• Title/Summary/Keyword: Shoulder Rehabilitation

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Effect of the Abdominal Drawing-in Maneuver on the Scapular Stabilizer Muscle Activities and Scapular Winging During Push-up Plus Exercise in Subjects With Scapular Winging

  • Kim, Da-eun;Shin, A-reum;Lee, Ji-hyun;Cynn, Heon-seock
    • 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.

Effects of Extracorporeal Shock Wave Therapy with Myofascial Release Techniques on Pain, Movement, and Function in Patients with Myofascial Pain Syndrome (근막통증 증후군 환자에게 체외충격파와 근막이완술 병행 치료가 통증, 움직임, 기능에 미치는 영향)

  • Choi, Won-Jae;Nam, Eun-Jung;Kim, Hyun-Joong;Lee, Seung-Won
    • PNF and Movement
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    • v.18 no.2
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    • pp.245-254
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    • 2020
  • Purpose: The study investigated the effects of extracorporeal shock wave therapy with myofascial release techniques (ESWT+MFR) on pain, movement, and function in patients with myofascial pain syndrome. Methods: Forty participants with upper trapezius trigger points were recruited and randomly allocated to two groups: an experimental group (n = 20) and a control group (n = 20). The experimental group performed the ESWT+MFR, and the control group performed only myofascial release techniques. Each group was treated for 15 minutes, twice a week for four weeks. Pain was assessed using a visual analogue scale and a pressure pain threshold measure. Movement was assessed by cervical range of motion, and cervical and shoulder function were assessed on the Constant-Murley Scale and the Neck Disability Index before and after treatment. Results: The results indicate statistically significant improvements in the two groups on all parameters after intervention as compared to baseline (p < 0.05). As compared to the control group, the experimental group showed statistically significant improvements on the visual analogue scale and pressure pain threshold, cervical range of motion (except rotation), and on the Neck Disability Index (p < 0.05). Conclusion: The ESWT+MFR is more effective than myofascial release techniques for pain, movement, and function in patients with myofascial pain syndrome and would be clinically useful for physical therapists treating myofascial pain syndrome.

Effect of wearing personal protective equipment on cardiopulmonary resuscitation: Focusing on 119 emergency medical technicians (개인보호장비 착용이 심폐소생술에 미치는 영향: 119 구급대원을 중심으로)

  • Shin, Dong-Min;Kim, Seung-Yong;Shin, Sang-Do;Kim, Chu-Hyun;Kim, Tae-Han;Kim, Kyoung-Yong;Kim, Jeong-Hee;Hong, Eun-Jeong
    • The Korean Journal of Emergency Medical Services
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    • v.19 no.3
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    • pp.19-32
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    • 2015
  • Purpose: This study examined the effect of wearing personal protective equipment (PPE) on cardiopulmonary resuscitation (CPR), positive airway pressure, and the posture of emergency medical technicians (EMTs) when conducting CPR. Methods: Twenty 119 EMTs performed 30:2 CPR on a manikin for 4 min. Imaging data were digitized with Kwon3D XP (version 4.0). Data were collected by analyzing the motion when starting in one cycle, such as pressing to the maximum and in the final position (relaxed), and were analyzed with SPSS 18.0. Results: The angle of the elbow joints was significantly reduced (p < .05). The trunk angle was statistically significantly (p < .01, p < .001) increased. The angular velocities of the shoulder joint and left elbow joint were reduced (p > .05). The angular velocity of the trunk was significantly reduced in the starting and maximum compression postures. The hand-escape time was increased. The average compression depth was increased but not significantly (p > .05). The positive airway pressure was reduced (p > .05). Conclusion: The angle of the elbow joints and the angular velocity of the trunk were reduced, and the angle of the trunk was increased. The success of CPR and positive airway pressure was reduced.

Changes in Muscle Activity of the Serratus Anterior According to Surface Tilt Angle During Push-up Plus Exercise in Subjects With Winged Scapula

  • Gu, Qian;Kim, Tae-ho;Chun, Jung-genn
    • Physical Therapy Korea
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    • v.26 no.4
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    • pp.29-34
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    • 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.

Efficacy of PNF Group Exercise Program in Chronic Stroke (만성 뇌졸중 환자에 대한 PNF 집단 운동프로그램의 효과)

  • Kim, Soo-Min;Bae, Sung-Soo
    • PNF and Movement
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    • v.3 no.1
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    • pp.1-15
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    • 2005
  • Objective : The purpose of this study was to evaluate the influence of a community based group exercise intervention on motor functional capacity. To evaluate the immediate(post-treatment) effects after 6-weeks exercise program on the group exercise intervention(PNF and Circuit exercise). Methods : Subjects-Included persons with stroke who were living in the community. Thirty-seven subjects were randomly assigned to the PNF, Circuit exercise and control group participated in a repeated measures design that evaluated the subjects with pre-treatment, post-treatment(6 weeks). Functional ability outcome measures assessed the motor assessment scale(MAS) and EMG. Both treatment groups participated in exercise cJass three times a week for 6 weeks. Group programs focused on balance, functional motor capacity and walking ability. The PNF program was modified PNF pattem and techniques with emphasis on functional tasks when possible, as well as stretching of the more affected limb particularly in the more affected shoulder. The Circuit program with subjects completing practice at a selies of work station as well as participating in walking races and relay with other members of the group. Results : Compared with the control group, the treatment group had larger improvements in the motor function ability after 6 weeks treatment and Post-treatment test scores were more significant than the pre-treatment score. 1. Motor function were assessed by using MAS, sit to stand, walking and upper function were assessed pre-treatment versus post-treatment measures revealed a statically significant(p<.05). There were significant differences between the groups. Compared with the control group, the treatment group had larger improvements. 2. In the treatment groups, demonstrated difference in the electromyographic activation of biceps, triceps, quadriceps and tibialis anterior muscles on the paretic side in the response to the reaching arm movement and stepping motion in stance. The difference in muscle activation improvement were not statically significant. Conclusion : The results of this study showed that the PNF and Circuit group exercise intervention can improve motor functional ability. This study suggests that the PNF and Circuit exercise programs is appropriate for community-based group exercise principles. It leads to gain and maintain potential function for disabled persons after stroke in the community.

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The Effects of Shoulder Mulligan Taping and Repeated Measurements on Wrist Flexor Muscle Activity and Grip Strength in Forward Head Posture (전방머리자세 대상자에게 어깨관절 멀리건테이핑 적용이 손목굽힘근의 근활성도와 파악력에 미치는 영향)

  • Oh, Kang-o;Park, Su-hyung;Kim, Dong-woo;Baek, Yong-hyeon;Choi, Su-hong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.24 no.2
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    • pp.1-7
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    • 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.

Upper Extremity Biomechanics of Manual Wheelchair Propulsion at Different Speeds (수동 휠체어 추진 속도에 따른 상지 관절 생체역학적 영향 분석)

  • Hwang, Seonhong
    • Journal of Biomedical Engineering Research
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    • v.43 no.4
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    • pp.241-250
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    • 2022
  • It is known that chronic pain and injury of upper limb joint tissue in manual wheelchair users is usually caused by muscle imbalance, and the propulsion speed is reported to increase this muscle imbalance. In this study, kinematic variables, electromyography, and ultrasonographic images of the upper limb were measured and analyzed at two different propulsion speeds to provide a quantitative basis for the risk of upper extremity joint injury. Eleven patients with spinal cord injury for the experimental group (GE) and 27 healthy adults for the control group (GC) participated in this study. Joint angles and electromyography were measured while subjects performed self-selected comfortable and fast-speed wheelchair propulsion. Ultrasound images were recorded before and after each propulsion task to measure the acromiohumeral distance (AHD). The range of motion of the shoulder (14.35 deg in GE; 20.24 deg in GC) and elbow (5.25 deg in GE; 2.57 deg in GC) joints were significantly decreased (p<0.001). Muscle activation levels of the anterior deltoid, posterior deltoid, biceps brachii, and triceps brachii increased at fast propulsion. Specifically, triceps brachii showed a significant increase in muscle activation at fast propulsion. AHD decreased at fast propulsion. Moreover, the AHD of GE was already narrowed by about 60% compared to the GC from the pre-tests. Increased load on wheelchair propulsion, such as fast propulsion, is considered to cause upper limb joint impingement and soft tissue injury due to overuse of the extensor muscles in a narrow joint space. It is expected that the results of this study can be a quantitative and objective basis for training and rehabilitation for manual wheelchair users to prevent joint pain and damage.

Comparison of Scapular Stabilizer Muscles Activity among Push-Up, Knee Push-Up and Wall push-Up (푸시업과 무릎 푸시업, 벽 푸시업 운동시 어깨안정근 활성도의 비교)

  • Yong-Kweon Kim
    • 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.

Impact of symptoms of Work-related Musculoskeletal Disorders on health related Quality of Life in firefighter under the IT environment (IT 환경에서 소방공무원의 근골격계 증상이 건강관련 삶의 질에 미치는 영향)

  • Oh, Gyung-Jae;Lee, Jeong-Mi;Yang, Chung-Yong;Park, Hyung-Ju;Park, Yun-Hee;Yoo, Chan-Uk;Kang, Eun-Yeong;Chong, Bok-Hee
    • The Journal of the Korea institute of electronic communication sciences
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    • v.9 no.3
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    • pp.311-322
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    • 2014
  • This study was conducted to assess the impact of work-related musculoskeletal disorders (WMSDs) on health related quality of life (QoL) in the firefighter under the recent IT environment. The data were collected by face to face interview using a structured questionnaire in the 366 respondents. WMSDs symptoms were measured by a self-assessed questionnaire on symptom table of NIOSH and health-related QoL was measured by SF-36. The prevalence of WMSDs was 38.0% in upper limbs, 35.5% in the low back, 21.6% in lower limbs, and 59.3% in two or more parts of the body. Subjects with symptoms of WMSDs had significantly lower scores in 7 dimensions of QoL except 'emotional role limitation' than those without symptoms of WMSDs at the area of upper extremities (neck, shoulder, arm/wrist, and hand/wrist/fingers). On the other hand, subjects with symptoms of WMSDs had significantly lower scores on all QoL dimensions than those without symptoms of WMSDs at the area of lower back or lower extremities. These results suggest that WMSDs had a negative effect on QoL. Therefore, prevention of WMSDs should be considered intervention strategies for improvement of QoL, especially in firefighters.

The Effects of Pulsator Washing Machine on Joints Torques and Muscles Strengths Considering Height of Outside Machine and Depth of Inside Drum for Average Height Users (투입구 높이 및 내부 드럼 깊이를 고려한 펄세이터 세탁기 사용시 평균신장 사용자의 관절 토크 및 근력에 미치는 영향)

  • Kim, Seong Guk;Cho, Young Kuen;Lee, Nam Gi;You, Joshua Sung Hyun;Lim, Dohyung;Kim, Han Sung;Ko, Chang-Yong
    • Journal of Biomedical Engineering Research
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    • v.33 no.4
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    • pp.184-193
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    • 2012
  • Many studies have reported that housework done using household appliances may affect biomechanical characteristics of the musculoskeletal system. The purpose of this study was to investigate the effects of housework done using a pulsator washing machine on joints and muscles. We calculated joint torques and muscle strengths on the basis of an experimental/virtual three-dimensional motion analysis for six healthy females using the pulsator washing machine at different heights (H) and depths (D) of the inside drum (H (mm){\times}D (mm), Trial1: $962.5{\times}609.4$, Trial2: $962.5{\times}624.4$, Trial3: $982.5{\times}644.4$, Trial4: $995.5{\times}642.4$, Trial5: $1015.5{\times}677.4$). The joint torques and muscle strengths tended to be considerably different during torso flexion in the sagittal plane for all the trials. The maximum joint torques for the thoracic vertebra, left ankle, and right shoulder measured in Trial4 were significantly higher than those measured in the other trials (p < 0.05); in addition, those for the thoracic vertebra and both ankles measured in Trial5 were significantly higher than those measured in the other trials (p < 0.05). The maximum muscle strengths for the left trapezius muscle and both tibialis anterior muscles measured in Trial5 were significantly higher than those measured in the other trials (p < 0.05). These results indicate that housework done using a pulsator washing machine may affect joint torques and muscle strengths, and these effects are dependent on the height and/or depth of the inside drum of the pulsator washing machine.