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Individuals with shoulder impingement syndrome (SIS) exhibit changes in corticospinal excitability, scapular kinematics, and scapular muscle-activation patterns. To restore the scapular kinematics and muscle-activation patterns in individuals with SIS, treatment protocols usually include scapula-focused exercises, such as scapular-orientation and strength training. To investigate whether scapular-orientation and strength training can reverse the altered corticospinal excitability of recreational overhead athletes with SIS. Randomized controlled clinical trial. University laboratory. Forty-one recreational overhead athletes with SIS: 20 in the scapular-orientation group (age = 26.45 ± 4.13 years, height = 171.85 ± 7.88 cm, mass = 66.70 ± 10.68 kg) and 21 in the strengthening group (age = 26.43 ± 5.55 years, height = 171.62 ± 5.87 cm, mass = 68.67 ± 10.18 kg). Both groups performed a 30-minute training protocol consisting of 3 exercises to strengthen the lower trapezius (LT) and serratus anterior muscles without overactivating the upper trapezius muscles. Participants in the scapular-orientation group were instructed to consciously activate their scapular muscles with electromyographic biofeedback and cues, whereas the strengthening group did not receive biofeedback or cues for scapular motion. Corticospinal excitability was assessed using transcranial magnetic stimulation. Scapular kinematics and muscle activation during arm elevation were also measured. After training, both groups demonstrated an increase in motor-evoked potentials in the LT (P =.004) and increases in scapular upward rotation (P =.03), LT activation (P <.001), and serratus anterior activation (P <.001) during arm elevation. Moreover, the scapular-orientation group showed higher LT activation levels during arm elevation after training than the strengthening group (P =.03). With or without biofeedback and cues, scapula-focused exercises improved scapular control and increased corticospinal excitability. Adding biofeedback and cues for scapular control during exercise helped facilitate greater LT activation, so feedback and cues are recommended during scapula-focused training. [ABSTRACT FROM AUTHOR]

Context: Scapular proprioception is a key concern in managing shoulder impingement syndrome (SIS). However, no study has examined the effect of elastic taping on scapular proprioception performance. Objective: To investigate the immediate effect of kinesiology taping (KT) on scapular reposition accuracy, kinematics, and muscle activation in individuals with SIS. Design: Randomized controlled study. Setting: Musculoskeletal laboratory, National Yang-Ming University, Taiwan. Participants: Thirty overhead athletes with SIS. Interventions: KT or placebo taping over the upper and lower trapezius muscles. Main Outcome Measures: The primary outcome measures were scapular joint position sense, measured as the reposition errors, in the direction of scapular elevation and protraction. The secondary outcomes were scapular kinematics and muscle activity of the upper trapezius, lower trapezius, and serratus anterior during arm elevation in the scapular plane (scaption). Results: Compared with placebo taping, KT significantly decreased the reposition errors of upward/downward rotation (P =.04) and anterior/posterior tilt (P =.04) during scapular protraction. KT also improved scapular kinematics (significant group by taping effect for posterior tilt, P =.03) during scaption. Kinesiology and placebo tapings had a similar effect on upper trapezius muscle activation (significant taping effect, P =.003) during scaption. Conclusions: Our study identified the positive effects of KT on scapular joint position sense and movement control. Future studies with a longer period of follow-up and clinical measurement might help to clarify the clinical effect and mechanisms of elastic taping in individuals with SIS. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Chang, C-C, Chang, C-M, and Shih, Y-F. Kinetic chain exercise intervention improved spiking consistency and kinematics in volleyball players with Scapular Dyskinesis. J Strength Cond Res 36(10): 2844–2852, 2022—Scapular dyskinesis (SD) is a common problem among volleyball players with chronic shoulder pain. This randomized controlled study examined the effectiveness of kinetic chain (KC) training on neuromuscular performance of the scapula and trunk during volleyball spikes. Forty volleyball players with SD and chronic shoulder pain received 4 weeks of KC training or the conventional shoulder exercise training (CT). Shoulder pain was assessed using the visual analogue scale (VAS) every week. The kinematics and muscle activation of the shoulder and upper trunk, and proprioceptive feedback magnitude (PFM) for scapular movement consistency, were recorded at the maximum shoulder flexion (T1) and ball contact (T2) during spiking tasks. The two-way repeated measures analysis of variances was used to assess the between-group differences before and after the intervention. The results showed a significant time by group interaction for the upper trunk rotation (p < 0.001) and PFM (p = 0.03) at T2. The post-hoc test indicated that the KC group significantly increased contralateral rotation of the upper trunk (9.63 ± 4.19° vs. −4.25 ± 10.05°), and improved movement consistency (error: 8.88 ± 11.52° vs. 19.73 ± 12.79°) at T2 compared with the CT group. Significant time effects were also identified for VAS, scapular upward rotation (T1 and T2), upper trunk contralateral side-bending and PFM at T1, and upper trunk contralateral rotation at T2. In conclusion, both KC and CT training would relieve shoulder pain and improve scapular and trunk movement, whereas the KC program was more effective for increasing scapular movement consistency and upper trunk rotation during volleyball spikes. [ABSTRACT FROM AUTHOR]

Abstract Background A high percentage of young children present with flatfeet. Although the percentage of those with flatfeet declines with age, about 15% of the population maintains a flat arch. A reduction in longitudinal arch height usually combines with excessive subtalar joint pronation and may be related to other musculoskeletal problems of the lower extremity kinetic chain. The purpose of this study is to describe and compare the lower extremity kinematics between children with normal arches and those with flexible flatfeet, with the intent of providing practical information for decision making when treating children with flexible flatfeet. Methods Twenty children with flexible flatfeet (years age mean (SD), 9.7 (0.9) years) and 10 children with normal arches (yeas age mean (SD), 9.6 (1.2) years) were included. Kinematic data (maximum and minimum angles, and movement range, velocity, and excursion) of the hip, knee and rearfoot were collected during walking using Liberty Electromagnetic Tracking System. Kinematic variables were compared between the normal arches and flexible flatfeet groups using repeated measures mixed effects ANOVA. Results Movement patterns at the hip, knee and ankle joints were similar between children with flexible flatfeet and with normal arches. The results of ANOVA showed no significant main effect or interaction in any of the kinematic variables (P ≥ 0.05). Conclusions This study identified no kinematic adaptation during walking in children with flexible flatfoot. We suggested that future research should take the influence of the mid-foot and forefoot into consideration when examining lower extremity kinematics in children with flexible flatfoot.

Abstract Background Assessment of three-dimensional kinematics and electromyography (EMG) activities is common in patients with chronic neck pain. However, the effect of hand dominance and neck pain location on the measurement of movement and EMG characteristics is still unclear. Therefore, the purpose of this study was to investigate the effect of neck pain location and arm dominance on the scapular kinematics and muscle EMG activities in patients with chronic neck pain. Methods Thirty subjects (10 males, 20 females; mean age (sd): 38 (11.9) years) with chronic neck pain for more than 3 months were recruited. The scapular kinematics and EMG activity of the upper trapezius and sternocleidomastoid muscles were measured during the bilateral arm elevation task. The three-way repeated measures ANOVA was used to examine the effect of neck pain location and hand dominance on the measurement of kinematics and EMG muscle activities. Results The movement of scapular posterior tilt was significantly influenced by arm dominance (P = 0.001) and by the interaction of arm dominance and elevation angle (P = 0.002). The movement of scapular upward/downward rotation was affected by the interaction of arm dominance and elevation angle (P = 0.02). The location of pain did not show any significant influence on the scapular movement and muscle activities. Conclusions Hand dominance could have an influence on the scapular kinematics, which should be taken into consideration when describing and comparing neuromuscular characteristics in individuals with chronic neck pain.

This study aimed to evaluate the anti-pronation effects of Kinesio tape on flexible flatfoot during running. Nine volunteers participated in a crossover trail of two conditions: with Kinesio tape (KT) or without taping (NT). The running consisted of 9 stages of different inclines on a treadmill over 28 minutes. Navicular drop distance (NDD) was measured before and after the running. Electromyography, the relative plantar pressure, Rating of Perceived Exertion and Visual Analogue Scale were recorded at each stage. After the application of Kinesio tapes over the tibialis posterior and transverse arch, the NDD reduced significantly and the relative posterior pressure reduced during stage 8. Without taping, the NDD decreased slightly after exercise. Comparing between conditions, the tibialis anterior were more activated with Kinesio tape in stages 4 and 5. During the latter half of the running, the medial gastrocnemius and peroneus longus reduced their activity in the KT and NT conditions respectively. In conclusion, the Kinesio tapes intended to facilitate the tibialis posterior and reinforce the transverse arch can reduce NDD in individuals with flexible flatfoot immediately after application, and increase muscle activity of their tibialis anterior during the first 15 minutes of the running. [ABSTRACT FROM AUTHOR]

Background: Contractile tissue plays an important role in mobility deficits in frozen shoulder (FS). However, no study has assessed the effect of the muscle release technique on the muscle activation and kinematics in individuals with FS. The purposes of this study were to assess the differences in shoulder muscle activity and kinematics between the FS and asymptomatic groups; and to determine the immediate effects of muscle release intervention in the FS group.Methods: Twenty patients with FS and 20 asymptomatic controls were recruited. The outcome measures included muscle activity of the upper and lower trapezius (UT and LT), infraspinatus (ISp), pectoralis major (PM), and teres major (TM), shoulder kinematics (humeral elevation, scapular posterior tilt (PT) and upward rotation (UR), shoulder mobility, and pain. Participants in the FS group received one-session of heat and manual muscle release. Measurements were obtained at baseline, and immediately after intervention. Multivariate analysis of variance was used for data analysis. The level of significance was set at α=0.05.Results: Compared to the controls, the FS group revealed significantly decreased LT (difference =55.89%, P=0.001) and ISp muscle activity (difference =26.32%, P =0.043) during the scaption task, and increased PM activity (difference =6.31%, P =0.014) during the thumb to waist task. The FS group showed decreased humeral elevation, scapular PT, and UR (difference = 35.36°, 10.18°, 6.73° respectively, P <0.05). Muscle release intervention immediately decreased pain (VAS drop 1.7, P <0.001); improved muscle activity during scaption (UT: 12.68% increase, LT: 35.46% increase, P <0.05) and hand to neck (UT: 12.14% increase, LT: 34.04% increase, P <0.05) task; and increased peak humeral elevation and scapular PT during scaption (95.18°±15.83° to 98.24°±15.57°, P=0.034; 11.06°±3.94° to 14.36°±4.65°, P=0.002), and increased scapular PT during the hand to neck (9.47°±3.86° to 12.80°±8.33°, P=0.025) task. No statistical significance was found for other group comparisons or intervention effect.Conclusion: Patients with FS presented with altered shoulder muscle activity and kinematics, and one-session of heat and manual muscle release showed beneficial effects on shoulder muscle performance, kinematics, mobility, and pain.Trial Registration: Retrospectively registered on Jan 18, 2016 (ACTRN 12616000031460 ). [ABSTRACT FROM AUTHOR]

Chronic hepatitis B (CHB) exhibits a variety of clinical outcomes, ranging from spontaneous resolution of hepatitis B to severe adverse consequences, including the development of cirrhosis, hepatic failure, and hepatocellular carcinoma. The heterogeneous clinical courses of chronic hepatitis B virus (HBV) infection reflect the complex host-virus interactions, and point to the difficulty and necessity of identifying the patients at risk. With the advance of HBV virology, several viral factors have been found to be associated with the long-term clinical outcomes of CHB patients. Different viral factors probe different aspects of CHB. Integration of these viral factors may help to determine the disease state of patients more accurately, and identify the patients who require timely antiviral therapy to prevent the development of detrimental clinical outcomes. In this article, we will introduce the conventional and emerging viral factors that are associated with clinical outcomes and discuss their utility in a clinical setting. [ABSTRACT FROM AUTHOR]