• The Journal of Korean Physical Therapy
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• v.32 no.2
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• pp.126-131
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• 2020

Purpose: The purpose of this study was to compare the change in pain, Neck Disability Index score, and the craniovertebral angle by performing scapular correction exercise or general neck exercise for five weeks in participants with mechanical neck pain. Methods: A total of 31 participants were randomly assigned between the scapular correction exercise and the general neck exercise groups, and all participants performed intervention for 40 minutes each, three times a week for five weeks The effects were evaluated by measuring the Visual Analog Scale score, the Neck Disability Index score, and the craniovertebral angle, before and after the intervention. Independent t-tests were used to compare differences between two groups, and to compare differences between pre- and post-intervention, paired t-tests were used. Results: As measured before and after the intervention, the scapular correction exercise group showed significant improvement in all variables (p<0.05), while the general neck exercise group improved only in the neck disability index score. The differences between the two groups revealed further improvement in the scapular correction exercise group compared to the general neck exercise group (p<0.05). Conclusion: We found that five weeks of the scapular correction exercise to modify the position and movements of the scapula is clinically an important treatment tool for recovery from chronic mechanical neck pain symptoms and restoration of proper neck function.

• 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 Digital Convergence
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• v.15 no.2
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• pp.411-419
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• 2017

This study was to investigate whether a trunk correction taping plus scapular setting exercises has an effect on trunk muscle activation and trunk balance and upper extremity function in patients with stroke. Twenty stroke patients were randomly divided into a trunk correction taping with scapular setting exercise group (n=10) and a scapular setting exercise group (n=10), and each group performed given interventions for 30 minutes for 4 weeks. In the experimental group, there were significant increases in muscle activation, K-TIS, and MFT (p<.05), and a significant improvement was detected in K-TIS and MFT compared to the control group (p<.05). This study suggests that a trunk correction taping with scapular setting exercises was more effective on trunk muscle activation, trunk balance, and upper extremity function in stroke patients compared to a scapular setting exercise. It could be clinically more significant if the change in the onset time of muscle activity is confirmed in the further researches.

• Physical Therapy Korea
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• v.19 no.4
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• pp.32-37
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• 2012

The purpose of this study was to investigate the quantitative data of downward pulling tension in subjects with scapular downward rotation syndrome (SDRS) before and after 6-week self scapular upward rotation exercise (SURE) program. Eleven subjects with bilateral SDRS. The downward pulling tension(DPT) was measured digital tension-meter. The tension force data were collected using a surface electromyography before and after a 6-week self-scapular SURE program. The significance of difference between pre- and post-program was assessed using a paired t-test, with the level of significance set at ${\alpha}$=.05. The results showed that significant differences between pre- and post-SURE program were found for DPT (p<.05). These findings suggest that 6-week self SURE program is effective for reducing DPT in subjects with SDRS. Additionally, our DPT measurement can be useful for maintaining shoulder position and providing quantitative data between pre- and post-SURE program during passive correction of scapular position test.

• 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.

• Physical Therapy Korea
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• v.22 no.4
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• pp.17-26
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• 2015

The purpose of this study was to investigate the effects of visual electromyography (EMG) biofeedback on the EMG activity of the lower trapezius (LT), serratus anterior (SA), and upper trapezius (UT) muscles, the LT/UT and SA/UT EMG activity ratios, and the scapular upward rotation angle during scapular posterior tilting exercise (SPTE). Twenty-four subjects with round-shoulder posture participated in this study. The EMG activities of the LT, SA, and UT were collected during SPTE both without and with visual EMG biofeedback. The scapular upward rotation angle was measured at the baseline, after SPTE without visual EMG biofeedback, and after SPTE with visual EMG biofeedback. The LT, SA, and UT EMG activities, and the LT/UT and SA/UT EMG activity ratios were analyzed by paired t-test. The scapular upward rotation angle was statistically analyzed using one-way repeated analysis of variance. If a significant difference was found, a Bonferroni correction was performed (p=.05/3=.017). The EMG activities of LT and SA significantly increased, and the EMG activity of UT significantly decreased during SPTE with visual EMG biofeedback compared to SPTE without visual EMG biofeedback (p<.05). In addition, the LT/UT and SA/UT EMG activity ratios significantly increased during SPTE with visual EMG biofeedback compared to SPTE without visual EMG biofeedback (p<.05). Significant increases were found in the scapular upward rotation angle after SPTE without and with visual EMG biofeedback compared to baseline (p<.017), and no significant differences were observed in the scapular upward rotation angle between SPTE without and with visual EMG biofeedback. In conclusion, SPTE using visual EMG biofeedback may be an effective method for increasing LT and SA activities while reducing UT activity.

• Physical Therapy Korea
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• v.25 no.4
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• pp.1-8
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• 2018

Background: Round shoulder posture, results from excessive flexed posture of the thorax, is defined as a position of scapular protraction, anterior tipping, and downward rotation. However, previous studies have focused on only passive position of the thorax during scapular posterior tilting (SPT) and have not reported on SPT combined with correction of flexed posture. Objects: The aim of this study was to compare effects of SPT and SPT with prone trunk extension (SPT + PTE) on activities of the lower trapezius, serratus anterior, and thoracic erector spinae and degree of posture in subjects with round shoulder and flexed posture. Methods: Fifteen subjects with round shoulder and flexed posture were recruited. The caliper was used to measure the degree of round shoulder and flexed posture. Electromyography was performed to collect data of muscle activities. Paired t-test was used to compare two exercise (${\alpha}=.05$). Results: When SPT + PTE was applied, the degree of round shoulder posture (p=.001) and flexed posture (p=.039) significantly decreased compared with that when SPT was applied. The lower trapezius activity significantly increased in the SPT + PTE condition compared with that in the SPT condition (p=.026). There were no significant differences in serratus anterior activity between SPT + PTE and SPT. The thoracic erector spinae activity significantly increased in the SPT + PTE condition compared with that in the SPT condition (p=.014). Conclusion: SPT + PTE might be one of the effective methods to enhance activities of lower trapezius and thoracic erector spinae, and to reduce round shoulder posture and flexed posture in subjects with round shoulder and flexed posture.

• 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.

• Journal of International Academy of Physical Therapy Research
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• v.4 no.2
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• pp.573-587
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• 2013

The purpose of this study was conducted in order to analyze the effects of the manual intervention and self-corrective exercise models of general coordinative manipulation(GCM) on the balance restoration of spine & extremities joints with distortions and mal-alignment areas. The subjects were the members who visited GCM Musculoskeletal Prevent Exercise Center from March 1 2012 to December 31 2013 because of spine & extremities joints distortion and mal-alignments, poor posture, and body type correction. All subjects were diagnosed with the four types of the GBT diagnosis. And according to the standards of the mobility vs stability types of the upper & lower body, they were classified into Group 1(40 persons) and Group 2(24 persons). For every other day for three times a week, GCM intervention models were applied to all subjects for four weeks, adding up to 12 times in total. Then the balance restoration effects were re-evaluated with the same methods. The results are as follows. 1) Balance restoration effects of VASdp(Visual analysis scale pain & discomfort) and ER(Equilibrium reaction: ER) came out higher in GCM body type(GBT) II III IV of Group 1. 2) In case of balance restoration effects in Moire and postural evaluation areas, Group 1 was higher and cervical and scapular girdle were higher in Group 2. The balance restoration of the four GBT types was significant in all regions(p<.05), and the scapular girdle came out as high in the order of GBTII IV I. 3) In case of thoracic-lumbar scoliosis and head rotation facial asymmetric cervical scoliosis ribcage forward, the balance restoration effects of the upper body postural evaluation areas came out the highest in Group 1 and Group 2, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in lumbar scoliosis GBTIII I, ribcage forward and thoracic scoliosis GBTII IV. 4) The balance restoration effects of the lower body postural evaluation areas came out higher in Group 1 and Group 2 for pelvis girdle deviation patella high umbilicus tilt and hallux valgus foot longitudinal arch: FLA patella direction, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in pelvis girdle deviation GBTIII I and patella high-direction GBTIV II I. 5) The balance restoration effects between the same GBT came out significant (p<.05) in all evaluation areas and items. The conclusions of this study was the manual intervention and self-corrective exercise models of the GCM about the mal-alignment of the spine & extremities joints across the whole body indicated high balance restoration effects(p<.05) in spine & extremities joints in all evaluation areas.

• Physical Therapy Korea
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• v.26 no.3
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• pp.1-10
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• 2019

Background: Winged scapular (WS) causes muscle imbalance with abnormal patterns when moving the arm. In particular, the over-activation of the upper trapezius (UT) and decrease in activity of the lower trapezius (LT) and serratus anterior (SA) produce abnormal scapulohumeral rhythm. Therefore, the SA requires special attention in all shoulder rehabilitation programs. In fact, many previous studies have been devoted to the SA muscle strength training needed for WS correction. Objects: The purpose of this study was to investigate the effect of shoulder girdle muscle and ratio according to the angle of shoulder abduction and external weight in supine position. Methods: Twenty three WS patients participated in this experiment. They performed scapular protraction exercise in supine position with the weights of 0 kg, 1 kg, 1.5 kg, and 2 kg at shoulder abduction angles of $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, and $90^{\circ}$. The angle and weight applications were randomized. Surface electromyography (EMG) was used to collect the EMG data of the SA, pectoralis major (PM), and UT during the exercise. The ratio of PM/SA and UT/SA was confirmed. Two-way repeated analyses of variance were used to determine the statistical significance of SA, PM, and UT and the ratios of PM/SA and UT/SA. Results: There was a significant difference in SA according to angle (p<.05). Significant differences were also identified depending on the angle and weight (p<.05). The angle of abduction at $0^{\circ}$, $30^{\circ}$ and weight of 2 kg showed the highest SA activity. However, there was no significant difference between PM and UT (p>.05). There was a significant difference between PM/SA and UT/SA in ratio of muscle activity according to angle (p<.05). Significant differences were found at PM/SA angles of $30^{\circ}$, $60^{\circ}$ and $90^{\circ}$ (p<.05). For UT/SA, significant difference was only observed at $90^{\circ}$ (p<.05). Conclusion: Based on the results of this study, in order to strengthen the SA, it was found to be most effective to use 1 and 1.5 kg weights with abduction angles of $0^{\circ}$ and $30^{\circ}$ at shoulder protraction in supine position.