WHY CHOOSE POSTURE APPAREL FROM ALIGNMED®?

Athough you may find several alternatives claiming that their products can do the same as ours, do not be fooled by cheap imitations or copycats. We are...

THE ORIGINAL POSTURE SHIRT®

Alignmed® is the world leader in manufacturing posture apparel and the first to be registered with the FDA.

The choice for enhanced performance, increased range of motion, injury prevention, pain reduction, and faster recovery

Anatomically constructed with tension panel NeuroBands® that activate and stimulate specific muscle groups and joints to keep you in perfect form.
Controlled resistance causes your muscles to contract to increase strengthand keep you performing at your best.

Zipper Closure

This product is the choice for enhanced performance, increased range of motion, injury prevention, pain reduction, and faster recovery.

Anatomically constructed with tension panel Neurobands® technology that helps to activate and stimulate specific muscle groups and joints to keep you in perfect form. Controlled resistance causes muscles to contract to increase strength while supporting the spine and shoulders and keeping you performing at your best.

This product is recommended for those recovering from injury or those with shoulder mobility issues.

This product may be HSA / FSA eligible.

FEATURES

Vented Powermesh™ panels.
Moisture wicking.
Designed with our patented Neuroband® technology.

BENEFITS

Increases upper body strength.
Increases oxygen intake.
Improves shoulder mechanics.
Improves core activation.
Decreases wear and tear on joints.

CONTENT & CARE

80% polyester, 20% spandex.
Wash cold.
Air dry.
No iron.

Tab 1 Content

STUDY 1***

The Influence of a Dynamic Elastic Garment on Musculoskeletal & Respiratory Wellness in Computer Users –

Michael Decker, PHD, Steven J. Narvy, M.D., C. Thomas Vangsness, Jr. M.D.

https://www.tandfonline.com/doi/full/10.1080/10803548.2016.1182321

STUDY 2***

Scapular Bracing and Alteration of Posture and Muscle Activity in Overhead Athletes With Poor Posture – University of North

Carolina at Chapel Hill, Department Exercise and Sport Science (Athletic Training)

http://natajournals.org/doi/full/10.4085/1062-6050-48.1.13?=

STUDY 3***

Measuring the Effects of a Posture Shirt on Ergonomic Position at the Dental Chair – David E. Cohen DDS, Clinical Restorative

Sciences, UMKC School of Dentistry, USA

https://www.google.com/url?q=http://austinpublishinggroup.com/dental-disorders/download.php%3Ffile%3Dfulltext/jdod-v4-

id1093.pdf&sa=U&ved=0ahUKEwjn57nes7DaAhVIj1QKHeesAYcQFggFMAA&client=internal-uds-

cse&cx=016120555718622698702:xpaictngqdy&usg=AOvVaw2Pu9A3882eQ8cpzvyfJAJA

STUDY 4

The Effects of a Posture Shirt on Throwing Velocity, Throwing Accuracy and Blood Flow in Professional Baseball Pitchers -

Department of Orthopaedic Surgery – Keck School of Medicine USC

STUDY 5

The Effect of a Postural Enhancing Device on Sub-Acromial and Coracohumeral Distances during Shoulder

Abduction: A Bi-Plane Fluoroscopy Imaging Study – Steadman Phillippon Research Institute Vail, Colorado

STUDY 6

The Effects of a Posture Shirt on Rotator Cuff Muscle Strength – Kerlan Jobe Sports Medicine Institute, Los Angeles, CA

STUDY 7

The Effects of the S3 for Shoulder Pathologies – Steven Smith, Kerlan Jobe Sports Medicine Institute, Los Angeles,

STUDY 8

The Effects of Anatomic Enhancing Garments on Knee Performance and Injury during Skiing – University of Denver, Anne

Bevington-Director of Health and Safety – Vail Resorts

STUDY 9

The Effectiveness of a Scapular Brace on Scapular Kinematics in American Society of Shoulder and Elbow Therapists Uhl TL, K.

W., Tripp BL, Spigelman TH, McClelland R

TITLE: The Influence of a Dynamic Elastic Garment on Musculoskeletal & Respiratory Wellness in Computer Users

INTRODUCTION

https://doi.org/10.1080/10803548.2016.1182321

Computer use in the business setting is ubiquitous.
Evidence is growing that computers users are at
increased risk of developing musculoskeletal disorders.
The purpose of this study was to determine the short-
term effects of wearing a dynamic elastic garment
(Posture Shirt; AlignMed; Santa Ana, CA) on
musculoskeletal wellness and health in the computer
work place.

MATERIALS AND METHODS

Ninety-five computer users employed at a municipal utility provider volunteered to be prospectively evaluated in the work place. A functional assessment of posture, lung function and strength was performedusing a dynamic elastic shirt for four weeks. Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was given. A training log was kept to track weekly sensations of postural fatigue using a visual analogue scale (VAS).

RESULTS

Postural fatigue and muscular fatigue decreased by 21% and 29%, respectively, and energy level and productivity increased by 20% and 13%, respectively. Lung function (FEV1) improved 2.8% immediately, rising to 3.8% improvement at study completion (p=0.67). Hand strength improved 3.8% immediately, and rose to 5.4% at study completion (p=0.13).

DISCUSSION

The form-fitting fabric and non-stretch neuro-bands within the garment gently pull the shoulders back, which in turn reduces/enhances the anatomical alignment of the spine, scapula, shoulder and arm and improves forward head and shoulder posture. This prospective study demonstrated a positive impact of this dynamic elastic garment on the short term subjective measures of fatigue and posture, head and shoulder posture, thoracic kyphosis, lung function and grip strength.

CONCLUSION

The dynamic elastic garment had a favorable effect on both subjective and objective measures of workplace ergonomics among occupational computer users in this short-term study.

TITLE: The Spine and Scapula Stabilizing (S3) Brace Has an Effect on Posture and Muscle Activity in Overhead Athletes with Poor Posture

Ashley Kahlil Cole, LAT, ATC

University of North Carolina at Chapel Hill Department Exercise and Sport Science (Athletic Training) Chapel Hill 2008

Dr. Bill Prentice

Dr. Darin Padua

Mrs. Melanie McGrath,

MS, ATC Ms. Shana Harrington,

PT Ms. Terri Jo Rucinski, ATC, PT

ABSTRACT

FHRSP while performing six scapular stabilization exercises. Posture was measured using a digital camera and Adobe Photoshop to determine both the forward head and rounded shoulder angles. Muscle activity was measure for the upper trapezius, middle trapezius, lower trapezius, and serratus anterior using the average EMG recorded during Y’s, T’s, W’s, shoulder extension, forward flexion, and scapular punches. This study found that there were significant changes in FSA and upper, middle, and lower trapezii EMG activity caused when wearing the S3 brace compared to not wearing it. However, this study did not find significant differences in the treatment group compared to the sham group for FHRSP or EMG activity in any muscles.

S3 SCAPULAR STABILIZATION BRACE

The bracing company AlignMed Evidence Based Apparel (EBA) has come out with a new brace designed to correct posture and scapular positioning similar to the theory behind scapular taping. (38) The Scapular Stabilizing System (S3) brace is “a spine and scapula stabilizing brace designed to improve posture, reduce pain, and increase range of motion." The company designed the S3 brace to "trigger the body to correct improper posture by re-educating and re-engineering the musculoskeletalsystem surrounding the shoulders and spine" as well as signaling the neuroreceptors in the skin to engage in proper posture. The company also states that the S3 brace “addresses and lends instant relief to fatigue and poor spine alignment associated with unnatural body position at the computer.” Uhl et al. performed a study on the prototype of the S3 brace and other studies are waiting to be been published. The abstract from this study statesthat the objective was to evaluate the S3 brace on scapular kinematics at rest and during active arm elevation. Fifteen healthy subjects and 15 subjects with scapular dyskinesis were used in this study. The results found that the brace increased posterior tipping by 3 degrees in the first and last 30 degrees of motion, decreased upward rotation in the dominant arm by 4 degrees at 90 degrees of elevation, while increasing upward rotation in the non-dominant arm by 2 degrees in the first and lat 40 deg of elevation. The S3 also decreased internal rotation by 3.5 degrees during the lowering phase of elevation. The authors concluded that the S3 brace affected the scapular kinematics at rest and in the lower

ranges of motion and that the increased posterior tipping and decreased internal rotation from wearing the brace may assist the scapular muscles in controlling scapular motion.

Forward head rounded shoulder posture causes excessive scapular protraction and acromial depression increasing the potential for impingement and 39 other chronic shoulder injuries. If the S3 brace decreases the shoulder angle this may improve scapular motion by restoring normal posterior tipping, upward rotation, and medial rotation. If the scapula is returned to optimal positioning while wearing the S3 brace then the scapular stabilizers may be more effectively strengthened while performing strengthening exercises. Theoretically, due to improved scapular positioning the lower trapezius, middle trapezius, and serratus anterior activity will increase and upper trapezius activity will decrease. Improved scapular positioning caused by wearing the S3 brace may improve muscular activation of the scapular stabilizers. As a result the scapular stabilizers may be more effectively strengthened while performing strengthening exercises. In conclusion, improving posture will
help to decrease the incidence of shoulder pain as well as decreasing the amount of time lost from sports participation and/ or daily activities. This will improve the playing time for overhead athletes as well as the quality of their performance.

SUBJECTS

Males and females between the ages of 18-25 were recruited from the student population at the University of North Carolina at Chapel Hill. Forty subjects were recruited through mass e-mails sent to the student population, through flyers placed around campus, and through exercise and sports science classes.
Subjects were included if they currently participated in a NCAA, club, or recreational overhead sport 3-4 days a week for at least 1 hour or more. An overhead sport was defined as baseball, softball, swimming, volleyball, tennis, water polo, javelin, shot put, or discus. Subjects displayed forward head rounded shoulder posture.
Subjects (41) were excluded if they had had a shoulder or back injury in the last 6 months, previous history of shoulder or back surgery, are currently performing formal shoulder rehabilitation, had any congenital postural abnormalities, a forward head or rounded shoulder posture less than the specified criteria, and had any prior experience with the S3 brace. The dominant arm (arm they would throw a ball with) was tested for each subject. Subjects were randomly assigned to either the treatment groups or sham group by trained research assistants to allow the principal investigator to remain blinded to group assignment and treatment condition.

STUDY DESIGN

This was a single blind randomized-control study. Each subject was blind to group assignment and brace condition. Subjects were randomly assigned to groups, and measurements were taken both with the brace applied and without for control purposes.

S3 Brace Fitting

The S3 brace was fitted and applied by two trained research assistants according to manufacturer specifications using a two strap method. The research assistantsfit allsubjectsfor the correct size. If a subject was in between sizes then he orshe tried on both sizes and the research assistants determined which size had the best fit.

Neither the treatment group nor the sham group was educated on the reasons for wearing the S3 brace. Men were shirtless and women wore a sports bra. After putting on and zipping up the S3 brace; both groups tightened the Velcro pads on the waist band so that they were snug, but not uncomfortable. Both groups were instructed to retract and depress the shoulder blades in preparation for strap placement. The treatment group had a small (C) strap applied from the posterior, superior Velcro pad (over the upper trapezius muscle) to the contralateral waist band. This method was repeated for the opposite side. Next, the medium (B) strap was attached from the lateral, superior Velcro pad (over the pectoralis major muscle) to the contralateral waistband Velcro pad inferior to the (C) strap. This method was repeated for the opposite side (Figure 3). The sham group used the same method of applying the brace, but the medium (B) straps were used in place of the short (C) straps and the long (A) straps were used in place of the medium (B) straps. There was a 5 ½ to 6 inch difference between the B and C straps and a 6 inch difference between the A and B straps. Due to this difference in length the straps did not cause retraction, but maintained the look of the brace.

PROCEDURES

Posture

During postural alignment assessment subject’s stood 40cm in front of a grid screen with reflective markers placed on the subject’s right tragus (ear), right acromion, and 7th cervical vertebrae spinous process (see Figure 2). High resolution digital pictures were then taken in a sagittal plane to determine the plumbline through the C7 spinous process. The primary investigator stood 3m from the grid and the camera was positioned on a tripod. The photos were then uploaded onto a personal computer for postural analysis using Adobe® Photoshop. The photos were then used to calculate the shoulder and head angle of each subject to determine whether or not they were included in the study. Forward head position was defined as having a forward head angle greater than or equal to 46° relative to the vertical line extending from C7 to the line connecting C7 to the tragus. Rounded shoulder position was described as having a forward shoulder angle of greater than 46or equal to 46° relative to the vertical line extending from C7 to the line connecting C7 to the acromion (Sawyer, 2006; Thigpen, 2006). Postural alignment criteria were based on a study done by Thigpen in which he screened 310 individuals from the university population.

MVIC

A maximal voluntary isometric contraction (MVIC) assessment was performed against manual resistance. Each subject performed one sub-maximal contraction to familiarize themselves with the manual muscle testing position. Subjects performed 3 MVIC’s for each muscle (lasting 5 seconds each) with 1 minute rest between each muscle and 30 seconds between each trial. The average EMG amplitude for all of the trials was recorded. The order of the muscles tested was randomized. MVIC’s were tested as follows:

Upper trapezius- The subject was seated with arms at his/her sides. The tester stood behind the subject and gave the subject instructions to “shrug the shoulder” which was being tested and “rotate the head in the opposite direction.” The tester applied a stabilizing force to the back of the head and a downward force to the acromion for 5 seconds. The subject was then instructed to “relax” (Kendall, 1993).

Middle trapezius- The subject laid in the prone position with the shoulder abducted to 90° and externally rotated. The tester stood at the subject’s side and gave the subject instructions to “raise the arm towards the ceiling” while the tester applied a downward force to the proximal end of the brachium for 5 seconds. The subject was then instructed to “relax” (Kendall, 1993). Lower trapezius- The subject laid in the prone position with the arm raised overhead in line with the lower trapezius muscle fibers. The tester stood at the subject’s side and gave the subject instructions to “raise the arm towards the ceiling” while the tester applied a downward force to the proximal end of the brachium for 5 seconds.

The subject was then instructed to “relax” (Kendall, 1993).

Serratus anterior- The subject was seated with the arm shoulder flexed between 120° and 130°, with the arm internally rotated. The tester stood beside the subject and gave the subject instructions to “raise the arm towards the ceiling,” while the tester applied a downward force to the proximal end of the brachium for 5 seconds.

The subject was then instructed to “relax” (Kendall, 1993).

The S3 Brace

The S3 brace has been designed to improve posture and reduce pain in patients suffering from poor posture and shoulder injuries. It has been found in previous unpublished studies that the S3 brace improves scapular kinematics and rest and in the lower ranges of motion. The designers of the brace state that through a “Velcro strapping system coupled with proprioceptive padding” the brace attempts to restore normal shoulder kinematics. Previous studies have found that exercise may improve scapular kinematics although it is unclear whether scapular positioning is improved. Wang et al found that when patients performed an exercises regimen that included 5 shoulder exercises resting scapular posture did not change and that the scapula showed less superior translation after the exercise program (Wang, McClure, Pratt, & Nobilini, 1999). Ludewig et al found that selective activation of the serratus anterior with minimal activation of the upper trapezius may improve the relative strength of the serratus anterior and improve the balance of these two muscles in patients with shoulder dysfunction (Ludewig, Hoff, Osowski, Meschke, & Rundquist, 2004). It is believed that strengthening the lower trapezius, middle trapezius, and serratus anterior muscles with the scapula in the proper position and a more normal force couple restored would overtime help to restore the force couple in the long run during rehabilitation exercises, sport activity, and everyday movements. Given the findings of this study it can be stated that wearing the brace does cause positive changes in forward shoulder posture and EMG activity of the upper and lower trapezii, however it has not been determined that these changes are a direct result of the strap placement suggested by the AlignMed company. This study does not disprove the claims that the AlignMed Company has made in regards (65) to the effectiveness of the brace, but further studies must be done to

determine whether the changes seen are a result of corrective straps or merely the result of the proprioception caused by wearing a compressive shirt.

Purpose:

The purpose of this study was to determine whether or not the S3 scapular stabilizing brace corrects the posture of participants with FHRSP. In addition, this study determined whether or not wearing the S3 scapular stabilizing brace has an effect on the muscle activity of participants with FHRSP while performing six scapular stabilization exercises. Our results indicate that wearing the brace compared to not wearing the brace had an effect on both posture and EMG; however there was no significant difference between then sham group and the treatment group.

Posture:

It was found that forward head posture was not improved with sham or treatment application of the brace. Although it was hypothesized that the brace would decrease forward head posture this did not occur. Since the S3 brace did not apply any direct force to the head or the cervical spine then it is not surprising that there was no change in FHP. Lewis et al. however, found that scapular taping did improve FHP compared to a placebo tape job when Leukotape was applied from the center of the spine of the scapula to the spinous process of T12 in a diagonal fashion (Lewis, Wright, & Green, 2005). The subjects were asked to retract and depress their scapulas as were our subjects during application of the S3 brace. This 57 difference in these findings cannot be fully explained, but it is possible that the direct application of the Leukotape to the skin may have allowed for a greater change in forward head posture compared to the brace where the attachment of the Velcro pads to a strap that goes over the acromion inside the brace is what retracts the shoulders. Although FHP was not changed, FSP was significantly decreased when subjects were wearing the brace compared to when they were not wearing the brace. However, there was not significant difference in the sham group compared to the treatment groups, in both groups FSA was decreased when wearing the brace compared to not wearing the brace. This suggests that it may not be the straps that cause the decrease in shoulder angle, but it may be the proprioceptive effects of the brace. Lewis et al. also found that scapular taping in the manner described previously caused a decrease in FSA (Lewis, Wright, & Green, 2005). Again, the tape was applied directly to the skin and this may be more effective than applying the straps to the brace. It is also possible that although the straps used in the sham treatment were 51/2 to 6 inches longer than the treatment straps they may not have been long enough to completely prevent shoulder retraction. Further studies should be done to investigate different brace applications and how they affect FHP and FSP. While the change in FSP may seem small this may be enough to make a difference clinically. Since this wearing the brace one time had positive effects, it is possible that with regular use of the S3 brace this difference would increase and have more of effect overtime. (58)

EMG:

There were no group effects found for EMG meaning that there were no significant differences between the sham group and the treatment group. Condition effects were found for certain muscles during certain exercises, which generally demonstrated that bracing, regardless of group, changed EMG activity. When evaluating EMG in relation to shoulder pathology it has been found that the upper trapezius is overactive while the middle trapezius, lower trapezius, and the serratus anterior are under active. This causes a disruption in the force couple which leads to changes in scapular kinematics. Ultimately these changes in the force couples and in scapular kinematics may lead to chronic shoulder pathologies such as subacromial impingement, associated subacromial bursitis, and rotator cuff or biceps tendonitis (Ludewig, Hoff, Osowski, Meschke, & Rundquist, 2004). Cools et al studied the balance of the trapezius muscles in overhead athletes with impingement syndrome compared to those without impingement syndrome and it was found that patients with impingement syndrome showed significantly higher EMG activity in the upper trapezius of their injured side compared to the dominant side of the control group (Cools, Declercq, Cambier, Mahieu, & Witvrouw, 2007). It was hypothesized that wearing the S3 brace while performing shoulder exercises would decrease the muscle activity of the upper trapezius and increase the muscle activity of the middle trapezius, lower trapezius, and serratus anterior thereby creating a more normal force couple for thesemuscles.

The S3 Brace

Future Research:

Future research should investigate different the brace applications described by the bracing company and how they affect FHRSP and EMG activity. Future research should compare different strap applicationsto just wearing the compression shirt portion of the brace without the straps applied. This was not done in this study in an effort to blind the primary researcher to the group that the subject was in. Future research should also evaluate different exercises which may better engage the specified muscles such as the push up plus for the serratus anterior. Future research should investigate the cumulative effects of wearing the brace while performing exercises to determine whether or not changes continue to occur. This could be done through an intervention program lasting several weeks I which the subjects wear the brace while performing various daily or weekly rehab exercises. Not only would this better help to determine the long-term effects of the brace, but it would further help to determine clinical significance since this is the manner in which the brace would be used clinically rather than wearing it just once (68) and expecting large changes. It would also be useful to include a survey in future research to determine whether the patient feels that the brace is improving posture, the comfort level of the brace, whether the brace felt different after exercises compared to before. This would be especially useful in studies comparing a treatment group to a sham group as this one did to determine if patients feel they are receiving a treatment and how that affects results. Further investigation should be done to determine whether or not it is the strap application or the proprioceptive effects of the brace that caused changes in the FSA and muscle activity for the upper, middle, and lower trapezii.

Conclusion:

In conclusion, this study found that there were significant changes in FSA and upper, middle, and lower trapezii EMG activity caused when wearing the S3 brace compared to not wearing it. However, this study did not find significant differences in the treatment group compared to the sham group for FHRSP or EMG activity in any muscles. This indicates that the specific strap application may not be the cause (or at least not the sole cause) of the changes in posture and EMG activity. This is not to say that use of the brace is ineffective or unwarranted, but future studies should be performed to further determine the effectiveness of the brace in improving posture and EMG activity.

TITLE: Measuring the Effects of a Posture Shirt of Ergonomic Positioning at the Dental Chair

INTRODUCTION There have been few studies on the effects of posture shirt wear with positive ergonomics and musculoskeletal pain relief. The Influence of a Dynamic Elastic Garment on Musculoskeletal and Respiratory Wellness in Computer Use by Decker, Gomas, Narvy and Vangsness [ l] is the only published literature that touches on the subject. There have been no studies on posture shirt effectiveness in the dental field to date. The most prevalent regions for pain in dentists have been shown to be the back (36.3- 60.1%) and neck (19.8-85%) [2,3]. Several studies have indicated that back, neck as well as shoulder pain as major problems among dentists. Finsen et al. (1997) [4] reported 65%; and Chowanadisai et al. (2000) [5] reported 78%. Musculoskeletal disorders (MSDs) are a major cause of early retirement among dentists [6].

*Musculoskeletal disorders (29.5%)

*Cardiovascular disease (21.2%)

*Neurotic Symptoms (16.5%)

*Tumors (7.6%)

*Disease of the nervous system (6.1%)

Dentistry requires strong endurance of the shoulder girdle stabilizing muscles for strength and range of arm motion. The missle and lower trapezius muscles supply the majority of this support. However, they ten

to fatigue quickly when the clinician works with their head in a forward position and have a rounded upper back When these muscles tire, the upper trapezius, scapula and upper rhomboids must then compensate and become overworked and tight, resulting in a decreased blood supply and oxygenation to these tissues (Figure 1). "Continual work in front of and below the operator's eye level leadsto a forward head and rounded shoulder posture. This can cause weakening and elongation of the stabilizer muscles of the shoulder blades (middle and lower trapezius, rhomboid and serratus anterior muscles). As a result, the shoulder blades tend to move away from the spine, leading to rounded shoulder posture. Meanwhile, anterior "mover" muscles (scalene, sternocleidomastoid and pectoralis) become short and tight, pulling the head forward" [7]. Posture affectstheabilityofthedental clinician to reach, hold, and use equipment. It also influences how long the task can be performed without suffering adverse health effects. Over 3 time, any position will eventually become fatiguing and may lead to MSDs. An MSD is characterized by presence of discomfort, disability or persistent pain in the joints, muscles, tendons, and other soft parts, caused or aggravated by repeated movements and prolonged awkward or forced body postures [7]. It is also important to note that the weight of the head greatly increases asit tiltsforward, placing increased neck stress on Cl-C7 [8] (Table 1).

For dentists to perform effectively, they need to have a posture position that allows them to achieve optimum access, visibility, comfort, and control at all times [9].

RESEARCH HYPOTHESIS

To determine the short-term effects of wearing the Posture Shirt " with subjective assessments of posture, including head, neck, Shoulder and back. It is a garment with an anatomic matrix of bands, panels and seams, collectively referred to as NeuroBands". The company describes the shirt as wearable therapy to retrain muscles and improve muscle tone, performance, posture, poise and reduce pain.

Alignmed Posture Shirt

Description