Background: Passive or therapist-assisted stretching, followed by scapular stabilization exercises, has been shown to be effective. However, most previous studies have focused on stretching individual muscles or specific movement directions, often neglecting the role of active scapular stretching. Objects: This study aimed to compare changes in the muscle activity of the lower trapezius (LT), serratus anterior (SA), and upper trapezius (UT), as well as the scapular posterior tilt (SPT) angle before and after scapular circle (SC) stretching during SPT exercise. Methods: Twenty participants were recruited for this study. Electromyography electrodes were attached to the LT, SA, and UT. Muscle activity and the posterior scapular tilt angle were measured while performing the SPT exercises. After the SC stretch, the measurements were repeated in the same manner. The LT, SA, and UT electromyography activities and SPT angles were analyzed using paired t-tests. Results: LT activity was significantly higher in the SC stretch plus SPT exercise compared with in the SPT exercise alone (p = 0.018). There were no significant differences in SA activity between the SPT and SC stretch plus SPT exercise conditions (p = 0.812). UT activity significantly increased in the SC stretch plus SPT exercise compared with that in the SPT exercise (p = 0.001). The SPT angle was significantly enhanced during SPT exercise after the SC stretching compared to that without SC stretching (p = 0.009). The RSP improved by 2.32% compared to the initial posture when only the SPT was performed, and improved by 9.95% when the SPT was performed after the SC stretching. Conclusion: These results suggest that performing SC stretching prior to SPT exercise may effectively improve scapular alignment and posture, even when UT activation increases more than of the LT. Elevated UT activity highlights the need to address muscular balance in corrective exercise design.

Background: Round shoulder posture, results from excessive flexed posture of the thorax, is defined as a position of scapular protraction, anterior tipping, and downward rotation. However, previous studies have focused on only passive position of the thorax during scapular posterior tilting (SPT) and have not reported on SPT combined with correction of flexed posture. Objects: The aim of this study was to compare effects of SPT and SPT with prone trunk extension (SPT + PTE) on activities of the lower trapezius, serratus anterior, and thoracic erector spinae and degree of posture in subjects with round shoulder and flexed posture. Methods: Fifteen subjects with round shoulder and flexed posture were recruited. The caliper was used to measure the degree of round shoulder and flexed posture. Electromyography was performed to collect data of muscle activities. Paired t-test was used to compare two exercise (α=.05). Results: When SPT + PTE was applied, the degree of round shoulder posture (p=.001) and flexed posture (p=.039) significantly decreased compared with that when SPT was applied. The lower trapezius activity significantly increased in the SPT + PTE condition compared with that in the SPT condition (p=.026). There were no significant differences in serratus anterior activity between SPT + PTE and SPT. The thoracic erector spinae activity significantly increased in the SPT + PTE condition compared with that in the SPT condition (p=.014). Conclusion: SPT + PTE might be one of the effective methods to enhance activities of lower trapezius and thoracic erector spinae, and to reduce round shoulder posture and flexed posture in subjects with round shoulder and flexed posture.

Background: Shoulder horizontal adduction (HA) is performed in many activities of daily living. The limited range of motion (LROM) of HA is affected by the tightness of the posterior deltoid, infraspinatus, teres major, and posterior capsule of glenohumeral joint. The LROM of shoulder HA contributes to excessive scapular abduction. Objects: The aim of this study is to compare the scapular abduction distance and three-dimensional displacement of the scapula during shoulder horizontal adduction between subjects with and without the LROM of shoulder HA. Methods: 24 subjects (12 people in LROM group and 12 people in normal ROM group) participated. Subjects with less than 115° of HA ROM were included in LROM group. Shoulder HA was performed 3 times for measuring scapular abduction distance and three-dimensional displacement of the scapula. Tape measure was used for measuring scapular abduction distance. Scapular abduction distance was normalized by dividing the scapular size. Polhemus Liberty was used for measuring the three-dimensional displacement of the scapula. Results: Normalized scapular abduction distance was significantly greater in LROM group than normal ROM group (p<.001). Three-dimensional displacement of the scapula during shoulder HA was greater in LROM group than normal ROM group (p<.05). Conclusion: LROM group had a greater scapular abduction and three-dimensional displacement of the scapula during shoulder HA compared to normal ROM group.