• 한국운동역학회지
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• 제31권3호
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• pp.155-161
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• 2021

Objective: There is a lack of studies using the 3D-2D image registration techniques on the mechanism of a shoulder injury for ice hockey players. This study aimed to analyze in vivo 3D glenohumeral joint arthrokinematics in collegiate ice hockey athletes and compare shoulder scaption with or without a hockey stick using the 3D-2D image registration technique. Method: We recruited 12 male elite ice hockey players (age, 19.88 ± 0.65 years). For arthrokinematic analysis of the common shoulder abduction movements of the injury pathogenesis of ice hockey players, participants abducted their dominant arm along the scapular plane and then grabbed a stick using the same motion under C-arm fluoroscopy with 16 frames per second. Computed tomography (CT) scans of the shoulder complex were obtained with a 0.6-mm slice pitch. Data from the humerus translation distances, scapula upward rotation, anterior-posterior tilt, internal to external rotation angles, and scapulohumeral rhythm (SHR) ratio on glenohumeral (GH) joint kinematics were outputted using a MATLAB customized code. Results: The humeral translation in the stick hand compared to the bare hand moved more anterior and more superior until the abduction angle reached 40°. When the GH joint in the stick hand was at the maximal abduction of the scapula, the scapula was externally rotated 2~5° relative to 0°. The SHR ratio relative to the abduction along the scapular plane at 40° indicated a statistically significant difference between the two groups (p < 0.05). Conclusion: With arm loading with the stick, the humeral and scapular kinematics showed a significant correlation in the initial section of the SHR. Although these correlations might be difficult in clinical settings, ice hockey athletes can lead to the movement difference of the scapulohumeral joints with inherent instability.

• 한국전문물리치료학회지
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• 제7권2호
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• pp.88-95
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• 2000

Thirty normal adults were tested to measure the electrical activity of the anterior (AD), middle (MD), and posterior portion (PD) of the deltoid muscle and sternal portion of the pectoralis major muscle (PM) during the performance of four upper extremity PNF diagonal patterns with elbow flexion angle in $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$. The PNF patterns in which these muscles function optimally have been theoretically advanced by Kabat and further described by Knott and Voss. They theorize that the MD should be most active with shoulder flexion, abduction, and external rotation (D2F); the PD with shoulder extension, abduction, and internal rotation (D1E); the AD with shoulder flexion, adduction, and external rotation (D1F); and the PM with shoulder extension, adduction and internal rotation (D2E). The patterns were performed through range of motion, with an isometric contraction performed in the shortened range. When the EMG activity of AD, MD, PD and PM in its optimal patterns was measured, it does not have significant difference among fixed elbow flexion angle $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$ (p>.05). In addition, suggestions were made for study of patients who exhibit imbalance of muscle strength and have muscle weakness.

• 한국전문물리치료학회지
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• 제21권3호
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• pp.1-10
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• 2014

The aim of this study was to investigate the effect of hip external rotation angle on pelvis and lower limb muscle activity during prone hip extension. Sixteen healthy men were recruited for this study. Each subject performed an abdominal drawing-in maneuver (ADIM) in a prone position, and extended the dominant hip at three different hip external rotation angles ($0^{\circ}$, $20^{\circ}$, $40^{\circ}$) with a $30^{\circ}$ hip joint abduction. Activity of the gluteus maximus (G Max), gluteus medius (G Med), and hamstring (HAM) and the G Max/HAM and G Med/HAM ratios were determined with surface electromyography (EMG). The EMG signal was normalized to 100% maximum voluntary isometric contractions (MVICs) and expressed as %MVIC. Data were analyzed by one-way repeated analysis of variance (alpha level=.05) and the Bonferroni post hoc test. Significant differences in G Max and G Med muscle activity were noted among the three different hip external rotation angles. G Max muscle activity increased significantly at both $40^{\circ}$ (p=.006) and $20^{\circ}$ (p=.010) compared to a $0^{\circ}$ hip external rotation angle. G Med muscle activity increased significantly at $20^{\circ}$ (p=.013) compared to a $40^{\circ}$ hip external rotation angle. The G Max/HAM activity ratio increased significantly at both $40^{\circ}$ (p=.004) and $20^{\circ}$ (p=.014) compared to a $0^{\circ}$ hip external rotation angle. The G Med/HAM activity ratio increased significantly at $20^{\circ}$ (p=.013) compared to a $40^{\circ}$ hip external rotation angle. In conclusion, $40^{\circ}$ and $20^{\circ}$ hip external rotation angles are recommended to increase G Max activity, and $20^{\circ}$ hip external rotation is advocated to enhance G Med muscle activity during prone hip extension with ADIM and $30^{\circ}$ hip abduction in healthy subjects.

• 한국전문물리치료학회지
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• 제23권2호
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• pp.57-66
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• 2016

Background: For the treatment of forward head posture (FHP) and forward shoulder posture, methods for strengthening scapular retractors and deep cervical flexors and stretching pectoralis and upper cervical extensors are generally used. No study has yet assessed whether suboccipital release (SR) followed by cranio-cervical flexion exercise (CCFE) (SR-CCFE) will result in a positive change in the shoulders and neck, showing a "downstream" effect. Objects: The purpose of this study was to investigate the immediate effects of SR-CCFE on craniovertebral angle (CVA), shoulder abduction range of motion (ROM), shoulder pain, and muscle activities of upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction in subjects with FHP. Methods: In total, 19 subjects (7 males, 12 females) with FHP were recruited. The subject performed the fifth phase of CCFE immediately after receiving SR. CVA, shoulder abduction ROM, shoulder pain, muscle activities of UT, LT, and SA, and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction were measured immediately after SR-CCFE. A paired t-test and Wilcoxon signed-rank test were used to determine the significance of differences in scores between pre- and post-intervention in the same group. Results: The CVA (p<.001) and shoulder abduction ROM (p<.001) were increased significantly post-versus pre-intervention. Shoulder pain was decreased significantly (p<.001), and LT (p<.05) and SA (p<.05) muscle activities were increased significantly post- versus pre-intervention. The LT/UT muscle activity ratio was increased significantly post- versus pre-intervention (p<.05). However, there was no significant change in UT muscle activity and SA/UT muscle activity ratio between pre- and post-intervention (p>.05). Conclusion: SR-CCFE was an effective intervention to improve FHP and induce downstream effect from the neck to the trunk and shoulders in subjects with FHP.

• 한국전문물리치료학회지
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• 제23권2호
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• pp.84-92
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• 2016

Background: Strengthening the supraspinatus is an important aspect of a rehabilitation program for subacromial impingement and tendinopathy. Many authors recommended empty-can (EC), full-can (FC), and prone full-can (PFC) exercises to strengthen the supraspinatus. However, no ultrasonography study has yet investigated supraspinatus muscle architecture (muscle thickness; MT, pennation angle; PA, fiber bundle length; FBL) in relation to supraspinatus strengthening exercises. Objects: The purpose of this study was to compare the architecture (MT, PA, and FBL) of the supraspinatus muscle during three different types of exercises (EC, FC, and PFC) using diagnostic ultrasound. Methods: Participants performed three different exercises: (A) EC; the arm was maintained at $60^{\circ}$ abduction with full internal rotation in the sitting position, (B) FC; the arm was maintained at $60^{\circ}$ abduction with full external rotation in the sitting position, and (C) PFC; the arm was maintained at $60^{\circ}$ abduction with full external rotation in the prone position. Ultrasonography was used to measure the MT, PA and FBL of the supraspinatus. One-way repeated analysis of variance with Bonferroni's post-hoc test was used to compare between the three exercises and the initial position of each exercise. Results: Compared with each initial position, the FC exercise showed the greatest mean difference in muscle architecture properties and the PFC exercise showed the least mean difference. Conclusion: The findings suggest that the FC exercise position may have an advantage in increasing the amount of contractile tissue or producing muscle power and the PFC exercise position may be useful in a rehabilitation program because it offers the advantage of maintaining the muscle architecture properties.

• 한국전문물리치료학회지
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• 제23권3호
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• pp.57-67
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• 2016

Background: Many previous studies recommended the side-lying hip abduction (SHA) exercise for targeting the gluteus medius (Gmed) and gluteus maximus (Gmax) muscle activity while the decreasing tensor fasciae latae (TFL) activation. Mischoice of hip position and angle in SHA may increase the risk of lower extremity injuries and undesirable muscle activation. However, information is limited on the effect of composite hip flexion angles and hip rotation on the gluteal muscle activity during SHA. Objects: This study aimed to compare muscle activity (Gmed, TFL, and Gmax) and activity ratios (Gmed/TFL, Gmax/TFL, and Gmed/Gmax) using surface electromyography (EMG) during SHA exercise at three different hip flexion angles either with or without internal rotation (IR) in subjects with Gmed weakness. We hypothesized that applying hip flexion and IR during SHA would increase gluteal muscle activity and decrease TFL activity. Methods: Muscle activity and activity ratios in 20 volunteers with Gmed weakness during 6 different SHA were investigated with surface EMG. One-way repeated-measures analysis of variance was used to determine the statistical significance. Results: Significant differences were found among the six different exercises for Gmed ($F_{2,41}=11.817$, p<.001) and Gmax ($F_{3,52}=5.513$, p=.003) muscle activity, and Gmed/TFL ($F_{3,54}=8.735$, p<.001) and Gmax/TFL ($F_{2,37}=4.019$, p=.028) activity ratios. Conclusion: Applying hip flexion is an effective method for increasing gluteal activity, and it elicits great Gmed/TFL and Gmax/TFL activity ratios during SHA in subjects with Gmed weakness.

• 대한통합의학회지
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• 제11권1호
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• pp.131-140
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• 2023

Purpose : The purpose of this study is to find out which shoulder abduction angle among the three representative angles of lower trapezius strengthening exercises most effectively improves rounded shoulder posture. Methods : Thirty-one people with rounded shoulders, the subjects of this study, were selected. With the use of a random number table, group A was randomly assigned to a Y-type exercise, group B to a T-type exercise, and group C to an MPC exercise. In the prone position, both arms are abducted at the angles suggested for each group (145 °, 90 °, and 45 °, respectively), and the hands are holding dumbbells to assume a functional posture. With the start signal, the thumb raised the arm to the sky and the arm is raised to the level of the ear for 10 seconds and then returned to the original position. Each week, the strength required was increased by changing the resistance weight, number of times, and set, and the exercise was performed three times a week for a total of four weeks. Results : There was a significant difference in the change in shoulder height of each group after four weeks of exercise in comparison to the amount of change in height before and after exercise in all groups (p<.05). However, no significant difference was observed between all groups in the change in muscle activity of the lower trapezius muscle in each group following four weeks of exercise (p>.05). Conclusion : The results of this study showed that the three lower trapezius strengthening exercises have a positive effect on the improvement of rounded shoulders. In consideration of these results, it is therefore proposed that the various lower trapezius strengthening exercises be applied in parallel during physical therapy for patients with rounded shoulders in clinical practice.

• 한국운동역학회지
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• 제20권2호
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• pp.197-204
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• 2010

Scapular position and motion are essential for normal upper limb mobility; Further, the posture of patients with thoracic kyphosis is related to shoulder girdle function and disorder. The purpose of this study was to examine the effects of thoracic posture on the shoulder range of motion and on three-dimensional scapular kinematics. Thirty healthy subjects performed right-arm abduction along the frontal plane while standing in both erect and in slouched trunk posture. The scapular position and rotation, and shoulder and thoracic angles were recorded using a motion analysis system. The scapular upward rotation and internal rotation were significantly altered according to postural tatiges; however, scapular tilt was not affected. Shoulder angle was significantly decreased in the slouched posture as c rpared to tatt in the erect posture. Thus, a slouched posture(thoracic kyphosis) significantly affects the shoulder range of motion and scapular kinematics during shoulder abduction in the frontal plane.

• PNF and Movement
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• 제21권1호
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• pp.95-105
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• 2023

Purpose: The study aims to determine the effect of a breathing exercise on shoulder pain, range of motion (ROM), and forward head posture in patients with rotator cuff repair. Methods: In total, 25 patients with rotator cuff repair were included in this study. The experimental group (n = 13) underwent a breathing exercise, while the control group (n = 12) received traditional physical therapy. The visual analogue scales (VASs) for pain, flexion and abduction ROM, and the craniovertebral angle (CVA) of both groups were recorded at both pre- and post-intervention. Paired t-tests were used to determine significant changes in the post-intervention compared with the pre-intervention period, and independent t-tests were used to analyze differences in dependent variables between the two groups. Results: After the two-week intervention, the experimental group experienced a significantly decreased VAS (p < 0.05) and significantly increased ROM and CVA (p < 0.05), while the control group experienced a significantly decreased VAS (p < 0.05). Further, the experimental group that underwent the breathing exercise showed greater improvements in flexion and abduction ROM and in the CVA than the control group (p < 0.05). Conclusion: The results suggested that a breathing exercise can reduce shoulder pain and enhance ROM and posture in patients with rotator cuff repair.

• The Journal of Korean Physical Therapy
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• 제22권4호
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• pp.21-28
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• 2010

Purpose: The purpose of this study was to evaluate the electromyographic (EMG) activity of vastus medialis oblique (VMO) and vastus lateralis (VL) muscles on foot position and knee angle for hemiplegia patients. Methods: Ten stroke subjects (10 males) participated in the study. Subjects were all right-hemiplegic patients. All subjects did $0^{\circ},\;20^{\circ}$ and $40^{\circ}$ knee flexion while maintaining the foot in a neutral position, or at $30^{\circ}$ adduction or at $30^{\circ}$ abduction. Surface EMG data were collected for VMO and VL muscles on the non-hemiplegic side and hemiplegic side. Collected data were analyzed using two-way ANOVA. Results: VMO and VL activities for the non-hemiplegic and the hemiplegic sides were highest for $40^{\circ}$ knee flexion while maintaining the three foot positions. There were no significant differences in EMG activity of the VMO and VL muscles with different foot positions. There were significant differences between VMO and VL activity for knee flexion angle while maintaining the foot in neutral (p<0.05), at $30^{\circ}$ adduction (p<0.05), or at $30^{\circ}$ abduction (p<0.05). Conclusion: Foot position does not influence VMO and VL activities. But, knee flexion exercise in a closed chain can increase VMO and VL muscle activity for hemiplegic patients. In particular, VMO and VL activities for both the non-hemi side and the hemi side were highest for $40^{\circ}$ knee flexion.