• PNF and Movement
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• v.3 no.1
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• pp.47-53
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• 2005

Purpose : To describes the important aspects of scapular movement and function used when applying PNF technique to the upper limb and scapular. Method : The scapular was a very important roles in the upper limb movement. This study summarizes the physiologic movement of scapular to the PNF upper extremity patterns or scapular patterns. Result : The shoulder joint has the most freedom of range of motion in the human body, composed of the glenohumeral joint, the subacromial joint, the acromioclavical joint, the sternoclavicular joint, the scapulothoracic joint, the costosternal joint, and the costovertebral joint. During upper limb movement, the scapular position change at the sternoclavicular joint and the acromioclavical joint. This concerted motion was characterized by scapulohumeral rhythm. In clinical situations, it is import to understand factors affect the scapulohumeral rhythm so that optimal evaluation and therapeutic intervention can be devised. Conclusions : The scapular movement depend on the proper and coordinated contraction of muscles. Physical therapists need to understand the normal scapular movement relationships of the scapulohumeral rhythm under different interventions for PNF techniques application.

• Journal of International Academy of Physical Therapy Research
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• v.12 no.2
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• pp.2308-2313
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• 2021

Background: Although the scapular posterior tilt movement could facilitate the lower trapezius (LT) muscle activity, no study identified the effects of the scapular posterior tilt movement on the selective activation of the LT muscle during prone shoulder extension. Objectives: To examine the influences of additional scapular posterior tilt on electromyography (EMG) of the upper trapezius (UT) and the LT muscles during prone shoulder extension. Design: Cross-sectional study. Methods: There were 15 asymptomatic male participants in this study who performed prone shoulder extension with and without scapular posterior tilt movements. For the scapular posterior tilt movements, participants performed visual biofeedback training for scapular movement using motion sensor. During the exercises, the EMG activity of the UT and LT was recorded using surface EMG system. Results: The EMG activity of the LT significantly increased during prone shoulder extension with scapular posterior tilt compared to that of general prone shoulder extension, whereas that of the UT was not significantly different between the two exercises. Moreover, scapular posterior tilt application significantly decreased UT/LT muscle activity ratio. Conclusion: Scapular posterior tilt movement may be emphasized during exercise when facilitating LT muscle activation.

• Physical Therapy Korea
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• v.23 no.3
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• pp.68-75
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• 2016

Background: Shoulder horizontal adduction (HA) is performed in many activities of daily living. The limited range of motion (LROM) of HA is affected by the tightness of the posterior deltoid, infraspinatus, teres major, and posterior capsule of glenohumeral joint. The LROM of shoulder HA contributes to excessive scapular abduction. Objects: The aim of this study is to compare the scapular abduction distance and three-dimensional displacement of the scapula during shoulder horizontal adduction between subjects with and without the LROM of shoulder HA. Methods: 24 subjects (12 people in LROM group and 12 people in normal ROM group) participated. Subjects with less than $115^{\circ}$ of HA ROM were included in LROM group. Shoulder HA was performed 3 times for measuring scapular abduction distance and three-dimensional displacement of the scapula. Tape measure was used for measuring scapular abduction distance. Scapular abduction distance was normalized by dividing the scapular size. Polhemus Liberty was used for measuring the three-dimensional displacement of the scapula. Results: Normalized scapular abduction distance was significantly greater in LROM group than normal ROM group (p<.001). Three-dimensional displacement of the scapula during shoulder HA was greater in LROM group than normal ROM group (p<.05). Conclusion: LROM group had a greater scapular abduction and three-dimensional displacement of the scapula during shoulder HA compared to normal ROM group.

• PNF and Movement
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• v.20 no.2
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• pp.215-222
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• 2022

Purpose: The purpose of this study was to compare the effects of passive scapular upward rotation and posterior tilt and active scapular posterior tilt on the muscle activity of the upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA). Methods: Fifteen healthy subjects performed general arm elevation, arm elevation with passive scapular upward rotation and posterior tilt, and arm elevation with active scapular posterior tilt. For active scapular posterior tilt, the subjects were trained in this movement using visual biofeedback and a motion sensor. During each arm elevation condition, electromyography was used to measure the muscle activity of the UT, LT, and SA. The measured data were analyzed using a one-way repeated ANOVA. Results: LT muscle activity was significantly increased during arm elevation with active scapular posterior tilt compared to both general arm elevation and arm elevation with passive scapular upward rotation and posterior tilt (p < 0.05). SA muscle activity was greater during arm elevation with passive scapular upward rotation and posterior tilt than during general arm elevation (p < 0.05). There was no significant change in UT muscle activity among the tested arm elevation conditions (p > 0.05). Conclusion: Performing arm elevation with active scapular posterior tilt and performing arm elevation with passive scapular upward rotation and posterior tilt may be useful strategies for increasing muscle activation of the LT and SA, respectively.

• PNF and Movement
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• v.4 no.1
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• pp.1-7
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• 2006

Objective : The purpose of this study was conducted to find scapular movement instability related with shoulder complex and provide strengthening the scapular muscles with proprioceptive neuromuscular facilitation(PNF). Methods : This is a literature study with books and articles, seminar note and book for PNF international course. Results : The scapular serve as the platform for humeral motions. The scapulothoracic articulation is stabilized and controlled, in part, by the scapular muscles. Therefore, if scapular muscle function is altered, then dysfunctional scapulothoracic kinematics may result. Strengthening exercise for scapular muscles are a common part of rehabilitation programs designed for patients with scapular instability. Conclusion : Treatment of the scapular instability is provided. It is that treatment with combination of isotonic, stabilize reversal on different patient's positions.

• The Journal of Korean Physical Therapy
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• v.14 no.3
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• pp.92-105
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• 2002

This research described dynamic scapulohumeral rhythm though the measurement of inter relationship between humorous and scapular movement during elevation of the arm in the scapular plane. In the previous studies static plane film X-ray has usually been used, but the limitation of such method was that it did not show the real· movement. In this study, we investigated real movement of humorous and scapular bones by Digital fluoroscopy system. 1. In resting position, humorous was taken to lie at the average $5.97^{\circ}$ in abduction, and scapular at the average $3.66^{\circ}$ in internal rotation. 2. At the maximal abduction, humorous was abducted to the average of 181.25", and scapular was rotated externally to $51.43^{\circ}$. 3. This research has shown that there is a variety of scapulohumeral rhythm from resting position to $60^{\circ}$ abduction in elevation of humorous. This case study demonstrated that the ratio n of scapulohumeral rhythm is 3.46 to 1, but there was individual difference.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.1
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• pp.41-48
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• 2013

PURPOSE: This study was to determine the effect of the plane of movement (sagittal plane vs. scapular plane) and shoulder flexion angle ($90^{\circ}$ vs. $130^{circ}$) during scapular protraction exercises in healthy subjects by investigating the elecromyographic (EMG) activities of the serratus anterior (SA), upper trapezius (UT), and pectoralis major (PM). METHODS: Twenty-one healthy subjects participated in this study. Subjects performed maximal scapular protraction at the $90^{\circ}$ or $130^{\circ}$ shoulder flexion angles in the sagittal or scapular planes. Surface EMG was recorded from the SA and UT, and PM muscles. Dependent variables were examined by 2 (plane) ${\times}$ 2 (angle) repeated measures of analysis of variance (ANOVA). RESULTS: Significantly increased EMG activities in the SA and UT were found during scapular protraction exercise at the $130^{\circ}$ shoulder flexion angle in the sagittal and scapular plane. Also, EMG activity of the PM significantly decreased at the $130^{\circ}$ shoulder flexion angle in the sagittal plane and the $90^{\circ}$ and $130^{\circ}$ shoulder flexion in the scapular plane. CONCLUSION: we recommend scapular protraction exercise at the $90^{\circ}$ shoulder flexion in the sagittal plane to selectively strengthen the SA muscle with limitation of upper trapezius activity and at the $130^{\circ}$ shoulder flexion in the scapular plane to selectively strengthen the SA muscle with limitation of pectoralis major activity.

• Physical Therapy Korea
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• v.27 no.2
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• pp.140-148
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• 2020

Background: Scapular winging (SW) could be caused by tightness or weakness of the periscapular muscles. Although data mining techniques are useful in classifying or predicting risk of musculoskeletal disorder, predictive models for risk of musculoskeletal disorder using the results of clinical test or quantitative data are scarce. Objects: This study aimed to (1) investigate the difference between young women with and without SW, (2) establish a predictive model for presence of SW, and (3) determine the cutoff value of each variable for predicting the risk of SW using the decision tree method. Methods: Fifty young female subjects participated in this study. To classify the presence of SW as the outcome variable, scapular protractor strength, elbow flexor strength, shoulder internal rotation, and whether the scapula is in the dominant or nondominant side were determined. Results: The classification tree selected scapular protractor strength, shoulder internal rotation range of motion, and whether the scapula is in the dominant or nondominant side as predictor variables. The classification tree model correctly classified 78.79% (p = 0.02) of the training data set. The accuracy obtained by the classification tree on the test data set was 82.35% (p = 0.04). Conclusion: The classification tree showed acceptable accuracy (82.35%) and high specificity (95.65%) but low sensitivity (54.55%). Based on the predictive model in this study, we suggested that 20% of body weight in scapular protractor strength is a meaningful cutoff value for presence of SW.

• Journal of Industrial Convergence
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• v.19 no.3
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• pp.83-90
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• 2021

The purpose of this study was to investigate the effect of scapular stabilization exercise and thoracic joint mobilization on scapular position, scapular motion and shoulder pain and disability index(SPADI) in adults with scapular dysfunction. A total 42 subjects were divided into a scapular stabilization exercise group(A, n=14), a thoracic joint mobilization group(B, n=14) and scapular stabilization exercise with thoracic joint mobilization group(C, n=14) and performed exercise and joint mobilization three times per week for four weeks, total 12 times. As for changes in scapular position among the groups, group C showed statistically significant increase(p<.05). In changes of scapular motion among the groups, group C showed statically significant improvement in shoulder abduction 45° and 90° both(p<.05), In changes of SPADI among the groups, group C were showed statistically significant improvement(p<.05). In conclusion, scapular stabilization exercise and thoracic joint mobilization were effective on improving scapular position, movement and SPADI score in adults with scapular dysfunction.

• The Journal of Korean Physical Therapy
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• v.11 no.3
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• pp.65-69
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• 1999

Proprioceptive neuromusculat facilitation(PNF), scapular patterns are very important for orthopaedic and neurologic patients. It is an essential treatment techniques for motor developmental disorder, CVA, cervical disk, frozen shoulder and pain control of cervical, shoulder girdle and upper extremity. Scapular patterns of PNF has 4 different type of pattern. each of them in combining of movement plane and functional movement. Biomechanically, most of PNF patterns are a concentric contraction with third-claw lever. But the movement pattern have a technique of combination of isotonic that should make a eccentric contraction with second-claw lever.