• 대한정형도수물리치료학회지
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• 제22권2호
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• pp.15-20
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• 2016

Background: The purpose of this study was to compared of scapular position between operation side and non-operation side to the rotator cuff surgery. Methods: This study was carried out with a total 34 patients: male (n=14), female (n=20). Shoulder range of motion (ROM), the quadruple visual analogue scale (QVAS), the shoulder pain and disability index (SPADI), and the scapular index (SI) were used to assess shoulder posture and function. SI was the resting position of the scapular was determined by measuring the distance from the mid-point of the sternal notch (SN) to the medial aspect of the coracoid process (CP) and the horizontal distance from the posterolateral angle of the acromion (PLA) to the thoracic spine (TS) with a soft tape measure. The SI was calculated using the equation: [(SN to CP/PLA to TS) ${\times}$ 100]. Results: There were no significant difference in ROM, QVAS to rotator repair patients according to SI (p>.05). There were significant differences in SI between the operation side and the non-operation side (p<.01). Conclusions: Scapular position was operation side more internal rotation, protraction, abduction than non-operation side. Therefore, health professionals managing for rotator cuff tear repair patients should consider scapular position.

• 대한정형도수물리치료학회지
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• 제27권3호
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• pp.37-46
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• 2021

Background: The increase in the activity of the upper trapezius (UT) muscle and decrease in the activity of the serratus anterior (SA) and lower trapezius (LT) muscle produce an abnormal scapulohumeral rhythem. Therefore, the SA is the focus of therapeutic exercise protocols for the rehabilitation. This study aimed to compare the activity of the muscles according to resistance levels during protraction exercise. Methods: Thirteen healthy 20 to 30 years old male and female subjected participated in the study. All subjects performed the scapular protraction exercise with the weights of 0, 5, and 10kg, combined with horizontal shoulder abduction and adduction. The electromyography data of the SA, UT, and pectoralis major (PM) during the exercise were recorded using surface electrodes. The ratios of PM/SA and UT/SA were calculated. Repeated one-way ANOVA was used to determine the statistical significance. Results: There was a significant difference in the muscle activity of the SA and PM (p<.05). Specifically, SA had the highest activity and PM had the lowest activity at an abduction resistance 10kg (p<.01). There was a significant difference in the ratios of UT/SA and PM/SA (p<.05). The ratio of PM/SA was the lowest at the abduction resistance of 10kg (p<.01). Conclusion: According to this study, for the selective activation of the serratus anterior, protraction exercises should be applied as a method of adding resistance to protraction and horizontal abduction.

• 한국전문물리치료학회지
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• 제24권4호
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• pp.60-67
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• 2017

Background: Scapular downward rotation syndrome (SDRS) is a common scapular alignment impairment that causes insufficient upward rotation and muscle imbalance, shortened levator scapulae (LS) and rhomboid, and lengthened serratus anterior (SA) and trapezius. A modified shrug exercise (MSE), performing a shrug exercise with the shoulders at $150^{\circ}$ abduction, is known as an effective exercise to increase scapular stabilizer muscle activation. Previous studies revealed that scapular exercise are more effective when combined with trunk stabilization exercises in decreasing scapular winging and increasing scapular stabilizer muscle activation. Objects: The purpose of our study was to clarify the effect of MSE with or without trunk stabilization exercises in subjects with SDRS. Methods: Eighteen volunteer subjects (male=10, female=8) with SDRS were recruited for this experiment. All subjects performed MSE under 3 different conditions: (1) MSE, (2) MSE with an abdominal draw-in maneuver (ADIM), and (3) MSE with an abdominal expansion maneuver (AEM). The muscle thickness of the lower trapezius (LT) and the SA were measured using an ultrasonography in each condition. Electromyography (EMG) data were collected from the LT, LS, SA, and upper trapezius (UT) muscle activities. Data were statistically analysed using one-way repeated analysis of variance at a significance level of .05. Results: The muscle thickness of the LT and the SA were the significant different in the MSE, MSE with ADIM (MSE+ADIM) and MSE with AEM (MSE+AEM) conditions (p<.05) In both LT and SA, the order of thick muscle thickness was MSE+AEM, MSE+ADIM, and MSE alone. No significant differences were found in the EMG activities of the SA, UT, LS, and LT in all condition. Conclusion: In conclusion, MSE is more beneficial to people with SDRS when combined with trunk stabilization exercises by increased thickness of scapular stabilizer muscles.

• 대한정형도수물리치료학회지
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• 제18권1호
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• pp.83-86
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• 2012

Background: The research examined the effect of a scapular stabilizing exercise on shoulder pain, active range of motion (AROM) and changes in the position of the shoulder blade of patients with frozen shoulder. Methods: General physical therapy and a scapular stabilizing exercise were applied to a 53-year-old female patient with frozen shoulder three times a week for four weeks. Before and after the therapy, measurements were made on the visual analog scale (VAS) and of the AROM, and a lateral scapular slide test was conducted. Results: Following the therapy, VAS fell from 7 to 3. Before therapy, flexion, abduction, internal rotation, and external rotation recorded $133^{\circ}$, $102^{\circ}$, $45^{\circ}$, and $53^{\circ}$ respectively; after the therapy they increased to $150^{\circ}$, $123^{\circ}$, $55^{\circ}$, and $65^{\circ}$ respectively. The lateral scapular slide test showed sliding distances before therapy of 8.5cm at $0^{\circ}$, 9.2cm at $45^{\circ}$, and 11.3cm at $90^{\circ}$; after therapy, the distances decreased to 6.8 cm at $0^{\circ}$, 8.2 cm at $45^{\circ}$, and 9cm at $90^{\circ}$. Conclusion: The scapular stabilizing exercise was effective in alleviating shoulder pain, increasing AROM, and reducing changes in the position of the shoulder blade of frozen shoulder patients.

• 한국전문물리치료학회지
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• 제19권2호
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• pp.12-19
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• 2012

The purpose of this study was to assess the influence of scapular alignment on the electromyographic (EMG) activity of the trapezius in people with a short pectoralis minor muscle. For the study, we recruited 15 volunteers who had positive results for short on a pectoralis minor muscle length test. We measured the EMG activity of the upper, middle and lower trapezius muscles. The participants lifted their dominant arm to ear level with the thumb up toward the ceiling in the prone position on a table with the shoulder at a flexion angle of 180 degrees and a horizontal abduction angle of 120 degrees. Scapula was manually aligned by an experienced physical therapist prior to arm lift for the scapular alignment condition. A paired t-test was used to compare the effects of scapular alignment on the EMG activity of the trapezius muscles. The EMG activity of the lower trapezius muscle was significantly increased during the test with the scapular alignment compared to that without scapular alignment (p<.05), while the upper trapezius and middle trapezius exhibited no significant difference between the two conditions (p>.05). The findings of this study suggest that a scapular alignment may alter the recruitment of the lower trapezius muscle during arm lifting in the prone position in people with a short pectoralis minor muscle.

• 산업융합연구
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• 제19권3호
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• pp.83-90
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• 2021

본 연구는 어깨뼈 기능이상이 있는 사무직원에 대해 어깨뼈 안정화 운동과 등뼈관절가동술을 시행한 후 어깨뼈의 위치와 움직임 및 어깨기능장애지수에 미치는 영향을 분석하기 위한 목적으로 실행되었다. 연구 대상자는 충남의 N대학에서 근무하는 사무직원 중에서 어깨뼈 기능이상 검사(Scapular Dyskinesis Test, SDT)를 하여 이에 해당되는 42명을 연구 대상자로, A그룹은 어깨뼈 안정화운동 적용군(N=14), B그룹은 등뼈관절가동술 적용군(N=14), 그리고 C그룹은 어깨뼈 안정화운동과 등뼈관절가동술을 결합한 실험군(N=14)으로 나누었다. 각 중재는 4주간 주 3회, 회당 25분씩 총 12회 실시하였다. 연구 결과, 어깨뼈 위치 변화의 그룹 간 비교에서는 C그룹이 다른 그룹에 비해 유의한 차이가 있었다(p<.05). 어깨뼈 움직임의 변화에서 위팔뼈 벌림 45°에서는 C그룹이 다른 그룹과 비교하여 그룹 내 및 그룹 간 비교에서 유의한 차이를 보였다(p<.001). 벌림 90°에서도 C그룹이 그룹 내 및 그룹 간 비교에서 유의한 차이를 보였다. 어깨기능장애지수(Shoulder pain and disability index, SPADI)에서는 C그룹이 다른 그룹에 비해 유의한 차이를 보였다(p<.05). 본 연구의 결과, 어꺠뼈 안정화운동과 등뼈관절가동술의 결합은 어깨뼈 기능이상이 있는 사무직원의 어깨뼈 위치와 움직임 그리고, 상지기능장애지수의 향상에 유의한 효과가 있었다.

• 한국전문물리치료학회지
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• 제18권2호
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• pp.76-83
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• 2011

The aim of this study was to determine the immediate effects of single treatment of strain-counter strain (SCS) on pressure pain threshold (PPT) and muscle activity during scapular plane abduction with 3% body weight load. Fifteen asymptomatic male adults with upper trapezius latent trigger point (LTrP) (PPT<2.9 $kg/cm^2$) participated in this study. Pressure algometer was used to measure PPT and surface electromyography was used to record upper, middle arid lower trapezius, serratus anterior, infraspinatus and middle deltoid muscle activity and relative ratio during scapular plane abduction between pre- and post-intervention. There was a significant increase in upper trapezius PPT after a 90-second SCS (p<.05). The activity of the upper trapezius and middle deltoid was significantly decreased (p=.014, p=.001), coupled with a decreased muscle activity ratio between the upper and lower trapezius (p<.05). These results indicate that the SCS may effectively deactivate upper trapezius activity, thereby alleviating muscle balance and reducing pain sensitivity.

• PNF and Movement
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• 제22권1호
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• pp.151-158
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• 2024

Purpose: The present study investigated how variations in diagonal exercises affect shoulder muscle activity, examining changes in neuromuscular activation during scapular and shoulder diagonal patterns of exercises. Furthermore, we explored whether the exercise phase affects muscle activation. Methods: Sixteen asymptomatic male participants were recruited. Four diagonal pattern exercises (scapular anterior elevation, posterior elevation, flexion-adduction-external rotation, flexion, abduction-external rotation), and two exercise phases (concentric and eccentric) were administered. Surface electromyography data were collected. Results: Upper trapezius activity was significantly higher during the concentric phase of scapular posterior elevation exercises compared with the others (p<0.05). The serratus anterior, anterior deltoid, and infraspinatus activities were significantly higher during shoulder diagonal pattern exercises compared with the scapular diagonal pattern exercises (p<0.05). Except for the lower trapezius, muscular activities during the concentric phase were significantly greater compared with the eccentric phase (p<0.05). Conclusion: The current study suggests that the diagonal pattern of exercise may contribute to selective strengthening of the shoulder complex muscles and that the form of exercise should be tailored to the subject. It also suggests that diagonal exercises with concentric contractions tend to be more beneficial than eccentric contractions for overall muscle recruitment, but the effects vary for specific diagonal patterns.

• Clinics in Shoulder and Elbow
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• 제25권4호
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• pp.265-273
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• 2022

Background: Massive rotator cuff tears (MRCTs) with subscapularis (SSC) tears cause severe shoulder dysfunction. In the present study, the influence of SSC tears on three-dimensional (3D) shoulder kinematics during scapular plane abduction in patients with MRCTs was examined. Methods: This study included 15 patients who were divided into two groups: supraspinatus (SSP) and infraspinatus (ISP) tears with SSC tear (torn SSC group: 10 shoulders) or without SSC tear (intact SSC group: 5 shoulders). Single-plane fluoroscopic images during scapular plane elevation and computed tomography (CT)-derived 3D bone models were matched to the fluoroscopic images using two-dimensional (2D)/3D registration techniques. Changes in 3D kinematic results were compared. Results: The humeral head center at the beginning of arm elevation was significantly higher in the torn SSC group than in the intact SSC group (1.8±3.4 mm vs. -1.1±1.6 mm, p<0.05). In the torn SSC group, the center of the humeral head migrated superiorly, then significantly downward at 60° arm elevation (p<0.05). In the intact SSC group, significant difference was not observed in the superior-inferior translation of the humeral head between the elevation angles. Conclusions: In cases of MRCTs with a torn SSC, the center of the humeral head showed a superior translation at the initial phase of scapular plane abduction followed by inferior translation. These findings indicate the SSC muscle plays an important role in determining the dynamic stability of the glenohumeral joint in a superior-inferior direction in patients with MRCTs.

• Clinics in Shoulder and Elbow
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• 제1권2호
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• pp.186-192
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• 1998

This study was performed to evaluate the influences of the passive glenohumeral rotation on the scapulothoracic motion. We took anteroposterior radiograms of the right shoulders including the thoracic vertebrae with supine position in 10 normal male adults, at 0 degree abduction, 45 degrees abduction and 90 degrees abduction in scapular plane and in neutral rotation, maximal internal rotation and maximal external rotation in each abduction view. The scapulothoracic motion was measured as the distances between the vertical line drawn from the spinous process of the 7th cervical vertebra and the inferior and superior angles of the right scapula respectively. At 0 degree abduction, the distances were not changed in internal rotation relative to neutral rotation, but decreased significantly in external rotation, that is, the scapula shifts medially on external rotation. At 45 degrees abduction, the distances were increased significantly only in internal rotation, that is, the scapula shifts laterally on internal rotation. At 90 degrees abduction, the scapula rotated laterally on internal rotation and medially on external rotation. In conclusion, when a physician examines the rotation of the shoulder joint, he cannot exclude the scapulothoracic motion just by examining the patient with supine position. And we concluded that the rotatory movement of the shoulder is not solely contributed to the glenohumeral motion.