• Physical Therapy Korea
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• v.24 no.4
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• pp.60-67
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• 2017

Background: Scapular downward rotation syndrome (SDRS) is a common scapular alignment impairment that causes insufficient upward rotation and muscle imbalance, shortened levator scapulae (LS) and rhomboid, and lengthened serratus anterior (SA) and trapezius. A modified shrug exercise (MSE), performing a shrug exercise with the shoulders at $150^{\circ}$ abduction, is known as an effective exercise to increase scapular stabilizer muscle activation. Previous studies revealed that scapular exercise are more effective when combined with trunk stabilization exercises in decreasing scapular winging and increasing scapular stabilizer muscle activation. Objects: The purpose of our study was to clarify the effect of MSE with or without trunk stabilization exercises in subjects with SDRS. Methods: Eighteen volunteer subjects (male=10, female=8) with SDRS were recruited for this experiment. All subjects performed MSE under 3 different conditions: (1) MSE, (2) MSE with an abdominal draw-in maneuver (ADIM), and (3) MSE with an abdominal expansion maneuver (AEM). The muscle thickness of the lower trapezius (LT) and the SA were measured using an ultrasonography in each condition. Electromyography (EMG) data were collected from the LT, LS, SA, and upper trapezius (UT) muscle activities. Data were statistically analysed using one-way repeated analysis of variance at a significance level of .05. Results: The muscle thickness of the LT and the SA were the significant different in the MSE, MSE with ADIM (MSE+ADIM) and MSE with AEM (MSE+AEM) conditions (p<.05) In both LT and SA, the order of thick muscle thickness was MSE+AEM, MSE+ADIM, and MSE alone. No significant differences were found in the EMG activities of the SA, UT, LS, and LT in all condition. Conclusion: In conclusion, MSE is more beneficial to people with SDRS when combined with trunk stabilization exercises by increased thickness of scapular stabilizer muscles.

• 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.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.2
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• pp.39-47
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• 2019

Purpose : This study was investigated effects of vibration on scapular winging of knee push-up plus exercise. Methods : Twenty-eight female subjects with scapular winging were evaluated after performing knee push-up plus exercise, with or without vibration, three times a week for four weeks. Muscle activation of the serratus anterior and upper trapezius, and the ratio of activation of the upper trapezius to serratus anterior were measured using surface EMG; and scapular winging length was measured by using the caliper. Results : The findings showed that knee push-up plus exercise -with and without- vibration induced a significant increase in muscle activation of serratus anterior (p<.05) and a significant decrease in muscle activation of the upper trapezius (p<.05), the ratio of muscle activation of the upper trapezius to the serratus anterior (p<.05) and scapular winging length (p<.05). There was also a significant difference in muscle activation of the serratus anterior (p<.05) and upper trapezius (p<.05) between control and experimental group at post-test. Conclusion : This study suggests positive clinical effects of knee push-up plus exercise with vibration which enhanced muscle activation of serratus anterior and reduced muscle activation of upper trapezius in person with scapular winging. However, vibration had no effectiveness to improve muscle imbalance between serratus anterior and upper trapezius, and reduce the scapular winging length.

• PNF and Movement
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• v.11 no.2
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• pp.49-56
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• 2013

Purpose : The purpose of this study was compared for rounded scapular between strechting on pectoralis minoor and strengthening on scapular stabilizer muscles. Methods : The main laboratory had an experiment of the exercise for rounded shoulder posture with 30 patients on a pectoralis minor stretching and scapula to stabilize the elastic band to divide into two groups in this study which were conducted. Results : Acromial height measured from changes of the rounded shoulder posture changes before and after workouts; stretching before exercise in the exercise group is from $94.19{\pm}3.47$ to after result of $94.84{\pm}3.19$, and the after exercise of an elastic band pre-exercise in the exercise group is from $93.60{\pm}3.42$ to $88.68{\pm}3.49$, dividing into two groups, which increased significantly. Compared to an acromial height variation results before and after workouts; stretching exercise group made $3.07{\pm}1.43$, $4.91{\pm}2.24$ and elastic band exercise group, $4.91{\pm}2.24$, which shows the difference between the two groups and was not statistically significant. Conclusion : Against a pectoralis minor that cause the findings of this study, RSP proximately shows serratus anterior and the strengthening of trapezius by exercises of the shoulder peaks which decrease in height arbitration scheme of a pectoralis minor stretching effect as shown. Therefore, it is expected RSP patients in clinical intervention methods combined with stretching exercises strengthens muscles against an elastic band exercise effective.

• 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.14 no.2
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• pp.44-52
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• 2007

This study was carried out to compare the muscle activities of the shoulder stabilizers between persons with and without winging scapular during push-up plus exercise (adds the scapular protraction to the general push-up exercise). For this study, eleven males with winging scapular and eleven healthy males were recruited. Surface electromyographic (EMG) activity was recorded from the serratus anterior, upper trapezius, lower trapezius, infraspinatus, and pectoralis major while the subjects performed the push-up plus. Each push-up plus was subdivided into three phases according to the elbow position which was measured using the 3-D motion analysis system: elbow flexion (EF), elbow extension (EE), and shoulder protraction phases (SP). Two-way repeated measure ANOVA (phase ${\times}$ group) were used for statistical analysis. There was significant phase by group interaction only on the EMG composition ratio of the serratus anterior (p>.05). The EMG composition ratio of the serratus anterior was significantly higher in SP than in either EF or EE however, it was not different between winging scapular and normal groups. For both groups, the EMG composition ratio of upper trapezius, lower trapezius, and pectoralis major was significantly different across the phases of push-up plus, but the infraspinatus EMG composition ratio was not. For both groups, in EF and EE phases, the EMG composition ratio of both pectoralis major and serratus anterior were relatively higher than that of other muscles. However, in both groups, the EMG composition ratio of the serratus anterior became much more predominant than that of the pectoralis major. In addition, infraspinatus activated greater than pectoralis major. These results showed that the push-up plus exercise is effective to selectively strengthen the serratus anterior for both individuals with and without winging scapular, but not equally effective for other shoulder stabilizers.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.03a
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• pp.9-10
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• 2007

• Journal of The Korean Society of Integrative Medicine
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• v.4 no.2
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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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.11 no.2
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• pp.71-82
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• 2005

The couple force of the scapular stabilizers for upward rotation that include the upper and lower trapezius, serratus anterior muscles is essential to maintain the stability of shoulder joint. But if there is an imbalance of these muscles, it would occur many problems of shoulder joint. A push-up plus exercise with an unstable support is used in order to increase the muscle activity and stimulate the proprioception of shoulder joint. The purpose of this study was to compare the muscle activity of upper and lower trapezius, serratus anterior muscles and to determine which exercise is more effective when subjects perform push-up plus exercise in the stable support and unstable support. 15 healthy subjects and 15 painful subjects with injury of shoulder joint participated in this study. Surface electromyography data were collected during plus phase of push-up plus exercise. The types of push-up plus exercise were composed of three conditions. Stable type is subjects performed the push-up plus exercise on the fixed support and unstable type 1 is on the sling without shaking and unstable type 2 is on the sling with shaking by tester's manual. The upper and lower trapezius activities of injured group were higher than uninjured group at three measure conditions, but serratus anterior activities were not. The UT/SA ratio of injured group was higher than uninjured group at three measure conditions. The serratus anterior activities were most high at unstable 2 measure in both groups. The UT/SA ratio was most low at unstable 2 measure condition in injured group only. The present result revealed that push-up plus exercise in the unstable support with shaking which took most high serratus anterior activities and most low of UT/SA ratio is optimal cure method that can improve the imbalance of the scapular stabilizer.

• Journal of Digital Convergence
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• v.10 no.1
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• pp.399-405
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• 2012

The purpose of this study was to compare the shoulder stabilizer muscle activity during a push up plus on a different conditioning surface. Eighteen healthy volunteers were tested. Surface EMG was recorded from the upper trapezius(UT), pectoralis major(PM), and serratus anterior(SA) using surface differential conditions. Measurements were performed for 7 days. The mean root mean square (RMS) of EMG activity was calculated. A one-way repeated measures analysis of variance was performed to compare RMS normalized values. The UT and PM did not show significant differences of electric activation amplitude in relation to different surface conditions(p>.05). However, the SA showed greater mean electric activation amplitude values on the push up plus exercise on a upper and lower unstable surface(p<.05). These results suggest that to improve SA EMG activity is more useful when performed on a upper and lower unstable surface conditions than on a stable surface conditions.