• Journal of the Korean Society of Physical Medicine
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• v.15 no.1
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• pp.55-63
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• 2020

PURPOSE: This study examined the effects of handgrip exercise, which was started two weeks after surgery for shoulder rotator cuff repair, on the extent of muscle activation around the shoulder and the cross-sectional area of the supraspinatus muscle. METHODS: Among patients diagnosed with rotator cuff rupture by an orthopedic surgeon and rotator cuff repair was performed using an arthroscope, 28 were selected as subjects. These subjects were allocated randomly to the experimental group and control group with 14 subjects in each group. An electromyogram was measured as a measure of the extent of muscle activation around the shoulder for a total of six times (%RVC). The cross-sectional area of the supraspinatus muscle was measured before and after the rotator cuff repair by magnetic resonance imaging. RESULTS: The extent of muscle activation in accordance with time in both the experimental group and control group displayed significant differences in various muscles including the anterior deltoid, pectoralis major, upper trapezius and infraspinatus muscle(p<.05). A significant difference in the variation of the cross-sectional area of the supraspinatus muscle was observed between the experimental group and the control group(p<.05). CONCLUSION: Handgrip exercise helps rehabilitate the shoulder joint at the acute stage after rotator cuff repair when assertive exercise therapy cannot be applied.

• PNF and Movement
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• v.22 no.1
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• pp.151-158
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• 2024

Purpose: The present study investigated how variations in diagonal exercises affect shoulder muscle activity, examining changes in neuromuscular activation during scapular and shoulder diagonal patterns of exercises. Furthermore, we explored whether the exercise phase affects muscle activation. Methods: Sixteen asymptomatic male participants were recruited. Four diagonal pattern exercises (scapular anterior elevation, posterior elevation, flexion-adduction-external rotation, flexion, abduction-external rotation), and two exercise phases (concentric and eccentric) were administered. Surface electromyography data were collected. Results: Upper trapezius activity was significantly higher during the concentric phase of scapular posterior elevation exercises compared with the others (p<0.05). The serratus anterior, anterior deltoid, and infraspinatus activities were significantly higher during shoulder diagonal pattern exercises compared with the scapular diagonal pattern exercises (p<0.05). Except for the lower trapezius, muscular activities during the concentric phase were significantly greater compared with the eccentric phase (p<0.05). Conclusion: The current study suggests that the diagonal pattern of exercise may contribute to selective strengthening of the shoulder complex muscles and that the form of exercise should be tailored to the subject. It also suggests that diagonal exercises with concentric contractions tend to be more beneficial than eccentric contractions for overall muscle recruitment, but the effects vary for specific diagonal patterns.

• 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.

• PNF and Movement
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• v.21 no.1
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• pp.53-61
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• 2023

Purpose: The study aims to examine the effects of the proprioceptive neuromuscular facilitation pattern exercise and scrambler therapy on pain, range of motion (ROM), and shoulder dysfunction in breast cancer patients. Methods: In total, 30 breast cancer patients were recruited and randomized to group I (n = 10), group II (n = 10), and group III (n = 10). Pain was measured using a visual analogue scale, ROM was measured using a goniometer, and shoulder dysfunction was measured using a shoulder pain and disability index. Group I practiced the proprioceptive neuromuscular facilitation pattern exercise and underwent scrambler therapy, group II underwent scrambler therapy only, and group III practiced the proprioceptive neuromuscular facilitation pattern exercise only. Results: A within-groups comparison showed that all groups demonstrated significant differences in pain, ROM, and shoulder dysfunction after the experiment (p<0.05). Further, according to a comparison of the three groups, group I showed a more significant difference in effectiveness than groups II and III in terms of pain, ROM, and shoulder dysfunction before and after the experiment (p<0.05). Conclusion: This study showed that the proprioceptive neuromuscular facilitation pattern exercise and scrambler therapy are effective in treating pain, ROM issues, and shoulder dysfunction in breast cancer patients.

• Physical Therapy Korea
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• v.30 no.3
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• pp.237-244
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• 2023

Background: The external rotation (ER) exercise in performed at a 90° abduction of the shoulder joint is an effective to strengthen the infraspinatus. However, failure of the humeral head to control axial rotation during exercise can be increased the posterior deltoid over activity. Biofeedback training is an effective method of promoting motor learning and control it could look forward to activate the infraspinatus selectively by controlling the humeral head during exercise. Objects: The aim of this study was investigated that whether biofeedback for axial rotation was effective to activate selectively the infraspinatus during ER exercise. Methods: The 15 healthy males participated, and all subjects performed both ER exercise in a sitting position with shoulder abducted 90° under conditions with and without axial rotation biofeedback. Exercise was performed in a range of 90° ER, divided into three phases: concentric, isometric, and eccentric. The infraspinatus and posterior deltoid muscle activity were observed using surface electromyography. Results: Both infraspinatus activity (p < 0.01) and infraspinatus to posterior deltoid activity ratio (p = 0.01) were significantly higher with biofeedback however, posterior deltoid activity was significantly lower with biofeedback (p = 0.01). The infraspinatus muscle activity and muscle activity ratio were the highest in the isometric contraction type, and there were significant differences for all contraction types (p < 0.05). Whereas, the posterior deltoid activity was the lowest in the isometric contraction type, and showed a significant difference between isometric and other two contraction types (p < 0.05), but no significant different between concentric and eccentric contraction. Conclusion: Our results indicate that the axial rotation biofeedback during sitting ER exercise might be effective method to activating selective infraspinatus muscle and recommended to enhance the dynamic stability of the shoulder joint.

• Journal of muscle and joint health
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• v.19 no.3
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• pp.319-328
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• 2012

Purpose: The purpose of this study was to explore effects of a Cancer-overcome BeHaS exercise program that consists of exercise, education, and cognitive supports to improve shoulder external rotation, cancer coping, group cohesion in mastectomy patients. Methods: A one group pre-post test design was used. Thirty mastectomy patients from C Hospital participated in the supervised exercise program once a week for 8 weeks. Data were collected from May to July 2011 using self-administered questionnaires and physical measurement. SPSS/WIN 19.0 was used for the data analysis. Results: The mean age of participants was 53.7 and the mean postoperative period after the surgery was 12.93 months. There were significant differences in the shoulder external rotation, cancer coping, group cohesion between pre and post program. Conclusion: The results showed that cancer-overcome BeHaS exercise program was an effective nursing intervention for improving breast cancer patient's shoulder external rotation, cancer coping and group cohesion.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.49-54
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• 2016

PURPOSE: This study was implemented to measure the muscle activity of muscles surrounding shoulder during push-up exercise according to the slope angle. METHODS: This study has research subject consisting of 25 normal male adults without neurologic or musculoskeletal injury in shoulder part. EMG was used as a tool for measuring muscle activity and four muscles including upper trapezius (UT), middle trapezius (MT), Lower Trapezius (LT), and Serratus Anterior (SA) were chosen for measuring the muscle activity of muscles surrounding shoulder. Tilting table slope was set at $0^{\circ}$, $30^{\circ}$, $45^{\circ}$, and $60^{\circ}$ and push-up motion was performed three time for each case to use the average value. The measured value was used after generalization process to create %RVC value where the measured value was standardized by using $0^{\circ}$ as a standard. RESULTS: There was a difference of muscle activity according to the tilting table slope during push-up exercise. In UT, MT, and SA, there was no significant $0^{\circ}$ and $30^{\circ}$, $45^{\circ}$ and $60^{\circ}$. But there was significant $30^{\circ}$ and $45^{\circ}$. LT was significant difference between $45^{\circ}$ and $60^{\circ}$ (p<.05). CONCLUSION: There are cases where push-up exercise should be selectively implemented due to shoulder problems. According to this results between $0^{\circ}$ and $30^{\circ}$, push up will be able to more effectively exercise. Applying proper angle of tilting table for push-up to patients who have difficulties in performing motions along with physical consumption can deliver effective and easy exercise program.

• Korean Journal of Applied Biomechanics
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• v.22 no.2
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• pp.193-199
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• 2012

The purpose of this study was to investigate the activities of the serratus anterior (SA) and upper trapezius (UT) muscles during scapular protraction exercise with a dumbbell. Twenty-one healthy subjects with no medial history of shoulder pain or upper extremity disorders were recruited for this study. Subjects performed scapular protraction at $90^{\circ}$ and $130^{\circ}$ shoulder flexion with a dumbbell in supine and standing positions. The activities of the SA and UT were measured via surface electromyography (EMG) during 4 scapular protraction exercises. A 2 (angle) ${\times}$ 2 (position) repeated-measures analysis of variance (ANOVA) was used to compare the normalized activities of the SA and UT and the UT/SA ratio. The results showed that activities of both the SA and UT were the highest for the scapular protraction exercise at $130^{\circ}$ shoulder flexion in the standing position. However, the UT/SA ratio was the lowest for the exercise at $90^{\circ}$ shoulder flexion in supine position. Therefore, for selective activation of the SA muscle, we recommend performing the scapular protraction exercise with a dumbbell in the supine position at $90^{\circ}$ shoulder flexion.

• The Journal of Korean Physical Therapy
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• v.31 no.4
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• pp.199-203
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• 2019

Purpose: This study investigated the effects of shoulder protraction exercise according to weight by examining the surface electromyography (EMG) amplitude in the serratus anterior (SA), upper trapezius (UT), and pectoralis major (PM) as well as the activity ratio of each muscle. Methods: Twenty three winging scapula subjects participated in the study. The subjects performed scapula protraction at shoulder $90^{\circ}$ flexion and $60^{\circ}$ horizontal abduction with up to four (none, 1kg, 1.5kg, and 2kg) dumbbells in the supine position. The EMG data were collected from the dominant side muscles during a shoulder protraction exercise according to weight in the supine position. One way repeated measures analysis of variance (ANOVA) was used to compare the normalized activities of the SA, UT, and PM and the ratios of PM/SA and UT/SA. Results: The results showed that the activities of both the SA and UT were highest for the shoulder protraction exercise at 2kg in the supine position. The UT/SA ratio also was the lowest for exercise at 2kg. On the other hand, the activities of both the UT and PM/SA ratio were similar under all conditions. Conclusion: These results show that there is a need to selectively strengthen the SA muscle in the case of patients with the shoulder dysfunction. In particular, it is necessary to weigh 2kg when performing shoulder protraction exercises in the supine position to activate the SA muscle in patients with a winging scapula.

• Journal of muscle and joint health
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• v.29 no.3
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• pp.141-150
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• 2022

Purpose: This study aimed to investigate the effects of rehabilitation programs with coaching exercise (CE) or home exercise (HE) on shoulder pain, muscle strength, and daily living functions (DLF) in patients with shoulder impingement syndrome. Methods: With quasi-experimental design, thirty patients (15 CE and 15 HE) participated in rehabilitation programs for 12 weeks. At first, data were collected for pain and DLF using questionnaires with testing muscle strength and range of motion. Then, subjects were allowed to receive training on rehabilitation with structured training materials. CE group visited sports center three times a week at P hospital and HE group did self-exercise at home. Data were analyzed using SPSS program. Results: After 12 weeks, both groups showed statistically significant changes in improving pain, muscle strength, and DLF. Compare to HE group, CE group showed a statistically significant improvement in shoulder pain (p=.021), muscle strength in internal rotation (p=.001) and abduction (p=.013) and DLF (p=.012). Conclusion: Rehabilitation programs for patients with shoulder impingement syndrome were effective to improve pain, muscle strength, and DLF. Although CE would bring the better effects, it is possible to apply HE through structured education to patients who are difficult to visit hospitals.