• PNF and Movement
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• v.20 no.3
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• pp.399-408
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• 2022

Purpose: This study investigated the differences in winged scapula between the symptomatic side and asymptomatic side, the reliability of the winged scapula test, and the correlation between winged scapula and the stability of the scapula in patients with subacromial impingement syndrome. Methods: Twenty-four patients with unilateral subacromial impingement syndrome participated in this study. Winged scapula was compared between the symptomatic and asymptomatic sides using a scapulometer. The reliability of the scapulometer was assessed by calculating the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal clinically important difference (MCID). The correlation between winged scapula and the results of the upper quarter Y-balance test were also obtained. Conclusion: Winged scapula was significantly greater on the symptomatic side compared with the asymptomatic side (p < 0.05). High to excellent ICCs were obtained for the winged scapula test, and SEM and MCID values were obtained for winged scapula (SEM: 0.2-0.3 cm, MCID: 0.6-0.8 cm); however, winged scapula and the results of the upper quarter Y-balance test were not correlated. Conclusion: The scapulometer is useful for measuring winged scapula in patients with subacromial impingement syndrome.

• Clinics in Shoulder and Elbow
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• v.3 no.1
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• pp.39-43
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• 2000

Osteochondromas, the most common tumor of the scapula, are one type of bone abnormality that may cause symptomatic scapula pseudowinging. This type of scapula winging is structural and maybe associated with significant scapula crepitus. We describe a case of a scapular solitary osteochondroma, arised from the ventral surface of the scapula in a 15-year-old boy, produced pseudowinging and scapula crepitus. The winging and scapula crepitus are alleviated with resection of the bony abnormality.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.2
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• pp.29-36
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• 2018

Background: The purpose of this study was to investigate the effect of leg lift difference on serratus and upper trapezius when exercising in a scapula in a prone position, a typical waist stabilization exercise for subjects with a winged scapula. Method: Twenty normal adults and 20 subjects with winged scapula participated in the experiment. The surface EMG recordings were obtained from external oblique muscle and internal oblique muscle during scapula protraction exercise. The presence or absence of winging of the shoulder bone was measured using an electronic digital caliper for the distance the medial border of the scapula is lifted to the rear. In prostrate pier movement posture in both groups, both legs supporting, dominant leg lifting, and non-dominant leg lifting including the scapula protraction were conducted respectively. Results: In the results of comparison between the two groups, the dominant external oblique muscle and the non-dominant internal oblique muscle tended to increase according to the difference of the leg lifting of normal people. In the winged scapula group, internal oblique muscle showed increased muscle activity more than external oblique muscle. Conclusion: It was most effective to exercise with lifting the same position leg for strengthening the same external oblique muscle, and the opposite internal oblique muscle. Also, it is effective to exercise in prone pier movement posture for trunk stability. In addition, internal oblique muscle shows increased muscle activity in subjects with winged scapula. Therefore, appropriate adjustment of external oblique muscle and internal oblique muscle may have a positive effect on scapula dysfunction for trunk stability.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.1
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• pp.29-36
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• 2019

Background: This study was conducted to investigate the effect of leg lift difference on the serratus anterior muscle and the upper trapezius muscle when a subject with winged scapula performs a scapula protraction exercise in a four-leg crawling posture. Method: Twenty normal adults and 20 subjects with winged scapula participated in the experiment. Surface EMG recordings were collected from serratus anterior muscle and back trapezius muscle during scapula protraction exercises. Scapular winging is measured with the lifting distance of scapula retraction to the back using an electronic digital caliper. In two groups of four-leg crawling posture, the two legs support, the dominant leg lifting, and the non-dominant leg lifting, including the scapula protraction, were performed. To examine the difference between groups in the variance analysis, the Bonferroni correction was used (significance level ${\alpha}=.017$). Statistical significance level ${\alpha}$ was .05. Results: There was a significant difference in serratus anterior muscle and upper trapezius muscle during push-up plus exercise in leg lifting in four-leg crawling posture, but there were no significant differences in muscle activity between serratus anterior muscle and upper trapezius muscle, and there was no significant difference according to the presence or absence of scapular winging. Conclusion: For the shoulder stability of the ipsilateral side with the serratus anterior muscle, the leg-lifting posture is effective in the four-leg crawling, and also when a subject with winged scapula chooses an exercise, lifting the ipsilateral side of leg with scapula protraction exercises at the same time may have a positive effect on scapula dysfunction.

• Clinics in Shoulder and Elbow
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• v.7 no.1
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• pp.46-50
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• 2004

The snapping scapula is a relatively uncommon phenomenon occuring as a consequence of some anomalous conditioin existing between the thoracic wall and the undersurface of the scapula. It may present in several ways like crepitus, pain during scapular movement and limitation of scapular motion. The causes of snapping scapula are changes in the intervening soft tissues, the muscles, or the bursae between the scapula and the chest wall; and changes in the congruence between the anterior scapular surface and the underlying chest wall. The congenital elbow fusion or humeroradioulnar synostosis is an extremely rare inheritable disorder that previously described just a few reports. Recently we experienced a case of snapping scapular with congenital bilateral elbow fusion treated by arthroscopic scapulothoracic bursectomy and consequent open superomedial scapulectomy. We would describe the clinical feature of a snapping scapula and result of treatment with literature review.

• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.170-175
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• 2005

Painful and disabling snapping scapula is an unusual condition and there have been several reports that have revealed good results after surgical treatment for unilateral snapping scapula. We experienced a case of bilateral painful snapping scapula in a young man, but with successful treatment by partial resection of the superomedial angle of both scapula. Preoperative 3-dimensional CT revealed bony prominence of the superomedial angle of both scapula and narrowing between superior scapular angle and chest wall.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.1
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• pp.57-65
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• 2018

Background: This study examined the effects of nerve mobilization exercise and scapula postural correction exercise and scapula postural correction exercise after applying conservative physical therapy to frozen shoulder. Methods: Thirty-four outpatients were divided into a nerve mobilization exercise and scapula postural correction exercise group and scapula postural correction exercise group. Each group performed its own exercise 30 minutes per day, three times per week, for 6 weeks. Pain intensity was measured by the visual analogue scale. Range of motion was measured by the goniometer. The scapular position was measured by scapular index. Grasping power was measured by the Grip Track Commander. Measurements were made at baseline and six weeks after the intervention. Results: the visual analogue scale, range of motion (except lateral rotation), and grasping power for each group showed significant changes at baseline and six weeks after the intervention (p<.05). Significant differences were also evident between the two groups for these three measurements (p<.05). Conclusions: Nerve mobilization exercise & scapula postural correction exercise is more effective than scapula postural correction exercise for reducing pain intensity and increasing grasping power, scapular index and range of motion (except lateral rotation) in frozen shoulder syndrome patients.

• Journal of the Korean Society of Radiology
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• v.4 no.2
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• pp.13-20
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• 2010

True lateral scapula image was very important to diagnosis the scapula fracture and dislocation induced by traumatic injury. The aim of this study was to know the patient rotation angle to be showing the scapula true lateral in korean. d Materials Thirty patients(22men, 8 women, mean ages 53.4)with scapular pain, had supine Anteroposterior projection taken with $30^{\circ}$, $40^{\circ}$, $45^{\circ}$ trunk rotation angle changing the manual angulation material. Radiographs were evaluated independently by 5 experienced observers(1 orthopedics surgery specialist, 1 diagnostic radiology specialist, 3 radiological technologist) They assessed overlap of vertebral border and axillary border of scapula as follows; Totally overlapping of vertebral border and axillary border is 4, partially overlapping is 3, not overlapping is 2 and oblique location with two borders is 1. All observers scored using by PACS monitor.$30^{\circ}$ trunk rotation was scored $1.53{\pm}0.39$, $40^{\circ}$ trunk rotation was scored $3.83{\pm}0.15$ and $45^{\circ}$ trunk rotation was scored $2.17{\pm}0.43$. There was no difference(p<0.05) between group of more than 100cm of the girth of the chest and group of less than 100cm. Similarly, men and women group showed no difference(p<0.05) with trunk rotation statistically. There was no result of trunk rotation angle to radiograph the true scapula lateral image up to date. This studies were summarized as follows; Adaptation of $40^{\circ}$ trunk rotation was the best to show the true scapula lateral image in korean. Our results were very useful to get the true scapula lateral images in clinic.

• Korean Journal of Applied Biomechanics
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• v.21 no.1
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• pp.77-83
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• 2011

In dance sport, hip movement is the most basic and essential technique, connecting the body movements to make the body move organically, and providing an overall balance of body movements. From that perspective, this study focused on the Cucarachas movement, representing a series of efficient hip movements in the center of gravity. For the purposes of this study, 4 dance sport participants who had won prizes at international contests were selected in order to analyze such variables as the radius of gyration (shift) on the hips and the shift of the center of gravity when scapula depression was performed and when it was not. To examine differences in these kinematic variables, a paired t-test was conducted, resulting in the following findings: First, the dancers were found to be able to control scapula depression, and a significant difference was observed in the vertical axis(Z) between the times when scapula depression was performed and when it was not. Second, when scapula depression was performed, shifts in the left-right axis(X) and anterior-posterior axis(Y) were found; the left-right axis showed a greater difference than the anterior-posterior axis. Third, scapula depression was found to have an influence on the shift to the left-right axis(X) of the center of gravity.

• PNF and Movement
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• v.13 no.2
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• pp.73-80
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• 2015

Purpose: The purpose of this study was to determine the effect of symmetrical-reciprocal pattern of scapula and pelvis exercises using proprioceptive neuromuscular facilitation (PNF) on gait speed and balance in patients with hemiplegia. Methods: Among the adult patients with hemiplegia that were hospitalized at Michuhol Rehabilitation Center after being diagnosed with stroke, 10 that were capable of independent walking for more than five minutes and that understood and cooperated with the therapy and test methods of this research, were selected as subjects. The therapy was implemented based on the concept of PNF, and it was performed on a low mat and a height-adjustable mat, as proscribed by the fundamental procedure for PNF. Symmetrical-reciprocal pattern of scapula and pelvis exercises were applied to the patients in the decubitus position. The therapy scheme included stabilizing reversals, rhythmic stabilization, and a combination of isotonics, rhythmic initiation, and dynamic reversals. To investigate gait speed and body trunk mobility before and after the symmetrical-reciprocal pattern of scapula and pelvis exercises were applied, walking speed for a distance of 10 m was measured and balance was tested based on the Berg-Balance scale test table. The Berg-Balance scale test was performed by one therapist to minimize any error that could occur from the subjective evaluation method used by therapists. Results: Gait speed increased by 8.97 seconds after applying the symmetrical-reciprocal pattern of scapula and pelvis exercises using the concept of PNF, showing a significant difference (p<0.01). However, balance showed no significant difference after the therapy (p>0.14). Conclusion: Exercise therapy that uses the symmetrical-reciprocal pattern of scapula and pelvis with the concept of PNF can be said to be a useful therapeutic technique that can enhance the walking speed of patients with hemiplegia.