• 대한통합의학회지
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• 제4권2호
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• pp.29-36
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• 2016

Purpose : The purpose of this study was to find out the effects on muscle activations of serratus anterior and upper trapezius muscles when push-up plus exercise togu applied differently depending on the body part. Method : Thirty six volunteers took part in this study and we divided into three groups(upper arm togu group 12, leg togu group 12, upper arm-leg togu group 12). Each experimental group performed push-up plus exercise. All volunteers received a total of 18 exercise session over a 6 week period (three times per week). Exercise program was composed of serratus anterior and upper trapezius push-up plus exercise. Then we measured muscle activation of scapular stabilizer by electromyography. Repeated ANOVA was used to examine the effects of the intervention on each outcome measure. Result : After the six week intervention, there was a significant difference between the pre and 6 week in serratus anterior and upper trapezius muscle activity(p<0.05). After the six week intervention, there was a significant difference among the three group in serratus anterior muscle activity but no significant difference in upper trapezius muscle activity(p>.05). Conclusion : Serratus anterior and upper trapezius showed high muscle activity during push-up plus exercise. Therefore have a positive impact of scapular stabilizer. The larger the area of the unstable support surface, the larger muscle activity was larger of variation quantity.

• 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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• 제19권3호
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• pp.31-39
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• 2012

The lower trapezius muscle is an important stabilizer and primary mover of the scapula. The potential use of ultrasound imaging to evaluate scapular muscle function warrants investigation. The purpose of this study is to use ultrasound imaging for determining the effectiveness of 4 different isometric exercises for maximally activating the lower trapezius muscles in healthy subjects. Twenty-eight (14 men and 14 women) volunteers were recruited for this study. Thickness measurements of the lower trapezius muscles were recorded during 4 exercises: latissimus pulldown (LP), prone V-raise (PV), prone row (PR), and modified prone cobra (MP). Lower trapezius muscle thickness was measured 3 times by 2 investigators at a point 3 cm lateral to the lateral edge of the T8 spinous process. The order of 4 exercise execution was randomized for each participant. To identify statistical significance, one-way ANOVA with repeated measures was used with the significance level of .05. Intraclass correlation coefficient (ICC) for intra-reliability was .86~.98 and inter-rater reliability .83~.96 for the lower trapezius, respectively (p<.01). Thickness changes in the lower trapezius muscles between the relaxed and contracted states in men were as follows: LP ($7.37{\pm}2.68mm$, 182%), MP ($4.69{\pm}1.74mm$, 167%), PV ($4.52{\pm}1.47mm$, 149%), and PR ($3.84{\pm}1.72mm$, 133%). In women the values were as follows: LP ($4.64{\pm}1.24mm$, 163%), MP ($2.79{\pm}.81mm$, 131%), PV ($2.78{\pm}.85mm$, 129%), and PR ($2.21{\pm}1.26$ mm, 100%). Thickness of the lower trapezius muscles significantly differed between exercises in both the gender (p<.01). The LP was the most effective exercise for increasing the activation of the lower trapezius muscle in both the gender. We recommend performing the LP exercise for strengthening the lower trapezius muscles.

• 대한물리의학회지
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• 제13권3호
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• pp.75-80
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• 2018

PURPOSE: Scapular stability is very important to arm function during activities of daily living. The push-up plus exercise is commonly used to stabilize the shoulder muscles. In the present study, we designed an elastic shoulder band (ESB) that could be used with the push-up plus exercise and studied muscle activities of the serratus anterior (SA) and the lower and the upper trapezius (LT and UT) on stable and unstable support. METHODS: Fifteen healthy people participated in this study. Three muscles were investigated using surface EMG with and without the ESB on stable and unstable support. All subjects performed each trial three times for 7 seconds per set and rested for 30 seconds. Repeated one-way ANOVA was used for statistical analyses. RESULTS: The EMG activity of the SA was significantly different during the push-up plus exercise on stable support with the ESB compared with that on unstable support without the ESB (p<.05). However, there were no differences in the activities of UT and LT on stable and unstable support (p>.05). CONCLUSION: The ESB was effective for the activity of SA during the push-up plus exercise on stable support; therefore, it has the potential for use by people during push-up plus exercises. However, further studies are required to investigate the rehabilitation tools for patients with shoulder instability.

• 대한물리의학회지
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• 제15권3호
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• pp.11-20
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• 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.

• 대한약침학회지
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• 제7권2호
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• pp.57-64
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• 2004

This study was carried to identify the component of Small Intestine Meridian Muscle in human, dividing the regional muscle group into outer, middle, and inner layer. the inner part of body surface were opened widely to demonstrate muscles, nerve, blood vessels and the others, displaying the inner structure of Small Intestine Meridian Muscle. We obtained the results as follows; 1. Small Intestine Meridian Muscle is composed of the muscle, nerve and blood vessels. 2. In human anatomy, it is present the difference between a term of nerve or blood vessels which control the muscle of Meridian Muscle and those which pass near by Meridian Muscle. 3. The inner composition of meridian muscle in human arm is as follows ; 1) Muscle ; Abd. digiti minimi muscle(SI-2, 3, 4), pisometacarpal lig.(SI-4), ext. retinaculum. ext. carpi ulnaris m. tendon.(SI-5, 6), ulnar collateral lig.(SI-5), ext. digiti minimi m. tendon(SI-6), ext. carpi ulnaris(SI-7), triceps brachii(SI-9), teres major(SI-9), deltoid(SI-10), infraspinatus(SI-10, 11), trapezius(Sl-12, 13, 14, 15), supraspinatus(SI-12, 13), lesser rhomboid(SI-14), erector spinae(SI-14, 15), levator scapular(SI-15), sternocleidomastoid(SI-16, 17), splenius capitis(SI-16), semispinalis capitis(SI-16), digasuicus(SI-17), zygomaticus major(Il-18), masseter(SI-18), auriculoris anterior(SI-19) 2) Nerve ; Dorsal branch of ulnar nerve(SI-1, 2, 3, 4, 5, 6), br. of mod. antebrachial cutaneous n.(SI-6, 7), br. of post. antebrachial cutaneous n.(SI-6,7), br. of radial n.(SI-7), ulnar n.(SI-8), br. of axillary n.(SI-9), radial n.(SI-9), subscapular n. br.(SI-9), cutaneous n. br. from C7, 8(SI-10, 14), suprascapular n.(SI-10, 11, 12, 13), intercostal n. br. from T2(SI-11), lat. supraclavicular n. br.(SI-12), intercostal n. br. from C8, T1(SI-12), accessory n. br.(SI-12, 13, 14, 15, 16, 17), intercostal n. br. from T1,2(SI-13), dorsal scapular n.(SI-14, 15), cutaneous n. br. from C6, C7(SI-15), transverse cervical n.(SI-16), lesser occipital n. & great auricular n. from cervical plexus(SI-16), cervical n. from C2,3(SI-16), fascial n. br.(SI-17), great auricular n. br.(SI-17), cervical n. br. from C2(SI-17), vagus n.(SI-17),hypoglossal n.(SI-17), glossopharyngeal n.(SI-17), sympathetic trunk(SI-17), zygomatic br. of fascial n.(SI-18), maxillary n. br.(SI-18), auriculotemporal n.(SI-19), temporal br. of fascial n.(SI-19) 3) Blood vessels ; Dorsal digital vein.(SI-1), dorsal br. of proper palmar digital artery(SI-1), br. of dorsal metacarpal a. & v.(SI-2, 3, 4), dorsal carpal br. of ulnar a.(SI-4, 5), post. interosseous a. br.(SI-6,7), post. ulnar recurrent a.(SI-8), circuirflex scapular a.(SI-9, 11) , post. circumflex humeral a. br.(SI-10), suprascapular a.(SI-10, 11, 12, 13), first intercostal a. br.(SI-12, 14), transverse cervical a. br.(SI-12,13,14,15), second intercostal a. br.(SI-13), dorsal scapular a. br.(SI-13, 14, 15), ext. jugular v.(SI-16, 17), occipital a. br.(SI-16), Ext. jugular v. br.(SI-17), post. auricular a.(SI-17), int. jugular v.(SI-17), int. carotid a.(SI-17), transverse fascial a. & v.(SI-18),maxillary a. br.(SI-18), superficial temporal a. & v.(SI-19).

• 대한물리의학회지
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• 제8권3호
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• pp.369-378
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• 2013

PURPOSE: The purpose of present study was to ascertain how the activity of the serratus anterior muscle, the upper trapezius muscle and the pectoral major muscle was affected while the upper arm was being flexed at 70, 90 and 110 degrees respectively in a closed kinetic chain exercise (wall push up plus) and an open kinetic chain exercise (static hug). METHODS: Sixteen healthy young men subjects participated in the study. Surface electromyography (EMG) data were collected from the dominant-side muscles during a closed kinetic chain exercise and an open kinetic chain exercise. The activity of each muscle was measured quantitatively, and by the use of the two-way repeated ANOVA, the data were compared with each other according to exercises and shoulder flexion angles. RESULTS: Results indicated that the closed kinetic chain exercise did not interact with the open kinetic chain exercise (p>.05). In both the closed kinetic chain exercise and the open kinetic chain exercise, the activity of the serratus anterior muscle became different significantly according to angles (p<.05). Its activity increased in order of 70, 90 and 110 degrees (p<.05). In both exercises and all angles, muscle activity was significantly higher in the serratus anterior muscle than in the upper trapezius muscle and the pectoral major muscle (p<.05). CONCLUSION: The above results show that there is a need to selectively control the exercise stress of the serratus anterior muscle in the case of the patients with the shoulder impingement syndrome characterized by the winged scapula, insufficient scapular protraction and upward rotation.

• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.88-94
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• 2016

Purpose: The purpose of this study was to compare therapeutic climbing exercise and general isometric exercise in patients with shoulder impingement syndrome. Methods: Among 20 adults, study subjects were arbitrarily classified into an experimental group of 10 and a control group of 10. The control group performed general isometric exercise (ISE) and the experimental group performed therapeutic climbing exercise (TC) (3 sets, 3 times per week for 8 weeks). To evaluate the effects of exercise, subjects were evaluated using a Disabilities of the arm, shoulder and hand score (DASH), a goniometer for range of motion, and shoulder activity measured serratus anterior, upper trapezius, and lower trapezius. Independent and paired t-test were used for comparison of the effect between groups. Results: DASH scores showed a significant decrease in both groups after 8 weeks of treatment (p<0.001) and significant difference was observed between the TC groups (p<0.01). Flexion and abduction were significantly increased after 8 weeks of treatment in the ISE group (p<0.001) and flexion, abduction, external and internal rotation were significantly increased after 8 weeks of treatment in the TC group (p<0.001). Serratus anterior and lower trapezius activity were significantly increased after 8 weeks of treatment (p<0.001) and upper trapezius activity was not significantly increased after 8 weeks of treatment in the ISE group (p>0.05). Serratus anterior, lower trapezius, and upper trapezius activity were significantly increased after 8 weeks of treatment in the TC group (p<0.001). Conclusion: Scapular stabilizing exercise using a therapeutic climbing exercise increases range of motion and decreases DASH, and increases activity of shoulder muscles in patients with impingement syndrome.

• 한국전문물리치료학회지
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• 제15권3호
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• pp.62-69
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• 2008

The purpose of this study was to measure intrarater and interrater reliability of a portable digital pressure algometer. Fifty healthy subjects were recruited for this study. Pressure pain thresholds of splenius capitis, levator scapular, and upper trapezius muscles were measured using by FPK algometer and portable digital pressure algometer. Three trials were done on each subject by two examiners. Intraclass correlation coefficients (ICCs) were used to determine the reliability of each measure. The intrarater reliability of the FPK algometer was good and excellent (ICC .63~.79) and the interrater reliability was poor and good (ICC .15~.57). The intrarater reliability of a portable digital pressure algometer was excellent (ICC .75~.86) and the interrater reliability was poor and good (ICC .35~.61). This result suggests that the intrarater reliability and interrater reliability of a portable digital pressure algometer were better than an FPK algometer.

• 한국전문물리치료학회지
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• 제18권1호
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• pp.1-8
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• 2011

Push-up plus has been advocated for increasing the activity of the serratus anterior muscle, the most critical scapular stabilizer. However, no previous study has reported the possibility of compensatory motion on the part of the pectoralis major, which could substitute for the action of the serratus anterior during push-up plus. The aim of the current study was to investigate the immediate effect of electromyography (EMG) biofeedback of the pectoralis major muscle on the pectoralis major, upper trapezius, and serratus anterior muscles during push-up plus. Fourteen healthy young subjects voluntarily participated in this study; each subject performed push-up plus from the quadruped position, in two conditions (i.e., with or without visual and auditory biofeedback). Surface EMG was used to measure pectoralis major, serratus anterior, and upper trapezius activity. A paired t-test was used to determine any statistically significant difference between the two conditions. Additionally, effect size was calculated to quantify the magnitude of EMG biofeedback in each muscle. Visual and auditory feedback reduced pectoralis major muscle activity significantly (p=.000) and increased the serratus anterior muscle activity significantly (p=.002), but did not induce a significant difference in upper trapezius muscle activity (p=.881). Thus, it is concluded that the visual and auditory feedback of pectoralis major muscle activity can be used to facilitate serratus anterior muscle activity during push-up plus.