Effect Of Open Kinetic Chain Exercises And Closed Kinetic Chain Exercises On Scapular Dyskinesis

Objectives: The purpose of this study was to investigate the effects of open kinetic chain exercises and closed kinetic chain exercises on scapular dyskinesis,and summarize the similarities and differences of the effect,provide new ideas for rehabilitation of scapula dyskinesis,guide to clinical practice.Methods: Thirty-six participants(male 17,female 19)had been screened,and they were randomly divided into the Blank Group,the Open-Chain Group,and the Closed-Chain Group,the Blank Group was no training,the Open-Chain Group received a program of open kinetic chain exercises only,and the Closed-Chain Group received a program of closed kinetic chain exercises only.Training was given 3 times/ week,for 6 consecutive weeks.Patients were measured Scapular Index(SI),Scapular Balance Angle(SBA),Y-Balance test(YBT),Closed Kinetic Chain Upper Extremity Stability Test(CKCUEST)and Surface EMG(s EMG)on pre and post training.Statistical analysis used parametric measures,the Paired Samples T test(comparison between groups)and ANOVA for repeated measures(comparison within each group).Results: 1.The result of SI and SBA were significantly improved after training in the Open-Chain Group(P<0.05)and the Closed-Chain Group(P<0.05),but there was no significant difference between the two groups(P>0.05).2.The result of YBT and CKCUEST were significantly improved after training in the Open-Chain Group(P<0.05)and the Closed-Chain Group(P<0.01).After training,the result of YBT and CKCUEST in the Closed-Chain Group were significantly higher than the results in the Open-Chain Group(P<0.05).3.s EMG:(1)In shoulder flexion,the UT of IMEG were significantly decreasing on post training(P<0.05),the MT and SA of IEMG were significantly increasing on post training(P<0.05)in Open-Chain Group.The UT of IMEG were significantly decreasing on post training(P<0.05),the MT,LT and SA of IMEG were significantly decreasing on post training(P<0.05)in Closed-Chain Group.After training,the IEMG of LT in the Closed-Chain Group were significantly higher than the results in the Open-Chain Group(P<0.05).(2)In shoulder abduction,The UT of IMEG were significantly decreasing on post training(P<0.05),the MT,LT and SA of IMEG were significantly decreasing on post training(P<0.05)in Open-Chain Group.The UT of IMEG were significantly decreasing on post training(P<0.05),the LT and SA of IEMG were significantly increasing on post training(P<0.05)in Cloed-Chain Group.After training,the IEMG of UT in the Closed-Chain Group were significantly lower than the results in the Open-Chain Group(P<0.05).(3)In push-up plus,the UT of IMEG were significantly decreasing on post training,the MT,LT and SA were significantly increasing in Open-Chain Group(P<0.05)and Closed-Chain Group(P<0.05).After training,the IEMG of UT in the Closed-Chain Group were significantly lower than the results in the Open-Chain Group(P<0.05).(4)The contribution ratio of UT in the Open-Chain Group and the Closed-Chain Group were significantly decreasing,and the contribution ratio of MT,LT and SA were significantly increasing on post training(P<0.05)in 3 actions.After training,the contribution ratio of UT in the Closed-Chain Group were significantly lower than the results in the Open-Chain Group(P<0.05)in 3 actions,the contribution ratio of LT in the Closed-Chain Group were significantly higher than the results in the Open-Chain Group(P<0.05)in shoulder flexion and abduction.Others results were no significantly different.Conclusions: In the rehabilitation of scapular dyskinesis,the result of exercises using closed kinetic chain exercises is better than using open kinetic chain exercises in improving function and coordination of muscle.Using close kinetic chain exercises can reduce the contribution rate of UT,improve the contribution rate of LT,and improve trapezius' s the ability of Co-contraction.In addition,it can obviously increase upper limb stability and shoulder function in patients with scapular dyskinesis.