RT Journal Article
SR Electronic
T1 Role of the kinetic chain in shoulder rehabilitation: does incorporating the trunk and lower limb into shoulder exercise regimes influence shoulder muscle recruitment patterns? Systematic review of electromyography studies
JF BMJ Open Sport & Exercise Medicine
JO BMJ OPEN SP EX MED
FD BMJ Publishing Group Ltd
SP e000683
DO 10.1136/bmjsem-2019-000683
VO 6
IS 1
A1 Eleanor Richardson
A1 Jeremy S Lewis
A1 Jo Gibson
A1 Chris Morgan
A1 Mark Halaki
A1 Karen Ginn
A1 Gillian Yeowell
YR 2020
UL http://bmjopensem.bmj.com/content/6/1/e000683.abstract
AB Objective To investigate the influence of trunk and lower limb motion on electromyography (EMG) muscle activity and recruitment patterns around the shoulder.Design Systematic review.Data sources MEDLINE, CINAHL, PEDro, AMED, PubMed, Cochrane Central Register of Controlled trials, Cochrane Database of Systematic reviews, SportsDiscuss and PROSPERO.Eligibility criteria Studies investigating both multiregional kinetic chain (KC) shoulder exercises and localised non-kinetic chain (nKC) shoulder exercises in healthy subjects under the same experimental conditions were included in this review.Results KC exercises produced greater EMG activation levels in 5 of 11 studies for the lower trapezius. Of the remaining studies, five found no difference between the exercise types and one favoured nKC exercises. KC exercises produced greater EMG activation levels in 5 of 11 studies for the serratus anterior. Of the remaining studies, three reported the opposite and three found no significant difference between the exercise types. nKC exercises produced greater EMG activation in infraspinatus in three of four studies. KC exercises produced the lowest trapezius muscle ratios in all studies. Studies investigating the upper trapezius, middle trapezius, supraspinatus, subscapularis, biceps brachii, latifissimus dorsi, pectoralis major, deltoid, and trapezius and serratus anterior ratios showed inconsistency.Conclusion This review found evidence that integrating the KC during shoulder rehabilitation may increase axioscapular muscle recruitment, produce lower trapezius muscle ratios and reduce the demands on the rotator cuff. Stepping appears preferable to squatting.PROSPERO registration number CRD42015032557, 2015.