Healthy VolunteersBSR-SERNCT07000773
Trapezius Muscle Activation During Bilateral Scapular Retraction and Shoulder External Rotation Under Kinetic Chain and Unstable Surface Conditions
A study testing Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise in people with Healthy Volunteers, run by Recep Tayyip Erdogan University at 1 site in Turkey (Türkiye).
Trial summary
This study aims to investigate the effects of performing the Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise under kinetic chain involvement and unstable surface conditions on trapezius muscle activation. Read more about this study
- Who is it for?
- Ages 18 to 35 yearsHealthy volunteers can take part
- Conditions the study is for
- Healthy Volunteers
- What is being tested?
- Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 20 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Apr 2022to 1 Jan 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 35 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Age between 18 and 35 years
- Body Mass Index (BMI) less than 30 kg/m²
Who cannot join
- Engaging in more than 6 hours per week of overhead sports or upper extremity strength training
- History of surgery in the spine, lower extremities, or upper extremities
- Experiencing pain in these regions within the past 6 weeks
- Having a rheumatologic, systemic, or metabolic disease
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Trapezius Activation During Bilateral Scapular Retraction With Shoulder External Rotation: The Incorporation of Knetic Chain and Unstable Surface
This study aims to investigate the effects of performing the Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise under kinetic chain involvement and unstable surface conditions on trapezius muscle activation. Surface electromyography (EMG) will be used to assess the activity levels of the upper, middle, and lower trapezius muscles. The goal is to determine whether integrating kinetic chain elements and instability can optimize muscle activation patterns in healthy individuals during a commonly used scapular rehabilitation exercise.
Read the detailed description
Maintaining muscular balance among the scapular stabilizers is crucial for optimal shoulder function. The Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise is frequently used in clinical rehabilitation to activate the lower trapezius while minimizing upper trapezius activity. Although this exercise is widely practiced, the effects of performing it under kinetic chain conditions (such as squat and lunge positions) and on an unstable surface have not been thoroughly explored.
This study will examine how adding kinetic chain involvement and instability influences the electromyographic activity of the upper trapezius (UT), middle trapezius (MT), and lower trapezius (LT) muscles during the BSR-SER exercise. Twenty healthy participants will perform the exercise in various lower extremity positions (standing, squat, lunge) and on both stable and unstable surfaces using a BOSU® ball. EMG data will be collected using a wireless surface EMG system and analyzed in terms of percentage of maximal voluntary isometric contraction (%MVIC).
The results of this study may provide valuable insights into the optimization of scapular stabilization exercises and guide clinicians in designing more effective shoulder rehabilitation programs by incorporating kinetic chain principles and unstable surfaces.
- Conditions
- Healthy Volunteers
- Being tested
- Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise
- Keywords
- scapular muscle activation, Electromyography, Kinetic Chain, Scapular Retraction, Trapezius, Unstable Surface
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) ExerciseBehavioural
Participants perform the Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise using a resistance band. The exercise is conducted under various conditions including stable and unstable surfaces (using BOSU® balance trainer) and in three different lower limb positions: standing, lunge, and squat. Each condition is randomized, and participants complete all conditions in a crossover design. The intervention aims to evaluate trapezius muscle activation patterns during these exercises using surface electromyography (EMG).
| Study group | Role | What they receive |
|---|---|---|
| Standing on Stable Surface | Experimental | Participants perform the bilateral scapular retraction with shoulder external rotation (BSR-SER) exercise in a standing position on a stable surface using resistance bands. Receives: Behavioral: Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise |
| Standing on Unstable Surface | Experimental | Participants perform the BSR-SER exercise in a standing position on an unstable surface (BOSU®) using resistance bands. Receives: Behavioral: Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise |
| Lunge Position on Stable Surface | Experimental | Participants perform the BSR-SER exercise in a lunge position on a stable surface using resistance bands. Knee and trunk angles are standardized. Receives: Behavioral: Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise |
| Lunge Position on Unstable Surface | Experimental | Participants perform the BSR-SER exercise in a lunge position on an unstable surface (BOSU®) using resistance bands. Knee and trunk angles are standardized. Receives: Behavioral: Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise |
| Squat Position on Stable Surface | Experimental | Participants perform the BSR-SER exercise in a squat position on a stable surface using resistance bands. Knee and trunk angles are standardized. Receives: Behavioral: Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise |
| Squat Position on Unstable Surface | Experimental | Participants perform the BSR-SER exercise in a squat position on an unstable surface (BOSU®) using resistance bands. Knee and trunk angles are standardized. Receives: Behavioral: Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise |
What is being measured
The primary outcome is the main question the study is designed to answer.
Upper Trapezius Muscle Activation
Surface electromyography (EMG) will measure the muscle activation level of the upper trapezius during the stationary phase of the BSR-SER exercise under various conditions. The activation will be normalized as a percentage of maximal voluntary isometric contraction (%MVIC).
Measured: Day 1 (during the exercise session)
Middle Trapezius Muscle Activation
Surface EMG will measure the muscle activation level of the middle trapezius muscle during the stationary phase of the BSR-SER exercise under different surface and lower limb position conditions. Activation levels will be expressed as %MVIC.
Measured: Day 1 (during the exercise session)
Lower Trapezius Muscle Activation
Surface EMG will measure the muscle activation of the lower trapezius during the stationary phase of the BSR-SER exercise. Muscle activity will be normalized to %MVIC.
Measured: Day 1 (during the exercise session)
Muscle Activation Ratios
Ratios of muscle activation between the upper, middle, and lower trapezius muscles will be calculated to assess balance of muscle recruitment during exercise.
Measured: Day 1 (during the exercise session)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Jun 2025
- Study start1 Apr 2022
- Primary completion1 Jun 2022
- Study completion1 Jan 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (8)Papers the sponsor has linked to this study.
- Other trials for Healthy VolunteersStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Crossover
- Model description
- This is a randomized crossover study where each participant performs the Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise under multiple conditions. The exercise is performed on both stable and unstable surfaces and in different lower extremity positions (standing, lunge, and squat). Each participant acts as their own control by completing all exercise conditions in a randomized order. Electromyographic (EMG) activity of the trapezius muscles is measured during each condition to assess muscle activation patterns.
- Masking
- None (open label)
- Enrolment
- 20 participants (actual)
Sponsor and investigators
- Lead sponsor
- Recep Tayyip Erdogan University
- Sponsor type
- University, hospital or other
- Collaborators
- Gazi University
- Responsible party
- Principal investigator, Gamze Çobanoğlu Demirkan, Recep Tayyip Erdogan University
- Investigators
- Gamze Cobanoglu Demirkan, PhD, Principal investigator, Gazi University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07000773
- Sponsor's protocol ID
- Gazi-BSR-SER
- Acronym
- BSR-SER
- Status last verified
- Jun 2025
- First submitted
- 22 May 2025
- Last updated
- 3 Jun 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Colado JC, Garcia-Masso X, Triplett NT, Calatayud J, Flandez J, Behm D, Rogers ME. Construct and concurrent validation of a new resistance intensity scale for exercise with thera-band(R) elastic bands. J Sports Sci Med. 2014 Dec 1;13(4):758-66. eCollection 2014 Dec.
PubMed 25435767Ecemis ZB, Cobanoglu G, Oksuz BS, Kaya B, Guzel NA, Kafa B, Kafa N. Trapezius Muscle Electromyographic Activity in Lawn-Mower Exercise: Standing Versus Quadruped. J Sport Rehabil. 2024 Dec 10;34(4):436-442. doi: 10.1123/jsr.2023-0404. Print 2025 May 1.
PubMed 39657698Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol. 2000 Oct;10(5):361-74. doi: 10.1016/s1050-6411(00)00027-4.
PubMed 11018445Cobanoglu G, Guzel NA, Ecemis ZB, Demirkan MY. Investigation of muscle activation during kinetic chain based exercises in individuals with and without forward head posture. J Back Musculoskelet Rehabil. 2024;37(6):1537-1549. doi: 10.3233/BMR-230397.
PubMed 38968043Kara D, Harput G, Duzgun I. Trapezius muscle activation levels and ratios during scapular retraction exercises: A comparative study between patients with subacromial impingement syndrome and healthy controls. Clin Biomech (Bristol). 2019 Jul;67:119-126. doi: 10.1016/j.clinbiomech.2019.05.020. Epub 2019 May 11.
PubMed 31103961Melo ASC, Vilas-Boas JP, Cruz EB, Macedo RM, E Ferreira SB, Sousa AS. The influence of shoulder position during multi-joint exercises in the relative scapular muscles activity in symptomatic and asymptomatic conditions. J Back Musculoskelet Rehabil. 2023;36(4):883-893. doi: 10.3233/BMR-220056.
PubMed 36776036Uysal O, Akoglu AS, Kara D, Sezik AC, Calik M, Duzgun I. Theraband Applications for Improved Upper Extremity Wall-Slide Exercises. J Athl Train. 2022 Aug 1;57(8):795-803. doi: 10.4085/1062-6050-0305.21.
PubMed 36356616Mendez-Rebolledo G, Morales-Verdugo J, Orozco-Chavez I, Habechian FAP, Padilla EL, de la Rosa FJB. Optimal activation ratio of the scapular muscles in closed kinetic chain shoulder exercises: A systematic review. J Back Musculoskelet Rehabil. 2021;34(1):3-16. doi: 10.3233/BMR-191771.
PubMed 32831190
Study at a glance
From the registry record, last updated by the sponsor on 3 Jun 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Trapezius Activation During Bilateral Scapular Retraction With Shoulder External Rotation: The Incorporation of Knetic Chain and Unstable Surface
- ClinicalTrials.gov ID
- NCT07000773
- Acronym / sponsor ID
- BSR-SER / Gazi-BSR-SER
- Conditions
- Healthy Volunteers
- Keywords
- scapular muscle activation, Electromyography, Kinetic Chain, Scapular Retraction, Trapezius, Unstable Surface
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 20 participants (actual)
- Lead sponsor
- Recep Tayyip Erdogan UniversityUniversity, hospital or other
- Collaborators
- Gazi University
- Study start
- 1 Apr 2022 (actual)
- Primary completion
- 1 Jun 2022 (actual)
- Study completion
- 1 Jan 2024 (actual)
- First posted
- 3 Jun 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to investigate the effects of performing the Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise under kinetic chain involvement and unstable surface conditions on trapezius muscle activation. Surface electromyography (EMG) will be used to assess the activity levels of the upper, middle, and lower trapezius muscles. The goal is to determine whether integrating kinetic chain elements and instability can optimize muscle activation patterns in healthy individuals during a commonly used scapular rehabilitation exercise.
Detailed description
Maintaining muscular balance among the scapular stabilizers is crucial for optimal shoulder function. The Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise is frequently used in clinical rehabilitation to activate the lower trapezius while minimizing upper trapezius activity. Although this exercise is widely practiced, the effects of performing it under kinetic chain conditions (such as squat and lunge positions) and on an unstable surface have not been thoroughly explored.
This study will examine how adding kinetic chain involvement and instability influences the electromyographic activity of the upper trapezius (UT), middle trapezius (MT), and lower trapezius (LT) muscles during the BSR-SER exercise. Twenty healthy participants will perform the exercise in various lower extremity positions (standing, squat, lunge) and on both stable and unstable surfaces using a BOSU® ball. EMG data will be collected using a wireless surface EMG system and analyzed in terms of percentage of maximal voluntary isometric contraction (%MVIC).
The results of this study may provide valuable insights into the optimization of scapular stabilization exercises and guide clinicians in designing more effective shoulder rehabilitation programs by incorporating kinetic chain principles and unstable surfaces.
Study design
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Number of arms
- 6
- Model description
- This is a randomized crossover study where each participant performs the Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise under multiple conditions. The exercise is performed on both stable and unstable surfaces and in different lower extremity positions (standing, lunge, and squat). Each participant acts as their own control by completing all exercise conditions in a randomized order. Electromyographic (EMG) activity of the trapezius muscles is measured during each condition to assess muscle activation patterns.
| Arm | Type | Receives |
|---|---|---|
| Standing on Stable Surface | Experimental | Behavioral: Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) ExerciseParticipants perform the bilateral scapular retraction with shoulder external rotation (BSR-SER) exercise in a standing position on a stable surface using resistance bands. |
| Standing on Unstable Surface | Experimental | Behavioral: Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) ExerciseParticipants perform the BSR-SER exercise in a standing position on an unstable surface (BOSU®) using resistance bands. |
| Lunge Position on Stable Surface | Experimental | Behavioral: Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) ExerciseParticipants perform the BSR-SER exercise in a lunge position on a stable surface using resistance bands. Knee and trunk angles are standardized. |
| Lunge Position on Unstable Surface | Experimental | Behavioral: Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) ExerciseParticipants perform the BSR-SER exercise in a lunge position on an unstable surface (BOSU®) using resistance bands. Knee and trunk angles are standardized. |
| Squat Position on Stable Surface | Experimental | Behavioral: Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) ExerciseParticipants perform the BSR-SER exercise in a squat position on a stable surface using resistance bands. Knee and trunk angles are standardized. |
| Squat Position on Unstable Surface | Experimental | Behavioral: Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) ExerciseParticipants perform the BSR-SER exercise in a squat position on an unstable surface (BOSU®) using resistance bands. Knee and trunk angles are standardized. |
Who may qualify
- Ages
- 18 to 35 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (2 listed)
- Age between 18 and 35 years
- Body Mass Index (BMI) less than 30 kg/m²
Key exclusion criteria (4 listed)
- Engaging in more than 6 hours per week of overhead sports or upper extremity strength training
- History of surgery in the spine, lower extremities, or upper extremities
- Experiencing pain in these regions within the past 6 weeks
- Having a rheumatologic, systemic, or metabolic disease
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) ExerciseParticipants perform the Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) exercise using a resistance band. The exercise is conducted under various conditions including stable and unstable surfaces (using BOSU® balance trainer) and in three different lower limb positions: standing, lunge, and squat. Each condition is randomized, and participants complete all conditions in a crossover design. The intervention aims to evaluate trapezius muscle activation patterns during these exercises using surface electromyography (EMG). | Behavioural | Lunge Position on Stable Surface, Lunge Position on Unstable Surface, Squat Position on Stable Surface, Squat Position on Unstable Surface, Standing on Stable Surface, Standing on Unstable Surface |
Primary outcome
Upper Trapezius Muscle Activation
Time frame: Day 1 (during the exercise session)
Surface electromyography (EMG) will measure the muscle activation level of the upper trapezius during the stationary phase of the BSR-SER exercise under various conditions. The activation will be normalized as a percentage of maximal voluntary isometric contraction (%MVIC).
Middle Trapezius Muscle Activation
Time frame: Day 1 (during the exercise session)
Surface EMG will measure the muscle activation level of the middle trapezius muscle during the stationary phase of the BSR-SER exercise under different surface and lower limb position conditions. Activation levels will be expressed as %MVIC.
Lower Trapezius Muscle Activation
Time frame: Day 1 (during the exercise session)
Surface EMG will measure the muscle activation of the lower trapezius during the stationary phase of the BSR-SER exercise. Muscle activity will be normalized to %MVIC.
Muscle Activation Ratios
Time frame: Day 1 (during the exercise session)
Ratios of muscle activation between the upper, middle, and lower trapezius muscles will be calculated to assess balance of muscle recruitment during exercise.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Jun 2025.
- Background: PubMed 25435767Colado JC, Garcia-Masso X, Triplett NT, Calatayud J, Flandez J, Behm D, Rogers ME. Construct and concurrent validation of a new resistance intensity scale for exercise with thera-band(R) elastic bands. J Sports Sci Med. 2014 Dec 1;13(4):758-66. eCollection 2014 Dec.
- Background: PubMed 39657698Ecemis ZB, Cobanoglu G, Oksuz BS, Kaya B, Guzel NA, Kafa B, Kafa N. Trapezius Muscle Electromyographic Activity in Lawn-Mower Exercise: Standing Versus Quadruped. J Sport Rehabil. 2024 Dec 10;34(4):436-442. doi: 10.1123/jsr.2023-0404. Print 2025 May 1.
- Background: PubMed 11018445Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol. 2000 Oct;10(5):361-74. doi: 10.1016/s1050-6411(00)00027-4.
- Background: PubMed 38968043Cobanoglu G, Guzel NA, Ecemis ZB, Demirkan MY. Investigation of muscle activation during kinetic chain based exercises in individuals with and without forward head posture. J Back Musculoskelet Rehabil. 2024;37(6):1537-1549. doi: 10.3233/BMR-230397.
- Background: PubMed 31103961Kara D, Harput G, Duzgun I. Trapezius muscle activation levels and ratios during scapular retraction exercises: A comparative study between patients with subacromial impingement syndrome and healthy controls. Clin Biomech (Bristol). 2019 Jul;67:119-126. doi: 10.1016/j.clinbiomech.2019.05.020. Epub 2019 May 11.
- Background: PubMed 36776036Melo ASC, Vilas-Boas JP, Cruz EB, Macedo RM, E Ferreira SB, Sousa AS. The influence of shoulder position during multi-joint exercises in the relative scapular muscles activity in symptomatic and asymptomatic conditions. J Back Musculoskelet Rehabil. 2023;36(4):883-893. doi: 10.3233/BMR-220056.
- Background: PubMed 36356616Uysal O, Akoglu AS, Kara D, Sezik AC, Calik M, Duzgun I. Theraband Applications for Improved Upper Extremity Wall-Slide Exercises. J Athl Train. 2022 Aug 1;57(8):795-803. doi: 10.4085/1062-6050-0305.21.
- Background: PubMed 32831190Mendez-Rebolledo G, Morales-Verdugo J, Orozco-Chavez I, Habechian FAP, Padilla EL, de la Rosa FJB. Optimal activation ratio of the scapular muscles in closed kinetic chain shoulder exercises: A systematic review. J Back Musculoskelet Rehabil. 2021;34(1):3-16. doi: 10.3233/BMR-191771.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Gamze Cobanoglu Demirkan, PhD principal investigator
Gazi University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Bilateral Scapular Retraction with Shoulder External Rotation (BSR-SER) Exercise in people with Healthy Volunteers, run by Recep Tayyip Erdogan University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 3 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Upper Trapezius Muscle Activation (time frame: Day 1 (during the exercise session)). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07000773, which also lists 8 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Jun 2025.