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ISSN : 2092-8475(Print)
ISSN : 2714-0148(Online)
Journal of International Academy of Physical Therapy Research Vol.16 No.4 pp.3684-3693
DOI : https://doi.org/10.20540/JIAPTR.2025.16.4.3684

Effects of Pressure Biofeedback on Shoulder Muscle Activation During External Rotation Exercise

Chihwan Kim, PT, Prof., PhDa, Soohan Kim, PT, Prof., PhDa
aDepartment of Physical Therapy, Kaya University, Gimhae, Republic of Korea

Abstract

Background: Pressure biofeedback may facilitate selective rotator cuff activation during shoulder external rotation, but training effects and structural changes are unclear.
Objectives: To examine the effects of a 4-week external rotation program with pressure biofeedback on shoulder muscle activity and rotator cuff thickness.
Design: Quasi-experimental design. Methods: Thirty healthy adults were randomized to experimental (n=15) or control (n=15). Both performed seated external rotation at 30° with an elastic band (3×12 reps, 4 sessions/week, 4-week); the biofeedback group maintained 40 mmHg scapular adduction pressure. Surface EMG (%MVIC) and ultrasound muscle thickness were assessed pre/post. Paired and independent t-tests were used (α=.05).
Results: In the experimental group, teres minor and infraspinatus activity increased, whereas middle and posterior deltoid activity decreased (P<.05). Post-intervention, rotator cuff activity was higher and posterior deltoid activity was lower versus control (P<.05). Muscle thickness showed no significant changes.
Conclusions: A 4-week pressure biofeedback training program changed muscle activation during shoulder external rotation by increasing rotator cuff activation and decreasing compensatory deltoid activity. These findings indicate meaningful neuromuscular adaptations during the external rotation task.

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