• Physical Therapy Korea
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• v.24 no.1
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• pp.61-70
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• 2017

Background: Scapular winging is a prominence of the entire scapular medial border, mainly caused by insufficient activity of the serratus anterior (SA) and imbalance of scapulothoracic muscles. Push-up plus (PUP) exercise has been commonly used to increase SA muscle activity. The facilitation of abdominal muscle may affect scapular muscle activity by myofascial connections. Thus, the sequential activation of the turnk muscles is suggested to facilitate the transition of proper force from upper limb and restore force couple of scapular muscles. The abdominal drawing-in maneuver (ADIM) has been effective in improving activation of the deep trunk muscles during movement. Objects: The aim of this study was to determine the effect of ADIM on the activity of the upper trapezius (UT), lower trapezius (LT), and SA during PUP exercises in subjects with scapular winging. Methods: Fourteen men with scapular winging (determined as a of distance between the scapular medial border and thoracic wall over 3 cm) volunteered for our study. The subjects performed the PUP exercise with and without ADIM. Surface electromyography was used to collect the electromyography data of the UT, LT, and SA. A scapulometer was used to measure the amount of scapular winging. Results: SA activity was significantly greater and scapular winging significantly lower during the PUP exercise with ADIM than during those without ADIM. Conclusion: PUP exercise with ADIM can be used as an beneficial method to improve SA activation and to reduce the amount of scapular winging in subjects with scapular winging.

• Physical Therapy Korea
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• v.29 no.2
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• pp.131-139
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• 2022

Background: Shoulder impingement syndrome, a major cause of shoulder pain, involves weakness of the scapular retractor muscles. The major scapular retractor muscles are the middle trapezius and rhomboid major muscles; however, the latter is excluded in most studies. Objects: We aimed to measure the thickness of the middle trapezius and rhomboid major muscles using an ultrasonic diagnostic imaging system while performing four different shoulder retraction exercises and comparing the thicknesses and ratio of the thicknesses of these muscles. Methods: The thickness of the middle trapezius and rhomboid major muscles was measured in 24 healthy adults using ultrasound. Muscle thickness was measured three times in the Reference posture and four times while performing four different exercises that involved scapular retraction. The averages and standard deviations of the measured muscle thicknesses were obtained and compared. The ratio of muscle thickness and rate of changes in muscle thickness between the reference posture and the four exercises were compared. Results: For both, male (n = 10) and female (n = 14), there was a significant difference in the thickness of the middle trapezius muscle between the reference posture and the four exercises (p < 0.05) and in the thickness of the middle trapezius and rhomboid major muscles between male and female (p < 0.05); however, there was no significant difference in the ratio of the thicknesses of these muscles. Although a significant difference in the rate of change in muscle thickness during the four exercises was noted, there was no significant difference in the ratio of change in muscle thickness. Conclusion: This study demonstrates the ratio of the thicknesses of the middle trapezius and rhomboid major muscles and the rate of change in their thickness during exercises involving scapular retraction in healthy people in their 20s-30s.

• 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.

• Journal of The Korean Society of Integrative Medicine
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• v.1 no.3
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• pp.51-62
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• 2013

PURPOSE : This study of 20 healthy male subjects by applying various scapular stabilization exercise to compared Serratus anterior and lower trapezius is change in ultrasound images. METHOD : Thirty healthy subjects voluntarily participated in this study. Ultrasound imaging was recorded from the increasing the activity of Serratus anterior(SA) and Lower trapezius(LT) muscles using Push-up plus, Wall slide, Scapular plane shoulder elevation with resistance exercise. Thickness changes in the Serratus anterior(SA) and lower trapezius(LT) muscles between the relaxed and contracted states in the each exercises. To identify statistical significance, one-way ANOVA with repeated measures was used with the significance level of .05. RESULT : The results of this study were as follows : 1) There were statistically significant difference in thickness changes in the Serratus anterior(SA) and lower trapezius(LT) muscles between the relaxed and contracted states in the each exercises. 2) The Scapular plane shoulder elevation with resistance is more effective to Strengthening in the scapular stabilization muscles than Push up-plus and Wall slide. CONCLUSION : The Scapular plane shoulder elevation with resistance may be used to effectively that patient with various shoulder pain.

• PNF and Movement
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• v.14 no.2
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• pp.113-120
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• 2016

Purpose: The purpose of this study was to compare the intramuscular activation of the scapular stabilizing muscles and the upper trapezius/middle serratus anterior (UT/MSA) ratios during shrug exercise and proprioceptive neuromuscular facilitation (PNF) scapular pattern exercise. Methods: The participants of this study were 13 young adult men who voluntarily consented to participate in this experiment after listening to its purpose and methods. All participants were instructed on maximal voluntary isometric contraction and scapular exercises. The intramuscular activation of the upper trapezius (UT), lower trapezius (LT), middle serratus anterior (MSA), and lower serratus anterior (LSA) muscles while performing scapular exercises in a side-lying position were measured using surface electromyography. To analyze the muscle activation and UT/MSA ratio between the two exercises, a one-way repeated ANOVA was performed. Post-hoc analyses were conducted using Tukey's multiple comparison and analysis. Hamstring flexibility for each group was measured by a passive straight leg raising test. Results: The shrug exercise showed significantly higher UT activation compared to PNF anterior elevation and posterior elevation scapular patterns. The PNF scapular anterior elevation pattern showed significantly higher serratus anterior activation than the shrug exercise. Additionally, the UT/MSA ratios were significantly lower in the PNF scapular anterior elevation pattern than in the two exercises. Conclusion: Although shrug exercise was effective for strengthening UT, the PNF scapular anterior elevation pattern may be effective for strengthening MSA and improving the UT/MSA ratio.

• Physical Therapy Korea
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• v.30 no.3
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• pp.245-252
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• 2023

Background: Various functional tests such as upper quarter Y-balance test (UQYBT) are used to evaluate shoulder stability and mobility in clinical or sports fields. Previous studies have been conducted to determine the correlation between the scapular or trunk muscle and UQYBT. However, the correlation between UQYBT and hip flexor, which can be considered as a core muscle, has not been confirmed. Objects: To verify the relationship between the UQYBT and scapular muscle (scapular protractor and lower trapezius [LT]), trunk muscle, and hip flexor strengths in healthy male participants. Methods: A total of 37 healthy male participants were recruited and underwent UQYBT in the push-up posture. The isometric strength of the scapular protractor, LT, trunk flexor and extensor, and hip flexors were measured using a smart KEMA strength sensor (KOREATECH Inc.). Results: The superolateral direction of the UQYBT was moderately to strongly related to trunk extensor (r = 0.443, p < 0.01), scapular protractor (r = 0.412, p < 0.05), LT (r = 0.436, p < 0.01), and both sides of the hip flexors (supporting-side: r = 0.669, p < 0.01; non-supporting-side: r = 0.641, p < 0.01). The inferolateral direction of the UQYBT was moderately related to the scapular protractor (r = 0.429, p < 0.01), LT (r = 0.511, p < 0.01), and both sides of hip flexors (supporting-side: r = 0.481, p < 0.01; non-supporting-side: r = 0.521, p < 0.01). The medial direction of the UQYBT was moderately to strongly related with the scapular protractor (r = 0.522, p < 0.01), LT (r = 0.541, p < 0.01), and both sides of hip flexors (supporting-side: r = 0.605, p < 0.01; non-supporting-side: r = 0.561, p < 0.01). Conclusion: This study showed that the strength of the scapular muscles, trunk muscles, and hip flexor muscles correlated to the UQYBT. Therefore, the strength of not only the scapular and trunk muscles but also the hip flexor muscles should be considered to improve the UQYBT.

• Journal of International Academy of Physical Therapy Research
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• v.8 no.1
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• pp.1090-1094
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• 2017

This study investigated the effects of indirectly applying proprioceptive neuromuscular facilitation (PNF) to the scapular adductor muscles of stroke patients on their scapular movements and walking ability. Five patients who were diagnosed with stroke participated in this study as a single group. PNF patterns were applied to the scapulae anterior elevation and posterior depression patterns and upper limbs patterns of the patients in side lying and sitting positions together. The data were analyzed with a paired t-test in order to identify within-group differences in the measurements before and after the intervention. The scapular movements of the upper and lower parts, weight bearing and walking speed were significantly improved in the stroke patients after the application of PNF (p<0.05). These results suggest that PNF training effective in improving the scapular movements and walking ability in patients with stroke.

• Physical Therapy Korea
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• v.24 no.4
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• pp.11-19
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• 2017

Background: Methods for exercising serratus anterior (SA) and upper trapezius (UT) muscles are important for the recovery of patients with various shoulder disorders, yet the efficacy of closed or open kinetic chain exercises have not yet been evaluated. Objects: The purpose of this study was to compare the activation of the SA and UT muscles during scapular protraction considering both closed and open kinetic chain exercises. Methods: Thirty subjects were randomly divided into experimental groups (closed kinetic chain exercise) and control groups (open kinetic chain exercise) in which scapular protraction was performed at $90^{\circ}$ or $125^{\circ}$ shoulder flexion. Electromyographic activity data were collected from the SA and UT muscles per position and exercise method. Results: Separate mixed 2-way analysis of variance showed significant differences in the activation of the SA (F1,28=6.447, p=.017) and the UT (F1,28=35.450, p=.001) muscles between the groups at $90^{\circ}$ and $125^{\circ}$ shoulder flexion. Also, the SA/UT ratio measures at $90^{\circ}$ and $125^{\circ}$ shoulder flexion significantly differed between the groups (F1,28=15.457, p=.001). That is, the closed chain exercise was more effective than open chain exercise for strengthening the SA muscle and controlling the UT muscle, $125^{\circ}$ of shoulder joint was more effective than $90^{\circ}$. Conclusion: The findings suggest that scapular protraction with shoulder $125^{\circ}$ flexion at the closed kinetic chain exercise may be more effective in increasing SA muscle activation and decreasing UT muscle activation as well as increasing the SA/UT ratio than open kinetic chain exercise.

• Journal of Industrial Convergence
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• v.21 no.4
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• pp.123-131
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• 2023

The purpose of this study was to investigate difference of activity of scapular stabilizer muscles among push-up, knee push-up and wall push-up exercise. Eight male college students were recruited as participants without any history of shoulder or pathology. The results showed that serratus anterior, anterior deltoid, infraspinatus were higher muscle activities than other scapular stabilizer muscles during push-up exercise and muscle activity of standard push-up exercise was higher muscle activity than that of Knee and Wall push-up exercise. Also, We know that knee push-down exercise was more effective than wall push-down exercise for scapular stabilization.

• 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.