Excessive excitability of inhibitory cortical circuit and disturbance of ballistic targeting movement in degenerative cerebellar ataxia.

This study aimed to investigate abnormalities in inhibitory cortical excitability and motor control during ballistic-targeting movements in individuals with degenerative cerebellar ataxia (DCA). Sixteen participants took part in the study (DCA group [n = 8] and healthy group [n = 8]). The resting motor-threshold and cortical silent period (cSP) were measured in the right-hand muscle using transcranial magnetic stimulation over the left primary motor cortex. Moreover, the performance of the ballistic-targeting task with right wrist movements was measured. The Scale for the Assessment and Rating of Ataxia was used to evaluate the severity of ataxia. The results indicated that the cSP was significantly longer in participants with DCA compared to that in healthy controls. However, there was no correlation between cSP and severity of ataxia. Furthermore, cSP was linked to the ballistic-targeting task performance in healthy participants but not in participants with DCA. These findings suggest that there is excessive activity in the gamma-aminobutyric acid-mediated cortical inhibitory circuit in individuals with DCA. However, this increase in inhibitory activity not only fails to contribute to the control of ballistic-targeting movement but also shows no correlation with the severity of ataxia. These imply that increased excitability in inhibitory cortical circuits in the DCA may not contribute the motor control as much as it does in healthy older adults under limitations associated with a small sample size. The study's results contribute to our understanding of motor control abnormalities in people with DCA and provide potential evidence for further research in this area.

Impact of Repetitive Transcranial Magnetic Stimulation to the Cerebellum on Performance of a Ballistic Targeting Movement.

This study aimed to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) of the cerebellum on changes in motor performance during a series of repetitive ballistic-targeting tasks. Twenty-two healthy young adults (n = 12 in the active-rTMS group and n = 10 in the sham rTMS group) participated in this study. The participants sat on a chair in front of a monitor and fixed their right forearms to a manipulandum. They manipulated the handle with the flexion/extension of the wrist to move the bar on the monitor. Immediately after a beep sound was played, the participant moved the bar as quickly as possible to the target line. After the first 10 repetitions of the ballistic-targeting task, active or sham rTMS (1 Hz, 900 pulses) was applied to the right cerebellum. Subsequently, five sets of 100 repetitions of this task were conducted. Participants in the sham rTMS group showed improved reaction time, movement time, maximum velocity of movement, and targeting error after repetition. However, improvements were inhibited in the active-rTMS group. Low-frequency cerebellar rTMS may disrupt motor learning during repetitive ballistic-targeting tasks. This supports the hypothesis that the cerebellum contributes to motor learning and motor-error correction in ballistic-targeting movements.

Comparison of The Effect of High- and Low-Frequency Vibration Foam Rolling on The Quadriceps Muscle.

Vibration foam rolling (VFR) intervention has recently gained attention in sports and rehabilitation settings since the superimposed vibration with foam rolling can affect several physiological systems. However, the sustained effect and a comparison of the effects of different VFR vibration frequencies on flexibility and muscle strength have not been examined. Therefore, in this study, we aimed to investigate the acute and sustained effects of three 60-s sets of VFR with different frequencies on knee flexion range of motion (ROM) and muscle strength of the knee extensors. Using a crossover, random allocation design, 16 male university students (21.2 ± 0.6 years) performed under two conditions: VFR with low (35 Hz) and high (67 Hz) frequencies. The acute and sustained effects (20 min after intervention) of VFR on knee flexion ROM, maximum voluntary isometric contraction (MVC-ISO) torque, maximum voluntary concentric contraction (MVC-CON) torque, rate of force development (RFD), and single-leg countermovement jump (CMJ) height were examined. Our results showed that knee flexion ROM increased significantly (p < 0.01) immediately after the VFR intervention and remained elevated up to 20 min, regardless of the vibration frequency. MVC-ISO and MVC-CON torque both decreased significantly (p < 0.01) immediately after the VFR intervention and remained significantly lowered up to 20 min, regardless of the vibration frequency. However, there were no significant changes in RFD or CMJ height. Our results suggest that VFR can increase knee flexion ROM but induces a decrease in muscle strength up to 20 min after VFR at both high and low frequencies.

The Time-Course Changes in Knee Flexion Range of Motion, Muscle Strength, and Rate of Force Development After Static Stretching.

Previous studies have shown that longer-duration static stretching (SS) interventions can cause a decrease in muscle strength, especially explosive muscle strength. Furthermore, force steadiness is an important aspect of muscle force control, which should also be considered. However, the time course of the changes in these variables after an SS intervention remains unclear. Nevertheless, this information is essential for athletes and coaches to establish optimal warm-up routines. The aim of this study was to investigate the time course of changes in knee flexion range of motion (ROM), maximal voluntary isometric contraction (MVIC), rate of force development (RFD), and force steadiness (at 5 and 20% of MVIC) after three 60-s SS interventions. Study participants were sedentary healthy adult volunteers (n = 20) who performed three 60-s SS interventions of the knee extensors, where these variables were measured before and after SS intervention at three different periods, i.e., immediately after, 10 min, and 20 min the SS intervention (crossover design). The results showed an increase in ROM at all time points (d = 0.86-1.01). MVIC was decreased immediately after the SS intervention (d = -0.30), but MVIC showed a recovery trend for both 10 min (d = -0.17) and 20 min (d = -0.20) after the SS intervention. However, there were significant impairments in RFD at 100 m (p = 0.014, F = 6.37, ηp 2 = 0.101) and 200 m (p < 0.01, F = 28.0, ηp 2 = 0.33) up to 20 min after the SS intervention. Similarly, there were significant impairments in force steadiness of 5% (p < 0.01, F = 16.2, ηp 2 = 0.221) and 20% MVIC (p < 0.01, F = 16.0, ηp 2 = 0.219) at 20 min after the SS intervention. Therefore, it is concluded that three 60-s SS interventions could increase knee flexion ROM but impair explosive muscle strength and muscle control function until 20 min after the SS intervention.

Relationship between changes in passive properties and muscle strength after static stretching.

BACKGROUND: The association between decreased muscle strength of rate of force development (RFD) immediately after static stretching (SS) and change in muscle stiffness or muscle slack has remained unclear. OBJECTIVE: This study aimed to investigate the association between changes in muscle strength and RFD and muscle stiffness or muscle slack immediately after SS. METHODS: Sixteen healthy male non-athlete volunteers participated in this study. The maximal voluntary contraction torque and shear elastic modulus of medial gastrocnemius muscle were measured before and after 300 s of SS intervention. RESULTS: The results showed that maximal voluntary contraction torque and RFD at 100, 150, and 200 ms decreased significantly after the 300-s SS (p < 0.01). Additionally, shear elastic modulus at 0° (decrease in muscle stiffness) and slack angle decreased (increase in slack length) significantly after the 300-second SS (p < 0.01). However, no significant association was observed between changes in muscle strength and changes in mechanical properties of the MG. CONCLUSION: These results suggested that the decrease in muscle strength and RFD could not be associated with changes in the passive mechanical properties of the medial gastrocnemius muscle.

Association between the Range of Motion and Passive Property of the Gastrocnemius Muscle-Tendon Unit in Older Population.

Range of motion has been widely known to decrease with age; however, factors associated with its decrease in the elderly population and especially its gender difference have been unclear. Therefore, this study aimed to investigate the factors associated with ankle dorsiflexion range of motion in the older population. Both male (n = 17, mean ± SD; 70.5 ± 4.2 years; 165.4 ± 5.3 cm; 63.8 ± 7.7 kg) and female (n = 25, 74.0 ± 4.0 years; 151.2 ± 4.9 cm; 50.1 ± 5.6 kg) community-dwelling older adults participated in this study. The ankle dorsiflexion and passive torque of both legs were measured using a dynamometer, and shear elastic modulus of the medial gastrocnemius muscle at 0° ankle angle was measured using ultrasonic shear wave elastography. In this study, we defined the passive torque at dorsiflexion range of motion (DF ROM) as the index of stretch tolerance, and shear elastic modulus as the index of passive muscle stiffness. The partial correlation coefficient adjusted by age, height, weight, and side (dominant or nondominant side) was used to analyze the relationship between DF ROM and passive torque at DF ROM or shear elastic modulus of MG in each male and female participant, respectively. Our results revealed that dorsiflexion range of motion was significantly associated with passive torque at dorsiflexion range of motion in both male (r = 0.455, p = 0.012) and female (r = 0.486, p < 0.01), but not with shear elastic modulus in both male (r = -0.123, p = 0.519) and female (r = 0.019, p = 0.898). Our results suggested that the ankle dorsiflexion range of motion could be related to the stretch tolerance, but not to passive muscle stiffness in community-dwelling elderly population regardless of gender.

Immediate effects of stance and swing phase training on gait in patients with stroke.

To compare the effects of gait trainings targeting the stance (stance training) and the swing phases (swing training) among the subjects with stroke, and quantify the characteristics in the subjects who benefitted from either the stance training or the swing training. Sixteen subjects with stroke performed the stance training, which focused on the center of pressure to move from the heel to the forefoot, and the swing training, which focused on the improvement of hip flexion in the swing phase. To investigate the immediate effects of the stance training and the swing training, the instrumented gait analysis was performed before and after training. To quantify the characteristics, subjects were divided into two groups based on the gait speed change. These two groups were compared using clinical examinations. After the stance training, the center of pressure displacement of the paretic limb was increased compared with the swing training. Subjects who benefitted from the stance training had slower Timed Up and Go and weaker paretic hip muscle strength than those who benefitted from the swing training. Stance training may be more effective in subjects with slower Timed Up and Go outcomes and weaker hip muscles.

The Associations between Rapid Strength Development and Muscle Stiffness in Older Population.

BACKGROUND: Previous studies suggest that the capacity for rapid force production of ankle plantar flexors is essential for the prevention of falls in the elderly. In healthy young adults, there were significant associations between rate of force development and muscle stiffness measured by shear wave elastography. However, there has been no study investigating the association of rate of force development with shear elastic modulus in older adults. METHODS: The muscle strength and shear elastic modulus of the medial gastrocnemius muscle in both legs were measured in 17 elderly men and 10 elderly women (mean ± SD; 70.7 ± 4.1 years; 160.6 ± 8.0 cm; 58.7 ± 9.5 kg). We investigated the rate of force development of plantar flexors and shear elastic modulus of medial gastrocnemius muscle using by shear wave elastography. RESULTS: Our results showed that there were no significant associations between normalized rate of force development and shear elastic modulus of medial gastrocnemius muscle. CONCLUSION: This suggests that the capacity of rapid force production could be related not to muscle stiffness of the medial gastrocnemius muscle, but to neuromuscular function in older individuals.

The Relationship between Stretching Intensity and Changes in Passive Properties of Gastrocnemius Muscle-Tendon Unit after Static Stretching.

This study aimed to investigate the relationship between relative or absolute intensity and changes in range of motion and passive stiffness after static stretching. A total of 65 healthy young adults voluntarily participated in this study and performed static stretching of the plantar flexor-muscle for 120 s. Dorsiflexion range of motion and passive torque during passive dorsiflexion before and after stretching were assessed. We measured the passive torque at a given angle when the minimum angle was recorded before and after stretching. The angle during stretching was defined as the absolute intensity. Dorsiflexion range of motion before stretching was defined as 100%, and the ratio (%) of the angle during stretching was defined as the relative intensity. A significant correlation was found between absolute intensity and change in passive torque at a given angle (r = -0.342), but relative intensity and range of motion (r = 0.444) and passive torque at dorsiflexion range of motion (r = 0.259). A higher absolute intensity of stretching might be effective in changing the passive properties of the muscle-tendon unit. In contrast, a higher relative intensity might be effective in changing the range of motion, which could be contributed by stretch tolerance.

The effects of static stretching programs on muscle strength and muscle architecture of the medial gastrocnemius.

INTRODUCTION: Static stretching (SS) program are widely used in clinical and athletic settings. Many previous studies investigate the effect of SS program on muscle strength and muscle architecture (muscle thickness, and pennation angleh). However, no consensus has been reached about the effect of SS programs on muscle strength and muscle architecture. The aim of this study was to investigate the effects of 6-week SS programs performed at different weekly frequencies on muscle strength, muscle thickness and pennation angle at different ankle joint positions. METHODS: A total of 24 healthy male volunteers were performed 6-week SS programs (2,160 s of SS: 360 s/week*6 weeks) and were randomized to a group that performed SS once a week, or a group that performed SS three times per week. Total time under stretching was equated between groups. The muscle strength (maximum voluntary isometric contraction) at three different ankle joints were assessed before and after the 6-week SS program. In addition, muscle thickness and pennation angle were assessed by ultrasonography before and after 6-week SS program. RESULTS: There were no significant changes in all variables before and after the 6-week SS program, regardless of weekly frequency (p > 0.05). CONCLUSIONS: Our results suggest that 6-week SS programs do not increase muscle strength or muscle architecture at different ankle joint positions, regardless of stretching frequency; however, no negative effect on these outcomes was observed, contrary to evidence on the immediate, detrimental effects of SS.

Cerebellar Repetitive Transcranial Magnetic Stimulation and Noisy Galvanic Vestibular Stimulation Change Vestibulospinal Function.

BACKGROUND: The cerebellum strongly contributes to vestibulospinal function, and the modulation of vestibulospinal function is important for rehabilitation. As transcranial magnetic stimulation (TMS) and electrical stimulation may induce functional changes in neural systems, we investigated whether cerebellar repetitive TMS (crTMS) and noisy galvanic vestibular stimulation (nGVS) could modulate vestibulospinal response excitability. We also sought to determine whether crTMS could influence the effect of nGVS. METHODS: Fifty-nine healthy adults were recruited; 28 were randomly allocated to a real-crTMS group and 31 to a sham-crTMS group. The crTMS was conducted using 900 pulses at 1 Hz, while the participants were in a static position. After the crTMS, each participant was allocated to either a real-nGVS group or sham-nGVS group, and nGVS was delivered (15 min., 1 mA; 0.1-640 Hz) while patients were in a static position. The H-reflex ratio (with/without bilateral bipolar square wave pulse GVS), which reflects vestibulospinal excitability, was measured at pre-crTMS, post-crTMS, and post-nGVS. RESULTS: We found that crTMS alone and nGVS alone have no effect on H-reflex ratio but that the effect of nGVS was obtained after crTMS. CONCLUSION: crTMS and nGVS appear to act as neuromodulators of vestibulospinal function.

Effects of static stretching programs performed at different volume-equated weekly frequencies on passive properties of muscle-tendon unit.

Whether static stretching (SS) frequency has an effect on increasing the range of motion (ROM) and decreasing muscle stiffness remains unclear. Therefore, this study aimed to investigate the effects of two 6-week SS programs performed with different frequencies but generally the same duration of stretching on the passive properties of the medial gastrocnemius muscle-tendon unit. The study participants comprised 24 male volunteers randomly assigned to either the one-time/week group or the three-times/week group, performing 6 min of SS once per week and 2 min of SS thrice per week, respectively. The dorsiflexion ROM (DF ROM) and muscle stiffness of the medial gastrocnemius during passive ankle dorsiflexion were assessed using a dynamometer and ultrasonography before and after 6 weeks of SS programs. The results show that the DF ROM was increased and muscle stiffness was decreased significantly in the three-times/week group (P < 0.01 and P < 0.01, respectively), whereas no significant changes were observed in DF ROM and muscle stiffness in the one-time per week group (P = 0.25 and P = 0.32, respectively). These results suggest that a high-frequency SS program is more effective than a low-frequency SS program in increasing ROM and decreasing muscle stiffness.

Cerebellar Transcranial Magnetic Stimulation Reduces the Silent Period on Hand Muscle Electromyography During Force Control.

: This study aimed to investigate whether cerebellar transcranial magnetic stimulation (C-TMS) affected the cortical silent period (cSP) induced by TMS over the primary motor cortex (M1) and the effect of interstimulus interval (ISI) on cerebellar conditioning and TMS to the left M1 (M1-TMS). Fourteen healthy adult participants were instructed to control the abduction force of the right index finger to 20% of the maximum voluntary contraction. M1-TMS was delivered during this to induce cSP on electromyograph of the right first dorsal interosseous muscle. TMS over the right cerebellum (C-TMS) was conducted prior to M1-TMS. In the first experiment, M1-TMS intensity was set to 1 or 1.3 × resting motor threshold (rMT) with 20-ms ISI. In the second experiment, the intensity was set to 1 × rMT with ISI of 0, 10, 20, 30, 40, 50, 60, 70, or 80 ms, and no-C-TMS trials were inserted. In results, cSP was significantly shorter in 1 × rMT condition than in 1.3 × rMT by C-TMS, and cSP was significantly shorter for ISI of 20-40 ms than for the no-C-TMS condition. Further, motor evoked potential for ISI40-60 ms were significantly reduced than that for ISI0. Thus, C-TMS may reduce cSP induced by M1-TMS with ISI of 20-40 ms.

Gait kinematics and physical function that most affect intralimb coordination in patients with stroke.

BACKGROUND: Disturbed lower limb coordination is thought to limit gait ability in patients with stroke. However, the relationship of lower limb coordination with gait kinematics and physical function has not yet been clarified. OBJECTIVE: The purpose of the study was to clarify the gait kinematic and physical function variables that most affect intralimb coordination by using the continuous relative phase (CRP) between the thigh and shank. METHODS: Fifteen participants with stroke were enrolled in this study. Kinematic and kinetic measurements were recorded during gait at preferred speeds. CRP was defined as the difference between the thigh and shank phase angles. RESULTS: Stepwise analysis revealed that non-paretic CRP during the propulsive phase was a determinant of gait speed. The paretic knee extension and flexion angles were determinants of the CRP during the propulsive phase in the non-paretic limb. Stepwise analysis showed that the paretic knee extension angle was a determinant of the CRP during the propulsive phase in the paretic limb. Stepwise analysis revealed that the paretic knee extensor muscle strength was a determinant of the CRP during the propulsive phase in both limbs. CONCLUSIONS: Our study indicates that improvement in knee movement during the stance phase may improve coordination.

Relationship between scapular initial position and scapular movement during dynamic motions.

Optimal scapular position and movement are necessary for normal function of the shoulder joint and it is essential to focus on scapula in the rehabilitation for shoulder disorders. The aim of this study was to discover the relationship between the scapular initial position and scapular movement during dynamic motions in healthy young men. Thirty-four men participated in this study. The scapular angles at initial position and in elevation and lowering during flexion and abduction were measured using an electromagnetic tracking device. The scapular movements from 30° to 120° during flexion and abduction were calculated. Spearman's rank correlation coefficients were used to analyze the relationship between the scapular initial position and scapular movements. For upward rotation and posterior tilt of the scapula, there were significant positive correlations between the scapular initial position and scapular movement during flexion and abduction. For internal rotation, there were significant positive correlations, except 90° in lowering phase and 120° in both phases. While the humeral elevation increased, the correlation coefficients tended to decrease. Except for the internal rotation our results clarified the interactions between the scapular initial position and scapular movement during dynamic motions in healthy young men. The tendency of the decrease in correlation coefficient with elevation angle was shown.

Cerebellum-mediated trainability of eye and head movements for dynamic gazing.

OBJECTIVE: To investigate whether gaze stabilization exercises (GSEs) improve eye and head movements and whether low-frequency cerebellar repetitive transcranial magnetic stimulation (rTMS) inhibits GSE trainability. METHODS: 25 healthy adults (real rTMS, n = 12; sham rTMS, n = 13) were recruited. Real or sham rTMS was performed for 15 min (1 Hz, 900 stimulations). The center of the butterfly coil was set 1 cm below the inion in the real rTMS. Following stimulation, 10 trials of 1 min of a GSE were conducted at 1 min intervals. In the GSE, the subjects were instructed to stand upright and horizontally rotate their heads according to a beeping sound corresponding to 2 Hz and with a gaze point ahead of them. Electrooculograms were used to estimate the horizontal gaze direction of the right eye, and gyroscopic measurements were performed to estimate the horizontal head angular velocity during the GSE trials. The percentage change from the first trial of motion range of the eye and head was calculated for each measurement. The percent change of the eye/head range ratio was calculated to assess the synchronous changes of the eye and head movements as the exercise increased. RESULTS: Bayesian two-way analysis of variance showed that cerebellar rTMS affected the eye motion range and eye/head range ratio. A post hoc comparison (Bayesian t-test) showed evidence that the eye motion range and eye/head range ratio were reduced in the fifth, sixth, and seventh trials compared with the first trial sham stimulation condition. CONCLUSIONS: GSEs can modulate eye movements with respect to head movements, and the cerebellum may be associated with eye-head coordination trainability for dynamic gazing during head movements.

Electrical Stimulation to the Infraspinatus on Hypertrophy and Strength of the Shoulder.

The purpose of this study was to determine the effects of six weeks of electrical muscle stimulation (EMS) on the strength and muscle mass of the infraspinatus muscle. Twenty non-athletes (age: 24±3.4 years, height: 171.5±5.6 cm, mass: 65.2±8.1 kg) were randomly classified into two groups, an electrical muscle stimulation group (EMS group) and a control group (CON group). The EMS group completed a total of 18 20- min EMS sessions, three times per week over a period of six weeks, while the CON group received no intervention. The muscle thicknesses of both the infraspinatus and the deltoid muscles, the cross-sectional area (CSA) of the whole infraspinatus muscle, and the isometric and isokinetic peak torques of shoulder external rotations were measured before and after intervention. It was found that the muscle thickness of the superior infraspinatus (Pre 0.92±0.19 cm2, Post 0.99±0.16 cm2, p=0.02) and the CSA (Pre 10.99±1.32 cm2, Post 11.99±1.02 cm2, p=0.03) significantly increased in the EMS group. This study demonstrated that EMS of the infraspinatus muscle over a period of six weeks resulted in hypertrophy of the infraspinatus muscle.

Effective stretching position for the supraspinatus muscle evaluated by shear wave elastography in vivo.

BACKGROUND: Stretching is useful for increasing flexibility in clinical and athletic situations. Although several authors have recommended various stretching techniques for the supraspinatus muscle, there is no consensus on the effective stretching position owing to a lack of quantitative analysis in vivo. This study used ultrasonic shear wave elastography in vivo to verify the effective stretching positions for the supraspinatus muscle. METHODS: The study participants were 15 healthy male volunteers. The shear elastic modulus, used as the index of supraspinatus muscle elongation, was computed using ultrasonic shear wave elastography. The shear elastic modulus was measured at neutral position and maximum internal rotation in 9 positions: 0° elevation, 90° abduction, 90° flexion, maximum extension, maximum horizontal adduction at 45° and 90° elevation, and maximum horizontal abduction at 20°, 45°, and 90° elevation. RESULTS: The shear elastic moduli were significantly greater in maximum internal rotation at maximum horizontal abduction with 45° and 90° elevation and maximum internal rotation at maximum extension than those in the other positions. There were no significant differences in the shear elastic moduli among these 3 positions. CONCLUSIONS: This study demonstrated that maximum internal rotation at maximum extension, maximum internal rotation at maximum horizontal abduction with 90° elevation, and maximum internal rotation at maximum horizontal abduction with 45° elevation are effective stretching positions for the supraspinatus muscle.

Scapular kinematic alterations during arm elevation with decrease in pectoralis minor stiffness after stretching in healthy individuals.

BACKGROUND: Pectoralis minor tightness may be seen in individuals with scapular dyskinesis, and stretching is used for the treatment of altered scapular motion in sports and clinical fields. However, few researchers have reported on the effects of pectoralis minor stiffness on scapular motion during arm elevation. This study investigated whether an acute decrease of pectoralis minor stiffness after stretching changes the scapular motion during arm elevation. METHODS: The study allocated 15 dominant and 15 nondominant upper limbs in healthy men as control and interventional limbs, respectively. In the intervention limb group, the shoulder was passively and horizontally abducted at 150° of elevation for 5 minutes to stretch the pectoralis minor muscle. Before and after stretching, an electromagnetic sensor was used to examine 3-dimensional scapular motion during abduction and scaption. Ultrasonic shear wave elastography was used to measure pectoralis minor stiffness before and immediately after stretching and after arm elevation. RESULTS: In the interventional limb, pectoralis minor stiffness decreased by 3.2 kPa immediately after stretching and by 2.5 kPa after arm elevation. The maximal changes in scapular kinematics after stretching were 4.8° of external rotation and 3.3° of posterior tilt in abduction, and 4.5° of external rotation and 3.7° of posterior tilt in scaption. Upward rotation in abduction or scaption did not change. CONCLUSIONS: Stretching for the pectoralis minor muscle increases external rotation and posterior tilt of the scapula during arm elevation.

Scapular kinematic and shoulder muscle activity alterations after serratus anterior muscle fatigue.

BACKGROUND: Although the serratus anterior muscle has an important role in scapular movement, no study to date has investigated the effect of serratus anterior fatigue on scapular kinematics and shoulder muscle activity. The purpose of this study was to clarify the effect of serratus anterior fatigue on scapular movement and shoulder muscle activity. METHODS: The study participants were 16 healthy men. Electrical muscle stimulation was used to fatigue the serratus anterior muscle. Shoulder muscle strength and endurance, scapular movement, and muscle activity were measured before and after the fatigue task. The muscle activity of the serratus anterior, upper and lower trapezius, anterior and middle deltoid, and infraspinatus muscles was recorded, and the median power frequency of these muscles was calculated to examine the degree of muscle fatigue. RESULTS: The muscle endurance and median power frequency of the serratus anterior muscle decreased after the fatigue tasks, whereas the muscle activities of the serratus anterior, upper trapezius, and infraspinatus muscles increased. External rotation of the scapula at the shoulder elevated position increased after the fatigue task. CONCLUSION: Selective serratus anterior fatigue due to electric muscle stimulation decreased the serratus anterior endurance at the flexed shoulder position. Furthermore, the muscle activities of the serratus anterior, upper trapezius, and infraspinatus increased and the scapular external rotation was greater after serratus anterior fatigue. These results suggest that the rotator cuff and scapular muscle compensated to avoid the increase in internal rotation of the scapula caused by the dysfunction of the serratus anterior muscle.