DOI QR코드

DOI QR Code

아래팔의 자세 변화에 따른 어깨 가쪽돌림 시 가시위근과 가시아래근의 근활성도 분석

Analysis of the Activity of the Supraspinatus and Infraspinatus Muscles during Lateral Rotation of the Shoulder according to the Posture Change of the Forearm

  • 엄주리 (부산가톨릭대학교 대학원 물리치료학과) ;
  • 이동률 (거인병원 물리치료실) ;
  • 이민형 (부산대학교병원 재활의학팀)
  • Ju-Ri Eom (Department of Physical Therapy, Graduated school Catholic University of Pusan) ;
  • Dong-Rour LEE (Department of Rehabilitation Medicine, Geo-in Hospital ) ;
  • Min-Hyung Rhee (Department of Rehabilitation Medicine, Pusan National University Hospital)
  • 투고 : 2023.04.12
  • 심사 : 2023.04.17
  • 발행 : 2023.04.30

초록

Purpose: The aim of this study is to provide basic information to create an efficient training program to improve shoulder stability and function in patients with injuries and in patients having undergone surgery of the supraspinatus and infraspinatus muscles, which have a relatively high incidence of injury in shoulder joint disease. Further, independent activities of the supraspinatus and infraspinatus muscles were investigated according to forearm rotation and the neutral and lateral rotation postures. Methods: The activities of the supraspinatus and infraspinatus muscles were measured using surface electromyography in 22 healthy adults in Busan, and isokinetic muscle strength measurement equipment was used to measure muscle strength during shoulder lateral rotation. The subjects performed lateral rotation of the shoulder in three different forearm postures (neutral, supine, prone) to measure shoulder muscle activity and lateral rotation strength. Results: The independent activity ratio (% Isolation) of the supraspinatus and infraspinatus muscles during lateral rotation of the shoulder joint demonstrated a significant difference (p<0.05) according to the change in forearm posture. Conclusion: The supraspinatus muscle showed independent activity ranging from highest to lowest in the order of pronation, neutral, and supination of the forearm, while the independent activity of the infraspinatus muscle ranged from highest to lowest in the order of neutral, supination, and pronation of the forearm. Therefore, the most active forearm positions for the supraspinatus and infraspinatus muscles are pronation and neutral, respectively.

키워드

참고문헌

  1. Abrams JS. Arthroscopic techniques for massive rotator cuff repairs. Current Orthopedic Practice. 2008;19(2):181-190. https://doi.org/10.1097/BCO.0b013e3282f54b48
  2. An SE, Kim BS. The effect of rehabilitation exercise programs on recoverability of muscle functions following the arthroscopy surgery performed on rotator cuff tear. The Korean Journal of Sport. 2013;11(1):301-9.
  3. Arlotta M, Lovasco G, McLean L. Selective recruitment of the lower fibers of the trapezius muscle. Journal of Electromyography and Kinesiology. 2011;21(3)403-410. https://doi.org/10.1016/j.jelekin.2010.11.006
  4. Ballantyne BT, O'Hare SJ, Paschall JL, et al. Electromyographic activity of selected shoulder muscles in commonly used therapeutic exercises. The Journal of Korean Society of Physical Therapy. 1993;73(10):668-682. https://doi.org/10.1093/ptj/73.10.668
  5. Bitter NL, Clisby EF, Jones MA, et al. Relative contributions of infraspinatus and deltoid during external rotation in healthy shoulders. Journal of Shoulder and Elbow Surgery. 2007;16(5):563-8. https://doi.org/10.1016/j.jse.2006.11.007
  6. Blackard DO, Jensen RL, Ebben WP. Use of EMG analysis in challenging kinetic chain terminology. Medicine & Science in Sports & Exercise. 1999;231(3):443-448. https://doi.org/10.1097/00005768-199903000-00014
  7. Blackburn T. EMG analysis of posterior rotator cuff exercises. Journal of Athletic Training. 1990;25:40-45.
  8. Brotzman SB, Wilk KE. Clinical orthopedic rehabilitation. Seoul. Hanmi medical. 2005.
  9. Choi H. The Effect of hand grip force on the activity of shoulder muscles in the patterns of arm position. The Journal of digital policy & management. 2012;10(9):435-441.
  10. Diamond W. The shoulder, saunders manual of physical therapy. 1st ed. Philadelpia, Pennsylvenia. Saunders Company. 1995.
  11. Eom AY, Lee EO. Shoulder range of motion in postmastectomy patients. Journal of Korean Oncology Nursing. 2004;4(1):62-70.
  12. Hedt C, Lambert BS, Daum J, et al. Forearm position matters during eccentric shoulder exercise: an EMG recruitment study with implications for rehabilitation. International Journal of Sports Physical Therapy. 2020;15(6):1110-1118. https://doi.org/10.26603/ijspt20201110
  13. Hertz H. Significance of the limbus glenoidalis for the stability of the shoulder joint. Wiener klinische Wochenschrift. Supplementum. 1984;152:1-23.
  14. Hyong IH. Effects of squats accompanied by hip joint adduction on the selective activity of the vastus medialis oblique. Journal of Physical Therapy Science. 2015;27(6):1979-19.
  15. Irish SE, Millward AJ, Wride J, et al. The effect of closed-kinetic chain exercises and open-kinetic chain exercise on the muscle activity of vastus medialis oblique and vastus lateralis. Journal of Strength and Conditioning Research. 2010;24(5):1256-1262. https://doi.org/10.1519/JSC.0b013e3181cf749f
  16. Itoi E, Kuechle DK, Newman SR, et al. Stabilising function of the biceps in stable and unstable shoulders. The Journal of bone and joint surgery. British volume. 1993;75(4):546-550. https://doi.org/10.1302/0301-620X.75B4.8331107
  17. Jang JW. The change of muscle activation in quadriceps femoris muscle during taking open kinetic chain exercise and closed kinetic chain exercise. Korea University. Dissertation of Master's Degree. 2003.
  18. Kang KH. The study about muscle activities and ROM of shoulder joint according to supination during external rotation. Korean society for Wellness. 2017;12(4):553-563. https://doi.org/10.21097/ksw.2017.11.12.4.553
  19. Kelly BT, William RJ, Cordasco FA, et al. Differential patterns of muscle activation inn patients with symptomatic and asymptomatic rotator cuff tears. Journal of Shoulder and Elbow Surgery. 2005;14(2):165-71. https://doi.org/10.1016/j.jse.2004.06.010
  20. Kim JH, Park SC, Jang MH et al. A study on muscular strength of korean young males. Journal of the Ergonomics Society of Korea. 1990;9(2):37-46.
  21. Kolber MJ, Beekhuizen KS, Santore T et al. Implications for specific shoulder positioning during external rotator strengthening. Strength and Conditioning Journal. 2008;30(4):12-16. https://doi.org/10.1519/SSC.0b013e31817764ae
  22. Lee DK, Jeong WK, Kim TK, et al. Comparison of rotational strength in shoulders with anterior instability and normal shoulders using isokinetic testing. Clinics in Shoulder and Elbow. 2012;15(2):79-85. https://doi.org/10.5397/CiSE.2012.15.2.79
  23. Lee GB, Hwang JM, Lee DY et al. The effect of forearm position on the activity of the upper-extremity muscles during shoulder external rotation exercise using a pulley. Neurotherapy. 2021;25(2):9-15.
  24. Ludewig PM, Hoff MS, Osowski EE, et al. Relative balance of serratus anterior and upper trapezius muscle activity during push-up exercises. American Journal of Sports Medicine. 2004;32(2):484-493. https://doi.org/10.1177/0363546503258911
  25. Mccluskey GM, Getz BA. Phathophysiology of anterior shoulder instability. Journal of Athletic Training. 2000;35(3):268-272.
  26. Neer CS II. Impingement lesions. Journal of Clinical Orthopaedics and Traum. 1983;173:70-77. https://doi.org/10.1097/00003086-198303000-00010
  27. Oh JS, Park JS, Kim SY, et al. Comparison of muscle activity during a push-up on a suspension sling and a fixed support. Physical Therapy Korea. 2003;10(3):29-40.
  28. Page P. Shoulder muscle imbalance and subacromial impingement syndrome in overhead athletes. International Journal of Sports Physical Therapy. 2011;6(1):51-58.
  29. Park SY, Yoo WG. Activation of the serratus anterior and upper trapezius in a population with winged and tipped scapulae during push-up-plus and diagonal shoulder-elevation. Journal of Back and Musculoskeletal Rehabilitation. 2015;28(1):7-12. https://doi.org/10.3233/BMR-140458
  30. Reinold MM, Wilk KE, Fleisig GS, et al. Electromyographic analysis of the rotator cuff and deltoid musculature during common shoulder external rotation exercises. Journal of Orthopedic and Sports Physical Therapy. 2004;34(7):385-394. https://doi.org/10.2519/jospt.2004.34.7.385
  31. Sahrmann S, Azevedo DC, Dillen LV. Diagnosis and treatment of movement system impairment syndromes. Brazilian Journal of Physical Therapy. 2017;21(6):391-399. https://doi.org/10.1016/j.bjpt.2017.08.001
  32. Sahrmann SA. Diagnosis and Treatment of movement impairment syndromes; Mosby: St. Louis, MO. USA. 2002.
  33. Stokdijk M, Eilers PH, Nagels J, et al. External rotation in glenohumeral joint during elevation of the arm. Clinical Biomechanics. 2003;18(4):296-302. https://doi.org/10.1016/S0268-0033(03)00017-2
  34. Wang HK, Juang LG, Lin JJ, et al. Isokinetic performance and shoulder mobility in taiwanese elite junior volleyball players. Isokinetics and Exercise Science. 2004;12(4):135-141. https://doi.org/10.3233/IES-2004-0165
  35. Woo DP, Lee DC. Effects of forearm posture on push and pull force. Journal of the Ergonomics Society of Korea. 2013;332-336.
  36. Worland Rl, Lee D, Orozco CG, et al. Correlation of age, acromial morphology, and rotator cuff tear pathology diagnosed by ultrasound in asymptomatic patients. Journal of the Southern Orthopaedic Association. 2003;12:23-26.
  37. Yoon K, Lim JY, Jung SH, et al. Tendinopathy, partial-thickness and full-thickness tears of supraspinatus tendon: comparison of clinical findings and functional disabilities. Journal of Korean Sports Medicine. 2007;25(2):210-14.