• Physical Therapy Korea
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• v.28 no.3
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• pp.194-199
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• 2021

Background: The scapulo-thoracic musculatures including serratus anterior (SA), upper trapezius and lower trapezius can provide shoulder stability and functional shoulder movement. Objects: The muscle activities of upper and lower SA were compared during three different scapular protraction exercises in healthy individuals in sitting position. Methods: Twenty-five healthy subjects were participated. Electromyography device was used to measure muscle activity of upper and lower SA and trapezius muscles. Each subject was asked to perform three different scapular protraction exercises (scapular protraction [SP], SP with self-resistance [SPSR], SPSR with hand-exerciser [SPSRH]) in random order. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Results: The muscle activity of lower SA muscle was significantly different among three conditions (SP vs. SPSR vs. SPSRH) (p < 0.01). The lower SA muscle activity was significantly greater during SPSRH compared to SP and SPSR, which required joint stability more than SP and SPSR (p < 0.01). Conclusion: SPSRH exercise can be recommended to facilitate the muscle activity of lower SA. In addition, the intramuscular variation in the upper and lower SA during scapular protraction exercise is required to consider the effective rehabilitation.

• 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.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.2 no.2
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• pp.141-150
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• 2007

Objectives : The purpose of this study was to investigate the correlation of stress and meridian muscle electrography in Korean adult males. Methods : Sixty-nine volunteers suffering from stress participated in this study. Physical examination, stress survey and meridian muscle electrography were performed. Each variable was compared with each other by correlation analysis. Results : Correlation between stress response inventory and fatigue of trapezius muscle right upper portion was statistically significant. In relationship between sub scales of stress response inventory and meridian muscle electrography, fatigue of trapezius muscle right upper portion was statistically significant with tension, depression, and frustration. Contraction power of left sternocleidomastoid muscle was significant with somatization and others were not significant. Conclusions : In Korean adult males, trapezius muscle shows more fatigue under more stress. This suggests that stress influences muscle fatigue. Although meridian muscle electrography is not a typical method for the evaluation of pain nor stress, this is referential method to clinical evaluation of painful shoulder caused stress.

• 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.

• Physical Therapy Korea
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• v.10 no.1
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• pp.37-50
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• 2003

The purpose of this study was to compare visual analogue scale (VAS), pain threshold (PT), $%RMS_{RVC}$, and EMG gaps before and after applying transcutaneous electrical nerve stimulation (TENS) on the upper trapezius muscle at the patients with myofascial pain syndrome (MPS). The subjects were 4 men and 10 women composed of both the inpatients and outpatients who were diagnosed as MPS at Wonju Medical Center. VAS and PT measurements were performed to assess the subjective pain level. The reference voluntary contraction (RVC) test was performed for 15 seconds for normalization on the bilateral trapezius muscle using surface electromyography (sEMG). After 3-minute resting time, the EMG signal was recorded while performing a typing activity for 2 minutes and then TENS was applicated with a comfortable intensity for 10 minutes. The EMG activity of the upper trapezius muscle was recorded during typing for 2 minutes. The results of study were as follows: 1) VAS score was significantly decreased on the more painful side after treatment, however, it was not significantly different on the less painful side. 2) PT was increased after treatment on both sides, however, it was not significantly different between before and after the TENS application. 3) The EMG activity during typing was significantly decreased after treatment, and 4) The EMG gaps were significantly increased after TENS treatment compared to before it. Consequently, the study showed that TENS was effective in decreasing VAS, $%RMS_{RVC}$, and in increasing EMG gaps. The EMG gap analysis could be a useful method to measure pain in patients with MPS in the upper trapezius.

• Physical Therapy Korea
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• v.17 no.4
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• pp.8-15
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• 2010

This study was designed to investigate the effect of different hand positions on scapulothorcic muscle activities during push-up plus exercises. Fourteen healthy males performed push-up plus exercises under three conditions (neutral, $90^{\circ}$ internally rotated, and $90^{\circ}$ externally rotated hand positions), during which the activities of the serratus anterior, pectoralis major, and upper trapezius muscles were recorded using surface electromyography. The statistical significance at three different hand positions was tested by repeated one-way ANOVA. The mean activities of the serratus anterior increased and the mean activities of the pectoralis major decreased in the order of neutral hand position, internally rotated hand position, and externally rotated hand position. There was a significant difference during push-up plus between neutral and externally rotated hand positions as well as in the serratus anterior/pectoralis major activity ratio (p<.0.5). However, no significant differences were found in the activity of the upper trapezius muscle or the serratus anterior/upper trapezius activity ratio. We suggest that the push-up plus exercise performed in the externally rotated hand position could a beneficial strategy for selective strengthening of the serratus anterior muscle, while minimizing the activity of the pectoralis major muscle.

• Physical Therapy Korea
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• v.24 no.3
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• pp.30-39
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• 2017

Background: Scapular posterior tilt (SPT) is important in the prevention of abnormal scapular movement and pain during elevation of the arm. However, previous studies have overlooked increased upper trapezius (UT) muscle activity interrupting the normal force couple of scapular motion and compensation of levator scapulae (LS) muscle activated simultaneously with UT during SPT exercise. Objects: The purpose of this study was to compare the effects of modified SPT with depression exercise versus SPT exercise on serratus anterior (SA), lower trapezius (LT), UT, and LS muscle activities and the clavicular tilt angle, in subjects with rounded shoulder posture (RSP) and myofascial pain in the UT muscle region. Methods: Eighteen subjects with RSP were recruited and randomly allocated to 2 groups; 9 in the SPT group and 9 in the SPT with depression group. All subjects met the specific RSP criteria and had myofascial pain of UT region. Depending on the allocated group, subjects performed the assigned SPT exercise and EMG data were recorded during the each exercise. Clavicular tilt angle was defined as the angle between the line joining the medial and lateral end of the clavicle and a horizontal line. Results: The SA muscle activity was significantly greater in SPT with depression than with SPT exercise (p<.05). The UT, LS muscle activity and the clavicular tilt angle was significantly lower in SPT with depression than with SPT exercise (p<.05). Conclusion: These findings were insightful because the potential risk of pain from overactivation of the UT and LS was considered, in contrast with SPT exercise. SPT with depression exercise can be implemented as an effective method to facilitate scapular muscle activity for stability and to prevent myofascial pain in the neck and shoulder.

• Archives of Orthopedic and Sports Physical Therapy
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• v.14 no.2
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• pp.127-133
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• 2018

Purpose: This study investigated the effects of changing the tilt angle of the exercise bed on physiological characteristics of trapezius, multifidus, and hamstring muscle function. Methods: Twenty elderly who complains of back and lumbar pain or discomfort participated in this study (average age: $64.70{\pm}4.55$ years). The physiological characteristics, including muscle tone (F), dynamic stiffness (S), and elasticity (D) of trapezius, multifidus, and hamstring muscles were measured by a Myoton device at three tilt angles (0, 15, and 30 degrees) during exercise. Results: The muscle tone, dynamic stiffness, and elasticity of the right trapezius and left hamstring muscle showed significant differences (p<0.05) according to exercise bed tilt angle, while the other muscles showed no significant differences. Conclusions: Our results demonstrate that physiological characteristics of the upper and lower extremity muscles are affected ipsilaterally, according to the tilt angles of the exercise bed.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.16 no.1
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• pp.26-36
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• 2010

Purpose: The study compared the muscle activity and ratio of upper trapezius (UT) to lower trapezius (LT) activity between acute and chronic whiplash-associated disorder (WAD) patients. Methods: Twelve healthy (male: 7), 14 acute WAD (male: 7), and 11 chronic WAD (male: 3) volunteers participated in this study. Electromyography using a surface EMG recorded the activity of the upper trapezius and lower trapezius of both shoulders (dominant and non-dominant) during $120^{\circ}$ elevation when standing and shoulder depression when sitting. The testing order was selected randomly. Subjects were asked to maintain each experimental position for 5 seconds at end range. EMG activity was normalized using the maximal voluntary isometric contraction (MVIC) elicited using a manual muscle-testing technique. One-way repeated measures analysis of variance (ANOVA) was used to compare the average root mean square (RMS) value of EMG activity for each condition. Results: The EMG activity of the dominant UT for chronic WAD subjects was significantly higher than for acute WAD subjects during $120^{\circ}$ elevation (p<.05). The EMG activity of the dominant LT for acute WAD subjects was significantly lower than for the control group (p<.05) during $120^{\circ}$ elevation. The EMG activity of the dominant LT for WAD patients was significantly lower than for the control group during shoulder depression (p<.05), and the chronic WAD patients scored significantly the lowest (p<.01). The dominant UT/LT for chronic WAD patients was significantly higher than the ratio for acute WAD subjects during shoulder depression (p<.05); this result was higher than for the control group (p<.01). The non-dominant UT/LT (ratio) for chronic WAD patients was significantly higher than the ratio for acute WAD subjects during shoulder depression (p<.05). Conclusion: The UT for chronic WAD subjects was hyperactive when compared to the acute WAD subjects, and the was hypoactive for both acute and chronic patients, therefore intra-trapezius imbalance was more prevalent during shoulder depression.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.2
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• pp.141-152
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• 2021

Purpose: This study aimed to compare the effects of ischemic compression (IC) therapy and extracorporeal shock wave therapy (ESWT) in patients with upper trapezius myofascial pain syndrome and to present an effective treatment method for these patients. Methods: A total of 42 patients with upper trapezius myofascial pain syndrome were randomly assigned to the IC group (n = 21) and ESWT group (n = 21). IC therapy and ESWT were performed in the IC and ESWT groups, respectively. Treatment was applied to the trigger point of the upper trapezius muscle. Visual analog scales (VAS), pain pressure threshold (PPT), range of motion, neck disability index (NDI), and fear-avoidance belief questionnaire (FABQ) were evaluated before and after the intervention to compare its effectiveness. Results: Both groups showed significant differences before and after the intervention in VAS, PPT, NDI, FABQ, flexion, extension, right side bending, and left side bending (p <.05). In addition, there were significant differences in the IC group compared to the ESWT group in VAS, PPT, and NDI (p <.05). Conclusion: IC therapy and ESWT applied to patients with upper trapezius myofascial pain syndrome are mediating methods of pain, function, and psychosocial effects. In addition, IC therapy may be a more effective mediating method for pain and dysfunction than ESWT.