• 대한물리치료과학회지
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• 제25권2호
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• pp.24-34
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• 2018

Purpose: The purpose of this study was to assess how much neurac technic affects the stability muscles of the shoulder according to the supporting surface in crawling position. Method: 29 healthy adult males participated in this experiment. The experiment consists of 2 experimental groups and 1 control group. It is conducted for 3 weeks. Each group exercised for 7 seconds and then rested for 3 seconds. Using EMG, the average value of serratus anterior, upper trapezius, and lower trapezius was repeated three times. Experimental group 1 conducted push up plus exercise applied neurac technic with sling on unstable supporting surface. Experimental group 2 conducted push up plus exercise applied neurac technic with sling on stable supporting surface. Control group conducted the push up plus exercise on stable supporting surface. One-way ANOVA was used for statistical analysis. Result: It was noticeable that the result of Experimental group 1 affects stability muscles of more than Experimental group 2 and Control group. Conclusion: Push up plus position applied neurac technic with sling on unstable supporting surface was the most effective in activating the stability muscles of the shoulder.

• 대한통합의학회지
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• 제5권3호
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• pp.21-28
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• 2017

Purpose: The purpose of this study was to investigate the effects of three exercise programs on forward head posture. Methods: Ninety-five individuals were recruited to assess the of the pectoralis minor muscle. Of these, 36 individuals with pectoralis minor muscles were selected and randomly divided into three groups: a functional massage group, a stretching group, and a stretching and muscle strengthening group. The exercise program consisted of sessions four times per week for two weeks. The length of pectoralis minor and the activity of the trapezius muscles were measured using electromyography. Forward head posture was assessed using the craniovertebral angle (CVA) and the cranial rotation angle (CRA) pre-, during and post-treatment. Result: Significant improvements were observed in pectoralis minor length, CRA, and CVA post-treatment in all groups (p<0.05, p<0.01, p<0.001). However, only the activity of the lower trapezius demonstrated a statistically significant difference post-treatment. There were no significant differences between the groups. Conclusion: The findings of this study suggest that all three exercise programs were effective in improving forward head posture and the length of pectoralis minor post-treatment.

• 한국전문물리치료학회지
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• 제24권1호
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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.

• 한국전문물리치료학회지
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• 제25권4호
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• pp.1-8
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• 2018

Background: Round shoulder posture, results from excessive flexed posture of the thorax, is defined as a position of scapular protraction, anterior tipping, and downward rotation. However, previous studies have focused on only passive position of the thorax during scapular posterior tilting (SPT) and have not reported on SPT combined with correction of flexed posture. Objects: The aim of this study was to compare effects of SPT and SPT with prone trunk extension (SPT + PTE) on activities of the lower trapezius, serratus anterior, and thoracic erector spinae and degree of posture in subjects with round shoulder and flexed posture. Methods: Fifteen subjects with round shoulder and flexed posture were recruited. The caliper was used to measure the degree of round shoulder and flexed posture. Electromyography was performed to collect data of muscle activities. Paired t-test was used to compare two exercise (${\alpha}=.05$). Results: When SPT + PTE was applied, the degree of round shoulder posture (p=.001) and flexed posture (p=.039) significantly decreased compared with that when SPT was applied. The lower trapezius activity significantly increased in the SPT + PTE condition compared with that in the SPT condition (p=.026). There were no significant differences in serratus anterior activity between SPT + PTE and SPT. The thoracic erector spinae activity significantly increased in the SPT + PTE condition compared with that in the SPT condition (p=.014). Conclusion: SPT + PTE might be one of the effective methods to enhance activities of lower trapezius and thoracic erector spinae, and to reduce round shoulder posture and flexed posture in subjects with round shoulder and flexed posture.

• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.106-111
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• 2016

Purpose: The aim of this study is to determine the effect of glenohumeral (GH) rotation position in modified knee push-up plus exercise (MKPUP) by examining the surface electromyography (EMG) amplitude in serratus anterior (SA), pectoralis major (PM), and upper trapezius (UTz) and the activity ratio of each muscle. Methods: A total of 22 healthy subjects volunteered for the study. Each subject performed the MKPUP at $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$ of GH joint internal rotation. EMG of the SA and PM, UTz was compared between GH rotation positions and each muscle activity ratio. EMG was used to measure the muscle activity in terms of ratios to maximal voluntary isometric contraction (MVIC). Results: The difference in EMG activity during the exercise in three GH joint internal rotation positions was observed with the SA and the PM. The greater the GH joint internal rotation angle was, the lower the activity of the PM. In contrast, the SA showed higher activity. However, the activity of UT was similar under all conditions. The ratio of the SA and the PM was considerably greater at $90^{\circ}$ GH joint internal rotation than at $0^{\circ}$ and $45^{\circ}$. Conclusion: When excessive activation of the PM or imbalanced activation between the PM and the SA occurs, the MKPUP exercise is most effective at $90^{\circ}$ of GH joint internal rotation. Use of this position would be a beneficial strategy for selective strengthening of the SA and minimizing PM activation.

• 대한물리의학회지
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• 제13권3호
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• pp.75-80
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• 2018

PURPOSE: Scapular stability is very important to arm function during activities of daily living. The push-up plus exercise is commonly used to stabilize the shoulder muscles. In the present study, we designed an elastic shoulder band (ESB) that could be used with the push-up plus exercise and studied muscle activities of the serratus anterior (SA) and the lower and the upper trapezius (LT and UT) on stable and unstable support. METHODS: Fifteen healthy people participated in this study. Three muscles were investigated using surface EMG with and without the ESB on stable and unstable support. All subjects performed each trial three times for 7 seconds per set and rested for 30 seconds. Repeated one-way ANOVA was used for statistical analyses. RESULTS: The EMG activity of the SA was significantly different during the push-up plus exercise on stable support with the ESB compared with that on unstable support without the ESB (p<.05). However, there were no differences in the activities of UT and LT on stable and unstable support (p>.05). CONCLUSION: The ESB was effective for the activity of SA during the push-up plus exercise on stable support; therefore, it has the potential for use by people during push-up plus exercises. However, further studies are required to investigate the rehabilitation tools for patients with shoulder instability.

• 문화기술의 융합
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• 제5권4호
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• pp.227-235
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• 2019

본 연구의 목적은 거북목을 가진 사람에게 메켄지 폄운동과 어깨안정화운동이 앞쪽머리자세에 미치는 영향에 대해 알아보는 것이다. 연구대상자는 30명의 거북목을 가진 평범하고 건강한 사람들로 이루어져 있다. 대상자는 어깨안정화운동과 메켄지 폄운동으로 나누어(인원=30, 남자 15명, 여자 15명) 무작위로 나누어 6주 동안 실시되었다. 본 연구는 마름근, 아래등세모근의 운동프로그램과 깊은목굽힘근, 위등세모근, 어깨올림근의 신장프로그램을 통한 목뼈의 머리척추각(Cervical Vertebra Angle) 값과 각 근육별 근전도의 차이를 알아보았다. 앞쪽머리자세와 경우에는 목과 등근육의 활성도가 감소하고 피로도는 증가함을 보였다. 이러한 결과는 목과 머리의 불안정한 상태를 안정시키기 위해서는 위등세모근, 깊은목굽힘근, 어깨올림근의 신장과 마름근, 아래등세모근의 운동을 통해 거북목의 개선에 긍정적인 변화를 줄 것으로 보인다. 이러한 근육들의 불균형한 수축과 과도한 긴장으로 근육의 경직과 피로가 누적되며 이러한 상태가 계속 유지되게 되면 만성화상태가 되어 근육의 불균형으로 인해 통증을 유발할 수 있으며, 피로의 누적으로 인하여 자극에 대한 반응과 근력을 약화시켜서 목 디스크가 발생할 확률이 높아질 것으로 사료된다.

• 국제물리치료학회지
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• 제6권1호
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• pp.815-823
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• 2015

This study aimed to examine the most effective exercise method for shoulder joint rehabilitation by comparatively observing activity of shoulder stabilizer muscles during push up and push up plus exercises under diverse stable conditions. The subjects were 20 healthy adults students who went to M university. While the subjects conducted push up and push up plus exercises under diverse stable conditions(a stable surface, a support of 25cm height, a support of 30 cm height and a balance pad), activities of the upper trapezius muscle, pectoralis major muscle, serratus anterior muscle, and triceps brachii muscle were recorded. During push up and push up plus exercises, activities of the stabilizer muscles were higher when the stable condition was changed rather than on the stable surface. In particular, when the support of 30cm height and balance pads were applied, activity of the shoulder stabilizer was highest. There were significant differences in the upper trapezius muscle and triceps brachii muscle during the push up exercise(p<.05) and in the serratus anterior muscle during the push up plus exercise(p<.05). Activities of the shoulder stabilizers were higher when the upper and lower limbs' surface stable conditions were changed than the stable surface. Therefore, when programs for rehabilitation of shoulder joints are applied, provision of diverse stable conditions according to patients' conditions will be effective methods.

• 대한정형도수물리치료학회지
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• 제22권1호
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• pp.51-58
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• 2016

Background: Evidence for effective management of scapular downward rotation syndrome is limited. The present study was performed to compare the scapular muscle activation through 4weeks wall slide exercise and sling slide exercise in subjects with scapular downward rotation syndrome. Methods: Twenty-two subjects with scapular downward rotation syndrome participated in the study. Surface electromyography data were collected from the upper and lower trapezius, serratus anterior and pectoralis major during shoulder flexion of $60^{\circ}$, $90^{\circ}$ and $120^{\circ}$ in the sagittal plane. The alignment of the scapula was measured using radiographic analysis. Subjects were assessed pre and post a 4 weeks exercise (wall slide, sling slide). The significance of the difference in pre- and post-exercise within each groups was assessed using a paired t-test. The significant difference between wall- and sling-exercise was used a independent t-test. Results: In the wall slide group, the muscle activity of upper trapezius decreased significantly during shoulder flexion at $60^{\circ}$, $90^{\circ}$ and $120^{\circ}$ after 4 weeks, and the muscle activity of serratus anterior increased significantly at all angles. Also, the muscle activity of pectoralis major decreased significantly at $90^{\circ}$ and $120^{\circ}$. Conclusions: Based on such results, it can be said that wall slide exercise is effective than sling slide exercise for the subjects with scapular downward rotation syndrome.

• 한국전문물리치료학회지
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• 제14권2호
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• pp.44-52
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• 2007

This study was carried out to compare the muscle activities of the shoulder stabilizers between persons with and without winging scapular during push-up plus exercise (adds the scapular protraction to the general push-up exercise). For this study, eleven males with winging scapular and eleven healthy males were recruited. Surface electromyographic (EMG) activity was recorded from the serratus anterior, upper trapezius, lower trapezius, infraspinatus, and pectoralis major while the subjects performed the push-up plus. Each push-up plus was subdivided into three phases according to the elbow position which was measured using the 3-D motion analysis system: elbow flexion (EF), elbow extension (EE), and shoulder protraction phases (SP). Two-way repeated measure ANOVA (phase ${\times}$ group) were used for statistical analysis. There was significant phase by group interaction only on the EMG composition ratio of the serratus anterior (p>.05). The EMG composition ratio of the serratus anterior was significantly higher in SP than in either EF or EE however, it was not different between winging scapular and normal groups. For both groups, the EMG composition ratio of upper trapezius, lower trapezius, and pectoralis major was significantly different across the phases of push-up plus, but the infraspinatus EMG composition ratio was not. For both groups, in EF and EE phases, the EMG composition ratio of both pectoralis major and serratus anterior were relatively higher than that of other muscles. However, in both groups, the EMG composition ratio of the serratus anterior became much more predominant than that of the pectoralis major. In addition, infraspinatus activated greater than pectoralis major. These results showed that the push-up plus exercise is effective to selectively strengthen the serratus anterior for both individuals with and without winging scapular, but not equally effective for other shoulder stabilizers.