Proprioceptive Neuromuscular Facilitation Exercise on Early Shoulder Muscle Activation in Healthy Individuals

NCT06667115 | Completed

• 1 other identifier: Dominican University New York
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

The study explores the effect of proprioceptive neuromuscular facilitation (PNF) exercises combined with virtual reality (VR) motion capture system and concurrent feedback (CF), on early shoulder muscle activation in healthy individuals. Thirty healthy individuals performed three PNF D2 shoulder exercises sequentially: first PNF alone, then PNF with VR (using U-Ball game (BeCure Global Inc.) on Xbox Kinect (PNF+VR), and PNF with VR and CF (PNF+VR+CF), with the latter two in a randomized order. Using wireless surface electromyography (EMG) and 3D inertial measurement units (Noraxon USA, Inc.), the activation of the upper trapezius (UT), lower trapezius (LT), infraspinatus (INF), and serratus anterior muscles (SA), along with shoulder flexion, abduction, and external rotation range of motion were recorded during three shoulder exercises.

Conditions

Exercise; Healthy

Keywords

proprioceptive neuromuscular facilitation; virtual reality; concurrent feedback; shoulder; muscle activation

Outcome Measures

Primary Outcomes (2)

• muscle activation

  Using wireless surface electromyography (EMG) (Noraxon USA, Inc.), the activation of the upper trapezius (UT), lower trapezius (LT), infraspinatus (INF), and serratus anterior muscles (SA) were recorded as milivolt.

  Through study completion, an average of 6 months

• Range of motion

  Ultium Motion (Noraxon) range of motion sensors were utilized to record shoulde rmovements during the PNF D2 shoulder flexion exercise in three different planes of motion via flexion, abduction, and external rotation. "Degree" was used as unit measure to record the range of motion.

  Through study completion, an average of 6 months

Secondary Outcomes (4)

• Age

  Through study completion, an average of 6 months

• Height

  Through study completion, an average of 6 months

• weight

  Through study completion, an average of 6 months

• The Borg Rating of Perceived Exertion scale

  Through study completion, an average of 6 months

Study Arms (2)

PNF and PNF with virtual reality and PNF with concurrent feedback

ACTIVE COMPARATOR

Participants began with the PNF D2 shoulder exercise for 1 minute. Then participants did PNF D2 exercise with virtual reality gaming as second intervention for 1 minute and then they did PNF D2 exercise with concurrent feedback as third intervention for 1 minute. Between each intervention, participants were given a 2-minute break. Baseline was always PNF exercise, however second and third interventions for the arm 1 and arm 2 were different.

Other: PNF exercise; Other: PNF exercise with virtual reality gaming; Other: PNF with concurrent feedback

PNF and PNF with concurrent feedback and PNF with virtual reality gaming

ACTIVE COMPARATOR

Participants began with the PNF D2 shoulder exercise for 1 minute. Then participants did PNF D2 exercise with concurrent feedback as second intervention for 1 minute and then they did PNF D2 exercise with virtual reality gaming as third intervention for 1 minute. Between each intervention, participants were given a 2-minute break. Baseline was always PNF exercise, however second and third interventions for the arm 1 and arm 2 were different.

Other: PNF exercise; Other: PNF exercise with virtual reality gaming; Other: PNF with concurrent feedback

Interventions

PNF exercise OTHER

Foundational PNF D2 shoulder flexion exercise incorporating shoulder flexion, abduction, and external rotation. This exercise was performed at a metronome-guided pace of 14 beats per minute to establish a consistent baseline.

PNF and PNF with concurrent feedback and PNF with virtual reality gaming; PNF and PNF with virtual reality and PNF with concurrent feedback

PNF exercise with virtual reality gaming OTHER

Combined the PNF D2 shoulder flexion exercise with a virtual reality motion capture game (the U-Ball game).

PNF and PNF with concurrent feedback and PNF with virtual reality gaming; PNF and PNF with virtual reality and PNF with concurrent feedback

PNF with concurrent feedback OTHER

PNF exercise with the addition of auditory concurrent feedback ("Sword") which referenced the action of unsheathing a sword in a diagonal upward direction.

PNF and PNF with concurrent feedback and PNF with virtual reality gaming; PNF and PNF with virtual reality and PNF with concurrent feedback

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• being 18-45 years old
• capable of performing PNF D2 shoulder flexion exercise

You may not qualify if:

• any shoulder injuries in the dominant arm within the last 3 months
• pain in the scapular region
• rotator cuff tear or reconstruction
• shoulder dislocation
• shoulder instability
• frozen shoulder
• fracture
• chronic neck pain

Sponsors & Collaborators

• Dominican University New York: lead

Study Sites (1)

Dominican University New York, Doctor of Physical Therapy Program

Orangeburg, New York, 10962, United States

Location

Related Publications (21)

• Lupinacci G, Gatti G, Melegari C, Fontana S. Interactive design of patient-oriented video-games for rehabilitation: concept and application. Disabil Rehabil Assist Technol. 2018 Apr;13(3):234-244. doi: 10.1080/17483107.2017.1306592. Epub 2017 Apr 11.

  PMID: 28398175 RESULT

• Ekblom MM, Eriksson M. Concurrent EMG feedback acutely improves strength and muscle activation. Eur J Appl Physiol. 2012 May;112(5):1899-905. doi: 10.1007/s00421-011-2162-2. Epub 2011 Sep 16.

  PMID: 21922262 RESULT

• Morais N, Ferreira J, Gordo J, et al. A diagonal movement pattern of arm elevation and depression in overhead throwing athletes: An exploratory kinematic analysis for Clinical Application. Applied Sciences. 2023 Sept 26;13(19):1-15. doi:10.3390/app131910691

  RESULT

• Forbush SW, Bandy WD, Garrison MK, Graves LC, Roberts R. TESTING INFRASPINATUS AND DELTOID MUSCLES WITH NEW TECHNIQUE TO DECREASE DELTOID ACTIVITY DURING TESTING USING EMG ANALYSIS. Int J Sports Phys Ther. 2018 Aug;13(5):896-904.

  PMID: 30276022 RESULT

• Januario LB, Cid MM, Zanca GG, Mattiello SM, Oliveira AB. Serratus anterior sEMG - sensor placement and test position for normalization purposes during maximal and submaximal exertions. Med Eng Phys. 2022 Mar;101:103765. doi: 10.1016/j.medengphy.2022.103765. Epub 2022 Feb 8.

  PMID: 35232545 RESULT

• Huang HY, Lin JJ, Guo YL, Wang WT, Chen YJ. EMG biofeedback effectiveness to alter muscle activity pattern and scapular kinematics in subjects with and without shoulder impingement. J Electromyogr Kinesiol. 2013 Feb;23(1):267-74. doi: 10.1016/j.jelekin.2012.09.007. Epub 2012 Nov 2.

  PMID: 23123099 RESULT

• Cheng, L., Li, J., Guo, A. et al. Recent advances in flexible noninvasive electrodes for surface electromyography acquisition. npj Flex Electron 7, 39 (2023). https://doi.org/10.1038/s41528-023-00273-0

  RESULT

• Szczepan S, Zaton K, Fernandez FC, et al. The effects of concurrent visual versus verbal feedback on swimming strength task execution. Balt J Health Phys Act. 2018;10(4):61-71. doi:10.29359/BJHPA.10.4.05.

  RESULT

• Chen MJ, Fan X, Moe ST. Criterion-related validity of the Borg ratings of perceived exertion scale in healthy individuals: a meta-analysis. J Sports Sci. 2002 Nov;20(11):873-99. doi: 10.1080/026404102320761787.

  PMID: 12430990 RESULT

• Chen C, Weyland S, Fritsch J, Woll A, Niessner C, Burchartz A, Schmidt SCE, Jekauc D. A Short Version of the Physical Activity Enjoyment Scale: Development and Psychometric Properties. Int J Environ Res Public Health. 2021 Oct 20;18(21):11035. doi: 10.3390/ijerph182111035.

  PMID: 34769552 RESULT

• Grime A, Daines S, Pringle L, et al. The within-day reliability of scapular and shoulder EMG measurements in asymptomatic individuals during shoulder abduction. NZJP. 2023;46(2):67-72. doi:10.15619/NZJP/46.2.02.

  RESULT

• Alizadehkhaiyat O, Hawkes DH, Kemp GJ, Frostick SP. ELECTROMYOGRAPHIC ANALYSIS OF SHOULDER GIRDLE MUSCLES DURING COMMON INTERNAL ROTATION EXERCISES. Int J Sports Phys Ther. 2015 Oct;10(5):645-54.

  PMID: 26491615 RESULT

• Campanini I, Disselhorst-Klug C, Rymer WZ, Merletti R. Surface EMG in Clinical Assessment and Neurorehabilitation: Barriers Limiting Its Use. Front Neurol. 2020 Sep 2;11:934. doi: 10.3389/fneur.2020.00934. eCollection 2020.

  PMID: 32982942 RESULT

• San Juan JG, Gunderson SR, Kane-Ronning K, Suprak DN. Scapular kinematic is altered after electromyography biofeedback training. J Biomech. 2016 Jun 14;49(9):1881-1886. doi: 10.1016/j.jbiomech.2016.04.036. Epub 2016 May 3.

  PMID: 27161990 RESULT

• Vitali RV, Barone VJ, Ferris J, Stirling LA, Sienko KH. Effects of Concurrent and Terminal Visual Feedback on Ankle Co-Contraction in Older Adults during Standing Balance. Sensors (Basel). 2021 Nov 2;21(21):7305. doi: 10.3390/s21217305.

  PMID: 34770611 RESULT

• Youdas JW, Arend DB, Exstrom JM, Helmus TJ, Rozeboom JD, Hollman JH. Comparison of muscle activation levels during arm abduction in the plane of the scapula vs. proprioceptive neuromuscular facilitation upper extremity patterns. J Strength Cond Res. 2012 Apr;26(4):1058-65. doi: 10.1519/JSC.0b013e31822e597f.

  PMID: 22446675 RESULT

• Knippenberg E, Verbrugghe J, Lamers I, Palmaers S, Timmermans A, Spooren A. Markerless motion capture systems as training device in neurological rehabilitation: a systematic review of their use, application, target population and efficacy. J Neuroeng Rehabil. 2017 Jun 24;14(1):61. doi: 10.1186/s12984-017-0270-x.

  PMID: 28646914 RESULT

• Lee HL, Khairunizam W, Cahyadi BN, et al. Progress monitoring in upper limb stroke rehabilitation by using muscle activation and hand speed. J Phys: Conf Ser. 2020;1529(4):042019. doi:10.1088/1742-6596/1529/4/042019

  RESULT

• Fuertes Munoz G, Mollineda RA, Gallardo Casero J, Pla F. A RGBD-Based Interactive System for Gaming-Driven Rehabilitation of Upper Limbs. Sensors (Basel). 2019 Aug 9;19(16):3478. doi: 10.3390/s19163478.

  PMID: 31395817 RESULT

• Zaidi S, Ahamad A, Fatima A, Ahmad I, Malhotra D, Al Muslem WH, Abdulaziz S, Nuhmani S. Immediate and Long-Term Effectiveness of Proprioceptive Neuromuscular Facilitation and Static Stretching on Joint Range of Motion, Flexibility, and Electromyographic Activity of Knee Muscles in Older Adults. J Clin Med. 2023 Mar 30;12(7):2610. doi: 10.3390/jcm12072610.

  PMID: 37048693 RESULT

• Witt D, Talbott N, Kotowski S. Electromyographic activity of scapular muscles during diagonal patterns using elastic resistance and free weights. Int J Sports Phys Ther. 2011 Dec;6(4):322-32.

  PMID: 22163094 RESULT

MeSH Terms

Conditions

Motor Activity

Interventions

Muscle Stretching Exercises

Condition Hierarchy (Ancestors)

Behavior

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Ayse Edeer, PT, PhD

  Dominican University New York

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: October 28, 2024
• First Posted: October 31, 2024
• Study Start: April 30, 2023
• Primary Completion: June 30, 2023
• Study Completion: December 30, 2023
• Last Updated: November 1, 2024

Record last verified: 2024-10

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)