To examine the efficacy of a brace combined with NMES (BNMES) during exercise over a six-week period in individuals with FT-RCT.
Twenty-one participants with FT-RCT were allocated to the BNMES group, while the other twenty-one were allocated to the control group. The BNMES group received additional NMES during their exercises. Both groups underwent a 6-week intervention consisting of humerus adduction and scapular-focused exercises. Outcome measures, including shoulder muscle strength, pain, self-reported shoulder function and scapular kinematics/muscle activities during arm elevation, were assessed at baseline, week 3, and week 6. A two-way mixed analysis of variance was used to analyze the effects of group and time on these outcomes.
Both groups demonstrated significant improvements in pain (2.6 ± 0.3, 95%CI: 1.9-3.4, p 0.001), function (4.5 ± 1.0, 95%CI: 2.0-7.0, p 0.001), and muscle strength (2.5-12.6% body mass, 95%CI: 1.5-15.7, p 0.001 - 0.027) from week 0 to week 6. Post-hoc analysis revealed that the BNMES group experienced significant improvements from week 0 to week 3 in pain (1.8 ± 0.4, 95%CI: 1.1-2.5, p 0.001) and muscle strength in the upper trapezius (9.4 ± 3.2%, 95%CI: 3.0-15.8, p = 0.005) and serratus anterior (6.5 ± 2.3%, 95%CI: 1.8-11.1, p = 0.007). Conversely, the control group exhibited significant improvements from week 3 to week 6 in the lower trapezius (3.4 ± 1.3%, 95%CI: 0.9-5.9, p = 0.01) and serratus anterior (10.1 ± 3.1%, 95%CI: 3.9-16.3, p = 0.002). The BNMES group also exhibited decreased muscle activation in the upper trapezius (4.7-10.5%, 95%CI: 0-20.0, p = 0.009-0.024), teres major (7.2 ± 3.2%, 95%CI: 0.8-13.6, p = 0.023), and lower trapezius (2.0-5.8%, 95%CI: 0-11.6, p = 0.019-0.022) after training. Both groups demonstrated decreased upward rotation (2.1 ± 0.8°, 95%CI: 0.1-4.1, p = 0.042), while the control group also exhibited increased internal rotation (1.3 ± 0.6°, 95%CI: 0.2-2.5, p = 0.02) from week 0 to 6. Additionally, the BNMES group demonstrated less posterior tilt (6.3 ± 2.9°, 95%CI: 0.4-12.2, p = 0.006) and lower muscle activation compared to the control group in the upper trapezius (6.0%-19.0%, 95%CI: 1.3-33.2, p = 0.07-0.017), serratus anterior (15.3-20.4%, 95%CI: 4.8-35.9, p = 0.009-0.016), and lower trapezius (7.3-4.0%, 95%CI: 0.6-13.1, p = 0.02-0.024) at either week 3 or week 6.
A six-week exercise program significantly reduced pain, improved function, and increased strength in individuals with FT-RCT. The addition of NMES braces during exercises accelerated these improvements. Patients with FT-RCT commonly exhibit compensatory changes in scapular biomechanics. Our exercise protocol successfully addressed these compensations by correcting decreased upward rotation, posterior tilt, increased internal rotation, and reduced muscle activation in the upper trapezius, serratus anterior, teres major, and lower trapezius.
Clinical practitioners may consider incorporating these exercises with NMES for patients with FT-RCT, as this combination appears to be a safe and promising approach.
neuromuscular electrical stimulation
teres major
