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  • 10.A.Cools Kinetic Chain PDF

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    Walter Pelaez
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    Kinetic chain rehabilitation focuses on integrating open and closed chain exercises that challenge sports-specific and functional positions and movements. Research has shown that varying lower limb and trunk positions can influence muscle recruitment patterns in the scapular muscles during common shoulder exercises like push-ups and rows. For example, highest scapular muscle activity occurs when the ipsilateral leg is extended during a push-up. Plyometric exercises also elicit high recruitment of the middle and lower trapezius muscles. The goal is to understand how kinetic chain variables impact muscle activity to optimize rehabilitation exercises.

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    Kinetic chain rehabilitation focuses on integrating open and closed chain exercises that challenge sports-specific and functional positions and movements. Research has shown that varying lower limb and trunk positions can influence muscle recruitment patterns in the scapular muscles during common shoulder exercises like push-ups and rows. For example, highest scapular muscle activity occurs when the ipsilateral leg is extended during a push-up. Plyometric exercises also elicit high recruitment of the middle and lower trapezius muscles. The goal is to understand how kinetic chain variables impact muscle activity to optimize rehabilitation exercises.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    179 views22 pages

    10.A.Cools Kinetic Chain PDF

    Uploaded by

    Walter Pelaez
    Kinetic chain rehabilitation focuses on integrating open and closed chain exercises that challenge sports-specific and functional positions and movements. Research has shown that varying lower limb and trunk positions can influence muscle recruitment patterns in the scapular muscles during common shoulder exercises like push-ups and rows. For example, highest scapular muscle activity occurs when the ipsilateral leg is extended during a push-up. Plyometric exercises also elicit high recruitment of the middle and lower trapezius muscles. The goal is to understand how kinetic chain variables impact muscle activity to optimize rehabilitation exercises.

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    of 22

    WHAT IS KINETIC CHAIN REHAB?

    Ann Cools, PT, PhD


    Dept Rehab. Sciences & Physiotherapy
    Ghent University, Belgium
    From a clinical perspective…

    Integrate kinetic chain into


    shoulder rehab exercises

    Focus on open and closed


    chain exercises

    Challenge sports specific


    and functional positions
    and movements

    A Cools EUSSER London Symp 2014


    Kinetic Chain Principle

    Wrist
    F Elbow
    O Shoulder
    R
    Trunk
    C and Back
    E
    Legs

    0
    TIME
    (Kibler et al. BJSM 2010, Linter et al. 2008, Cools et al. BJSM 2008)
    From a scientific point of view…

    Evidence of integrating
    functional body positions
    and lower limb movements
    into shoulder exercises?

    In particular: how is
    muscle recruitment
    (EMG) influenced by kinetic
    chain variables?

    A Cools EUSSER London Symp 2014


    Purpose of this presentation:
    What is the influence of kinetic chain
    variables on EMG-activity of the scapular
    muscles during frequently used shoulder
    exercises?

    1. Closed chain exercises (push-up-plus)


    2. Open chain exercises (low row exercise)
    3. Different modalities of scapular elevation
    4. Plyometric shoulder exercises
    A Cools EUSSER London Symp 2014
    Thank you colleagues ☺
    Ann Cools, PT, PhD, Ghent, Belgium

    Annelies Maenhout, PT, PhD, Ghent, Belgium

    Birgit Castelein, PT, MsC, PhD student, Ghent, Belgium

    Mia Werin, PT, MsC, Stockholm, Sweden

    Maya Benzoor, PT, PhD, Haifa University, Israel

    A Cools EUSSER London Symp 2014


    1. Influence of lower limb position
    during push-up exercises (2009)

    A Cools EUSSER London Symp 2014


    Highest SA activity (44%MVC) en best
    UT/SA ratio (0.40) when ipsilateral leg is
    extended

    A Cools EUSSER London Symp 2014


    Highest activity in MT & LT, when
    contralateral leg is extended
    (LT=20%MVC)

    A Cools EUSSER London Symp 2014


    2. Influence of lower limb and body
    position during open chain
    “rowing” exercises (2012)

    A Cools EUSSER London Symp 2014


    * *
    *
    * *

    A Cools EUSSER London Symp 2014


    *= significant main effect “exercise”
    (De Mey & Cools, 2012 )
    3. Changes in scapular muscle
    recruitment during scapular
    elevation exercises (2014)

    A Cools EUSSER London Symp 2014


    1. Elevation scap plane

    2. Wall slide UT/MT/LT/SA

    3. Elevation + ER
    Pect Min
    Lev scap
    A Cools EUSSER London Symp 2014

    rhomb
    UT ↓ UT ↓
    SA = SA =
    Lev Scap ↓ MT & LT ↑
    Rhomb ↓ Rhomb ↑
    Pect Min ↓

    A Cools EUSSER London Symp 2014


    4. Scapular muscle recruitment
    during plyometric exercises (2014)

    A Cools EUSSER London Symp 2014


    UT MT LT SA

    120
    EMG Muslce activity (% MVC)

    MT SA
    100 LT LT
    MT
    UT
    80
    SA SA
    UT SA
    60 SA SA
    MT LT
    UT UT MT LT MT LT SA
    40 MT
    UT UT UT
    SA LT
    SA
    UT SA UT UT MT LT MT LT MT LT MT LT
    20

    0
    1 2 3 4 5 6 7 8 9 10
    Exercise

    Highest MT-LT in
    prone exercises
    (>80%MVC)

    BUT also higher UT


    A Cools EUSSER London Symp 2014
    UT MT LT SA

    120
    EMG Muslce activity (% MVC)

    MT SA
    100 LT LT
    MT
    UT
    80
    SA SA
    UT SA
    60 SA SA
    MT LT
    UT UT MT LT MT LT SA
    40 MT
    UT UT UT
    SA LT
    SA
    UT SA UT UT MT LT MT LT MT LT MT LT
    20

    0
    1 2 3 4 5 6 7 8 9 10
    Exercise

    Highest SA in Xco exercises


    and plyometric PU on Bosu
    >60% MVC

    Lowest UT in plyometric PU
    on Bosu
    A Cools EUSSER London Symp 2014
    UT MT LT SA

    120
    EMG Muslce activity (% MVC)

    MT SA
    100 LT LT
    MT
    UT
    80
    SA SA
    UT SA
    60 SA SA
    MT LT
    UT UT MT LT MT LT SA
    40 MT
    UT UT UT
    SA LT
    SA
    UT SA UT UT MT LT MT LT MT LT MT LT
    20

    0
    1 2 3 4 5 6 7 8 9 10
    Exercise

    Lowest UT in sidelying
    and Bosu push up

    A Cools EUSSER London Symp 2014


    UT MT LT SA

    120
    EMG Muslce activity (% MVC)

    MT SA
    100 LT LT
    MT
    UT
    80
    SA SA
    UT SA
    60 SA SA
    MT LT
    UT UT MT LT MT LT SA
    40 MT
    UT UT UT
    SA LT
    SA
    UT SA UT UT MT LT MT LT MT LT MT LT
    20

    0
    1 2 3 4 5 6 7 8 9 10
    Exercise

    Highest overall
    scapular muscle activity

    A Cools EUSSER London Symp 2014


    Goal of the exercise:
    1. MT & LT ↑

    2. SA ↑ and UT ↓

    3. UT ↓

    4. Overall scap muscles↑


    A Cools EUSSER London Symp 2014
    Take home message: 2
    YES
    kinetic chain exercises work!
    1. Diagonals in closed chain increase lower/middle trap
    activity

    1. Diagonals in open chain exercises increase overall


    scapular muscle recruitment

    2. Changing modalities of the “scapular elevation”


    exercises may focus on selective muscle recruitment

    3. Plyometrics highly challenge scapular muscle activity


    A Cools EUSSER London Symp 2014
    THANK YOU!

    A Cools EUSSER London Symp 2014

    (Gent, Belgium)

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