• Physical Therapy Korea
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• v.21 no.4
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• pp.9-14
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• 2014

Violinists tend to position the neck asymmetrically to hold the violin between the chin and the left shoulder. Asymmetrical neck posture may induce unilateral neck pain. Previous studies have suggested that individuals with unilateral neck pain exhibit reduced muscle strength of the lower trapezius, but no study has investigated violinists with unilateral neck pain. To this end, we recruited 18 violinists with unilateral neck pain for the present study in which the side on which neck pain was experienced, pain duration, and intensity were recorded. Lower trapezius strength was measured bilaterally in each subject using a handheld dynamometer. Significant differences in lower trapezius strength were evident between the ipsilateral and contralateral sides of neck pain (p<.05). No significant association between neck pain intensity or duration, and the extent of a deficit in lower trapezius strength, was evident (both p>.05). The association between the sides of weakened lower trapezius strength and neck pain was significant (p<.05). In conclusion, violinists with unilateral neck pain exhibited significantly less lower trapezius strength on the ipsilateral compared to the contralateral side of the pain. Unilateral neck pain more frequently involved the left side of the neck, which is used to stabilize the violin during playing. Thus, our study suggests that a possible relationship exists between muscle weakness in the lower trapezius and neck pain.

• Physical Therapy Korea
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• v.22 no.1
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• pp.58-68
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• 2015

This study aimed to determine the effect of lower trapezius muscle strengthening exercises on pain, neck disability index (NDI), cervical range of motion (ROM), and lower trapezius muscle strength in patients with unilateral neck pain. Following baseline measurements, the subjects (N=40) with unilateral neck pain were randomized into one of two 5 weeks exercise intervention groups: a experimental group (EG, $n_1=20$) that received strength training of the lower trapezius muscles or a control group (CG, $n_2=20$) that received routine physical therapy program. Each group participated in the intervention for 30 minutes, 3 times a week, for 5 weeks. All participants performed 2 repetitions of each intervention per day. The numeric pain rating scale for pain, NDI, ROM, and lower trapezius strength were recorded both pre- and post-intervention for both groups. Paired t-tests were used to determine significant changes post-intervention compared with pre-intervention and independent t-tests were used to analyze differences in the dependent variables between the 2 groups. After the 5-weeks intervention, both groups experienced significantly decreased pain and disability level (p<.05) and significantly increased cervical flexion, extension, lateral flexion, and rotation ROM (p<.05). The EG that received strength training of the lower trapezius muscles showed greater improvements in pain and functional disability level, cervical rotation, and lower trapezius strength than the CG (p<.05). These results suggest that a lower trapezius strengthening exercises reduce neck pain and neck disability level and enhance cervical ROM and lower trapezius strength level in patients with unilateral neck pain.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.3
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• pp.143-153
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• 2024

Purpose : Forward head posture (FHP), characterized by the anterior positioning of the head relative to the spine, is a common postural deviation that can lead to neck pain, reduced mobility, and muscle imbalances. Recently, high-frequency deep heat therapy (HFDT) has been gaining attention for the intervention of FHP. This research aims to investigate the efficacy of HFDT in comparison to instrument assisted soft-tissue mobilization (IASTM) for treating FHP among 30 young adults. Methods : Participants were randomly assigned to either the HFDT or IASTM group. The study focused on examining changes in neck joint mobility, pain thresholds, rounded shoulder distance, lower trapezius muscle strength, and neck dysfunction. Measurements were taken before and after the interventions. Paired t-tests were used for within-group analyses, and independent t-tests were employed for between-group comparisons. The statistical significance level α was set to .05. Results : Statistically significant improvements were observed across all measured parameters in both groups (p<.05). The HFDT group showed significantly greater enhancements in neck joint mobility, pain thresholds, rounded shoulder distance, lower trapezius muscle strength, and neck dysfunction parameters. Specifically, HFDT was more effective than IASTM in improving neck joint mobility, right upper trapezius pain threshold, left rounded shoulder distance, and right lower trapezius strength. The only exceptions were neck flexion range of motion, left upper trapezius pain threshold, right rounded shoulder distance, and left lower trapezius strength, where no significant differences were found between the groups. Conclusion : The findings suggest that HFDT, by combining the benefits of high-frequency therapy and manual therapy, effectively alleviates upper trapezius muscle pain and tension, enhances neck mobility, and strengthens lower trapezius muscles. Thus, HFDT could be considered a valuable intervention for clinicians aiming to address FHP and associated musculoskeletal problems.

• Physical Therapy Rehabilitation Science
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• v.5 no.2
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• pp.95-100
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• 2016

Objective: The purpose of this study was to investigate effects of hand grip strength on the muscle activation of shoulder joint in breast cancer patients. Design: Cross-sectional study. Methods: Ten breast cancer patients who agreed to active participation were included. These patients were operated with either conservative surgery or segmental mastectomy, and then were treated with radiation therapy and chemotherapy. The activity of the upper trapezius, lower trapezius, supraspinatus and serratus anterior muscle were measured using surface electrodes during 4 hand gripping tasks (lowered their arms in standing position, 0%, 30%, and 50% of maximum voluntary contraction) in the scapular abduction plane. Results: The results were analyzed using a one-way repeated measures ANOVA. There was a significant difference in the lower trapezius and supraspinatus muscles according to grip strength, lower trapezius and supraspinatus muscles showed significantly difference according to grip strength (p<0.05). The result of the muscle activation according to hand strength (0%, 30%, and 50%) it showed a significant difference between the upper trapezius and supraspinatus in 0% grip strength (p<0.05). In addition, it did not show a significant difference between muscles in 30%, 50% hand strength. Conclusions: This study showed an increase in shoulder muscle activation with increasing hand grip strength with the upper trapezius muscle being more activated than other muscles in 0% grip strength. The finding of this study suggests usefulness for development of preventative measures and rehabilitation strategies for increasing shoulder motor function in patients with breast cancer.

• Journal of The Korean Society of Integrative Medicine
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• v.3 no.3
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• pp.1-8
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• 2015

Purpose : The purpose of this study was to find out the effect of shoulder exercise program for improving forward head posture. Method : Subjects were divided into two groups. The experimental group(15 people) participated in strength exercise and stretching exercise, three times every week, during 4 weeks. And the control group(the other 15 people) didn't participate in exercises. Exercise program was composed of strength exercise of middle and lower trapezius and stretching exercise of levator scapulae and upper trapezius. And then we measured cervical alignment with GPS and muscular activity by EMG. Result : The results of this study were as follows; 1. After the intervention, experimental group was significantly decreased in cervical alignment than control group(p<.05). 2. After the intervention, experimental group was significantly increased in middle lower trapezius musclar activity than control group(p<.05). Conclusion : Strength exercise of middle and lower trapezius and stretching exercise of levator scapulae and upper trapezius were considered a efficient for improving forward head posture.

• PNF and Movement
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• v.19 no.3
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• pp.401-412
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• 2021

Purpose: The study aimed to determine the effect of the proprioceptive neuromuscular facilitation (PNF) lower trapezius muscle strengthening exercise on pain, shoulder range of motion, and shoulder pain and disability index (SPADI) in patients with frozen shoulder. Methods: Following baseline measurements, 30 subjects (n=30) with frozen shoulder were randomized into two groups: the PNF group (n=15), which received PNF strength training of the lower trapezius muscles, and the control group (n=15), which received gentle palpation of the skin. Each group participated in the intervention for 30 minutes, three times per week, for six weeks. The visual analogue scales for pain, range of motion, and SPADI of both groups were recorded at both pre- and post-intervention. Paired t-tests were used to determine significant changes in the post-intervention period compared with pre-intervention, and independent t-tests were used to analyze differences in the dependent variables between the two groups. Results: After the six-week intervention, both groups experienced significantly decreased pain and SPADI (p < 0.05) and significantly increased shoulder flexion, abduction, internal rotation, and external rotation range of motion (p < 0.05). The PNF group that received the PNF strength exercise of the lower trapezius muscles showed greater improvements in pain and range of motion than those of the control group (p < 0.05). Conclusion: These results suggest that the PNF lower trapezius strengthening exercise reduces shoulder pain and disability levels and enhances shoulder range of motion in patients with frozen shoulder.

• PNF and Movement
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• v.19 no.1
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• pp.137-146
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• 2021

Purpose: The study aimed to determine the effect of proprioceptive neuromuscular facilitation (PNF) lower trapezius muscle strengthening exercise on pain, cervical range of motion (ROM), and neck disability index (NDI) in patients with chronic neck pain. Methods: Following baseline measurements, the subjects (n = 30) with chronic neck pain were randomized into two groups: the PNF group (n = 15) that received PNF strength training of the lower trapezius muscles or a control group (n = 15) that received gentle palpation of the skin. Each group participated in the intervention for 30 min, three times per week for six weeks. The visual analogue scale for pain, ROM, and NDI 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 pre-intervention, and independent t-tests were used to analyze differences in the dependent variables between the two groups. Results: After the six-week intervention, both groups experienced significantly decreased pain and NDI (p < 0.05) and significantly increased cervical flexion, extension, lateral flexion, and rotation ROM (p < 0.05). The PNF group that received PNF strength exercise of the lower trapezius muscles showed greater improvements in pain and NDI and cervical rotation of ROM than those of the control group (p < 0.05). Conclusion: These results suggest that the PNF lower trapezius strengthening exercise reduces neck pain and disability level and enhances cervical ROM in patients with chronic neck pain.

• Journal of Korean Physical Therapy Science
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• v.30 no.3
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• pp.14-22
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• 2023

Background: This study was to investigate the relationship between scapular downward rotation ratio (SDRR), lower trapezius (LT) muscle, and rounded shoulder angle (RSA) on each side in subjects with scapular downward rotation syndrome (SDRS). Design: Cross-sectional Study Methods: Fifteen subjects have participated in this study. The RSA and SDRR were assessed using a tape measure in standing posture. The RSA was computed by the angle made by two lines: one was the distance between the root of the scapula and the acromion, and the other was the distance between the acromion and the horizontal line in the root of the scapula. The SDRR was computed by two horizontal lines: one was the distance between the mid-line and root of the scapula, and the other was the distance between the mid-line and inferior angle of the scapula. LT muscle strength was performed in a prone position by the hand-held dynamometer. Results: There was a positive correlation between SDRR and LT strength in the less affected sides (r=.59; p=.02), however, there was no correlation between RSA and LT strength in the more affected sides (p>.05).

• Journal of the Korean Society of Physical Medicine
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• v.10 no.2
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• pp.9-16
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• 2015

PURPOSE: The objective of this study was to identify the effects of shoulder abduction strength and EMG activities of the selected scapular and shoulder muscles during isometric shoulder abduction. METHODS: Thirty-four healthy young females were recruited for this study. Surface EMG equipment with inline force sensor was used to determine the shoulder abductor strength and the activity of the serratus anterior (SA), upper trapezius (UT), lower trapezius (LT), and middle deltoid (MD) during three shoe heel height conditions: (1) barefoot, (2) 3-cm shoe heel height, and (3) 7-cm shoe heel height. RESULTS: Isometric shoulder strength showed statistically significant difference among the conditions (p<0.05), and post-hoc test showed lower strength during the 7-cm condition ($49.98{\pm}17.56kg$) than during the barefoot ($44.97{\pm}20.15kg$) and 3-cm conditions ($36.59{\pm}17.07kg$). Furthermore, EMG activities of the SA, UT, and MD appeared to be statistically significantly different among the conditions, with lower values in the 7-cm condition compared to the barefoot condition (p<0.05). EMG ratios (MD/UT and SA/UT) were lower during the 7-cm condition than during the barefoot condition (p<0.05). CONCLUSION: These findings suggest that isometric shoulder abduction strength and EMG activities of scapular and shoulder muscles may be adversely changed with increasing shoe heel height.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.1
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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.