Kinematics and Muscle Activation of Thoracic Spine and Shoulder in Rock Climbers With Shoulder Pain

Background and Purpose: Rock climbing has been a popular sport in recent years. Rock climbing includes various open-chain and closed-chain arm movements. Overhead reaching and pull-up are the basic rock climbing elements heavily involving upper extremities. Different inclination of the wall and terrain also demand sufficient range of motion and strength of the trunk. Generally overhead reaching and arm elevation may have similar shoulder kinematics, including scapular upward rotation, posterior tilt and external rotation. Arm elevation usually is accompanied with thoracic extension and unilateral lateral flexion and rotation. During pull-up, the scapula rotates downward and externally and tilts anterior. The prevalence of shoulder injuries are about 17%, the second most common among rock climbing injuries. In the shoulder injuries, shoulder labrum lesions and shoulder impingement are the most common. Previous studies have shown that individuals with shoulder impingement syndrome have shown decreased upward and externally rotation during arm elevation, and have limited thoracic extension range of motion and greater kyphotic posture. However, a previous study found no difference in the scapular kinematics and scapular muscle activation during pull-up in rock climbers with shoulder pain and healthy climbers. The non-significant finding may be due to that the pure pull-up may not mimic climbing tasks, in which the shoulder and trunk need to adapt different inclination of the wall. Therefore, the purpose of this study is to investigate the kinematics and muscle activation of the thoracic spine and shoulder in rock climbers with shoulder pain during climbing tasks with different reaching angles. Methods: Thirty sport climbers with shoulder pain and 30 healthy climbers matched with gender, age, and dominant hand will be recruited in this study. Testing tasks will include arm elevation in the scapular plane, overhead reaching to the target 15° backward to the frontal plane, pull-up with overhead reaching forward and backward. Thoracic and shoulder kinematics will be collected using an electromagnetic tracking system. The upper trapezius, lower trapezius, serratus anterior, latissimus dorsi, and erector spinae were collected with surface electromyography (EMG). A two-way mixed ANOVA will be used to determine differences between groups in the kinematics and EMG measures at the different arm elevation angles for the testing tasks.

Study Overview

• Status: Recruiting
• Conditions: Shoulder Impingement Syndrome; Shoulder Pain
• Intervention / Treatment: Device: Electromagnetic tracking system, surface electromyography

• Study Type: Observational
• Enrollment (Estimated): 60

Contacts and Locations

• Study Contact: Name: YIN-LIANG LIN; Phone Number: +886-2-28267288; Email: yllin1020@nycu.edu.tw
• Study Contact Backup: Name: GUAN-XUAN WU; Email: guanxuan.be11@nycu.edu.tw

Study Locations

• Taiwan
  • Taipei, Taiwan, 112
    • Recruiting
    • National Yang Ming Chiao Tung University
    • Contact: YIN-LIANG LIN; Phone Number: +886-2-28267288; Email: yllin1020@nycu.edu.tw
    • Contact: GUAN-XUAN WU; Email: guanxuan.be11@nycu.edu.tw

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Probability Sample

Study Population

Rock climbers with and without shoulder pain

Description

Inclusion Criteria of Patients with Shoulder Pain:

1. Ages ranges from 18-40 years old
2. At least one year of experience of sport climbing
3. Sport Climbing frequency ≥ 6 hours per week in the last one month
4. Shoulder pain ≥ 1 month
5. Minimum of 3/10 on the numerical rating scale (NRS) in the last one month

Inclusion Criteria of Healthy Subjects in the control group:

1. Ages ranges from 18-40 years old
2. Gender, age, dominant hand and experience matching to shoulder pain climbers group
3. At least one year of experience of sport climbing
4. Sport Climbing at least 6 hours per week in the last one month
5. No history of shoulder pain in the last six months

Exclusion Criteria of Patients with Shoulder Pain and All Healthy Subjects

1. History of upper limb surgery or fracture
2. History of shoulder dislocation
3. History of neck pain, back pain, or elbow injuries in the last one year
4. Wrist or finger pain during sport climbing > 3/10 on the numerical rating scale (NRS)
5. Shoulder pain during pull-up > shoulder pain during sport climbing
6. Intensive exercise within 12 hours or any delay onset muscle soreness
7. Systemic autoimmune disease
8. Cancer
9. Pregnancy

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
rock climbers (healthy group); Climbers without shoulder pain	Device: Electromagnetic tracking system, surface electromyography; arm elevation in the scapular plane, overhead reaching to the target 15° backward to the frontal plane, pull-up with overhead reaching forward and backward.
rock climbers (shoulder pain group); Climbers with shoulder pain	Device: Electromagnetic tracking system, surface electromyography; arm elevation in the scapular plane, overhead reaching to the target 15° backward to the frontal plane, pull-up with overhead reaching forward and backward.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Shoulder kinematics during arm elevation	Scapular kinematics, including anterior/posterior tilt, upward/downward rotation, and internal/external rotation in scapular plane elevation at 30°, 60°, 90°, and 120°, and will be described with degree (°).	Immediately during the experiment
Scapular muscles activation during arm elevation	The root mean square of electromyography (EMG) data of the upper trapezius, lower trapezius, serratus anterior, and latissimus dorsi will be normalized by the maximum voluntary contraction amplitude (percentage of maximal voluntary contraction, %) and calculated over three 30° increments of motion during arm elevation from 30° to 120°, including 30° - 60°, 60° - 90°, and 90° - 120°.	Immediately during the experiment
Thoracic kinematics during arm elevation	Thoracic kinematics, including flexion, extension, side flexion and rotation in arm elevation at 30°, 60°, 90°, and 120°, and will be described with degree (°).	Immediately during the experiment
Shoulder kinematics during pull-up with overhead reaching forward and backward	Scapular kinematics, including anterior/posterior tilt, upward/downward rotation, and internal/external rotation, and will be described with degree (°).	Immediately during the experiment
Thoracic kinematics during pull-up with overhead reaching forward and backward	Thoracic kinematics, including flexion, extension, side flexion and rotation	Immediately during the experiment
Trunk muscle activation during arm elevation	The root mean square of electromyography (EMG) data of the erector spinae will be normalized by the maximum voluntary contraction amplitude (percentage of maximal voluntary contraction, %) and calculated over three 30° increments of motion during arm elevation from 30° to 120°, including 30° - 60°, 60° - 90°, and 90° - 120°.	Immediately during the experiment
Scapular muscles activation during pull-up with overhead reaching forward and backward	The root mean square of electromyography (EMG) data of the upper trapezius, lower trapezius, serratus anterior, and latissimus dorsi will be normalized by the maximum voluntary contraction amplitude (percentage of maximal voluntary contraction, %)	Immediately during the experiment
Trunk muscle activation during overhead reaching forward and backward.	The root mean square of electromyography (EMG) data of the erector spinae will be normalized by the maximum voluntary contraction amplitude (percentage of maximal voluntary contraction, %)	Immediately during the experiment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Thoracic mobility	Range of motion of thoracic spine, described with degree (°).	Immediately during the experiment
Thoracic kyphosis angle	measured by inclinometers, described with degree (°).	Immediately during the experiment
Muscle length of pectoralis major	In a supine position with hands behind the head. A positive (+) indicates muscle tightness, when the elbows cannot touch the testing surface.	Immediately during the experiment
Muscle length of pectoralis minor	In a supine position, the distance between acromion and testing surface, described with cm.	Immediately during the experiment
Muscle length of latissimus dorsi	shoulder flexion range of motion in a hook-lying position, described with degree (°)	Immediately during the experiment

Collaborators and Investigators

• Sponsor: National Yang Ming University
• Investigators: Principal Investigator: YIN-LIANG LIN, National Yang Ming Chiao Tung University

Study record dates

Study Major Dates

• Study Start (Actual): November 11, 2023
• Primary Completion (Estimated): June 1, 2024
• Study Completion (Estimated): July 1, 2024

Study Registration Dates

• First Submitted: July 11, 2023
• First Submitted That Met QC Criteria: July 11, 2023
• First Posted (Actual): July 18, 2023

Study Record Updates

• Last Update Posted (Estimated): November 21, 2023
• Last Update Submitted That Met QC Criteria: November 20, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Keywords: Shoulder pain; Shoulder impingement syndrome; Rock climbers; Thoracic mobility; Thoracic kinematics
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Wounds and Injuries; Joint Diseases; Musculoskeletal Diseases; Shoulder Injuries; Arthralgia; Shoulder Impingement Syndrome; Shoulder Pain
• Other Study ID Numbers: NYCU112095AE

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No