder rehabilitation exercises
Timothy L Uhl1, Tiffany A Muir, Laura Lawson
1Department of Rehabilitation Sciences, Division of Athletic Training, University of Kentucky, Lexington, KY 40536-0200, USA. tluhl2@uky.edu
Objective:
To determine the electromyographical (EMG) activation levels of shoulder musculature during early rehabilitation exercises to regain active range of motion.
Design:
Descriptive.
Setting:
University clinical research laboratory.
Participants:
Ten asymptomatic volunteers (age, 25 +/- 5 years; height, 171 +/- 7 cm; weight, 78 +/- 15 kg).
Intervention:
Fine-wire (supraspinatus and infraspinatus) and surface (anterior deltoid, upper trapezius, lower trapezius, and serratus anterior) electrodes recorded EMG activity from each muscle during 12 therapeutic exercises completed during a single testing session in random order.
Main Outcome Measure:
EMG root mean squared amplitude normalized to a percentage of maximum voluntary contraction (% MVC).
Results:
Passive exercises generated the lowest mean EMG activity (<10%) for all muscles studied. The standing active shoulder elevation exercises generated the greatest mean EMG activity with an upper boundary of 95% CI (40% MVC). Overall the active-assistive exercises generated a small (<10%) increase in muscle activity compared with the passive exercises for the supraspinatus and infraspinatus muscles, which was not a significant increase (P > .05).
Conclusion:
This electrophysiological data in normal volunteers suggest that many exercises used during the early phase of rehabilitation to regain active elevation do not exceed 20% MVC. Progression from passive to active-assisted can potentially be performed without significantly increasing muscular activation levels exercises. Upright active exercises demonstrated a consistent and often a statistically significant increase in muscular activities supporting that these exercises should be prescribed later in a rehabilitation program.
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