• Physical Therapy Korea
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• v.14 no.4
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• pp.58-65
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• 2007

The purpose of this study was to investigate the effects of serratus anterior strengthening exercises on scapular position and Visual Analog Scale (VAS) pain measurements taken at the resting position in young adults with adducted scapular. The exercise program included stretching of the scapular retractor and strengthening of the serratus anterior muscle. We measured the distance from the midline of the thorax to the vertebral border of the scapular with a tape line (Superior Kibler), and the distance from the 7th cervical spinous process to the acromial angle with 3-dimension motion analysis system, to compare the resting scapular position before and after exercise. Fifteen subjects with adducted scapular were recruited to compare the resting scapular position and VAS. The distance from 7th cervical spine process to acromial angle of the scapular and VAS decreased significantly (p<.01) after exercise, while the distance from the midline of the thorax to vertebral border of the scapular increased (p<.05). The conclusion is that the serratus anterior exercise program altered the resting scapular position and decreased VAS.

• The Journal of Korean Physical Therapy
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• v.27 no.4
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• pp.246-251
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• 2015

Purpose: The purpose of this study was to compare activities of shoulder girdle muscles according to types of closed chain exercise in the sixties. Methods: The subjects consisted of 15 persons in their sixties. Muscle activity of the pectoralis major, deltoid middle, deltoid posterior, upper trapezius, lower trapezius, and serratus anterior were measured using electromyography according to shape of the support base and angle of shoulder flexion. According to types of closed chain exercises, muscles activities were compared by paired t-test. Significance level to verify statistical significance was .05. SPSS win (ver. 22.0) program was used for statistical analysis. Results: Muscle activities of the pectoralis major, middle deltoid, trapezius lower, and serratus anterior showed significant difference according to types of closed chain exercise (p<0.05). Conclusion: According to types of closed chain exercises of the shoulder girdle, muscle activities of the pectoralis major, deltoid middle, posterior and lower trapezius showed change of muscle activities.

• Physical Therapy Korea
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• v.17 no.1
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• pp.77-85
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• 2010

This study was conducted to find the effects of scapular taping on muscle activities of the scapular rotators and upper trapezius pain in subjects with upper trapezius pain. Fifteen male subjects were recruited from Yonsei University for this study. Muscle activity of upper trapezius, lower trapezius, and serratus anterior was measured using surface electromyography. Visual analog scale was used for measuring upper trapezius pain. The subjects were asked to maintain $90^{\circ}$ shoulder flexion position with holding a 1 kg dumbbell in standing position. Scapular taping was applied over the muscle belly of the upper trapezius and attached parallel with the lower trapezius muscle fibers. For normalization, % maximal voluntary isometric contraction (%MVIC) was conducted. Paired t-test was applied to compare the muscle activities of scapular rotator and upper trapezius pain before and after applying the scapular taping. The muscle activity of the upper trapezius muscle and serratus anterior decreased significantly after tape application (p<.05). However, no significant difference was observed in lower trapezius muscle. The level of pain in the upper trapezius muscle significantly decreased after tape application (p<.05). The results of this study suggest that scapular taping can be used an additional therapy for reducing muscle activity of upper trapezius, serratus anterior and upper trapezius pain during shoulder flexion in patient with upper trapezius pain.

• The Journal of Korean Physical Therapy
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• v.31 no.2
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• pp.134-139
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• 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.

• Physical Therapy Korea
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• v.11 no.1
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• pp.45-52
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• 2004

Altered scapular kinematics in the scapular joint is commonly believed to be a factor contributing to trunk posture. The purpose of this study was to analyze the muscle activity with several changes of the shoulder angle. Tests were performed on 10 male subjects by repeated measures. Each subject was measured while sitting in both erect and slouched trunk positions. In each sitting posture, a three-dimensional motion analysis measurement was used to measure thoracic angle and shoulder abduction angle. Measurements were taken with the shoulder abdcution angle at $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, $90^{\circ}$, $120^{\circ}$, and $150^{\circ}$. By using surface Electromyography (EMG) electrodes, we recorded the activity of the upper trapezius, middle trapezius, lower trapezius, middle deltoid, and serratus anterior muscle while the subject held a 4 kg weight at each angle. The mean of root mean square (RMS) of EMG activity was calculated. The middle trapezius, lower trapezius, and middle deltoid muscle activity showed significantly higher results but serratus anterior muscle activity showed significantly lower results (p<.05). With the shoulder angle increased, the muscle activity was also significantly increased (p<.05). In conclusion, the thoracic spine posture significantly affects the scapular muscle during scapular plane abduction, and the slouched posture is associated with increased trapezius muscle activity and with decreased serratus anterior muscle activity.

• Journal of Korean Physical Therapy Science
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• v.15 no.3
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• pp.31-41
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• 2008

Purpose : The purpose of this study is to examine the muscle activity of shoulder stabilization according to change of supporting base interval between push-up bend and push-up plus position and is to prevent or treat a shoulder injury by the most effective exercise for rehabilitation. Methods : This study analyzed the muscle activity according to change of supporting base interval between push-up bend and push-up plus movement. The participants without neuromuscular disease were 25 students - 12 males and 13 females - all twenty or over and the surface electrode of EMG attached on pectoralis major, triceps long head, middle trapezius, lower trapezius, serratus anterior and latissimus dorsi. The process has practiced 3 sessions of supporting base interval - narrowing interval, two shoulder interval, broad interval - by push-up bend and push-up plus movement. Result : 1. The muscle activity of pectoralis major was significantly increased according to narrow interval of supporting base on push-up plus movement and was significant difference(p<.05). 2. The muscle activity of biceps was significantly increased according to narrow interval of supporting base on push-up bend movement(p<.05). 3. The muscle activity of middle or lower trapezius was a difference according to change of supporting base on push-up bend and push-up plus movement but was not significant difference. 4. The muscle activity of serratus anterior was significantly increased according to broad interval of supporting base on push-up bend movement(p<.05). 5. The muscle activity of latissimus dorsi was significantly increased according to broad interval of supporting base on push-up bend movement(p<.05). Conclusion : These results lead us to the conclusion that push-up bend exercise have the effect of muscle strength of biceps on narrowing interval, of serratus anterior or latissimus dorsi on broad interval and push-up plus exercise have the effect of muscle strength of pectoralis major on narrowing interval of support base.

• Physical Therapy Korea
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• v.23 no.4
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• pp.55-62
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• 2016

Background: The functioning of the serratus anterior (SA) muscle is essential to normal scapulohumeral rhythm during forward flexion (FF) of the shoulder. Also, SA weakness and overuse of the upper trapezius (UT) is observed in patients with shoulder dysfunction and trapezius myalgia. We designed a combination exercise involving FF and scapular protraction with resistance (CFFSP) to activate the SA muscle and to deactivate the UT muscle. Objects: The purpose of this study was to determine whether or not CFFSP would be more effective in activating the SA muscle than FF alone and FF with scapular protraction (FFP). Methods: Nineteen subjects (12 men and 7 women) participated in this study and performed FF, FFP, and CFFSP at $120^{\circ}$. Surface electromyography was applied to the SA, UT, and pectoralis major (PM) muscles, as was one-way analysis of variance (ANOVA) with repeated measures. Statistical significance was set at .05. Bonferroni adjustment was used to counteract the problem of multiple comparisons, with a statistical level of significance of .017 (.05/3). Results: A statistically significant difference was found in relation to the three positions for the SA muscle (p<.001) and the SA/UT ratio (p=.005) using ANOVA. Significantly different results, depending on the position, were also demonstrated using the Bonferroni post-hoc test for the SA muscle ($FF=28.27{\pm}16.20$, $FFP=45.66{\pm}15.81$, and $CFFSP=62.4{\pm}27.21$) and for the SA/UT ratio ($FF=3.04{\pm}2.14$, $FFP=3.61{\pm}2.38$, and $CFFSP=5.95{\pm}3.01$). Significant differences between the three positions was not found regarding the average amplitude of SA/PM muscle ratio (SA/PM: p=.060). Conclusion: We recommend the use of CFFSP to strengthen the SA muscle at $120^{\circ}$.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.199-207
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• 2022

Purpose : The purpose of this study is to investigate the effect of shoulder stabilization exercise accompanied by application of a pelvic compression belt on the muscle activity, pain and function of the muscles around the shoulder in subjects with round shoulders. Methods : For the study method, 28 students who were enrolled in K University with a distance of 1 cm or more between the clavicle of the peak and the outer ear path were selected through GPS 400 global postural analysis system measurement. The subjects were randomly assigned to 14 participants in the group wearing a pelvic compression belt and 14 patients in the group not wearing a pelvic compression belt. In all subjects, the muscle activities of the middle trapezius, lower trapezius, and serratus anterior muscles and the shoulder pain disorder index (SPADI) were measured. The intervention was performed 3 times a week for 4 weeks, and the applied intervention was push-up plus and modified prone cobra exercise. The muscle activities of the middle trapezius, lower trapezius, and serratus anterior muscles and SPADI score were compared using dependent t test before and after intervention. Results : In this study, both groups showed that the muscle activity of the middle trapezius, lower trapezius, and serratus anterior significantly increased after the intervention compared to before the intervention. On the other hand, SPADI showed no significant difference. Conclusion : The results of this study showed that muscle activity in the peri-shoulder joint was increased after push-up plus and modified prone cobra exercise in both groups, regardless of whether pelvic compression was applied or not. Therefore, it was found that shoulder stabilization exercise using the pelvic compression belt also contributed to the enhancement of muscle activity in the joints around the shoulder.

• Physical Therapy Korea
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• v.31 no.1
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• pp.55-62
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• 2024

Background: The serratus anterior (SA) is a muscle that performs protraction of the scapulothoracic joint and plays a role in stabilizing the scapula. Imbalances or weaknesses in SA activation are associated with a variety of shoulder dysfunctions, making selective SA strengthening important for rehabilitation. Objects: We aimed to compare the muscle activation of the pectoralis major (PM), SA, external oblique (EO), and internal oblique (IO) during the push-up plus (PUP) exercise with isometric hip adduction (HA) and abdominal drawing-in maneuver (ADIM). Methods: Nineteen healthy male participants performed three PUP exercises: standard PUP, PUP with ADIM, and PUP with HA. Surface electromyography was used to measure and analyze the muscle activity for PM, SA, EO, and IO. Results: PUP with HA showed the lowest PM activity and highest SA activity, and no significant difference was observed between PUP and PUP with ADIM. PUP with ADIM showed significantly the highest EO and IO activity, followed by PUP with HA and PUP. Additionally, PUP with HA showed the lowest PM/SA ratio, and no significant difference was noted between PUP and PUP with ADIM. Conclusion: PUP with HA was able to show high SA muscle activity while reducing PM muscle activity. In addition, PUP with HA can lead to higher EO and IO muscle activity than standard PUP. This exercise could be used as a practical exercise method to selectively strengthen SA and improve scapular muscle stability during early shoulder rehabilitation.

• The Journal of Korean Physical Therapy
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• v.27 no.5
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• pp.325-331
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• 2015

Purpose: This study attempts to understand the effect of stabilization exercise of biofeedback scapular on muscle activity and functional evaluation of the upper extremity in stroke patients. Methods: Patients were divided into two groups; a biofeedback scapular stabilization exercise group comprised of 8 patients and a task-oriented training group including another 8 patients, and 30-minute exercise was performed 5 times a week for 8 weeks. Electromyogram was used to measure muscular activity of lower trapezius, deltoid middle, and serratus anterior. Fugl-Meyer Assessment and Manual Function Test were used to evaluate functions of the muscles mentioned. Results: Significant difference was observed in the comparison group before and after exercise in muscular activity of lower trapezius, deltoid middle, and serratus anterior, Fugl-Meyer Assessment, and Manual Function Test. Conclusion: Therefore, we could see that biofeedback scapular stabilization exercise is more effective than task-oriented training in facilitating muscle activation and functional capacity of upper limb.