• The Journal of Korean Physical Therapy
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• 제35권6호
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• pp.167-176
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• 2023

Purpose: Due to the high incidence of shoulder injuries, including shoulder impingement syndrome (SIS), among CrossFit practitioners due to frequent overhead movements, serratus anterior exercises are considered crucial for scapular stabilization in both intervention and prevention. Objective: The objective of this study is to compare the muscle activity and ratios of scapular stabilizing and shoulder girdle muscles between individuals with and without SIS during serratus punch and wall slide exercises, both targeting the serratus anterior muscle, in CrossFit training practitioners. Methods: Surface electromyography was used to compare the muscle activity and activity ratio of scapular stabilizing muscles and shoulder muscles during serratus punch and wall slide exercises in two groups of 20 CrossFit practitioners: ten with SIS and ten without symptoms. Results: The group with SIS showed higher activation of the pectoralis major, upper trapezius, and a higher pectoralis major/serratus anterior and upper trapezius/serratus anterior muscle activation ratio during the serratus punch exercise compared to the group without SIS. Similarly, during the wall slide exercise, the group with SIS exhibited higher activation of the upper trapezius and a higher upper trapezius/serratus anterior muscle activation ratio compared to the group without SIS. However, no significant difference in serratus anterior muscle activation was observed between the two groups. Conclusions: This study highlights the higher activation of the pectoralis major and upper trapezius muscles in CrossFit practitioners with SIS during the serratus anterior exercise, suggesting the importance of minimizing the overactivation of these muscles to prevent impingement syndrome in this population.

• 한국전문물리치료학회지
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• 제29권2호
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• pp.165-170
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• 2022

Background: The serratus anterior (SA) muscle prevents scapular winging (SW) by stabilizing the medial border of the scapula during arm movement. The upper trapezius (UT) and lower trapezius (LT) muscles may compensate for the weak SA muscle in individuals with SW during shoulder flexion. However, there is no study to examine whether compensation by UT and LT occurs in individuals with SW. Objects: This study compared the muscle activities of UT, LT, and SA as well as the SA/UT activity ratio between individuals with and without SW during shoulder flexion with load. Methods: This study recruited 27 participants with SW (n = 14) and without SW (n = 13). Electromyography data of the SA, UT, and LT muscles and SA/UT activity ratio were recorded and analyzed during shoulder flexion with 25% load of the maximal shoulder flexion force. Independent t-test was used to compare the UT, LT, and SA muscle activities and SA/UT ratio between the groups with and without SW; statistical significance was set at α of 0.05. Results: SA activity was significantly lesser in the group with SW than in the group without SW. However, there were no significant differences in the UT and LT activities and SA/UT activity ratio between the two groups. Conclusion: The SA activity was lesser in the group with SW than in the group without SW with 25% load of the maximal shoulder flexion force, but there was no compensatory muscle activity of the UT and LT observed. Therefore, further studies are warranted to clarify the compensatory strategy of scapular stabilization in individuals with SW during shoulder flexion under other heavy load conditions.

• Physical Therapy Rehabilitation Science
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• 제10권2호
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• pp.106-111
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• 2021

Objective: This study covered the effect of stabilization exercise on muscle activity, shoulder painanddisability index(SPADI) oftheelderly people with chronic shoulder pain by tele-rehabilitation village hall in rural area. Design: A randomized controlled trial. Methods: The study subjects are 29 elders with chronic shoulder pain aged over 65-year-old who reside in the rural area (experimental group: 14 elders and control group: 15). The elderly people in the experimental group were asked to perform shoulder stabilization exercise 60 minutes per one time for 4 weeks and three times in a week and the others in the control group were asked to receive education related to pain management for the initial one time. Before and after the experiment, we measured the subjects' muscle activity of upper trapezius, serratus anterior and the lower trapezius. In addition, SPADI is measured through the questionnaire. Results: Compared to the control group, the experimental group showed significant differences in the muscle activity of the three muscles (upper trapezius, serratus anterior, lower trapezius), and SPADI. Conclusions: It is found that shoulder stabilization exercise is effective in muscleactivity, pain and ability of the elderly people through tele-rehabilitation service. This study should be used for improving the quality of the elderly people's lives through active tele-rehabilitation service for areas where have poor medical benefits.

• The Journal of Korean Physical Therapy
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• 제26권3호
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• pp.140-146
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• 2014

Purpose: Differences in scapular kinematics and muscle activity appear in the forward head and rounded shoulder posture (FHRSP). Thus, the aim of this study was to investigate the following effects according to different postures on scapular kinematics and muscle activity around scapular region in individuals with and without FHRSP during overhead reaching task. Methods: Thirty pain-free subjects with/without FHRSP participated in this study. All subjects were positioned into three positions: habitual head posture (HHP), self-perceived ideal head posture (SIHP) and therapist-perceived neutral head posture (TNHP). Muscle activities of upper trapezius (UT), lower trapezius (LT) and serratus anterior (SA) were measured during overhead reaching task. Results: Muscle activity of trapezius muscle (UT and LT) during HHP was significantly higher than SIHP and TNHP in FHRSP group (p<0.05), but there was no difference between SIHP and TNHP. SA also significantly increased muscle activity in HHP more than SIHP and TNHP in FHRSP group (p<0.05), but there was no significant difference between SIHP and TNHP. In Non-FHRSP group, although there was a tendency of different muscle activities among three postures, it was not statistically significant. Conclusion: This result demonstrates that muscle activity associated with overhead reaching task is increased in HHP which affects the scapular kinematics and SIHP contributes changed scapular kinematics and proper recruitment of muscle activity in FHRSP similarly to TNHP.

• The Journal of Korean Physical Therapy
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• 제28권1호
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• pp.52-58
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• 2016

Purpose: This study intended to mediate shoulder exercise using grasping and investigate examine how its effects on affects activities of the shoulder surrounding muscles of the shoulder and thickness of shoulder muscle to suggest effective exercise for patients with rotator cuff repair to return to daily life. Methods: This study has been done targeteding male patients more than 6 weeks after having En-masse Suture Bridge Technique as rotator cuff repair of the right shoulder, aged 40 to 55 in a medical institution located in Jeollanam-do. Experimental group I (n=15) was selected for a conducting common exercise therapy program and Experimental group II (n=15) was selected for an conducting exercise therapy program using grasping. %RVC was measured by surface electromyography and muscle thickness was measured by ultrasound before mediation to for analysisze of before and after results within group and between groups. Results: In comparison of change of %RVC, Tthere were meaningful differences in only posterior deltoid and infraspinatus in comparing a change of %RVC within experimental group I (p<0.001),. and Tthere were meaningful differences in both supraspinatus and infraspinatus in muscle thickness within experimental group I (p<0.001). In comparison of change of %RVC, Tthere were meaningful differences in anterior deltoid, posterior deltoid and infraspinatus in comparing a change of %RVC within experimental group II (p<0.05)(p<0.01) (p<0.001), and there were meaningful differences in both supraspinatus and infraspinatus in muscle thickness within experimental group II (p<0.001). In comparison of change of %RVC between groups, Tthere was a meaningful difference in only posterior deltoid in comparing a change of %RVC between groups (p<0.001). Conclusion: We found that exercise therapy using grasping has a positive effect on shoulder stability muscles such as supraspinatus muscle and infraspinatus muscle and activity of deltoid muscle.

• 한국전문물리치료학회지
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• 제23권2호
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• pp.57-66
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• 2016

Background: For the treatment of forward head posture (FHP) and forward shoulder posture, methods for strengthening scapular retractors and deep cervical flexors and stretching pectoralis and upper cervical extensors are generally used. No study has yet assessed whether suboccipital release (SR) followed by cranio-cervical flexion exercise (CCFE) (SR-CCFE) will result in a positive change in the shoulders and neck, showing a "downstream" effect. Objects: The purpose of this study was to investigate the immediate effects of SR-CCFE on craniovertebral angle (CVA), shoulder abduction range of motion (ROM), shoulder pain, and muscle activities of upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction in subjects with FHP. Methods: In total, 19 subjects (7 males, 12 females) with FHP were recruited. The subject performed the fifth phase of CCFE immediately after receiving SR. CVA, shoulder abduction ROM, shoulder pain, muscle activities of UT, LT, and SA, and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction were measured immediately after SR-CCFE. A paired t-test and Wilcoxon signed-rank test were used to determine the significance of differences in scores between pre- and post-intervention in the same group. Results: The CVA (p<.001) and shoulder abduction ROM (p<.001) were increased significantly post-versus pre-intervention. Shoulder pain was decreased significantly (p<.001), and LT (p<.05) and SA (p<.05) muscle activities were increased significantly post- versus pre-intervention. The LT/UT muscle activity ratio was increased significantly post- versus pre-intervention (p<.05). However, there was no significant change in UT muscle activity and SA/UT muscle activity ratio between pre- and post-intervention (p>.05). Conclusion: SR-CCFE was an effective intervention to improve FHP and induce downstream effect from the neck to the trunk and shoulders in subjects with FHP.

• 한국전문물리치료학회지
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• 제18권1호
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• pp.47-56
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• 2011

The purpose of this study was to compare electromyography (EMG) activity for the middle and lower trapezius muscle according to various shoulder abduction angles. Thirty healthy male subjects were recruited for this study. Each subject performed three repetitions of horizontal abduction at $75^{\circ}$, $90^{\circ}$, $125^{\circ}$, $160^{\circ}$, and $180^{\circ}$ of shoulder abduction angle in a prone position. Surface EMG activity was recorded from the middle and lower trapezius while the subjects held for five seconds at a predetermined position. The EMG activity was normalized using the maximal voluntary isometric contraction (MVIC) elicited using a manual muscle testing technique. A repeatedly measured ANOVA was performed by Bonferroni's post hoc test. The EMG activity of the middle and lower trapezius was significantly different among shoulder abduction angles (p<.05). The greatest level of muscle activity for the middle and lower trapezius were demonstrated at $90^{\circ}$ and $160^{\circ}$ of shoulder abduction angle, respectively. These results suggest that middle and lower trapezius strengthening exercise and manual muscle testing should be performed at different shoulder abduction angles.

• The Journal of Korean Physical Therapy
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• 제27권5호
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• pp.299-303
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• 2015

Purpose: The objective of this study was to examine the changes in muscle activity on the anterior deltoid muscle depending on the stretch rate of kinesio tape when applying kinesio tape in healthy adult subjects. Methods: This study was a single-blind randomized controlled trial, including 22 healthy participants (male 15, female 7) with no pathology or past history of shoulder who participated voluntarily. Participants applied a different stretch rate of the kinesio tape, and the functional activity was tested. The stretch rate of kinesio tape was 0%, 10%, and 20%. Subjects lifted a weight (5% of their body weight) to their shoulder height. Subjects lifted a weight up to an angle of 90 degrees in the sagittal plane, and muscle activities (biceps brachii, anterior deltoid, middle deltoid, upper trapezius) were assessed using EMG (electromyography). Analysis of muscle activity was divided into two parts (lift weight and keep holding). The EMG activity of each muscle was normalized to the value of reference voluntary contraction (%RVC) and explored using repeated ANOVA. Results: There were no significant differences in muscle activity depending on the ratio of tape stretch when lifting a weight (p>0.05). There were no significant differences in muscle activity depending on the ratio of tape stretch when holding a weight (p>0.05). Conclusion: According to the results of this study, in the case of applying kinesio taping therapy for healthy people, it was found that the stretch rate of the tape does not have an effect on muscle activity.

• 대한물리치료과학회지
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• 제9권3호
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• pp.77-87
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• 2002

The purpose of this study was to compare the changes of muscle activities in deltoid with those in supraspinatus using electromyography(EMG) while subjects abducted their shoulder to different angles with different resistance. Methods : 20 volunteers who were comprised of 10 males(mean age: $21.2{\pm}2.0$) and 10 females(mean age: $20.2{\pm}1.6$) were collected. Surface electrodes were attached on deltoid and supraspinatus muscle for recording. Each reference electrode was located 3 cm to the each recording electrode. Muscle action potentials were recorded with changing the angle of shoulder abduction, $30^{\circ}$, $60^{\circ}$, $90^{\circ}$. This procedure was repeated with different resistance 0 pound, 2 pounds, 4.5pounds. The angle of shoulder abduction was determined by clinical goniometer. SPSS(Statistical Program for Social Science)/WIN 10.0 was used for statistics. Analysis included ANOVA, T-test. Results : The following results were obtained in this study. 1. There was significant differences during isometric shoulder abduction $30^{\circ}$, $60^{\circ}$, $90^{\circ}$ comparing muscle activity in deltoid and supraspinatus muscles at 0 pound, 2pound, 4.5pound resistance(p<0.05). 2. There was no useful significant in the deltoid and supraspinatus muscles activity EMG compared by physical condition. 3. Their was significant in the deltoid EMG compared by gender t=-5.41, P<0.01, but no difference in the supraspinatus EMG(P=0.333 >a=0.05). Conclusions: There are many previous studies on influence of shoulder angles and speeds of muscle activity. However most of them placed the focus on isotonic or isokinetic exercise, or shoulder function. But this study was done during isometric exercise, which is better for early assessment and treatment for injured patients. There is strong relationship between the shoulder angle with resistance in deltoid supraspinatus muscle activity. We conclude that it is important to apply isometric shoulder abduction exercise with correct angle and resistance especially in early stage.

• The Journal of Korean Physical Therapy
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• 제24권6호
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• pp.388-392
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• 2012

Purpose: Muscle imbalance between upper trapezius (UT) and serratus anterior (SA) during arm elevation is a factor causing shoulder dysfunction. However, there is no study to compare the muscle activities of the UT and middle deltoid (MD). The purpose of this study was to compare the muscle activities of the UT and MD between with and without elevation of shoulder girdle (ESG) during shoulder abduction. Methods: The subjects without (control group=9) or with (ESG group=8) participated in this study. The muscle activities of the UT and MD were measured using a electromyography during $90^{\circ}$ shoulder abducted position in both group. The data in middle of 3-second of the 5-second periods were used. The mean value of three trials was used in the data analysis. For each muscle, independent t-tests were performed to compare for group differences. Results: The muscle activity of UT was significantly greater in ESG group, compared to that of the control group (p<0.05). The muscle activity of MD was significantly smaller in ESG group, compared to that of the control group (p<0.05). Conclusion: These findings showed that low muscle activation of MD as well as SA may contribute to hyperactivity of UT during arm elevation.