EFFECTIVENESS OF MUSCLE

ENERGY TECHNIQUE AND

THERABAND RESISTANCE TRAINING
IN FORWARD SHOULDER POSTURE
AMONG THE COLLEGE STUDENTS

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 INTRODUCTION

• Posture is the attitude assumed by body either when the body is

stationary or when it is moving. It is attained as a result of
coordinated action of various muscles working to maintain
stability.

• The scapulothoracic joint is directly not connected to axial

skeleton its connected by the muscles any imbalance or
weakness in scapular muscles causes the abnormal position of
the scapula results in abnormal motions of acromioclavicular
joint and sternoclavicular joint.1,2.

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 • Forward shoulder posture is a forward deviation of the
shoulders associated with a protraction , upward rotation and
anterior tilt of the scapula .It is due to muscular imbalance
between a shortened pectoralis minor and a lengthened middle
trapezius , lower trapezius and rhmboids major and minor

• Thus scapula is the important linkage between the axial

skeleton and the upper limb it also provides the stability for
functional activity for the upper extremity. The Chronic
abnormal scapular position causes the muscle imbalance
results in the shoulder pathology such as impingement.

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 AIM OF THE STUDY :To find out effectiveness of
muscle energy technique and theraband resistance training in
forward shoulder posture among the college students

NEED FOR STUDY: The purpose of the study is to

evaluate the effect of muscle energy technique and Theraband
resistance training program in forward shoulder posture. The
person with the relatively shorter pectoralis minor length have
abnormal scapular kinematics may predispose to the risk of
subacromial impingement when performing the overhead tasks.

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 METHODOLOGY

 STUDY DESIGN : Experimental

 STUDY TYPE : Pre and Post
 NUMBER OF SAMPLES: 30 samples
:(GroupA-15 and group B-15)
 STUDY DURATION : 4 weeks
 STUDY SETTING : SRM College of physiotherapy
SRM Institute of science and
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Kattankulathur

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 INCLUSION CRITERIA

Age group 18-24 years.

The only male were included in the study.

The people who are with the forward shoulder posture.

EXCLUSION CRITERIA
The subjects with shoulder pathology such as impingement syndromes.

Structural scoliosis.

Excessive thoracic kyphosis.

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 MATERIALS USED IN THE STUDY

• Digital camera
• Reflective markers
• Adobe® Photoshop®

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 PROCEDURE
No of samples 30

Divided into Group-A 15 and Group B 15

For Group-A Theraband exercises and Muscle energy technique

Theraband exercises 1. scapular retraction 2. Shoulder external rotation 3.lower trapezius

activation , three sets of ten repetitions with protocol consist of single session per day, 3
days per week for 6 weeks.

Muscle energy technique : Three post isometric relaxation techniques were given
for per session in a day likewise four days for a week for 6 weeks.

For Group-B postural advice is given

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The muscle energy technique is kind of soft tissue manipulation methods where the
patient initiates directed and controlled isometric and/ or isotonic contractions
designed to enhance musculoskeletal function and reduce pain.
This technique is commonly used to strengthen and lengthen muscles, reduce
edema, improve circulation, and mobilize restricted articulations. The post-
isometric relaxation is the term refers to the gradual reduction in muscle tone in an
individual muscle or group of muscles, after the periods of isometric contraction
has been performed
The colour selection of the theraband was based on level of challenging, 5
repetitions of each exercise were asked to perform if it is easier the next grade of
theraband was selected, if the level of challenging was more difficult the next lower
grade of theraband was selected.
Three post isometric relaxation techniques were given for per session in a day
likewise four days for a week for 6 weeks.

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 OUTCOME MEASURE
The degree of forward shoulder posture was assessed by photogrammetry method
using adobe photoshop software.

The photographic analysis was performed using Adobe Photoshop ®, which

determined coordinates of the anatomical points on the photographs. For the
accuracy of the analysis the image was zoomed to 200 %, and the angle less than
52degree is considered as Forward shoulder posture.

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 TABLE 1
COMPARISON OF FORWARD SHOULDER
ANGLE
FOR GROUP A AND GROUP B
group A group b
Sig.(2-
tailed)
53.29
N Mean Std.
t P value
Deviation

51.3 51.4

50.34

Pre-test 15 50.34 1.37467

-8.430 .000
GROUP A
Post-test 15 53.29 2.12417
Pre-test 15 51.3 .67612 -1.324 .207

pre-test post-test
.
GROUP B 594
Post-test 15 51.4 26

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 TABLE 2
COMPARISON OF POST-TEST VALUES
OF FORWARD SHOULDER ANGLE FOR
GROUP A AND GROUP B
53.5

Variables n Mean
53

Sig. 52.5
(2 tailed)
Std. Error 52
Std. Mean
Deviation
51.5

51
Post-
GROUP A test 15 53.29 2.12417 .003 .54846
50.5

50
Post-
GROUP B test 15 51.42 .59426 .005 .15344

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 RESULTS

According to Table -1 & Graph-1, in forward shoulder angle, the post-test

mean values of GROUP A and GROUP B are 53.29 and 51.42 when compared
between the groups. There is an increase in the mean values of GROUP A than
GROUP B of Forward shoulder angle among the groups. The P-value is 0.000
which is <0.05, it is statistically significant. It shows the significant difference
between the Pre-test and Post-test of GROUP A

According to Table -2 & Graph -2, in forward shoulder angle shows an

increase in the post-test mean value of GROUP A and GROUP B from 53.29 to
51.42 when compared between groups. The P-value is 0.03 which is <0.05, it is
statistically significant. It shows that Group A has significantly improved than
GROUP B among the post-test group comparison

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 DISCUSSION
The objective of the study was to find the effectiveness of muscle
energy technique and theraband resistance training in forward
shoulder posture among the college students. The shoulder joint is
the complex joint which is maintained by acromioclavicular joint,
scapulothoracic joint, glenohumeral joint and sternoclavicular joint.

Any alteration in the scapulothoracic joint causes the scapular

muscles to be imbalanced which leads to Forward shoulder. The
pectoralis minor which serves as an efficient lever for scapula by its
attachment to forward projecting coracoid process. When there is an
imbalance such as the lengthening of scapular muscles especially the
middle trapezius, lower trapezius rhomboids major and minor which
provides the stability for the scapula.
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 CONT…
John D Borstad et.al., (2005) stated relatively shorter pectoralis minor muscle
length will result in increased scapular internal rotation during abduction of arm
and decreased scapular posterior tilting at higher arm arm abduction angles (90°
and 120°) when compared with a group of subjects with a relative longer pectoralis
minor muscle length this indicates that there is a relationship between posture and
pectoralis minor length .

The key factor that might account for positive results in this study was, the
exercise program was monitored and the subjects did under the supervision of the
therapist. The muscle energy technique for pectoralis minor was administered by
the same therapist throughout the exercise program. The strengthening of the
lengthened scapular muscles using the theraband and stretching of the pectoralis
minor using the muscle energy technique altered the abnormal biomechanics and
the muscle imbalance between the anterior shoulder muscle and posterior scapular
muscles are corrected. Hence this study concluded that there was a significant
change in Forward shoulder angle in GROUP A and no difference was found in
GROUP B.
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 CONCLUSION

The study concludes that the Experimental group (GROUP A) who underwent
Muscle energy technique and theraband resistance training has shown statistically
significant improvement in Forward shoulder angle.

Control group (GROUP B) who were given only postural correction advice has
not shown any statistically significant improvement in Forward shoulder angle.

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 CONTRIBUTION TO SOCIETY
• This study is helpful for the person to adopt the good posture
and prevents the person from future risk of developing
shoulder impingement syndromes and should pain in future

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 LIMITATIONS
• Small sample size.
• The intervention period used in this study was relatively short
• This study describes only the alignment of shoulder at rest, the findings are
not taken during the functional tasks, especially when the upper limb is
loaded or moving.

RECOMMENDATIONS
• In further studies, the third group can be added performing only one exercise
program which can further light on the static posture of the shoulder.
• The Dosage of the muscle energy technique duration can be increased from 5
seconds to 15 seconds.
• The functional benefit of the subject can be assessed.

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 REFERENCES
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 Cont….
•Ruivo, R.M., Pezarat-Correia, P. and Carita, A.I., 2014. Cervical and shoulder postural assessment
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