• The Journal of Korean Physical Therapy
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• v.32 no.3
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• pp.157-162
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• 2020

Purpose: This study was to evaluate several tasks performed at a high intensity in terms of their ability to elicit EMG activity in the serratus anterior by comparing the EMG activities of the serratus anterior, upper trapezius, and lower trapezius muscles during six tasks combined shoulder flexion with rotation. Methods: Fifteen healthy males were recruited to this study. Each subject was instructed to assume a sitting position without back support and asked to flex (90° or 120°) the right shoulder and protract the scapula in the sagittal plane with maximal external rotation; to assume a neutral position; or to internally rotate the glenohumeral joint. The EMG data were collected from the serratus anterior (SA), upper trapezius (UT), and lower trapezius (LT) muscles were normalized to maximum voluntary isometric contraction. The UT/LT and UT/SA muscle activity ratios in each task were assessed by calculating the surface EMG. Data were analyzed by two-way repeated-measures analysis of variance, with the level of significance set at p<0.05. Results: The results of this study, shoulder flexion with external rotation resulted in low upper trapezius/serratus anterior and upper trapezius/lower trapezius ratios and a relatively high level of serratus anterior activation. Conclusion: Shoulder flexion with external rotation used herein may be considered as important for clinical interventions aimed at selectively increasing SA strengthen and clinical selection of exercises for improving glenohumeral joint and scapulothoracic control.

• The Journal of Korean Physical Therapy
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• v.14 no.1
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• pp.15-26
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• 2002

The purpose of this study was to find the effects of scapular pattern and hold-relax technique of propriocetive neuromuscular facilitation(PNF) on the range of motion(ROM) and to find the effects of pain relieve through visual analogue scale(VAS) in frozen shoulder patients. The subjects were consisted of thirty frozen shoulder patients(men ; 9, women ; 21). The measurement of the shoulder range of motion was taken by measuring the degrees of flexion, abduction, and external rotation with a goniometer and the measurement of pain was performed by VAS from pre treatment to one to four weeks The results were as follows : 1. There was the statistical significance not only in the range of motion such as shoulder flexion, abduction, and external rotation, but also in VAS during four weeks(p<.05). 2. By the result of Scheffe's multiple comparison test. there was statistical significance between the values of pre treatment and treatment after one week in the range of motion of shoulder flexion. In that of shoulder external rotation, there was statistical significance between the values of pre treatment and treatment after one week, and between those of treatment after one and two weeks. As the result of this statistical significance of shoulder external rotation, the early treatment was thought to be more effective. However, there was statistical significance in the treatment after two and three weeks in shoulder abduction and was statistical significance between the values of pre treatment and the treatment after one weeks, and between those of treatment after two and three weeks in VAS (p<.05). 3. There was not statistical significance between men and women in the range of motion of the shoulder and in VAS(p>.05). 4. There not statistical significance between th right and left frozen shoulder patients in the range of motion of shoulder and in VAS(p>.05).

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.141-148
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• 2019

Purpose: The present study investigated the effects of 12-week aquatic exercise training on isokinetic muscle function of the shoulder in adolescents with cerebral palsy. Methods: The study included four male and four female adolescents with cerebral palsy. Isokinetic muscle function was measured at an angular velocity of $60^{\circ}/s$, using Biodex System VI Pro. The peak torques of internal rotation and external rotation were measured before and after training. Aquatic exercise training was performed once a day for 120 min, 4 times a week for 12 weeks. Results: The peak torque of external rotation according to body weight and mean power of internal rotation were significantly higher after training (p < 0.05). Conclusion: Our findings suggest that 12-week aquatic training for adolescents with cerebral palsy can improve isokinetic muscle function of the shoulder. Future studies should analyze the changes in isokinetic muscle function of the shoulder in more detail using various aquatic exercise programs to investigate their effects on individuals with cerebral palsy.

• PNF and Movement
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• v.16 no.2
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• pp.169-178
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• 2018

Purpose: This study aimed to investigate the effect of angular joint mobilization (AJM) on the shoulder pain, range of motion, and functional improvement in a patient with shoulder adhesive capsulitis. Methods: The patient diagnosed with right shoulder adhesive capsulitis by an orthopedic surgeon was a 60-year-old male, right hand/arm dominant, with a height of 175 cm and weight of 75 kg. The patient received 12 sessions of AJM once or twice per week for eight weeks. AJM was applied for 5 min each of flexion, abduction, external rotation, internal rotation, for a total of 20 min per session. The visual analog scale, the goniometer, and the Oxford shoulder score were used to measure pain, range of motion, and shoulder pain & disability index, respectively. Results: After all the treatments, the pain decreased from 6 to 2 points. The range of motion increased in flexion by $54.3^{\circ}$ from $125^{\circ}$ to $179.3^{\circ}$, abduction by $38^{\circ}$ from $140^{\circ}$ to $178^{\circ}$, external rotation by $54.4^{\circ}$ from $30.3^{\circ}$ to $84.7^{\circ}$, and internal rotation by $25^{\circ}$ from $45^{\circ}$ to $70^{\circ}$. The shoulder disability index decreased from 33 points to 17 points. Conclusion: This study found that AJM has a positive effect on the improvement of shoulder pain, range of motion, and function in a patient with shoulder adhesive capsulitis. Further studies on AJM are needed in the future.

• The Journal of Korean Physical Therapy
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• v.32 no.2
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• pp.101-106
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• 2020

Purpose: This study examined the effects of the directions of neck rotation on the muscle activity of the upper trapezius and lower trapezius while rotating a shoulder externally. Methods: Twenty-five healthy males participated in this study. The subjects were asked to rotate their shoulder externally with 90° shoulder abduction and 90° elbow flexion in three different neck rotations (neutral, ipsilateral, and contralateral) in the prone position. The muscle activities of the upper and lower trapezius were measured using surface electromyography. One way repeated measures ANOVA was used to compare the muscle activity of the upper and lower trapezius depending on the different neck turning directions. Results: In the upper trapezius, turning the neck in the ipsilateral direction while turning a shoulder externally decreased the muscle activity significantly, but the muscle activity was increased significantly by turning the neck in the contralateral direction. On the other hand, in the lower trapezius, turning the neck in the ipsilateral direction increased the muscle activity significantly, but the muscle activity was decreased significantly by turning the neck in the contralateral direction decreased it significantly. Conclusion: When someone has an imbalance of shoulder function, turning the neck in the ipsilateral direction while turning the shoulder externally in the prone position is effective in decreasing the activity of the upper trapezius and increasing the activity of the lower trapezius. Therefore, these results could be used as basic evidence for researching patients with shoulder problems.

• Journal of International Academy of Physical Therapy Research
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• v.2 no.1
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• pp.229-236
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• 2011

The purpose of this study was to comparatively analyze the active stability of shoulder joints according to the frequency of overhead motions, such as serving and spiking, engaged in by female professional volleyball athletes who play different positions, and to provide the results as the basic data for developing exercise programs to prevent shoulder joint injuries. The subjects of this study were 50 Korean female professional volleyball players and positions were as follows: left and right attackers, centers, setters, and liberos. The external rotation and internal rotation muscle strength and muscle strength ratios of the dominant and non-dominant arms of all subjects were measured using Biodex. The results of this study are as follows: Frist, no significant differences were found in the internal and external rotation muscle strength of the dominant and non-dominant arms between positions. Second, for the shoulder joint muscle strength ratio of the dominant arm, by position, the setter showed significantly greater stability compared to the other positions. Third, for the shoulder joint muscle strength ratio of the non-dominant arm, by position, no significant difference in stability between positions was found. Fourth, it was found that the dominant arm had significantly greater instability of the shoulder joint than the non-dominant arm for attackers and centers, but no significant difference was found for setters and liberos. This study comparatively analyzed the muscle strength ratios of the external/internal rotations and dominant/non-dominant arms, which can determine the stability of the shoulder joints between female professional volleyball playing positions that engage in jumps and spikes using only the dominant hand and positions that do not.

• 대한관절경학회:학술대회논문집
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• 2006.11a
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• pp.35-39
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• 2006

Posterior capsular tightness with glenohumeral internal rotation deficit is usually considered to be an acquired condition of the throwing shoulder and is usually treated conservatively. However, because posterior capsular tightness is sometimes irreversible, we have performed arthroscopic capsular release for painful throwing shoulder with posterior capsular tightness. The true loss of internal rotation and posterior stiffness was confirmed by examination with the patient under anesthesia, and contracture of the posterior capsule and the posterior band of the inferior glenohumeral ligamant was observed arthroscopically. Because an extensive adhesion between the capsule and the fascia of the external rotators was noted, a capsular release was performed from 6 o'clock to 11 o'clock (in the right shoulder) to completely expose the muscle belly of the external rotators. Of the first 16 consecutive patients, 4 had no concomitant lesions and underwent posterior capsular release alone. With a minimum of 2 years' follow-up, it was ascertained that the throwing pain completely disappeared in 14 patients and improved in 2. In all, 11 patients returned to their preinjury performance level, and 5 returned to a lower level of function. In the 4 patients who had no concomitant lesions, throwing pain completely disappeared, and all were able to return to their preinjury performance level.

• Clinics in Shoulder and Elbow
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• v.3 no.1
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• pp.26-32
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• 2000

Purpose : The aim of this study is the assessment of the clinical outcomes after percutanous pinning of unstable two-parts fracture of surgical neck in humerus. Materials and Methods: This study was based on thirteen cases of non-comminuted unstable surgical neck fracture of humerus among 19 cases, which followed-up more than one year. Follow-up averaged 29 months. We treated with percutaneous pinning techniques and assessed clinical outcomes. Functional evaluation was performed using the standard method of research committee of American Shoulder and Elbow Surgeons(ASES). Results: Last follow-up ROM of shoulder joint were 142 degrees of forward elevation, 57 degrees of external rotation, 72 degrees of external rotation in 90 degrees abduction, and T8 of internal rotation. Pain scale was l(range : 0∼3). ASES scores was 86.2(range : 63.3~98.3). Patient satisfaction based on ASES were excellent in 6 cases, good in 5 cases, fair in 1 case, poor in 1 case. A case of fair result was caused by limitation of motion in shoulder joint and poor case was paraplegia patient after traffic accident. Conclusion : Percutaneous pinning is recommended for non-comminuted unstable fracture of surgical neck in humerus.

• Physical Therapy Korea
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• v.17 no.1
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• pp.1-8
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• 2010

The purpose of this study was to compare EMG activity for pectoralis major muscle during shoulder movement with various abduction angle and rotation position in supine position. Fifteen healthy subjects were recruited for this study. All subjects performed shoulder horizontal adduction holding a 2 kg dumbbell in shoulder abduction $40^{\circ}C$, $70^{\circ}C$, $90^{\circ}C$, $130^{\circ}C$, $160^{\circ}C$ with shoulder neutral, internal rotation (IR), and external rotation (ER). Surface EMG activity was recorded from pectoralis major clavicle part and pectoralis major sternum part for 5 seconds and EMG activity was normalized to the value of maximal voluntary isometric contraction (%MVIC). Dependent variables were examined with 3 (Neutral, IR, ER) ${\times}$ 5 ($40^{\circ}C$, $70^{\circ}C$, $90^{\circ}C$, $130^{\circ}C$, $160^{\circ}C$) analysis of variance with repeated measures. The EMG activity of pectoralis major muscle was significantly different between shoulder abduction angles and between shoulder rotation positions (p<.05). The highest value of EMG activity of pectoralis major clavicle part among shoulder abduction angles was in $70^{\circ}C$ and, $90^{\circ}C$ in that order. The highest value of EMG activity of pectoralis major sternum part among shoulder abduction angles was in $130^{\circ}C$ and, $90^{\circ}C$ in that order. According to the rotation degree, shoulder ER showed the highest value and IR showed the lowest value in both muscle parts. These results suggest that shoulder abduction $70^{\circ}C$, $90^{\circ}C$, $130^{\circ}C$ will be effective during manual muscle testing (MMT) and strengthening exercise for pectoralis major muscle. It is also supposed that shoulder ER is the efficient posture for strengthening of pectoralis major muscle.

• Clinics in Shoulder and Elbow
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• v.4 no.2
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• pp.181-185
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• 2001

Purpose: We reviewed the bilateral anterior shoulder instability to evaluate the final outcomes and influencing factors that had effect on the final outcomes. Materials and Methods: Sixteen patients of the bilateral shoulder instability underwent the operative treatment and 15 patients could be followed up average 29 months. There were Bankart lesions in 28 cases and 46% retracted markedly onto the medial side of the glenoid neck. Capsular redundancy could be seen in 50%, but the generalized ligamentous laxity in only two patients. We performed open Bankart repair in 21 cases and arthroscopic repair in 9 cases. Inferior capsular shift was performed in 12 cases of 15 cases in patients who was shown the capular redundancy. Results: The average increment of the forward flexion was 4° postoperatively but the average decrement of the external rotation was 6° postoperatively. After the inferior capsular shift surgery, there were significantly the decrement in external rotation by 13° even though the forward flexion was at the same level comparing with preoperative motion. There were 13 cases(43%) in excellent result, 14 cases(47%) in good and 3 case(l0%) in poor. Rowe score improved from 53 to 87.3 postoperatively. Conclusion : Re-establishing a proper capsular tensioning in a bilateral anterior shoulder instability is critical to ultimate success because there was a redundant laxity in a half and majority of them had marked retraction of an anteroinferior glenohumeral ligament complex. Especially, it should be considered that an unexpected limitation of external rotation could be occurred in the inferior capsular shift surgery.