• The Journal of Korean Physical Therapy
• /
• 제31권2호
• /
• pp.134-139
• /
• 2019

Purpose: This study examined the most effective exercise while performing shoulder abduction below ninety degrees. Methods: Thirty two healthy individuals (17 males, 15 females) participated and performed four exercises, 1) Posterior fly, 2) Prone row, 3) Modified prone cobra, and 4) External rotation in the prone position. Surface electromyography (sEMG) was used to measure the electrical activities for the lower, middle and upper fiber of trapezius and serratus anterior. Results: A significant difference in the muscle activities of the upper/middle/lower trapezius and serratus anterior was observed among the three different positions in terms of the PF (posterior fly), PR (prone row), and MPC (modified prone cobra) (p<0.05). In post-hoc analysis, the activities of the lower and upper trapezius were significantly higher than those of the upper trapezius and serratus anterior (p<0.05). In addition, in ERP (external rotation in prone), there was a significant difference in each activity of the muscles. Post-hoc results indicated that the upper trapezius showed greater EMG activity than the other three muscles. Conclusion: External rotation in the prone position revealed the highest activation of the lower trapezius compared to upper trapezius muscle activity. This may be particularly useful in isolating the lower trapezius in cases where excessive scapular elevation is noted. Therefore, the most effective lower trapezius exercise should be performed below ninety degrees of shoulder abduction.

• Archives of Reconstructive Microsurgery
• /
• 제10권2호
• /
• pp.111-117
• /
• 2001

Introduction : The Functional muscle transfer is used to reconstruct the injuried muscle and paralysis of the shoulder. Especially transfer of the trapezius has been the treatment of choice but it has disadvantages of inadequate function and deformed contour, and instability of humeral head in case of acromion resection. We report an operation for shoulder reconstruction after wide resection of malignant fibrous histiocytoma, using rotational latissimus dorsi flap and review the operation method and clinical outcome. Materials and Methods : A patient, 53 year old, with malignant fibrous histiocytoma in the acromioclavicular joint area had been underwent wide excision, including the deltoid, clavicular head of pectoralis major, part of trapezius, lateral 1/3 of clavicle and acromion including scapular spine. The rotational latissimus dorsi flap with its neurovascular pedicle was dissected and then placed over the resected area and transfer of muscle attached at coracoid process was done to achieve stability of the humeral head. The range of motion of the shoulder and test of muscle power were evaluated for functional outcome. Total follow-up period is 2 years 11 months. Results : At last follow-up, the range of motion of the shoulder is abduction $90^{\circ}$, flexion $90^{\circ}$, internal rotation $40^{\circ}$, external rotation $50^{\circ}$ and the muscle power is 4 grade in all direction and then we obtained good functional results. There are no complications such as instability or subluxation of the humeral head and deformed contour and he is a disease-free survival state. Conclusions : The transfered latissimus dorsi flap provides adequate lever arm and stabilization and covering of the humeral head by sufficient muscle volume and width. This procedure can be useful not only for the paralysed deltoid reconstruction but also for use in reconstructive surgery after wide resection of the shoulder for malignant tumor.

• 대한정형도수물리치료학회지
• /
• 제22권1호
• /
• pp.17-25
• /
• 2016

Purpose: This study was aimed to determine the effects of thoracic spine thrust manipulation on muscle activities of the scapular upward rotators and middle deltoid, active range of motion (AROM), shoulder pain, and rounded shoulder posture in young adults with rounded shoulder. Methods: The subjects were 30 young adults (14 males, 16 females) with rounded shoulder. Thirty subjects were randomly assigned to an experimental (manipulation) and control (placebo) groups of fifteen subjects respectively. The manipulation group received the manipulation (high velocity, low amplitude), which was performed by a physical therapist with the subject in the supine position and with the arms crossed over the chest and hands passed over the shoulders. For the sham group, the same procedure was performed, with the exception that the high-velocity thrust was not applied. Measurements were taken before and after the intervention. Muscle activity of upper and lower trapezius, serratus anterior, middle deltoid was measured using surface electromyography. Visual analog scale (VAS) was used for shoulder pain. Goniometry was used for shoulder abduction active range of motion (AROM). Straight edge was used for supine rounded shoulder posture (RSP) distance. Results: The muscle activity of the upper trapezius, lower trapezius and middle deltoid muscle increased significantly after the intervention (p<.05). However, no significant difference was observed in serratus anterior muscle (p>.05). The VAS was significantly decreased and AROM significantly increased after the intervention (p<.05). The distance of RSP were not significant (p>.05). The control group showed no differences before and after the intervention (p>.05). Conclusion: The results of this study suggest that thoracic spine thrust manipulation can be an effective component of treatment plan to improve pain and function.

• 한국전문물리치료학회지
• /
• 제26권4호
• /
• pp.29-34
• /
• 2019

Background: The serratus anterior is one of the most important muscle for maintaining good scapular alignment in the shoulder joint. The pectoralis major and upper trapezius may also compensate for weak serratus anterior muscles. The push-up plus exercise has been identified as the optimal exercise for maximum activation of the serratus anterior. Objects: The purpose of this study was to examine differences in surface electromyography (EMG) activity of upper trapezius, pectoralis major, and serratus anterior muscles during push-up plus exercises on variously angled surfaces in subjects with winged scapula. Methods: Sixteen subjects with winged scapula (male=5, female=11) volunteered for this study. The subjects performed push-up plus exercise on four different tilt angles, namely $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, and $90^{\circ}$. EMG activities in the serratus anterior, upper trapezius, and pectoralis major muscles during performance of push-up plus exercise were measured in all subjects. Data were processed from repeated measures one-way analysis of variance. Results: There was significant difference in the muscle activity of the serratus anterior on the different surface angles (p<.05). The results of the post-hoc analysis showed significantly greater serratus anterior muscle activity on a surface at a $0^{\circ}$ angle than at others tilt angles (p<.05). There was also significant difference in the ratio of serratus anterior to upper trapezius and serratus anterior to pectoralis major across the four surfaces (p<.05), and post-hoc analysis showed significantly greater values on the $0^{\circ}$ surface than on other tilts (p<.05). Conclusion: This study found that performing push-up plus exercises on a flat surface with $0^{\circ}$ and $30^{\circ}$ tilt angle achieves high activation of the serratus anterior muscle for selective strengthening. It can also take into account the sequential application, which is first performed at a $30^{\circ}$ and at a $0^{\circ}$ tilt angle for and effective but not excessive muscle activation.

• 대한정형도수물리치료학회지
• /
• 제24권2호
• /
• pp.1-7
• /
• 2018

Background: This study was carried out to investigate the effect of mulligan taping group and repeated measurement group on muscle activity and grip strength of adult with forward head posture. Methods: Thirty adults with forward head posture were randomly assigned to each of 15 mulligan taping and repeat measurement groups. The mulligan taping group measured the pre-test and post-test muscle activity and the grip strength three times and compared the mean values. The repeat group was repeatedly measured and measured before and after the experiment, The collected data were analyzed using SPSS statistical program. Results: There was no significant difference between mulligan taping group and repeated measurement group in changes of muscle activity. There was a significant difference between mulligan taping group and repeated measurement group in changes of grip strength. Conclusions: Mulligan taping was applied to an adult with forward head posture, there was no significant change in muscle activity of flexor carpi radialis and palmaris longus, but it seems to improve hand function by re-aligned of nearby muscles by maintaining scapular stability.

• Archives of Reconstructive Microsurgery
• /
• 제8권2호
• /
• pp.163-169
• /
• 1999

Purpose : To evaluate the efficacy of free musculocutaneous flap in the treatment of chronic osteomyelitis with drain sinus. Materials and Methods : Eighteen patients (sixteen male and two female) whose average age was 42.6 years were followed for an average of 3.5 years after free musculocutaneous flap for chronic osteomyelitis with drain sinus tract. The period of time between the initial injury and this procedure was average 10.6 years. The patients had an average of 4.1 prior surgical procedure before it. Results : Sixteen(88.9%) of the eighteen free musculocutaneous flap survived, including thirteen of latisimus dorsi flap, three of scapular free flap with muscle, two of medial plantar flap with abductor muscle. Sixteen cases had no evidence of recurrence at follow up. Conclusion : Free musculocutaneous flap is an extremely successful and reliable procedure for the treatment of chronic osteomyelitis with drain sinus. This flap with microvascular anastomses is highly vascularized through its own intrinsic blood vessels, which has the advantage of obliterating dead space and providing improved vascularity to the relatively ischemic recipient site and covering the skin defect.

• Clinics in Shoulder and Elbow
• /
• 제23권2호
• /
• pp.100-104
• /
• 2020

Function and strength of the deltoid muscle are important in reverse shoulder arthroplasty (RSA). Moreover, location and shape of the acromion, clavicle, and scapular spine, which are origins of the deltoid muscle, are also important. The frequency of os acromiale is 5% to 15%; however, it is rare in the Asian population, affecting approximately 0.7% of Koreans. RSA has rarely been reported in patients with os acromiale. We present a case series of two patients with cuff tear and arthropathy combined with os acromiale who underwent RSA. From 2016 to 2018, two patients with os acromiale who presented with pain and limited range of motion (ROM) underwent RSA with cuff tear arthropathy using the subscapularis-sparing deltopectoral approach. Their ROM, visual analog scale (VAS), and satisfaction were evaluated before and after surgery. In both patients, VAS decreased, ROM increased, and postoperative satisfaction increased. There were no specific complications due to os acromiale. The VAS, ROM, and satisfaction of patients improved after surgery compared with values before surgery. However, careful attention must be given during surgery to ensure optimal repair and recovery.

• 대한물리의학회지
• /
• 제15권3호
• /
• pp.11-20
• /
• 2020

PURPOSE: Excessive activity of the upper trapezius (UT) muscle contributes to a rounded shoulder posture (RSP) through abnormal rotation of the scapula that weakens the lower trapezius (LT) and serratus anterior (SA) muscles. This study compared the effects of two arm-lifting exercises with and without the use of a Thera-band on the activities of LT, SA, and UT muscles, and the LT/UT and SA/UT activity ratio in subjects with a rounded shoulder posture. METHODS: Sixteen subjects with RSP participated in this study. All subjects performed arm-lifting (AL), diagonal arm-lifting (DAL), arm lifting with isometric adduction (ALIA), and diagonal arm-lifting with isometric adduction (DALIA) exercises. The surface electromyography data, LT, SA, UT, and the LT/UT and SA/UT activity ratios were measured. A paired t-test was used to compare the differences between two arm-lifting exercises and two arm lifting with isometric adduction exercises. RESULTS: In ALIA and DALIA exercises, the UT muscle activity decreased significantly, whereas the LT/UT, SA/UT activity ratio increased significantly. The activity of SA muscle increased significantly more with DALIA than that with DAL. CONCLUSION: Arm-lifting exercises using a Thera-band can be implemented as an effective way to reduce the UT overactivity and increase the SA activity and LT/UT, SA/UT activity ratio in subjects with RSP.

• 한국융합학회논문지
• /
• 제9권2호
• /
• pp.341-347
• /
• 2018

본 연구의 목적은 4가지 자세의 푸시업 플러스(PUP) 운동 시 5번째와 7번째의 앞톱니근(SA), 위등세모근(UT), 중간등세모근(MT), 아래등세모근(LT), 큰가슴근(PM)의 근활성도를 알아보는 것이다. 25명의 대상자가 다양한 자세의 PUP 융합 운동 (일반자세, $90^{\circ}$, $120^{\circ}$, BOSU)을 실시하였다. 각 근육의 근활성도를 비교하기 위하여 반복 측정된 분산분석을 적용하였다. 다양한 PUP 융합 운동동안 SA7, PM, UT, MT에서 유의한 차이가 있었다(p <.05). SA7은 PUP 와 $90^{\circ}PUP$, BOSUPUP에서 각각 유의한 차이가 나타났다(p <.05). PM은 $90^{\circ}PUP$와 PUP, BOSUPUP에서 각각 유의한 차이가 나타났다(p <.05). UT은 $90^{\circ}PUP$와 PUP, BOSUPUP에서 각각 유의한 차이가 나타났다 (p <.05). MT는 $90^{\circ}PUP$와 PUP, $120^{\circ}PUP$, 그리고 PUP와 $120^{\circ}PUP$에서 유의한 차이가 있었다(p <.05). 본 연구 결과, 어깨의 기능부전이 없는 대상자가 어깨 안정근을 훈련할 때 일반적인 PUP가 효과적일 것이다.

• 한국임상수의학회:학술대회논문집
• /
• 한국임상수의학회 2007년도 추계국제학술대회 및 컨퍼런스
• /
• pp.568-568
• /
• 2007