The intended scapular motion is a strategy to strengthen the lower trapezius (LT). However, few studies have explored the effects of the intended scapular posterior tilt motion on selective LT activation. Thus, the present study investigated the effect of the intended scapular posterior tilt on the electromyography (EMG) activity of trapezius muscles during prone shoulder horizontal abduction (PSHA). Eighteen asymptomatic men performed three types of PSHA: (1) preferred PSHA, (2) PSHA with the intended scapular posterior tilt, and (3) PSHA with the intended scapular posterior tilt and trunk extension. EMG activity of the upper trapezius (UT), middle trapezius (MT), and LT were measured during PSHAs. Scapular posterior tilt angle, with and without the intended scapular posterior tilt, were measured using inclinometer. The results indicated that LT muscle activity increased when scapular posterior tilt was applied with and without trunk extension (14–16%), compared to the preferred condition, during PSHA (p < 0.05). However, the addition of trunk extension to PSHA with the intended scapular posterior tilt increased the UT muscle activity (28%) and the UT/LT (29%) and UT/MT (31%) ratios (p < 0.05). The scapular posterior tilt angle was higher (15%) when applying the intended scapular posterior tilt (p = 0.020). These findings suggest that the intended scapular posterior tilt may be a useful strategy for selective LT muscle activation.

BACKGROUND: People with forward head posture (FHP) and rounded shoulder posture (RSP) may experience shifts in scapular position and alterations in the strength of the muscles surrounding the scapula. Therefore, a reliable scapula position and scapula muscle strength test are required to identified scapula problem and provided appropriate intervention programs. OBJECTIVE: This study aimed to determine the reliability of scapular position measurements obtained using a modified digital inclinometer and palpation meter, as well as muscle strength using a hand-held dynamometer (HHD) in individuals with FHP and RSP. METHODS: Thirty healthy subjects underwent scapular position tests (upward rotation, anterior tilt, depression, and protraction) and strength tests of periscapular muscles (serratus anterior, upper trapezius, middle trapezius, and lower trapezius) on both the dominant and non-dominant sides. The reliability of the measurements was confirmed by computing the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal clinically important difference (MCID). Test and re-tests were conducted over a period of one week and actual values for each measurement were also obtained and assessed. RESULTS: The ICC ranged from 0.802 to 0.935 for the scapular position tests and from 0.808 to 0.949 for muscle strength tests on the dominant and non-dominant sides. For scapular position tests, SEM values ranged from 0.3 cm to 0.6 cm (protraction and depression), from 1.0^∘ to 1.7^∘ (upward rotation and anterior tilt) and MCID values ranged from 0.7 cm to 1.6 cm (protraction and depression), from 2.8^∘ to 4.7^∘ (upward rotation and anterior tilt). Regarding muscle strength tests, SEM and MCID values were in the range 14.4N–27.3N and 39.9N–75.7N, respectively. CONCLUSIONS: Scapular position and periscapular muscle strength can be reproducibly measured in healthy subjects individuals with FHP and RSP. These instruments can hence be recommended for evaluating these functional traits in subjects with FHP and RSP.

Introduction: Stroke is a leading cause of mortality and long-term disability worldwide, often resulting in low levels of physical activity post-discharge. A comprehensive exercise program could be a safe method to increase stroke patients’ physical activity and exercise volume. This pilot study examines the effectiveness, safety, and feasibility of a comprehensive exercise regimen for stroke patients residing in the community after discharge. Methods: This single-group pilot study included patients who received inpatient rehabilitation for motor impairment following a stroke. Community-dwelling participants engaged in a comprehensive exercise program, which was structured and individualized, consisting of stretching, aerobic exercise, strength training, and balance exercises, conducted under the supervision of a health exercise specialist in a dedicated living lab within the hospital. The program involved 20 sessions, each lasting 50 min, conducted three to five times weekly. The pre- and post-intervention evaluations were comprehensive, including safety and validity assessments, along with physical function tests such as cardiopulmonary exercise testing and various fitness tests (6 min walk test, timed up and go test, chair stand test, figure-of-8 walk test, grip strength test, and sit-and-reach test). Depression levels were assessed using the Geriatric Depression Scale (GDS). Results: A total of 22 subjects were recruited, with 21 completing the study after one dropout due to fatigue and visiting distance. Among the 21 completers, one subject experienced a mild adverse event (hypoglycemia), which was not serious, confirming the program’s safety. The exercise participation rate was 95.5%, and the adherence rate averaged 95.2%, with all completers achieving over 80% adherence. Significant improvements were observed in VO₂ peak (p = 0.000), 6 min walk test (p = 0.000), timed up and go test (p = 0.000), chair stand test (p = 0.000), figure-of-8 walk test (p = 0.000), and grip strength (p = 0.001). However, changes in the peak respiratory exchange ratio (p = 0.078), sit-and-reach test (p = 0.228) and GDS scores (p = 0.275) were not significant. Conclusion: This study demonstrates that the comprehensive exercise program is sufficiently safe and valid for stroke rehabilitation patients. The program significantly enhances cardiopulmonary endurance, walking ability, balance, muscle strength, muscle endurance, and coordination. Further research with larger sample sizes and control groups is needed to confirm these findings and explore additional benefits.