Validation of the pectoralis minor length test: A novel approach

Effects of modified long stick exercise on hyperkyphosis, muscle imbalance and balance control in elderly community-dwelling women with hyperkyphosis

BACKGROUND

Hyperkyphosis is a condition often seen in older women. This condition causes muscle imbalance in the upper back of the body and impacts balance control. Long stick exercise (LSE) is an exercise programme for the elderly that improves muscle strength and balance control.

OBJECTIVE

This research was designed to investigate the effects of a modified LSE on hyperkyphosis, muscle imbalance and balance control in elderly community-dwelling women with hyperkyphosis.

METHODS

Twenty-eight elderly women with hyperkyphosis were divided into experimental and control groups. The experimental group was assigned to practice the modified LSE programme 30-40 minutes/day, 3 days/week, for 12 weeks. Hyperkyphosis, pectoralis minor length, muscle strength, functional reach test (FRT) and timed up and go test (TUG) were obtained at baseline, after 6 weeks and after 12 weeks of exercise.

RESULTS

The experimental group demonstrated improved hyperkyphosis, pectoralis minor length, muscle strength, FRT, and TUG after 12 weeks of training. Moreover, the experimental group exhibited significantly greater improvements in all outcomes than the control group (p< 0.05).

CONCLUSION

The modified LSE programme is an alternative exercise that is easy and low-impact for improving hyperkyphosis, muscle imbalance, and balance control in elderly community-dwelling women with hyperkyphosis.

Clinical Measures Related to Forward Shoulder Posture: A Reliability and Correlational Study

OBJECTIVES

The purpose of this study was to examine the reliability of clinical measures related to forward shoulder posture (pectoralis minor index [PMI], scapular index [SI], abduction index [AI], acromion to the wall index [AWI] acromion to the treatment table index [ATI], and thoracic curvature [TC]), and to investigate the association (redundancy) among these measures.

METHODS

Twenty-one asymptomatic participants participated in this study. Two physiotherapists were trained to perform the clinical measurements. Intraclass correlation coefficients (ICC_2,k) were calculated to assess intra- and interrater reliabilities. Pearson product moment correlation was used to investigate the existence of possible redundancy between the measures that showed high intra- and interrater reliabilities.

RESULTS

The measures showed ICCs between 0.30 and 0.97. Five measures, PMI, SI, AWI, ATI, and TC, showed appropriate values for intrarater reliability (ICCs 0.77-0.94), and 3 measures, AWI, ATI, and TC, for interrater reliability (ICCs 0.82-0.85). Among measures that showed acceptable intra- and interrater reliability values, 2 measures were redundant, showing high association (AWI vs ATI) (r = 0.80, P < .001).

CONCLUSION

For PMI, SI, AWI, ATI, and TC measures, adequate values of intrarater reliability were observed. For AWI, ATI, and TC, adequate values of interrater reliability were found. Two pairs of measures were highly associated (PMI with SI; AWI with ATI), which indicates redundancy among them. Our results suggest that, when the same examiner performs the assessment, the combined use of the PMI, AWI, and TC measures allows a quick but comprehensive evaluation of the presence of forward shoulder posture.

Pectoralis Minor Contracture in Throwing Shoulders of Asymptomatic Adolescent Baseball Players

BACKGROUND

Although scapular malpositioning is commonly associated with rotational deficits and risk of injury, modifiable causes of such malpositioning in overhead athletes are not well described.

PURPOSE/HYPOTHESIS

The purpose of this study was to examine the scapulothoracic profile of adolescent baseball players, specifically, pectoralis minor (PM) length. We hypothesized that PM would be shorter in throwing shoulders compared with nonthrowing shoulders.

STUDY DESIGN

Cross-sectional study; Level of evidence, 3.

METHODS

Forty-nine healthy adolescent baseball players underwent clinical screening of PM lengths in throwing and nonthrowing shoulders by means of previously described, validated techniques. PM measurements were conducted while players were supine with arms at rest, sitting with arms at rest, and sitting with shoulders in maximal external rotation; measurements were made with a digital caliper and by assessment of table-to-acromion distance. Static scapular position and range of motion measurements were recorded. Demographic information and playing history were documented.

RESULTS

All players were male, they had a mean ± SD age of 16.2 ± 1.16 years, and they predominantly threw right-handed (83.7%). Sixty-nine percent of players were pitchers, 61.2% had played baseball for 9 or more months per year, and 67.3% had played in excess of 30 games in the previous year. Significant differences were noted during side-to-side comparisons within participants. Absolute PM length was significantly shorter in throwing compared with nonthrowing shoulders when measured with players sitting with arms at rest (by 3.7 ± 11.8 mm) and with their shoulders in maximal external rotation (by 4.8 ± 15.1 mm) (P < .004 for both). The PM index was significantly reduced in throwing compared with nonthrowing shoulders while players were supine with arms at rest (P = .007), sitting with arms at rest (P = .006), and sitting with shoulders in maximal external rotation (P < .001). Mean table-to-acromion distance was increased 7.7 ± 1.26 mm in throwing versus nonthrowing arms (P < .001). The scapular index was significantly reduced in throwing compared with nonthrowing shoulders (P < .005).

CONCLUSION

Asymptomatic adolescent baseball players have significant differences in PM length and static scapular measurements in throwing compared with nonthrowing shoulders. The clinical significance requires further investigation, but emphasis on PM stretching routines is encouraged.