title: Optimal Normalization Tests for Muscle Activation of the Levator Scapulae, Pectoralis Minor, and Rhomboid Major: An Electromyography Study Using Maximum Voluntary Isometric Contractions.
abstract: OBJECTIVE
  To identify maximum voluntary isometric contraction (MVIC) test positions for the deeper-lying scapulothoracic muscles (ie, levator scapulae, pectoralis minor, rhomboid major), and to provide a standard set of a limited number of test positions that generate an MVIC in all scapulothoracic muscles.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Physical and rehabilitation medicine department.
  
  
  METHODS
  Healthy subjects (N=21).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Mean peak electromyographic activity from levator scapulae, pectoralis minor, and rhomboid major (investigated with fine-wire electromyography) and from upper trapezius, middle trapezius, lower trapezius, and serratus anterior (investigated with surface electromyography) during the performance of 12 different MVICs.
  
  
  RESULTS
  The results indicated that various test positions generated similar high mean electromyographic activity and that no single test generated maximum activity for a specific muscle in all subjects. The results of this study support using a series of test positions for normalization procedures rather than a single exercise to increase the likelihood of recruiting the highest activity in the scapulothoracic muscles.
  
  
  CONCLUSIONS
  A standard set of 5 test positions was identified as being sufficient for generating an MVIC of all scapulothoracic muscles: seated T, seated U 135°, prone T-thumbs up, prone V-thumbs up, and supine V-thumbs up. A standard set of test positions for normalization of scapulothoracic electromyographic data that also incorporates the levator scapulae, pectoralis minor, and rhomboid major muscles is 1 step toward a more comprehensive understanding of normal and abnormal muscle function of these muscles and will help to standardize the presentation of scapulothoracic electromyographic muscle activity.
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University Hospital, Ghent, Belgium. Electronic address: Birgit.Castelein@ugent.be.
authors.forename: Birgit
authors.initials: B
authors.lastname: Castelein
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University Hospital, Ghent, Belgium.
authors.forename: Barbara
authors.initials: B
authors.lastname: Cagnie
authors.affiliation: Department of Physical Medicine and Orthopedic Surgery, University Hospital, Ghent, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Parlevliet
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University Hospital, Ghent, Belgium.
authors.forename: Lieven
authors.initials: L
authors.lastname: Danneels
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University Hospital, Ghent, Belgium.
authors.forename: Ann
authors.initials: A
authors.lastname: Cools
mesh_terms: D000328:Adult; D064131:Back Muscles / Q000502:physiology*; D003430:Cross-Sectional Studies; D004576:Electromyography / Q000379:methods*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology; D012785:Shoulder Joint / Q000502:physiology*
keywords: Electromyography; Rehabilitation; Shoulder