{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T12:33:41Z","timestamp":1777466021366,"version":"3.51.4"},"reference-count":74,"publisher":"SAGE Publications","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMR"],"published-print":{"date-parts":[[2023,6,30]]},"abstract":"<jats:p>BACKGROUND: Scapular muscles changes, as increased upper trapezius activity and decreased middle and lower trapezius and serratus anterior muscle activity, have been demonstrated in shoulder pain specific or non-specific conditions. Shoulder external rotation exercises have been recommended to improve scapular activity in shoulder pain. OBJECTIVE: To evaluate the relative scapular muscles activity during multi-joint exercises combining shoulder external rotation, trunk rotation and scapular squeeze. METHODS: Forty-one participants with and without shoulder pain were assessed in a cross-sectional study. They performed isometric multi-joint exercises at 0\u2218 and 90\u2218 of shoulder abduction with and without support. The relative activity of upper, middle, and lower trapezius and serratus anterior (upper\/middle and lower portions) was measured through electromyography. The scapular muscular balance was assessed by the ratio between relative activity of the upper trapezius and the other muscles. RESULTS: Both groups presented similar results. The exercise at 90\u2218 abduction led to increased relative muscle activity against maximal voluntary contraction in both groups for upper trapezius (with support: 4% MVIC, p= 0.001 or 15% MVIC, p&lt; 0.0001; and without support: 11% MVIC, p&lt; 0.0001 or 13%, p&lt; 0.0001, for asymptomatic and symptomatic group, respectively) and lower trapezius (with support: 66% MVIC, p&lt; 0.0001 or 62% MVIC, p&lt; 0.0001, for asymptomatic and symptomatic group,<\/jats:p>","DOI":"10.3233\/bmr-220056","type":"journal-article","created":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T11:25:53Z","timestamp":1675769153000},"page":"883-893","source":"Crossref","is-referenced-by-count":3,"title":["The influence of shoulder position during multi-joint exercises in the relative scapular muscles activity in symptomatic and asymptomatic conditions"],"prefix":"10.1177","volume":"36","author":[{"given":"Ana S.C.","family":"Melo","sequence":"first","affiliation":[{"name":"Center for Rehabilitation Research \u2013 Human Movement System (Re)habilitation Area, Department of Physiotherapy, ESS, Polytechnic of Porto, Porto, Portugal"},{"name":"Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal"},{"name":"Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal"},{"name":"Center for Interdisciplinary Applied Research in Health, Health School of the Setubal Polytechnic Institute, Campus do IPS Estefanilha, Set\u00fabal, Portugal"}]},{"given":"J. Paulo","family":"Vilas-Boas","sequence":"additional","affiliation":[{"name":"Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal"},{"name":"Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal"}]},{"given":"Eduardo B.","family":"Cruz","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Escola Superior de Sa\u00fade, Instituto Polit\u00e9cnico de Set\u00fabal, Campus do IPS Estefanilha, Set\u00fabal, Portugal"},{"name":"Comprehensive Health Research Center (CHRC), Universidade Nova de Lisboa, Lisbon, Portugal"}]},{"given":"Rui M.","family":"Macedo","sequence":"additional","affiliation":[{"name":"Center for Rehabilitation Research \u2013 Human Movement System (Re)habilitation Area, Department of Physiotherapy, ESS, Polytechnic of Porto, Porto, Portugal"}]},{"given":"S\u00edlvia B.","family":"e Ferreira","sequence":"additional","affiliation":[{"name":"ESS, Polytechnic of Porto, Porto, Portugal"}]},{"given":"Andreia S.","family":"Sousa","sequence":"additional","affiliation":[{"name":"Center for Rehabilitation Research \u2013 Human Movement System (Re)habilitation Area, Department of Physiotherapy, ESS, Polytechnic of Porto, Porto, Portugal"}]}],"member":"179","reference":[{"issue":"2","key":"10.3233\/BMR-220056_ref1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1054\/math.2000.0241","article-title":"Functional stability of the glenohumeral joint","volume":"5","author":"Hess","year":"2000","journal-title":"Man Ther."},{"issue":"4","key":"10.3233\/BMR-220056_ref2","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/S1356-689X(03)00094-8","article-title":"Dynamic evaluation and early management of altered motor control around the shoulder complex","volume":"8","author":"Magarey","year":"2003","journal-title":"Man Ther."},{"issue":"2","key":"10.3233\/BMR-220056_ref4","doi-asserted-by":"crossref","first-page":"199","DOI":"10.4085\/1062-6050-49.3.80","article-title":"Serratus anterior and lower trapezius muscle activities during multi-joint isotonic scapular exercises and isometric contractions","volume":"50","author":"Tsuruike","year":"2015","journal-title":"J Athl Train."},{"issue":"8","key":"10.3233\/BMR-220056_ref5","doi-asserted-by":"crossref","first-page":"663","DOI":"10.2165\/00007256-200939080-00004","article-title":"Shoulder muscle activity and function in common shoulder rehabilitation exercises","volume":"39","author":"Escamilla","year":"2009","journal-title":"Sports Med."},{"issue":"1","key":"10.3233\/BMR-220056_ref6","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/JSA.0b013e31824716a8","article-title":"Evaluation and management of scapular dysfunction","volume":"20","author":"McClure","year":"2012","journal-title":"Sports Med Arthrosc."},{"issue":"1","key":"10.3233\/BMR-220056_ref7","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.rehab.2017.09.002","article-title":"Kinematic patterns in normal and degenerative shoulders. Part II: Review of 3-D scapular kinematic patterns in patients with shoulder pain, and clinical implications","volume":"61","author":"Lef\u00e8vre-Colau","year":"2018","journal-title":"Ann Phys Rehabil Med"},{"issue":"4","key":"10.3233\/BMR-220056_ref8","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1123\/jsr.21.4.354","article-title":"Scapular kinematics and subacromial-impingement syndrome: A meta-analysis","volume":"21","author":"Timmons","year":"2012","journal-title":"J Sport Rehabil."},{"issue":"2","key":"10.3233\/BMR-220056_ref9","doi-asserted-by":"crossref","first-page":"90","DOI":"10.2519\/jospt.2009.2808","article-title":"The association of scapular kinematics and glenohumeral joint pathologies","volume":"39","author":"Ludewig","year":"2009","journal-title":"J Orthop Sports Phys Ther."},{"issue":"3","key":"10.3233\/BMR-220056_ref10","doi-asserted-by":"crossref","first-page":"289","DOI":"10.4085\/1062-6050-49.5.05","article-title":"Range of motion as a predictor of clinical shoulder pain during recovery from delayed-onset muscle soreness","volume":"50","author":"Larkin-Kaiser","year":"2015","journal-title":"J Athl Train."},{"issue":"1","key":"10.3233\/BMR-220056_ref11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1590\/S1413-35552009005000012","article-title":"Scapular and rotator cuff muscle activity during arm elevation: A review of normal function and alterations with shoulder impingement","volume":"13","author":"Phadke","year":"2009","journal-title":"Rev Bras Fisioter."},{"issue":"1","key":"10.3233\/BMR-220056_ref12","doi-asserted-by":"crossref","first-page":"12","DOI":"10.4085\/1062-6050-48.1.13","article-title":"Scapular bracing and alteration of posture and muscle activity in overhead athletes with poor posture","volume":"48","author":"Cole","year":"2013","journal-title":"J Athl Train."},{"issue":"9","key":"10.3233\/BMR-220056_ref13","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1177\/0363546508316281","article-title":"Electromyographic analysis of specific exercises for scapular control in early phases of shoulder rehabilitation","volume":"36","author":"Kibler","year":"2008","journal-title":"Am J Sports Med."},{"issue":"3","key":"10.3233\/BMR-220056_ref14","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1093\/ptj\/80.3.276","article-title":"Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement","volume":"80","author":"Ludewig","year":"2000","journal-title":"Phys Ther."},{"issue":"3","key":"10.3233\/BMR-220056_ref15","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1111\/j.1600-0838.2010.01274.x","article-title":"Scapular positioning and movement in unimpaired shoulders, shoulder impingement syndrome, and glenohumeral 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Ther."},{"issue":"9","key":"10.3233\/BMR-220056_ref18","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1093\/ptj\/84.9.832","article-title":"Shoulder function and 3-dimensional kinematics in people with shoulder impingement syndrome before and after a 6-week exercise program","volume":"84","author":"McClure","year":"2004","journal-title":"Phys Ther."},{"issue":"1","key":"10.3233\/BMR-220056_ref19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1590\/S1413-35552009005000012","article-title":"Scapular and rotator cuff muscle activity during arm elevation: A review of normal function and alterations with shoulder impingement","volume":"13","author":"Phadke","year":"2009","journal-title":"Revista Brasileira de Fisioterapia (Sao Carlos (Sao Paulo, Brazil))."},{"issue":"2","key":"10.3233\/BMR-220056_ref20","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/j.jbmt.2016.09.002","article-title":"The role of scapular kinematics in patients with different shoulder musculoskeletal disorders: A systematic review approach","volume":"21","author":"Keshavarz","year":"2017","journal-title":"Journal of Bodywork and Movement Therapies."},{"issue":"3","key":"10.3233\/BMR-220056_ref21","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/s00221-010-2405-1","article-title":"Movement timing and reach to reach variability during a repetitive reaching task in persons with chronic neck\/shoulder pain and healthy subjects","volume":"206","author":"Lomond","year":"2010","journal-title":"Exp Brain Res."},{"issue":"3","key":"10.3233\/BMR-220056_ref22","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1053\/apmr.2002.29666","article-title":"Effect of scapular protraction and retraction on isometric shoulder elevation strength","volume":"83","author":"Smith","year":"2002","journal-title":"Archives of Physical Medicine and 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subjects","volume":"49","author":"Lin","year":"2016","journal-title":"Human Movement Science."},{"issue":"2","key":"10.3233\/BMR-220056_ref35","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1177\/036354659202000206","article-title":"EMG analysis of the scapular muscles during a shoulder rehabilitation program","volume":"20","author":"Moseley","year":"1992","journal-title":"Am J Sports Med."},{"issue":"5","key":"10.3233\/BMR-220056_ref36","doi-asserted-by":"crossref","first-page":"247","DOI":"10.2519\/jospt.2003.33.5.247","article-title":"Surface electromyographic analysis of exercises for the trapezius and serratus anterior muscles","volume":"33","author":"Ekstrom","year":"2003","journal-title":"J Orthop Sports Phys Ther."},{"issue":"7","key":"10.3233\/BMR-220056_ref37","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2519\/jospt.2004.34.7.385","article-title":"Electromyographic analysis of the rotator cuff and deltoid musculature during common shoulder external rotation exercises","volume":"34","author":"Reinold","year":"2004","journal-title":"J Orthop Sports Phys Ther."},{"issue":"4","key":"10.3233\/BMR-220056_ref38","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1007\/s00402-015-2180-3","article-title":"Electromyographic analysis: Shoulder muscle activity revisited","volume":"135","author":"Heuberer","year":"2015","journal-title":"Arch Orthop Trauma Surg."},{"issue":"8","key":"10.3233\/BMR-220056_ref39","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1093\/ptj\/86.8.1075","article-title":"Shoulder Function and 3-Dimensional Scapular Kinematics in People With and Without Shoulder Impingement Syndrome","volume":"86","author":"McClure","year":"2006","journal-title":"Physical Therapy."},{"issue":"12","key":"10.3233\/BMR-220056_ref40","doi-asserted-by":"crossref","first-page":"2438","DOI":"10.1016\/j.jse.2019.04.059","article-title":"Effect of different trunk postures on scapular muscle activities and kinematics during shoulder external rotation","volume":"28","author":"Miyakoshi","year":"2019","journal-title":"Journal of Shoulder and Elbow Surgery."},{"issue":"1","key":"10.3233\/BMR-220056_ref41","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.gaitpost.2008.07.012","article-title":"Recording scapular motion using an acromion marker cluster","volume":"29","author":"van Andel","year":"2009","journal-title":"Gait Posture."},{"issue":"3","key":"10.3233\/BMR-220056_ref42","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.jelekin.2013.01.012","article-title":"Effects of trunk rotation on scapular kinematics and muscle activity during humeral elevation","volume":"23","author":"Nagai","year":"2013","journal-title":"J Electromyogr Kinesiol."},{"issue":"1","key":"10.3233\/BMR-220056_ref43","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1053\/j.otsm.2012.03.012","article-title":"Shoulder Rehabilitation Strategies, Guidelines, and 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Electromyographic Analysis of the Shoulder Girdle Musculature During External Rotation Exercises. Orthop J Sports Med 2015; 3(11).","DOI":"10.1177\/2325967115613988"},{"issue":"1","key":"10.3233\/BMR-220056_ref46","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.jelekin.2012.09.007","article-title":"EMG biofeedback effectiveness to alter muscle activity pattern and scapular kinematics in subjects with and without shoulder impingement","volume":"23","author":"Huang","year":"2013","journal-title":"J Electromyogr Kinesiol."},{"key":"10.3233\/BMR-220056_ref47","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.ptsp.2020.01.015","article-title":"Muscle recruitment during plyometric exercises in overhead athletes with and without shoulder pain","volume":"43","author":"Werin","year":"2020","journal-title":"Phys Ther Sport."},{"issue":"5","key":"10.3233\/BMR-220056_ref48","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1007\/s10389-010-0331-0","article-title":"Portuguese version of the standardized Nordic musculoskeletal questionnaire: Cross cultural and reliability","volume":"18","author":"Mesquita","year":"2010","journal-title":"Journal of Public Health."},{"issue":"14","key":"10.3233\/BMR-220056_ref49","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1136\/bjsports-2012-091066","article-title":"Which physical examination tests provide clinicians with the most value when examining the shoulder? 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