Electromyographical Assessment of Passive, Active Assistive, and Active Shoulder Rehabilitation Exercises

ObjectiveTo determine the electromyographical (EMG) activation levels of shoulder musculature during early rehabilitation exercises to regain active range of motion.DesignDescriptive.SettingUniversity clinical research laboratory.ParticipantsTen asymptomatic volunteers (age, 25 ± 5 years; height, 171 ± 7 cm; weight, 78 ± 15 kg).InterventionFine-wire (supraspinatus and infraspinatus) and surface (anterior deltoid, upper trapezius, lower trapezius, and serratus anterior) electrodes recorded EMG activity from each muscle during 12 therapeutic exercises completed during a single testing session in random order.Main Outcome MeasureEMG root mean squared amplitude normalized to a percentage of maximum voluntary contraction (% MVC).ResultsPassive exercises generated the lowest mean EMG activity (<10%) for all muscles studied. The standing active shoulder elevation exercises generated the greatest mean EMG activity with an upper boundary of 95% CI (40% MVC). Overall the active-assistive exercises generated a small (<10%) increase in muscle activity compared with the passive exercises for the supraspinatus and infraspinatus muscles, which was not a significant increase (P > .05).ConclusionThis electrophysiological data in normal volunteers suggest that many exercises used during the early phase of rehabilitation to regain active elevation do not exceed 20% MVC. Progression from passive to active-assisted can potentially be performed without significantly increasing muscular activation levels exercises. Upright active exercises demonstrated a consistent and often a statistically significant increase in muscular activities supporting that these exercises should be prescribed later in a rehabilitation program.