Background: Adhesive capsulitis occurs with synovial inflammation and capsular fibrosis in the glenohumeral joint, leading to restriction of joint motion and pain. Heat therapy modalities, which aim at modifying dense collagenous tissues are commonly practiced interventions for patients with adhesive capsulitis; however, the effectiveness of ultrasound deep heat therapy (UST) on adhesive capsulitis is still unclear. Purpose: This systematic review and meta-analysis study was conducted to evaluate the effects of UST on the improvement of pain and glenohumeral joint function in adhesive capsulitis compared to (1) no treatment or placebo, and (2) any other therapeutic modalities. Methods: A literature search was carried out in January 2021 in Cochrane Central Register of Controlled Trials, PubMed, EMBASE, PEDro, Web of Science, and Google Scholar. The main outcomes of interest were self-reported pain scores, disability scores, and the range of motion. This study was conducted based on the guidelines of the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) protocols, using random-effects models. Results: Seven studies were included in the systematic review with five studies forming the basis for meta-analyses. The effects of UST in patients with adhesive capsulitis were compared with placebo, shockwave therapy, corticosteroid injection, platelet-rich plasma injection, or cryotherapy. The results indicated that UST significantly improved pain scores when performed together with exercise and/or other physical modalities compared to placebo; however, whether UST provides benefits for the improvement of disability and/or the range of motion was uncertain in the present results. Conclusions: The present findings suggest that UST as a co-intervention combined with other physical modalities is an effective means of improving the overall pain in patients with adhesive capsulitis.

Background: Excess and repetitive glenohumeral external rotation (ER) is at a higher risk for shoulder injuries, which occurs frequently in professional sports and specific occupations. Current rehabilitation programs emphasize selective targeting of muscle activity, which can help restore dysfunctional muscle imbalances or prevent injuries. However, the impact of different body postures on GH muscle activity during ER exercises has not been fully understood. Therefore, the purpose of this study was to investigate shoulder EMG activity for different body positions and humeral abduction angles during ER exercises. Method: Twenty-three healthy young men (age: 22.3 ± 2.3, height: 175.75 ± 4.02, mass: 75.37 ± 9.14) participated in this study. Surface Electromyography was recorded from seven shoulder muscles: upper trapezius, lower trapezius, serratus anterior, infraspinatus, and deltoid. Six ER exercises: three postures (sitting, supine lying, and prone lying) and two abduction angles (ABD; 45° and 90°) were tested using an isokinetic dynamometer. Results: During a sitting position, the lower trapezius/upper trapezius muscle activity ratios were significantly increased for sitting compared to supine lying and prone lying (p < 0.001, p = 0.004). Serratus anterior/upper trapezius co-contraction indices were significantly increased for 90° than 45° ABD (p < 0.001). Conclusion: These findings can provide insight into new training programs aimed at restoring GH muscle imbalances.

Background: Core muscles serve as a central group within the functional kinetic chain, stabilizing the spine during movement. The Reformer is one of the most popular and primary pieces used in Pilates core exercises, requiring effective control of core muscles. The purpose of this study was to investigate the effect of Reformer spring resistance on core muscle activity. Method: 18 healthy adult females (age: 29.83 ± 4.22 years, body height: 164.98 ± 4.14 cm, body mass: 53.67 ± 5.32 kg) participated in this study. Surface electromyography was recorded from six muscles: rectus abdominis, internal oblique, erector spinae, multifidus, rectus femoris, and biceps femoris during core exercises. Participants performed three core exercises (hip roll, knee-off, and elephant) under three different Reformer spring conditions (fixed platform, platform connected to springs with moderate resistance, platform connected to springs with low resistance). Results: During the hip roll exercise, mean muscle activity of the rectus abdominis, erector spinae, multifidus, and biceps femoris was significantly increased on the low-resistance spring platform compared to the moderate-resistance platform and fixed platform conditions (p < 0.001). During the knee-off exercise, mean muscle activity of the rectus abdominis, internal oblique, erector spinae, and multifidus significantly increased on the low-resistance platform compared to the fixed platform (p < 0.001). Furthermore, during the elephant exercise, mean muscle activity of the rectus abdominis, internal oblique, and rectus femoris significantly increased on the low-resistance spring platform compared to the fixed platform (p < 0.001). Conclusions: These findings suggest the unstable platform caused by the Reformer spring modification impacts core muscle activity during basic core exercises. Therefore, when designing core exercise programs using the Reformer, platform instability should be considered a key factor for rehabilitation and core stability.