{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:49:12Z","timestamp":1792068552433,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiotherapy Res Intl"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background and Purpose<\/jats:title>\n Lower trapezius (LT) weakness\u2010induced anterior scapular tilt is a key mechanism of shoulder dysfunction. Although the primary motor innervation of the trapezius originates from the spinal accessory nerve, cervical nerve branches (C3\/C4) contribute sensory and accessory motor fibers, leading to hypotheses that C3\/C4 segmental sensitivity may be associated with altered LT performance. We aimed to investigate the immediate effects of C3\/C4 manual decompression on scapular posterior tilt (SPT) kinematics, LT activity, and maximal isometric strength.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Twenty\u2010seven participants with functional LT weakness and C3\/C4 tenderness were enrolled in this single\u2010group pretest\u2010posttest study. Active SPT was quantified as acromial vertical displacement during prone scapular posterior tilting. Neuromuscular control was assessed by the vertical drop in arm height during a 10\u2010s prone arm lifting task. LT activity (% MVIC) and maximal strength (kg) were assessed using surface electromyography and a KEMA sensor. A 5\u2010min C3\/C4 manual decompression was administered. Data were analyzed using a paired\n t<\/jats:italic>\n \u2010test.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n After the intervention, active SPT increased by 10.49% (\n p<\/jats:italic>\n \u00a0=\u00a00.004,\n d<\/jats:italic>\n \u00a0=\u00a00.60). Vertical drop distance decreased by 50.82% (\n p<\/jats:italic>\n \u00a0<\u00a00.001,\n d<\/jats:italic>\n \u00a0=\u00a02.12). LT muscle activity improved by 20.61% (\n p<\/jats:italic>\n \u00a0<\u00a00.001,\n d<\/jats:italic>\n \u00a0=\u00a01.17). LT maximal isometric strength increased by 24.29% (\n p<\/jats:italic>\n \u00a0<\u00a00.001,\n d<\/jats:italic>\n \u00a0=\u00a01.65).\n <\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n C3\/C4 manual decompression was followed by immediate, short\u2010term improvements in scapular control, LT muscle activity, and isometric strength in individuals with functional LT weakness. These findings provide a preliminary rationale for further investigation of this cervical intervention as an adjunctive strategy pending confirmation in controlled trials. However, given the uncontrolled study design, these results reflect overall immediate post\u2010intervention responses and cannot confirm specific neurophysiological mechanisms or nerve\u2010root decompression. Randomized controlled trials incorporating sham comparisons are required.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/pri.70365","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:06:19Z","timestamp":1792065979000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of C3\/C4 Manual Decompression on Scapular Posterior Tilt, Lower Trapezius Muscle Activity, and Strength in Individuals With Lower Trapezius Weakness"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3895-0590","authenticated-orcid":false,"given":"Kyung\u2010Hee","family":"Jung","sequence":"first","affiliation":[{"name":"Department of Physical Therapy Yonsei University Mirae Campus Wonju Republic of Korea"},{"name":"VANTT SHP Corporation Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9699-768X","authenticated-orcid":false,"given":"Oh\u2010Yun","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy Yonsei University Mirae Campus Wonju Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6623-3806","authenticated-orcid":false,"given":"Woochol Joseph","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy Yonsei University Mirae Campus Wonju Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5281-3463","authenticated-orcid":false,"given":"One\u2010Bin","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy Eulji University Seongnam Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6457-8125","authenticated-orcid":false,"given":"Il\u2010Young","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy Hallym Sacred Heart University Chuncheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2554-8083","authenticated-orcid":false,"given":"Chung\u2010Hwi","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy Yonsei University Mirae Campus Wonju Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_2_16_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina61020187"},{"key":"e_1_2_16_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2011.03.008"},{"key":"e_1_2_16_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2005.08.011"},{"key":"e_1_2_16_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jht.2017.03.006"},{"key":"e_1_2_16_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00421\u2010018\u20103799\u2010x"},{"key":"e_1_2_16_7_1","doi-asserted-by":"publisher","DOI":"10.4085\/1062\u20106050\u201048.1.13"},{"key":"e_1_2_16_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507303560"},{"key":"e_1_2_16_9_1","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0000000000003720"},{"key":"e_1_2_16_10_1","volume-title":"Introduction to Surface Electromyography","author":"Cram J. 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