• Clinical Pain
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• v.18 no.1
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• pp.52-57
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• 2019

Spinal accessory neuropathy (SAN) is commonly caused by an iatrogenic procedure, and that caused by tumors is very rare. We present a case of a 49-year-old man suffering from weakness in the right trapezius and sternocleidomastoid muscle. An electrophysiology study confirmed proximal SAN. Fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) revealed a diffuse large B-cell lymphoma compressing the right spinal accessory nerve. Ultrasonography showed definite atrophy on the trapezius and sternocleidomastoid muscles. In addition, post-chemotherapy FDG-PET/CT showed increased FDG uptake in the right upper trapezius, suggestive of denervation. This is the first report of SAN caused by direct compression by a diffuse large B-cell lymphoma, comprehensively assessed by an electrophysiology study, ultrasonography, and FDG-PET/CT.

• Physical Therapy Korea
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• v.31 no.1
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• pp.55-62
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• 2024

Background: The serratus anterior (SA) is a muscle that performs protraction of the scapulothoracic joint and plays a role in stabilizing the scapula. Imbalances or weaknesses in SA activation are associated with a variety of shoulder dysfunctions, making selective SA strengthening important for rehabilitation. Objects: We aimed to compare the muscle activation of the pectoralis major (PM), SA, external oblique (EO), and internal oblique (IO) during the push-up plus (PUP) exercise with isometric hip adduction (HA) and abdominal drawing-in maneuver (ADIM). Methods: Nineteen healthy male participants performed three PUP exercises: standard PUP, PUP with ADIM, and PUP with HA. Surface electromyography was used to measure and analyze the muscle activity for PM, SA, EO, and IO. Results: PUP with HA showed the lowest PM activity and highest SA activity, and no significant difference was observed between PUP and PUP with ADIM. PUP with ADIM showed significantly the highest EO and IO activity, followed by PUP with HA and PUP. Additionally, PUP with HA showed the lowest PM/SA ratio, and no significant difference was noted between PUP and PUP with ADIM. Conclusion: PUP with HA was able to show high SA muscle activity while reducing PM muscle activity. In addition, PUP with HA can lead to higher EO and IO muscle activity than standard PUP. This exercise could be used as a practical exercise method to selectively strengthen SA and improve scapular muscle stability during early shoulder rehabilitation.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.30 no.2
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• pp.1-12
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• 2024

Background: This study aimed to determine the effects of pectoralis minor stretching, lower trapezius strengthening exercise with serratus anterior strengthening exercise to find an effective therapeutic exercise for alignment, shoulder range of motion, muscle imbalance of rounded shoulder patient. Methods: This study targeted on a total of 28 male subjects, aged 20s and 30s, and randomly divided the subjects into each group, with 14 subjects each. The experimental group performed pectoralis minor stretching, lower trapezius strengthening exercise, and serratus anterior strengthening exercise, while the control group performed pectoralis minor stretching and lower trapezius strengthening exercise. Results: both group showed an increase in active range of motion for shoulder flexion, a muscle activity of the serratus anterior muscle and the lower trapezius muscle, a decrease in muscle activity of the upper trapezius muscle, and a significant improvement in scapular alignment after the intervention. In the comparison between group, the experimental group showed greater increased shoulder joint flexion range of motion, serratus anterior muscle activity, and decreased upper trapezius muscle activity than the control group. Conclusion: Performing serratus anterior strengthening exercises with pectoralis minor stretching and lower trapezius strengthening exercises is effective for improving the active range of motion in shoulder joint flexion and muscle imbalance

• Physical Therapy Korea
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• v.31 no.2
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• pp.142-150
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• 2024

Background: Scapular dyskinesis (SD) is closely related to imbalance of the rotator cuff (RC) muscles. However, previous studies have only focused on isometric strength. To our knowledge, there has been no study examining potential differences in concentric and eccentric strength and functional strength ratio (FSR) of the RC muscles based on functional parameters related to throwing in with or without SD. Objects: This study aimed to determine whether there was a difference in the RC muscle strength and FSR between the dominant shoulder with SD and the non-dominant shoulder without SD in adolescent baseball players. Methods: Forty adolescent baseball players participated and classified types of SD based on movement patterns using the SD test by two examiners. The isokinetic concentric and eccentric peak torque of the internal rotation (IR) and external rotation (ER) were measured and quantified as peak torque to body weight (PT/BW). Also, the FSR was obtained by calculating the strength ratios of eccentric IR to concentric ER (IRecc/ERcon) and eccentric ER to concentric IR (ERecc/IRcon), respectively. Results: There was a significant decrease in the IR and ER PT/BW in the dominant shoulder with SD compared to the non-dominant shoulder without SD (p < 0.05), regardless of contraction types. However, no significant difference was observed in the FSR in both IRecc/ERcon and ERecc/IRcon ratios. Conclusion: The findings indicate that the isokinetic concentric and eccentric PT/BW of the IR and ER muscles were significantly lower in the dominant shoulder with SD than in the nonthrowing shoulder without SD. Therefore, when establishing a strategy for addressing RC muscle weakness in adolescent baseball players with SD, it is essential to consider an approach that accounts for scapular kinematic recovery.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.3
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• pp.121-130
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• 2024

Purpose : This study was conducted to investigate the effect of neck stabilization exercises using a stick on the pain, headache, and quality of life of adult patients with chronic non-specific neck pain. Methods : The participants of this study were 28 adult patients with chronic non-specific neck pain. The subjects were assigned to the experimental group (n=15, neck stabilization exercises using a stick after conservative physical therapy) and the control group (n=13, conservative physical therapy) according to the order of participation in the study and the intervention methods. The intervention was conducted three times a week for four weeks. The neck stabilization exercises using a stick consisted of isometric exercises of the muscles around the neck and strengthening exercises of the muscles around the scapula. The visual analog scale (VAS) and headache impact test (HIT-6) were used to measure the pain and headache, and the SF 36 health questionnaire (SF-36) was used to measure the quality of life. Results : In the comparison of VAS, HIT-6, and SF-36, there were significant differences between before and after the intervention in both the experimental and control groups (p<.05). The pre-post comparisons between the two groups according to the experiment showed significant differences between the experimental group and the control group (p=.001). However, the experimental group showed greater changes than the control group. Conclusion : Through this study, it was confirmed that neck stabilization exercises using a stick have positive effects on reducing the neck pain and headaches and improving the quality of life of adult patients with chronic neck pain. Therefore, it is considered that neck stabilization exercises using a stick can be used as an effective exercise method for the treatment and prevention of patients with chronic neck pain in the future.

• Journal of the Korean Society of Clothing and Textiles
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• v.29 no.12 s.148
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• pp.1595-1607
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• 2005

Three-dimensional(3-D) body scanners used to capture anthropometric measurements are now becoming a common research tool far apparel. This study had two goals, to test the accuracy and reliability of 3-D measurements of dynamic postures, and !o analyze the change in upper body surface measurements between the standard anthropometric position and various dynamic positions. A comparison of body surface measurements using two different measuring methods, 3-D scan measurements using virtual tools on the computer screen and traditional manual measurements for a standard anthropometric posture and for a posture with shoulder flexion were $-2\~20mm$. Girth items showed some disagreement of values between the two methods. None of the measurements were significantly different except f3r the neckbase girth for any of the measuring methods or postures. Scan measurements of the upper body items showed significant linear surface change in the dynamic postures. Shoulder length, interscye front and back, and biacromion length were the items most affected in the dynamic postures. Changes of linear body surface were very similar for the two measuring methods within the same posture. The repeatability of data taken from the 3-D scans using virtual tools showed satisfactory results. Three times repeated scan measurements f3r the scapula protraction and scapula elevation posture were proven to be statistically the same for all measurement items. Measurements from automatic measuring software that measured the 3-D scan with no manual intervention were compared with the measurements using virtual tools. Many measurements from the automatic program were larger and showed quite different values.

• Journal of the Korean Society of Food Science and Nutrition
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• v.26 no.2
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• pp.334-343
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• 1997

This study was performed to elucidate the effects of dietary calcium-salt, estrogen-treatment, and estrogen/calcium treatment on bone metabolism. Ovariectomized rats were used as an animal model. Female Sprague-Dawley rats with a body weight of $250{\sim}280g$ underwent ovariectomy or sham-operation. The ovariectomized rats were divided into 9 different experimental groups including saline-treated group, estrogen-treated group, high calcium salt-treated group, and estrogen/calcium treated groups, and fed the experimental diet for 6 weeks. The mineral content, weight, length, strength and density in femur and scapula of the animals were determined. The results of the experiment are as follows: there were no difference in weight of wet bone, density, length, strength and content of ash in right femur between ovariectomized rat and sham-operation. When the weight of bones was expressed as bone gram per body weight, it was significantly lower in ovariectomized rat than sham-operation. Estrogen and estrogen/calcium in ovariectomized rats resulted in increased weight of wet bone. Estrogen with its gradual reduction in ovariectomized rats showed the lowest values in strength, content of ash, content of calcium and content of phosphorus among the groups. There were no differences in weight of wet hone, density, content of ash, content of calcium and content of phosphorus in right scapula between ovariectomized rat and sham-operation. In addition skeletal composition was not changed by ovariectomy. Estrogen and estrogen/calcium in ovariectomized rats resulted in decreased skeletal composition however, estrogen with its gradual reduction did not caused the skeletal composition change. Moreover, the gradual reduction of estrogen had a preventive effect on bone loss when the treatment was combined with calcium intensification.

• The Journal of Korean Academy of Prosthodontics
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• v.49 no.2
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• pp.168-176
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• 2011

Purpose: This study aims at investigating the influence of various insertion torques on thermal changes of bone. A proper insertion torque is derived based on the thermal analysis with two different implant designs. Materials and methods: For implant materials, bovine scapula bone of 15 - 20 mm thickness was cut into 35 mm by 40 - 50 mm pieces. Of these, the pieces having 2 - 3 mm thickness cortical bone were used as samples. Then, the half of the sample was immersed in a bath of $36.5^{\circ}C$ and the other half was exposed to ambient temperature of $25^{\circ}C$, so that the inner and surface temperatures reached $36.5^{\circ}C$ and $28^{\circ}C$, respectively. Two types of implants ($4.5{\times}10\;mm$ Br${\aa}$nemark type, $4.8{\times}10\;mm$ Microthread type) were inserted into bovine scapula bone and the temperature was measured by a thermocouple at 0.2 mm from the measuring point. Finite element method (FEM) was used to analyze the thermal changes at contacting surface assuming that the sample is a cube of $4\;cm{\times}4\;cm{\times}2\;cm$ and a layer up to 2 mm from the top is cortical bone and below is a cancellous bone. Boundary conditions were set on the basis of the shape of cavity after implants. SolidWorks was used as a CAD program with the help of Abaqus 6.9-1. Results: In the in-vitro experiment, the Microhead type implant gives a higher maximum temperature than that of the Br${\aa}$nemark type, which is attributed to high frictional heat that is associated with the implant shape. In both types, an Eriksson threshold was observed at torques of 50 Ncm (Br${\aa}$nemark) and 35 Ncm (Microthread type), respectively. Based on these findings, the Microthread type implant is more affected by insertion torques. Conclusion: This study demonstrate that a proper choice of insertion torque is important when using a specific type of implant. In particular, for the Microthread type implant, possible bone damage may be expected as a result of frictional heat, which compensates for initial high success rate of fixation. Therefore, the insertion torque should be adjusted for each implant design. Furthermore, the operation skills should be carefully chosen for each implant type and insertion torque.

• Physical Therapy Korea
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• v.19 no.3
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• pp.31-39
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• 2012

The lower trapezius muscle is an important stabilizer and primary mover of the scapula. The potential use of ultrasound imaging to evaluate scapular muscle function warrants investigation. The purpose of this study is to use ultrasound imaging for determining the effectiveness of 4 different isometric exercises for maximally activating the lower trapezius muscles in healthy subjects. Twenty-eight (14 men and 14 women) volunteers were recruited for this study. Thickness measurements of the lower trapezius muscles were recorded during 4 exercises: latissimus pulldown (LP), prone V-raise (PV), prone row (PR), and modified prone cobra (MP). Lower trapezius muscle thickness was measured 3 times by 2 investigators at a point 3 cm lateral to the lateral edge of the T8 spinous process. The order of 4 exercise execution was randomized for each participant. To identify statistical significance, one-way ANOVA with repeated measures was used with the significance level of .05. Intraclass correlation coefficient (ICC) for intra-reliability was .86~.98 and inter-rater reliability .83~.96 for the lower trapezius, respectively (p<.01). Thickness changes in the lower trapezius muscles between the relaxed and contracted states in men were as follows: LP ($7.37{\pm}2.68mm$, 182%), MP ($4.69{\pm}1.74mm$, 167%), PV ($4.52{\pm}1.47mm$, 149%), and PR ($3.84{\pm}1.72mm$, 133%). In women the values were as follows: LP ($4.64{\pm}1.24mm$, 163%), MP ($2.79{\pm}.81mm$, 131%), PV ($2.78{\pm}.85mm$, 129%), and PR ($2.21{\pm}1.26$ mm, 100%). Thickness of the lower trapezius muscles significantly differed between exercises in both the gender (p<.01). The LP was the most effective exercise for increasing the activation of the lower trapezius muscle in both the gender. We recommend performing the LP exercise for strengthening the lower trapezius muscles.

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.93-99
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• 1998

We measured the glenohumeral and scapulothoracic movements during abduction of the arm in the coronal plane with radiologic analysis in the 30 shoulders of normal male adults who were without pain, limitation of motion, and history of trauma. In the resting position, the glenoid cavity of the scapula faced somewhat superiorly in over 80 percents of the individuals, the mean superior tilting was 5.7 degrees. The mean total scapulothoracic movement was 65.8 degrees and the mean total glenohumeral movement was 106.8 degrees during abduction of arm in the coronal plane. The mean ratio of the glenohumeral movement to the scapulothoracic movement was 1.6 and this GH/ST ratio was decreased toward the extreme abduction. When the arm was abducted, external rotation of the humeral head occurred and this external rotation was increased smoothly during 0 degree through 90 degrees, but steeply above 90 degrees. The acromiohumeral interval was 10.9 mm at the resting positon, and this interval decreased during the arm abduction. The superior migration of the humeral head was 3.1 mm while abducting the arm. Our measurement of the relationships of glenohumeral and scapulothoracic movements at the coronal plane would be useful in the understandings of the biomechanics of shoulder, but further study would be required for the analysis of the three dimensional relationship because of the limitation of our two dimensional analysis.