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The Effect of Shoulder Stabilization Exercise and Core Stabilization Exercise on the Shoulder Height and Respiratory Function in Young Adults with Round Shoulder Posture

  • Received : 2023.07.30
  • Accepted : 2023.08.24
  • Published : 2023.11.30

Abstract

PURPOSE: The purpose of this study was to compare how the shoulder height and respiratory function are affected by applying shoulder stabilization exercises and core stabilization exercises that are effective for strengthening the trunk muscles and postural stability for adults with a round shoulder posture (RSP). METHODS: The participants were 28 young adults with RSP. They were assigned randomly to two groups: shoulder stabilization exercise and core stabilization exercise. They performed the exercises for 30 minutes twice a week for four weeks. They measured the shoulder height and respiratory function before and after exercise. RESULTS: No significant difference in shoulder height was found between the groups. A significant decrease in shoulder height was found in the shoulder stabilization exercise group after exercise. The core stabilization exercise group showed a significant decrease after exercise. In respiratory function, no significant difference was found between the groups. The forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were increased significantly in the shoulder stabilization exercise group before and after exercise. The FEV1, FEV1/FVC, and peak expiratory flow were significantly higher in the shoulder stabilization exercise group after exercise than in the core stabilization exercise group. CONCLUSION: Shoulder stabilization exercise and core stabilization exercise improved the postural alignment and pulmonary function, and the exercises could be helpful in shoulder rehabilitation as well as the clinical part of the treatment of rounded shoulder posture.

Keywords

References

  1. Tafreshi ES, Moghadam AN, Bakhshi, E., et al. Comparing scapular position and scapular dyskinesis in individuals with and without rounded shoulder posture. Physical Treatments-Specific Physical Therapy Journal. 2015;5(3):127-36.  https://doi.org/10.15412/J.PTJ.07050302
  2. Fani M, Ebrahimi S, Ghanbari A. Evaluation of scapular mobilization and comparison to pectoralis minor stretching in individuals with rounded shoulder posture: a randomized controlled trial. J Bodyw Mov Ther. 2020;24(4):367-72.  https://doi.org/10.1016/j.jbmt.2020.07.021
  3. Singla D, Veqar Z. Association between forward head, rounded shoulders, and increased thoracic kyphosis: a review of the literature. J Chiropr Med. 2017;16(3):220-9.  https://doi.org/10.1016/j.jcm.2017.03.004
  4. Wong CK, Coleman D, Song J, et al. The effects of manual treatment on rounded-shoulder posture, and associated muscle strength. J Bodyw Mov Ther. 2010;14(4):326-33.  https://doi.org/10.1016/j.jbmt.2009.05.001
  5. Borstad JD, Ludewig PM. The effect of long versus short pectoralis minor resting length on scapular kinematics in healthy individuals. J Orthop Sports Phys Ther. 2005;35(4):227-38.  https://doi.org/10.2519/jospt.2005.35.4.227
  6. Sahrmann S. Diagnosis and Treatment of Movement Impairment Syndromes (1st ed.). USA. Mosby. 2002. 
  7. Kang FJ, Chiu YC, Wu SC, et al. Kinesiology taping with exercise does not provide additional improvement in round shoulder subjects with impingement syndrome: a single-blinded randomized controlled trial. Phys Ther Sport. 2019;40:99-106.  https://doi.org/10.1016/j.ptsp.2019.09.001
  8. Ball JM, Cagle P, Johnson, BE, et al. Spinal extension exercises prevent natural progression of kyphosis. Osteoporos Int. 2009;20(3):481-9.  https://doi.org/10.1007/s00198-008-0690-3
  9. Zafar H, Albarrati A, Alghadir AH, et al. Effect of different head-neck postures on the respiratory function in healthy males. Biomed Res Int. 2018;(2018):1-5. 
  10. Ghanbari A, Ghaffarinejad F, Mohammadi F, et al. Effect of forward shoulder posture on pulmonary capacities of women. Br J Sports Med. 2008;42(7):622-3.  https://doi.org/10.1136/bjsm.2007.040915
  11. Shiravi S, Letafatkar A, Bertozzi L, et al. Efficacy of abdominal control feedback and scapula stabilization exercises in participants with forward head, round shoulder postures and neck movement impairment. Sports Health. 2019;11(3):272-9.  https://doi.org/10.1177/1941738119835223
  12. Thakur D, Motimath B, Raghavendra M. Forward head posture correction versus shoulder stabilization exercises effect on scapular dyskinesia and shoulder proprioception in athletes an experimental study. International Journal of Physiotherapy. 2016;3(2):197-203.  https://doi.org/10.15621/ijphy/2016/v3i2/94887
  13. Ekstrom RA, Soderberg GL, Donatelli RA. Normalization procedures using maximum voluntary isometric contractions for the serratus anterior and trapezius muscles during surface EMG analysis. J Electromyogr Kinesiol. 2005:15(4);418-28.  https://doi.org/10.1016/j.jelekin.2004.09.006
  14. Umehara J, Nakamura M, Nishishita S, et al. Scapular kinematic alterations during arm elevation with decrease in pectoralis minor stiffness after stretching in healthy individuals. J Shoulder Elbow Surg. 2018;27(7):1214-20.  https://doi.org/10.1016/j.jse.2018.02.037
  15. Magarey ME, Jones MA. Dynamic evaluation and early management of altered motor control around the shoulder complex. Man Ther. 2003;8(4):195-206.  https://doi.org/10.1016/S1356-689X(03)00094-8
  16. Fathollahnejad K, Letafatkar A, Hadadnezhad M. The effect of manual therapy and stabilizing exercises on forward head and rounded shoulder postures: a six-week intervention with a one-month follow-up study. BMC Musculoskelet Disord. 2019;20(1):1-8.  https://doi.org/10.1186/s12891-018-2378-y
  17. Kuo YL, Lee TH, Tsai YJ. Evaluation of a cervical stabilization exercise program for pain, disability, and physical impairments in university violinists with nonspecific neck pain. Int J Environ Res Public Health. 2020;17(15):5430. 
  18. Dusunceli Y, Ozturk C, Atamaz F, et al. Efficacy of neck stabilization exercises for neck pain: a randomized controlled study. Journal of Rehabilitation Medicine. 2009;41(8):626-31.  https://doi.org/10.2340/16501977-0392
  19. Kim MK, Lee JC, Yoo KT. The effects of shoulder stabilization exercises and pectoralis minor stretching on balance and maximal shoulder muscle strength of healthy young adults with round shoulder posture. J Phys Ther Sci. 2018;30(3):373-80.  https://doi.org/10.1589/jpts.30.373
  20. Borstad JD, Ludewig PM. Comparison of three stretches for the pectoralis minor muscle. J Shoulder Elbow Surg. 2006;15(3):324-30.  https://doi.org/10.1016/j.jse.2005.08.011
  21. Develi E, Subasi F, Aslan GK, et al. The effects of core stabilization training on dynamic balance and pulmonary parameters in patients with asthma. J Back Musculoskelet Rehabil. 2021;34(4):639-48.  https://doi.org/10.3233/BMR-191803
  22. Imai A, Kaneoka K, Okubo Y, et al. Trunk muscle activity during lumbar stabilization exercises on both a stable and unstable surface. J Orthop Sports Phys Ther. 2010;40(6):369-75.  https://doi.org/10.2519/jospt.2010.3211
  23. Lynch SS, Thigpen CA, Mihalik JP, et al. The effects of an exercise intervention on forward head and rounded shoulder postures in elite swimmers. Br J Sports Med. 2010;44(5):376-81.  https://doi.org/10.1136/bjsm.2009.066837
  24. Han J, Park S, Kim Y, et al. Effects of forward head posture on forced vital capacity and respiratory muscles activity. J Phys Ther Sci. 2016;28(1):128-31.  https://doi.org/10.1589/jpts.28.128
  25. Park YJ, Kim WM, Yu JH, et al. Effects of combined exercise program on spinal curvature and balance ability in adolescents with kyphosis. Children. 2022;9(12):1999.1-7.  https://doi.org/10.3390/children9121999
  26. Yu LJ, Gu Q, Kim TH. The effects of cervical stabilization exercises with breathing exercises on respiratory function in subjects with forward head posture. WSEAS Transactions on Systems and Control. 2021;16:486-92.  https://doi.org/10.37394/23203.2021.16.44
  27. Werasirirat P, Namsawang J, Muanjai P, et al. Effect of blood flow restriction training with strengthening exercises in individuals with rounded shoulder posture: a randomized controlled trial. Journal of Physical Education & Sport. 2023;23(5):1262-71. 
  28. McClure P, Greenberg E, Kareha S. Evaluation and management of scapular dysfunction. Sports Med Arthrosc Rev. 2012;20(1):39-48.  https://doi.org/10.1097/JSA.0b013e31824716a8
  29. Lewis JS, Valentine RE. The pectoralis minor length test: a study of the intra-rater reliability and diagnostic accuracy in subjects with and without shoulder symptoms. BMC Musculoskelet Disord. 2007;8(1):1-10.  https://doi.org/10.1186/1471-2474-8-1
  30. Nijs J, Roussel N, Vermeulen K, et al. Scapular positioning in patients with shoulder pain: a study examining the reliability and clinical importance of 3 clinical tests. Arch Phys Med Rehabil. 2005;86(7):1349-55.  https://doi.org/10.1016/j.apmr.2005.03.021
  31. Kim EK, Kim JS. Correlation between rounded shoulder posture, neck disability indices, and degree of forward head posture J Phys Ther Sci. 2016;28(10):2929-32.  https://doi.org/10.1589/jpts.28.2929
  32. Kim SY, Hwang YI, Kim KS. The effects of thoracic mobilizing and stretching exercise on maximal inspiratory pressure and maximal expiratory pressure in healthy adults. PNF and Movement. 2022;20(1):9-17.  https://doi.org/10.21598/JKPNFA.2022.20.1.9
  33. Kang MS, Shim JH, Kang SY. Comparisons of diaphragm movement, pulmonary function, and pulmonary strength among exercise methods in children with cerebral palsy. Korean Society of Physical Medicine. 2018;13(1):121-8.  https://doi.org/10.13066/kspm.2018.13.1.121
  34. Jung SI, Lee NK, Kang KW, et al. The effect of smartphone usage time on posture and respiratory function. J Phys Ther Sci. 2016;28(1):186-9.  https://doi.org/10.1589/jpts.28.186
  35. Messan F, Lawani MM, Mama D. FVC and FEV reference values for beninese individuals aged 17-20 years. Open Journal of Respiratory Diseases. 2019;9(2):48-59.  https://doi.org/10.4236/ojrd.2019.92005
  36. Wong CK, Coleman D, Song J, et al. The effects of manual treatment on rounded-shoulder posture, and associated muscle strength. J Bodyw Mov Ther. 2010;14(4):326-33.  https://doi.org/10.1016/j.jbmt.2009.05.001
  37. Kluemper M, Uhl T, Hazelrigg H. Effect of stretching and strengthening shoulder muscles on forward shoulder posture in competitive swimmers. J Sport Rehabil. 2006;15(1):58-70.  https://doi.org/10.1123/jsr.15.1.58
  38. Naderi A, Mousavi SH, Katzman WB, et al. Kinesiotaping as an adjunct to exercise therapy for symptomatic and asymptomatic swimmers: a randomized controlled trial. Science & Sports. 2022;37(5-6):492-e1-e11. 
  39. Hurer C, Angin E, Tuzun EH. Effectiveness of clinical Pilates and home exercises in sagittal cervical disorientation: randomized controlled study. J Comp Eff Res. 2021;10(5):365-80.  https://doi.org/10.2217/cer-2020-0186
  40. Manral D, Sethi J, Jain A, et al. Effect of core-shoulder stability exercises on shoulder performance among throwers with glenohumeral internal rotation deficit. Journal of Medical Pharmaceutical and Allied Sciences. 2023;12(3):5814-19.  https://doi.org/10.55522/jmpas.V12I3.5124
  41. Musiyenko OV, Mykhats LV, Budynkevych SN, et al. Determination of the functional state of the body using non-traditional research methods when performing the static exercise: "prone press ups, static top position" (Cobra). Health, Sport, Rehabilitation. 2020;6(1):41-8.  https://doi.org/10.34142/HSR.2020.06.01.05
  42. Seif HE, Alenazi A, Hassan SM, et al. The effect of stretching hamstring, gastrocnemius, iliopsoas and back muscles on pain and functional activities in patients with chronic low back pain: a randomized clinical trial. Open Journal of Therapy and Rehabilitation. 2015;3(4):139-45.  https://doi.org/10.4236/ojtr.2015.34019
  43. Kim KS, Jeon IC. Effectiveness of iliopsoas self-stretching on hip extension angle, gluteus maximus activity, and pelvic compensations during prone hip extension in subjects with iliopsoas shortness. The Journal of Korean Physical Therapy. 2018;30(1):23-8.  https://doi.org/10.18857/jkpt.2018.30.1.23
  44. Fox M. Effect on hamstring flexibility of hamstring stretching compared to hamstring stretching and sacroiliac joint manipulation. Clinical Chiropractic, 2006;9(1):21-32.  https://doi.org/10.1016/j.clch.2006.01.005
  45. Junker D, Stoggl T. The training effects of foam rolling on core strength endurance, balance, muscle performance and range of motion: a randomized controlled trial. Journal of Sports Science & Medicine. 2019;18(2):222-38. 
  46. Andrade LS, Mochizuki L, Pires FO, et al. Application of pilates principles increases paraspinal muscle activation. J Bodyw Mov Ther. 2015;19(1):62-6.  https://doi.org/10.1016/j.jbmt.2014.11.011
  47. Narouei S, Barati AH, Akuzawa H, et al. Effects of core stabilization exercises on thickness and activity of trunk and hip muscles in subjects with nonspecific chronic low back pain. J Bodyw Mov Ther. 2020;24(4):138-46.  https://doi.org/10.1016/j.jbmt.2020.06.026
  48. Escalante G, Fine D, Ashworth K. Progressive exercise strategies to mitigate shoulder injuries among weight-training participants. Strength Cond J. 2021;43(1):72-85.  https://doi.org/10.1519/SSC.0000000000000547
  49. Luque-Suarez A, Diaz-Mohedo E, Medina-Porqueres I, et al. Stabilization exercise for the management of low back pain. In: Norastech, AA. (Ed.) Low back pain. InTech: 2012:261-92. 
  50. Hong YJ, Kwon OY, Yi CH, et al. Effects of the support surface condition on muscle activity of abdominalis and erector spinae during bridging exercises. Physical Therapy Korea. 2010;17(4):16-25. 
  51. Zahiri A, Alizadeh S, Daneshjoo A, et al. Core muscle activation with foam rolling and static planks. Front Physiol. 2022;13:1-9.  https://doi.org/10.3389/fphys.2022.852094
  52. Ertekin E, Gunaydin OE. Neck pain in rounded shoulder posture: Clinico-radiologic correlation by shear wave elastography. Int J Clin Pract. 2021;75(8):e14240-1-6. 
  53. Kapreli E, Vourazanis E, Billis E, et al. Respiratory dysfunction in chronic neck pain patients. a pilot study. Cephalalgia. 2009;29(7):701-10.  https://doi.org/10.1111/j.1468-2982.2008.01787.x
  54. Tarnanen SP, Ylinen JJ, Siekkinen KM et al. Effect of isometric upper-extremity exercises on the activation of core stabilizing muscles. Arch Phys Med Rehabil. 2008;89(3):513-21.  https://doi.org/10.1016/j.apmr.2007.08.160
  55. Park C, Yoon S, Yoon H, et al. Effects of core stabilization exercise on muscle activity during horizontal shoulder adduction with loads in healthy adults: a randomized controlled study. J Mech Med Biol. 2021;21(09):1-11.  https://doi.org/10.1142/S0219519421400492
  56. Kendall FP, McCreary EK, Provance PG, et al. (2005). Muscles: testing and function with posture and pain (5th ed). USA. Lippincott Williams & Wilkins. 2005. 
  57. Lee JH. Effects of forward head posture on static and dynamic balance control. J Phys Ther Sci. 2016;28(1):274-7.  https://doi.org/10.1589/jpts.28.274
  58. Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther. 2000;80(3):276-91.  https://doi.org/10.1093/ptj/80.3.276
  59. Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Medicine. 2006;36(3):189-98.  https://doi.org/10.2165/00007256-200636030-00001
  60. Park SH, Lee MM. Effects of lower trapezius strengthening exercises on pain, dysfunction, posture alignment, muscle thickness and contraction rate in patients with neck pain; randomized controlled trial. Med Sci Monit: International Medical Journal of Experimental and Clinical Research. 2020;26:e920208-1-9. 
  61. Cools AM, Declercq GA, Cambier DC, et al. Trapezius activity and intramuscular balance during isokinetic exercise in overhead athletes with impingement symptoms. 2Scand J Med Sci Sports. 2007;17(1):25-33.  https://doi.org/10.1111/j.1600-0838.2006.00570.x
  62. Kang JI, Choi HH, Jeong DK, et al. Effect of scapular stabilization exercise on neck alignment and muscle activity in patients with forward head posture. J Phys Ther Sci. 2018;30(6):804-8.  https://doi.org/10.1589/jpts.30.804
  63. Lee SH, Yu WJ, Lee DY. Effects of planck exercise on the cranio-vertebral angle, round shoulder posture and forward head posture. Indian J Public Health Res Dev. 2019;10(11):4678-83.  https://doi.org/10.5958/0976-5506.2019.04344.4
  64. Kim JH, Rhee MH. Change of craniovertebral angle and scapula alignment in adults with forward head posture by shoulder and abdominal stabilization exercise. PNF and Movement. 2021;19(2):251-60.  https://doi.org/10.21598/JKPNFA.2021.19.2.251
  65. Abhilash P, Priya S, Kheriwala MK. Correlation between static balance and core endurance among college student with forward head posture. International Journal of Science and Healthcare Research. 2021;6(3):244-50.  https://doi.org/10.52403/ijshr.20210742
  66. Jo SH, Choi HJ, Cho HS, et al. Effect of core balance training on muscle tone and balance ability in adult men and women. Int J Environ Res Public Health. 2022;19(19):12190-1-11.  https://doi.org/10.3390/ijerph191912190
  67. Bird ML, Hill KD, Fell JW. A randomized controlled study investigating static and dynamic balance in older adults after training with Pilates. Arch Phys Med Rehabil. 2012;93(1):43-9.  https://doi.org/10.1016/j.apmr.2011.08.005
  68. Kim SG, Oh SM, Lee JY, et al. Correlation between lung capacity, resporatory gas analysis and diaphragm movement distance according to forward head posture and round shoulder posture. The Journal of Natural Healing. 2022;7(1):37-47.  https://doi.org/10.12972/jnh.20220011
  69. Foskolou A, Emmanouil A, Boudolos K, et al. Abdominal breathing effect on postural stability and the respiratory muscles' activation during body stances used in fitness modalities. Biomechanics. 2022;2(3):478-93.  https://doi.org/10.3390/biomechanics2030037
  70. Thongchote K, Threetepchanchai K, Chuwijit A, et al. Pilot study on the improvement effects of scapulothoracic exercises on the respiratory functions in sedentary young female adult with forward shoulder posture: a randomized control trial. Advances in Rehabilitation. 2023;37(1).23-32.  https://doi.org/10.5114/areh.2023.125825
  71. Pawaria S, Sudan DS, Kalra S, et al. Effectiveness of cervical stabilization exercises with feedback on respiratory status in chronic neck pain patients with forward head posture. International Journal of Physiotherapy. 2019;6(3):70-4.  https://doi.org/10.15621/ijphy/2019/v6i3/183874
  72. Kang NY, Kim K. Effects of a combination of scapular stabilization and thoracic extension exercises on respiration, pain, craniovertebral angle and cervical range of motion in elementary school teachers with a forward head posture: a randomized controlled trial. Korean Society of Physical Medicine 2022;7(2):9-40.  https://doi.org/10.13066/kspm.2022.17.2.29
  73. Cavaggioni L, Ongaro L, Zannin E, et al. Effects of different core exercises on respiratory parameters and abdominal strength. J Phys Ther Sci. 2015;27(10):3249-53.  https://doi.org/10.1589/jpts.27.3249
  74. Borge CR, Hagen KB, Mengshoel AM, et al. Effects of controlled breathing exercises and respiratory muscle training in people with chronic obstructive pulmonary disease: results from evaluating the quality of evidence in systematic reviews. BMC Pulm Med. 2014;14(1):1-15.  https://doi.org/10.1186/1471-2466-14-1
  75. McGill SM, Karpowicz A. Exercises for spine stabilization: motion/motor patterns, stability progressions, and clinical technique. Arch Phys Med. 2009;90(1):118-26.  https://doi.org/10.1016/j.apmr.2008.06.026
  76. Gollee H, Hunt KJ, Fraser MH, et al. Abdominal stimulation for respiratory support in tetraplegia: a tutorial review. Journal of Automatic Control, 2008;18(2):85-92. https://doi.org/10.2298/JAC0802085G