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Effect of Resistance Training Maintaining the Joint Angle-torque Profile Using a Haptic-based Machine on Shoulder Internal and External Rotation.
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PMID:  24764626     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
[Purpose] The aim of this study was to present an individualized resistance training method to enable exercise while maintaining an exercise load that is set according to an individual's joint angle-torque using a haptic-based resistance training machine. [Methods] Five participants (machine group) performed individualized shoulder internal and external rotation training with a haptic resistance training machine, while another five participants performed general dumbbell-based shoulder internal and external rotation training for eight weeks. Internal and external rotation powers of subjects were measured using an isokinetic machine before and after training. [Results] The average powers of both shoulder internal and external rotation has been improved after training (25.72%, 13.62%). The improvement in power of external rotation in the machine group was significantly higher than that in the control group. [Conclusion] This study proposes a haptic-based individualized rotator cuff muscle training method. The training protocol maintaining the joint angle-torque profile showed better improvement of shoulder internal/external rotation than dumbbell training.
Authors:
Yeonghun Kim; Kunwoo Lee; Jeheon Moon; Dohoon Koo; Jaewoo Park; Kyengnam Kim; Daehie Hong; Inshik Shin
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Publication Detail:
Type:  Journal Article     Date:  2014-04-23
Journal Detail:
Title:  Journal of physical therapy science     Volume:  26     ISSN:  0915-5287     ISO Abbreviation:  J Phys Ther Sci     Publication Date:  2014 Apr 
Date Detail:
Created Date:  2014-04-25     Completed Date:  2014-04-25     Revised Date:  2014-04-28    
Medline Journal Info:
Nlm Unique ID:  9105359     Medline TA:  J Phys Ther Sci     Country:  Japan    
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Languages:  eng     Pagination:  525-8     Citation Subset:  -    
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Journal Information
Journal ID (nlm-ta): J Phys Ther Sci
Journal ID (iso-abbrev): J Phys Ther Sci
Journal ID (publisher-id): JPTS
ISSN: 0915-5287
ISSN: 2187-5626
Publisher: The Society of Physical Therapy Science
Article Information
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2014©by the Society of Physical Therapy Science
open-access:
Received Day: 20 Month: 9 Year: 2013
Accepted Day: 30 Month: 10 Year: 2013
Electronic publication date: Day: 23 Month: 4 Year: 2014
Print publication date: Month: 4 Year: 2014
Volume: 26 Issue: 4
First Page: 525 Last Page: 528
PubMed Id: 24764626
ID: 3996414
Publisher Id: jpts-2013-438
DOI: 10.1589/jpts.26.525

Effect of Resistance Training Maintaining the Joint Angle-torque Profile Using a Haptic-based Machine on Shoulder Internal and External Rotation
Yeonghun Kim1*
Kunwoo Lee1
Jeheon Moon2
Dohoon Koo23
Jaewoo Park4
Kyengnam Kim4
Daehie Hong4
Inshik Shin2
1) Human Centered CAD Laboratory, School of Mechanical and Aerospace Engineering, Seoul National University, Republic of Korea
2) Biomechanics Laboratory, Department of Physical Education, Seoul National University, Republic of Korea
3) Korea National Rehabilitation Center Research Institute, Department of Rehabilitation and Assistive Technology, Republic of Korea
4) Mechatronics and Field Robotics Laboratory, Department of Mechanical Engineering, Korea University, Republic of Korea
*Corresponding author. Yeonghun Kim, Human Centered CAD Laboratory, School of Mechanical and Aerospace Engineering, Seoul National University: 301-dong 209-ho, 1 Gwanak-ro, Gwanak-gu, Seoul 151-744, Republic of Korea. (E-mail: toya84@snu.ac.kr)

INTRODUCTION

Rotator cuff diseases are some of the most common musculoskeletal diseases among adults, occurring frequently in both the young and the old1). There are various causes and symptoms of rotator cuff diseases, and it is important to implement treatments appropriate for each case. As one ages and the rotator cuff weakens or tears, it becomes harder to prevent rotator cuff diseases from occurring2). However, various studies have proposed methods to prevent these symptoms through rotator cuff muscle training exercises3,4,5,6).

The patterns of maximum torque and muscle activity for a given joint angle and velocity are different for each person. Existing resistance training machines assume the general hill type muscle model to produce a cam shape that keeps muscle activation consistent during the exercise process and appropriate for these patterns. However, there is a limit to maintaining the muscle activity using a cam shape7). West et al. and Carignan et al. proposed a training machine that enables exercise that satisfies the individual user’s patterns of joint torque and muscle activation using a haptic device8, 9). When a haptic device is used, the individual user’s patterns can be measured and registered using a force sensor, and the exercise load can be adjusted to maintain the muscle activity at a steady level throughout the exercise process. In fields such as rehabilitation, in which exercise customized to the individual user is especially effective, various uses of exercise machines using haptic devices have been attempted10).

Because it is hard to effectively train the target muscles in a proper posture using dumbbells unless the user is experienced in performing resistance training with them, training using machines is advantageous for beginners. Shoulder joint rotator cuff training exercise is necessary for athletes who actively use their rotator cuffs, such as professional golfers, but it is also necessary for the middle-aged and older populations who suffer from diseases such as frozen shoulder or who want to prevent such diseases. It is difficult for this population to maintain a correct posture during rotator cuff exercises using dumbbells or cables without some help of an assistant. However, except for expensive isokinetic machines, resistance training machines for rotator cuff exercise that are not easily accessible at general fitness centers. Even the rotator cuff training exercises suggested by past studies include many routines that use dumbbells or a resistance band or cable3). The present study proposed an individualized resistance training method to enable exercise while maintaining a workload that is set according to an individual’s joint angle-torque using a haptic-based resistance training machine.


SUBJECTS AND METHODS

This study was used to develop a haptic-based resistance training machine that enables exercise using a 2-D arbitrary path and then used the machine for rotator cuff muscle training. Figure 1 shows the haptic-based resistance training machine and controlling software11). Haptic-based resistance training machines enable exercise and measurement of 2-D force using two electric motors and a force sensor, and can apply resistance in an arbitrary 2-D direction. This makes it possible to measure and record an individual user’s exercise trajectory and force profile, and to apply a dynamic exercise load according to a predefined exercise trajectory (PDET) and location appropriate for each user by position-based impedance control11). By using this haptic-based resistance training machine, the user can exercise with a subject-specific dynamic exercise load.

The experiment was conducted on ten subjects to verify the effects of exercise using the haptic-based resistance training machine for rotator cuff muscle training. The recruited subjects were Korean males in their twenties who had no history of shoulder injury and who had no professional experience in weight training in the year before the experiment (24.9±1.7 ages, 174.4±4.6 cm, 67.3±8.5 kg). Before the start of the experiment, the subjects were given a full explanation of the purpose and experimental procedure, and signed Institutional Review Board consent forms to comply with the ethical standards of the Declaration of Helsinki (1975, revised 1983). They were not allowed any exercise that could affect the rotator cuff during the training period (e.g., tennis, baseball, golf). Subjects were placed in two groups at random. The machine group consisted of five subjects who performed rotator cuff training exercises using the haptic-based resistance training machine developed in this study, and the control group consisted of five subjects who performed standard rotator cuff training exercises using dumbbells.

Before starting training, each subject’s 1 repetition maximums (1 RMs) of internal rotation and external rotation were measured. For both groups, 1 RM was measured using dumbbells. In the case of the control group, 20 RM, which was calculated based on 1 RM, was set as the load for the training12, 13). In the case of the machine group, an individual’s exercise trajectory and force-velocity-angle curve were determined in an isokinetic manner using the haptic device, and was then applied to the haptic-based training machine to set the load pattern for training. The training load pattern for each subject was set to 20 RM by scaling down the angle-force profile.

Training was conducted over an eight-week period, and each exercise session lasted about one hour and was performed twice per week. The machine group anchored their upper arm to the support of the haptic device while sitting in a chair, as shown in Fig. 2, and executed internal and external rotation motions. A pair of internal rotation and external rotation motions was counted as one repetition, and five sets of twenty repetitions were executed. The control group executed internal and external rotation motions using dumbbells while lying on their sides, as shown in Fig. 3. Five sets of twenty repetitions each of internal and external rotations were executed.

To evaluate the exercise performance of the shoulder joint rotator cuff before and after training, the average powers of the shoulder internal and external rotation motions were measured with a Biodex System 3 isokinetic dynamometer (Biodex Medical Systems, Shirley, New York, USA) on a scapular plane14,15,16,17,18). The one-way ANOVA test was used to compare average power progresses between the two groups.


RESULTS

The average powers of shoulder internal and external rotation were increased after eight weeks training for both groups. Tables 1 and 2 show the results of training. In the machine group, the mean average power of external rotation increased 25.7% and mean average power of internal rotation increased 13.6%. In the control group, the mean average power of external rotation increased 8.77%, while that of internal rotation increased 7.84% In the case of external rotation, there were significant differences in mean average power progress between the two groups (p<0.05), while that of internal rotation did not show any significant difference.


DISCUSSION

Comparison of the average power before and after training indicates that shoulder external rotation training using the haptic-based resistance training machine has a larger impact than conventional training using dumbbells In the case of internal rotation, however, haptic-based training and dumbbell-based training show similar progresses on average power. The differences in average power progress of external rotation between the groups are due to the difference in the joint angle-torque profiles when engaged in exercise using dumbbells as opposed to exercise using haptic-based resistance training. Each subject’s joint angle-torque profile was measured as shown in Fig. 2, and the resistance of the haptic device was determined based on this measurement. In contrast, in the case of the control group, the exercise load was determined by the weight of the dumbbell and the influence of gravity for each joint angle as shown in Fig. 3. In the case of internal rotation, there was no substantial difference in the impact of the training sessions because the joint angle-force profiles for the machine group and control group showed similar tendencies. However, in the case of external rotation, the profiles exhibited opposite tendencies, as shown in Fig. 3, and this was consistent with the finding that the machine group showed a greater improvement in exercise performance by maintaining consistent muscle activation throughout the exercise. Many previous studies mentioned the effectiveness of a training load considering the joint angle-torque relationship in elbow or knee joint exercises7, 11, 19).

There were some limitations of this study. The number of subjects was limited, because we had only one haptic device and only one subject could use the device at a time. To clarify the effects of haptic resistance training, studies with more subjects using haptic devices will be needed in the future. This study focuses on the effect of resistance training in the beginners; however, the results cannot be applied to older people who need to train rotator cuff muscles, because the subjects who participated in this study were young, with the mean age being only 24.9.

This study proposes a rotator cuff muscle training exercise using a haptic-based resistance training machine. In the case of existing rotator cuff training exercises using dumbbells, cables, or rubber bands, it is difficult for beginners or older subjects to effectively train the target muscles because it is difficult to assume the appropriate postures without assistance. In the case of the haptic-based resistance training, every subject could effectively train in a stable posture without assistance, as the machine guides the exercise trajectory and direction of the force. Furthermore, the impact of exercise can be expected to be the same as, or greater than, that of the standard rotator cuff training exercise because the muscle activation levels are kept relatively consistent during the exercise process.


This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (MSIP) (No. 2007-0056094).


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Figures

[Figure ID: fig_001]
Fig. 1. 

Haptic-based resistance training machine and the controlling and measurement software



[Figure ID: fig_002]
Fig. 2. 

External/internal rotation exercise using a haptic-based resistance training machine (upper) and force profiles of external/internal rotation measured by a haptic-based resistance training machine (lower)



[Figure ID: fig_003]
Fig. 3. 

External (left)/ internal (right) rotation exercise using dumbbells (upper) and force profiles with respect to shoulder rotation angle (lower)



Tables
[TableWrap ID: tbl_001] Table 1. Summary of the progress in average power of external rotation
External rotation

Average power (watts)

Pre Post Progress %
Sub1 16.4 19.4 18.29
Sub2 14.3 17.8 24.48
Sub3 16.7 19 13.77
Sub4 15.2 22.8 50.00
Sub5 15.4 18.8 22.08
Sub6* 18.4 20.2 9.78
Sub7* 12.2 14.3 17.21
Sub8* 13.7 15.1 10.22
Sub9* 12.3 12.8 4.07
Sub10* 19.3 19.8 2.59
Progress of average power of machine group % (SD) 25.72 (14.16)

Progress of average power of control group % (SD) 8.77 (5.80)

* Control group


[TableWrap ID: tbl_002] Table 2. Summary of progress in average power of internal rotation of internal rotation
Internal rotation

Average power (watts)

Pre Post Progress %
Sub1 31.2 35.2 12.82
Sub2 25.9 26.5 2.32
Sub3 28.9 32.9 13.84
Sub4 29.8 40.5 35.91
Sub5 34 35.1 3.24
Sub6* 38.2 40.2 5.24
Sub7* 27.6 28.7 3.99
Sub8* 25.9 30.3 16.99
Sub9* 22.8 25.1 10.09
Sub10* 34.4 35.4 2.91
Progress of average power of machine group % (SD) 13.62 (13.53)

Progress of average power of control group % (SD) 7.84 (5.80)

* Control group



Article Categories:
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Keywords: Key words Rotator cuff, Haptic machine.

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