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Using biofeedback to optimize scapular muscle activation ratios during a seated resisted scaption exercise.
Linda M Riek1, Katherine Pfohl1, Jenna Zajac2
1Department of Physical Therapy, Nazareth College, Rochester, NY, United States.
Summary
Biofeedback during shoulder exercises can improve muscle activation ratios, potentially preventing or treating shoulder pain. Visual EMG biofeedback significantly altered upper trapezius/lower trapezius ratios, suggesting its utility in rehabilitation.
Area of Science:
- Biomechanics
- Sports Medicine
- Rehabilitation Science
Background:
- Muscle activation impairments are linked to shoulder pathologies like subacromial impingement syndrome (SIS) and rotator cuff injuries.
- Individuals with SIS often exhibit increased upper trapezius (UT) activation and reduced serratus anterior (SA) and lower trapezius (LT) activation, impacting muscle activation ratios (UT/SA, UT/LT).
- Targeted exercise and electromyography (EMG) biofeedback are crucial for shoulder rehabilitation, aiming to restore optimal muscle activation patterns.
Purpose of the Study:
- To compare the effects of three biofeedback types (visual EMG, auditory, verbal cues) on shoulder muscle activation ratios during a seated resisted scaption exercise.
- To investigate the efficacy of different biofeedback modalities in altering the UT/SA and UT/LT muscle activation ratios in healthy individuals.
- To address a literature gap concerning the effectiveness of various biofeedback methods beyond visual EMG for shoulder rehabilitation.
Main Methods:
- Fifteen healthy subjects performed a seated resisted scaption exercise under three randomized biofeedback conditions: visual EMG, auditory, and verbal cues.
- Baseline muscle activation data was collected and compared to real-time muscle activation during each biofeedback trial.
- Electromyography (EMG) was used to measure the activation of the upper trapezius (UT), serratus anterior (SA), and lower trapezius (LT) muscles.
Main Results:
- All tested biofeedback types (visual EMG, auditory, verbal cues) demonstrated improvements in both UT/SA and UT/LT muscle activation ratios.
- Visual EMG biofeedback resulted in a statistically significant improvement in the UT/LT muscle activation ratio (p < 0.05).
- These findings indicate that various forms of biofeedback can positively influence scapular muscle activation patterns.
Conclusions:
- Biofeedback interventions show promise for improving muscle activation ratios during shoulder exercises.
- Visual EMG biofeedback appears particularly effective in modulating the UT/LT ratio, suggesting its potential in clinical applications.
- These results support the integration of biofeedback as a component in rehabilitation programs aimed at preventing or treating shoulder pain and related injuries.

