• Physical Therapy Korea
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• v.25 no.3
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• pp.1-11
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• 2018

Background: Lumbopelvic stability is highly important for exercise therapy for patients with low back pain and shoulder dysfunction. It can be attained using a pelvic compression belt. Previous studies showed that external pelvic compression (EPC) enhances form closure by reducing sacroiliac joint laxity and selectively strengthens force closure and motor control by reducing the compensatory activity of the stabilizer. In addition, when the pelvic compression belt was placed directly on the anterior superior iliac spine, the laxity of the sacroiliac cephalic joint could be significantly reduced. Objects: This study aimed to compare the effects of EPC on lumbopelvic and shoulder muscle surface electromyography (EMG) activities during push-up plus (PUP) and deadlift (DL) exercise, trunk extensor strength during DL exercise. Methods: Thirty-eight subjects (21 men and 17 women) volunteered to participate in this study. The subjects were instructed to perform PUP and DL with and without the EPC. EMG data were collect from serratus anterior (SA), pectoralis major (PM), erector spinae (ES), and multifidus (MF). Trunk extensor strength were tested in DL exercise. The data were collected during 3 repetitions of all exercise and the mean of root mean square was used for analysis. Results: The EMG activities of the SA and PM were significantly increased in PUP with pelvic compression as compared with PUP without pelvic compression (p<.05). In DL exercise, a significant improvement in trunk extensor strength was observed during DL exercise with pelvic compression (p<.05). Conclusion: The results of this study indicate that lumbopelvic stabilization reinforced with external pelvic compression may be propitious to strengthen PUP in more-active SA and PM muscles. Applying EPC can improve the trunk extensor strength during DL exercise. Our study shows that EPC was beneficial to improve the PUP and DL exercise efficiency.

• Physical Therapy Korea
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• v.28 no.4
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• pp.256-265
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• 2021

Background: Individuals with scapular winging may have proprioceptive dysfunction which is important for motor control and causes shoulder instability. Reduced serratus anterior (SA) and lower trapezius (LT) muscle activity accompanied by over-active upper trapezius (UT), and pectoralis major (PM) may be contributing factors. Flexi-bar (FB) exercise may be used to increase joint position sense (JPS) and alter the target muscle activities. Objects: This study aimed to investigate the immediate effects of flexi-bar exercise prior to knee push-up plus (FPK) versus knee push-up plus (KPP) on JPS and muscle activity of SA, LT, UT, and PM in subjects with scapular winging. Methods: Eighteen subjects with scapular winging were recruited. JPS was investigated at baseline, after KPP and after FPK. Passive and active JPS errors were calculated by isokinetic equipment. Surface electromyography was used to record muscle activities during KPP and FPK. One-way repeated-measures analysis of variance and post hoc analyses were used to analyze the JPS error measured at baseline, after KPP and after FPK. Paired t-tests were used to compare muscle activities between KPP and FPK. Results: Passive JPS error was significantly decreased after KPP (p = 0.005) and after FPK (p = 0.003) compared to the baseline. Active JPS error was also significantly decreased after KPP (p = 0.016) and after FPK (p = 0.012) compared to the baseline. There was no significant difference in the passive and active JPS errors between KPP and FPK. SA activity during FPK was significantly increased (p = 0.024), and LT activity during FPK was significantly increased (p = 0.006). There were no significant differences in the UT and PM activity. Conclusion: FB might be recommended to immediately improve passive and active JPS and to selectively increase SA and LT muscle activities during KPP in individuals with scapular winging.

• Journal of The Korean Society of Integrative Medicine
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• v.1 no.3
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• pp.51-62
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• 2013

PURPOSE : This study of 20 healthy male subjects by applying various scapular stabilization exercise to compared Serratus anterior and lower trapezius is change in ultrasound images. METHOD : Thirty healthy subjects voluntarily participated in this study. Ultrasound imaging was recorded from the increasing the activity of Serratus anterior(SA) and Lower trapezius(LT) muscles using Push-up plus, Wall slide, Scapular plane shoulder elevation with resistance exercise. Thickness changes in the Serratus anterior(SA) and lower trapezius(LT) muscles between the relaxed and contracted states in the each exercises. To identify statistical significance, one-way ANOVA with repeated measures was used with the significance level of .05. RESULT : The results of this study were as follows : 1) There were statistically significant difference in thickness changes in the Serratus anterior(SA) and lower trapezius(LT) muscles between the relaxed and contracted states in the each exercises. 2) The Scapular plane shoulder elevation with resistance is more effective to Strengthening in the scapular stabilization muscles than Push up-plus and Wall slide. CONCLUSION : The Scapular plane shoulder elevation with resistance may be used to effectively that patient with various shoulder pain.

• Physical Therapy Korea
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• v.24 no.4
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• pp.29-37
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• 2017

Background: The serratus anterior (SA) muscle is one of the important muscles in the upward rotation of the scapula when the arm is raised. Insufficient muscle activity of the SA can cause deformation of the shoulder rhythm resulting in shoulder pathology. Objects: This study intends to compare SA and upper trapezius (UT) activity during the conventional wall-slide and push-up plus exercises for SA muscle strengthening and the scapular upward rotation (SUR) exercise. Methods: A total of 30 subjects participated in this study, and we measured the muscle activity of the SA and UT muscles during the wall-slide, push-up plus and SUR exercises. The one-way repeated ANOVA was used to compare SA and UT muscle activities during the 3 exercises. Results: During the SUR exercise, SA muscle activity was 79.88% maximum voluntary isometric contraction (MVIC), which was significantly higher than its activity during the other 2 exercises. The UT muscle activity was 47.53 %MVIC during the SUR exercise, indicating a significantly higher UT muscle activity than during the other 2 exercises. Conclusion: These findings suggest that the SUR exercise can maximize SA muscle activity to strengthen the SA while keeping UT muscle activity at an appropriate level.

• Journal of Digital Convergence
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• v.10 no.1
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• pp.399-405
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• 2012

The purpose of this study was to compare the shoulder stabilizer muscle activity during a push up plus on a different conditioning surface. Eighteen healthy volunteers were tested. Surface EMG was recorded from the upper trapezius(UT), pectoralis major(PM), and serratus anterior(SA) using surface differential conditions. Measurements were performed for 7 days. The mean root mean square (RMS) of EMG activity was calculated. A one-way repeated measures analysis of variance was performed to compare RMS normalized values. The UT and PM did not show significant differences of electric activation amplitude in relation to different surface conditions(p>.05). However, the SA showed greater mean electric activation amplitude values on the push up plus exercise on a upper and lower unstable surface(p<.05). These results suggest that to improve SA EMG activity is more useful when performed on a upper and lower unstable surface conditions than on a stable surface conditions.

• The Journal of Korean Physical Therapy
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• v.28 no.2
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• pp.106-111
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• 2016

Purpose: The aim of this study is to determine the effect of glenohumeral (GH) rotation position in modified knee push-up plus exercise (MKPUP) by examining the surface electromyography (EMG) amplitude in serratus anterior (SA), pectoralis major (PM), and upper trapezius (UTz) and the activity ratio of each muscle. Methods: A total of 22 healthy subjects volunteered for the study. Each subject performed the MKPUP at $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$ of GH joint internal rotation. EMG of the SA and PM, UTz was compared between GH rotation positions and each muscle activity ratio. EMG was used to measure the muscle activity in terms of ratios to maximal voluntary isometric contraction (MVIC). Results: The difference in EMG activity during the exercise in three GH joint internal rotation positions was observed with the SA and the PM. The greater the GH joint internal rotation angle was, the lower the activity of the PM. In contrast, the SA showed higher activity. However, the activity of UT was similar under all conditions. The ratio of the SA and the PM was considerably greater at $90^{\circ}$ GH joint internal rotation than at $0^{\circ}$ and $45^{\circ}$. Conclusion: When excessive activation of the PM or imbalanced activation between the PM and the SA occurs, the MKPUP exercise is most effective at $90^{\circ}$ of GH joint internal rotation. Use of this position would be a beneficial strategy for selective strengthening of the SA and minimizing PM activation.

• Physical Therapy Korea
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• v.31 no.1
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• pp.55-62
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• 2024

Background: The serratus anterior (SA) is a muscle that performs protraction of the scapulothoracic joint and plays a role in stabilizing the scapula. Imbalances or weaknesses in SA activation are associated with a variety of shoulder dysfunctions, making selective SA strengthening important for rehabilitation. Objects: We aimed to compare the muscle activation of the pectoralis major (PM), SA, external oblique (EO), and internal oblique (IO) during the push-up plus (PUP) exercise with isometric hip adduction (HA) and abdominal drawing-in maneuver (ADIM). Methods: Nineteen healthy male participants performed three PUP exercises: standard PUP, PUP with ADIM, and PUP with HA. Surface electromyography was used to measure and analyze the muscle activity for PM, SA, EO, and IO. Results: PUP with HA showed the lowest PM activity and highest SA activity, and no significant difference was observed between PUP and PUP with ADIM. PUP with ADIM showed significantly the highest EO and IO activity, followed by PUP with HA and PUP. Additionally, PUP with HA showed the lowest PM/SA ratio, and no significant difference was noted between PUP and PUP with ADIM. Conclusion: PUP with HA was able to show high SA muscle activity while reducing PM muscle activity. In addition, PUP with HA can lead to higher EO and IO muscle activity than standard PUP. This exercise could be used as a practical exercise method to selectively strengthen SA and improve scapular muscle stability during early shoulder rehabilitation.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.9 no.2
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• pp.69-77
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• 2003

Objective: The purpose of this study is to describe the effect of the serratus anterior muscle exercise in a patient with winging of the scapular. Background and Purpose: The patient was a 33-year-old man with an 3 years history of the left deltoid region. He had not responded to previous treatments of rest, TENS and medicine. Materials and Methods: After Surgical operation of the shoulder, the patient was treated for 6 months in 144 visits. treatment consisted of push-up with plus in the standing position with his hands against the wall and unique push-up with quadruped position at mat. Also, Sling exercise therapy was utilized to control scapular stabilization and reduce stress on the scapulohumeral joint. Result: Following 104 physical therapy visits, the patient was able to full range of motion of the shoulder without shrug motion. Conclusion and Discussion: Scapular winging and serratus anterior muscle function are important consider in the rehabilitation of the shoulder dysfunction. Therefore, specific exercise program for people with the winging scapular should be considered.

• Physical Therapy Korea
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• v.24 no.1
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• pp.61-70
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• 2017

Background: Scapular winging is a prominence of the entire scapular medial border, mainly caused by insufficient activity of the serratus anterior (SA) and imbalance of scapulothoracic muscles. Push-up plus (PUP) exercise has been commonly used to increase SA muscle activity. The facilitation of abdominal muscle may affect scapular muscle activity by myofascial connections. Thus, the sequential activation of the turnk muscles is suggested to facilitate the transition of proper force from upper limb and restore force couple of scapular muscles. The abdominal drawing-in maneuver (ADIM) has been effective in improving activation of the deep trunk muscles during movement. Objects: The aim of this study was to determine the effect of ADIM on the activity of the upper trapezius (UT), lower trapezius (LT), and SA during PUP exercises in subjects with scapular winging. Methods: Fourteen men with scapular winging (determined as a of distance between the scapular medial border and thoracic wall over 3 cm) volunteered for our study. The subjects performed the PUP exercise with and without ADIM. Surface electromyography was used to collect the electromyography data of the UT, LT, and SA. A scapulometer was used to measure the amount of scapular winging. Results: SA activity was significantly greater and scapular winging significantly lower during the PUP exercise with ADIM than during those without ADIM. Conclusion: PUP exercise with ADIM can be used as an beneficial method to improve SA activation and to reduce the amount of scapular winging in subjects with scapular winging.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.199-207
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• 2022

Purpose : The purpose of this study is to investigate the effect of shoulder stabilization exercise accompanied by application of a pelvic compression belt on the muscle activity, pain and function of the muscles around the shoulder in subjects with round shoulders. Methods : For the study method, 28 students who were enrolled in K University with a distance of 1 cm or more between the clavicle of the peak and the outer ear path were selected through GPS 400 global postural analysis system measurement. The subjects were randomly assigned to 14 participants in the group wearing a pelvic compression belt and 14 patients in the group not wearing a pelvic compression belt. In all subjects, the muscle activities of the middle trapezius, lower trapezius, and serratus anterior muscles and the shoulder pain disorder index (SPADI) were measured. The intervention was performed 3 times a week for 4 weeks, and the applied intervention was push-up plus and modified prone cobra exercise. The muscle activities of the middle trapezius, lower trapezius, and serratus anterior muscles and SPADI score were compared using dependent t test before and after intervention. Results : In this study, both groups showed that the muscle activity of the middle trapezius, lower trapezius, and serratus anterior significantly increased after the intervention compared to before the intervention. On the other hand, SPADI showed no significant difference. Conclusion : The results of this study showed that muscle activity in the peri-shoulder joint was increased after push-up plus and modified prone cobra exercise in both groups, regardless of whether pelvic compression was applied or not. Therefore, it was found that shoulder stabilization exercise using the pelvic compression belt also contributed to the enhancement of muscle activity in the joints around the shoulder.