• 한국전문물리치료학회지
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• 제24권3호
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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.

• Clinics in Shoulder and Elbow
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• 제21권3호
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• pp.145-150
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• 2018

Background: This study evaluated the shoulder girdle muscle characteristics of elite archery athletes and provides suggestions for archery training programs. Methods: This study enrolled 15 cases of high level archery athletes (7 males, 8 females) and 30 cases of (15 males, 15 females) sex, age-matched, healthy, non-athletic individuals. We measured peak torques of flexion (FL), extension (EX), abduction (ABD), adduction (ADD), external rotation (ER) and internal rotation (IR) of both shoulders at an angular velocity of $30^{\circ}/sec$, $60^{\circ}/sec$, and $180^{\circ}/sec$. The peak torques and peak torque ratios of FL/EX, ABD/ADD, and ER/IR of the two groups were compared. Results: The archer group had a greater peak torque of IR and ADD, but only in the left shoulder (p<0.05). In the same group, both shoulders had greater peak torque of EX and lower peak torque of FL. The peak torque ratios of FL/EX of both shoulders were significantly lower in the archer group at all three angular velocities (p<0.05). The peak torque ratios of ABD/ADD were significantly greater in only the left shoulder of the archer group (p<0.05). Conclusions: The prominent characteristics of the shoulder girdle muscles of an elite archer are stronger adductor muscles of the bow shoulder and stronger extensors of both shoulders, as compared to healthy, non-athletic individuals. These muscle groups of the shoulder probably contribute a major role in maintaining the accuracy and stability during archery shooting. Hence, a training program that selectively enhances the adductor and extensor muscles could prove helpful in enhancing the archery skills of the athlete.

• The Journal of Korean Physical Therapy
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• 제15권4호
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• pp.412-430
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• 2003

Functional stability is dependent on integrated local and global muscle function. Movement dysfunction can present as a local and global problem, though both frequently occur together. To good understand how movement induces pain syndrome, the optimal actions and interaction of the multiple anatomic and functional systems involved in motion must be considered. Minor alterations in the precision of movement cause microtrauma and, if allowed to continue, will cause macrotrauma and pain. These alteration of the movement result in the development of compensatory movement and movement impairment. Muscle that become tight tend to pull the body segment to which they are attached, creating postural deviation. The antagonistic muscles may become weak and allow postural deviations due to lack of balanced support. Both hypertonic and inhibited muscles will cause an alteration of the distribution of pressure over the joint(s) that they cross and, thus, may not only result from muscle dysfunction, but produce joint dysfunction as well. Alteration of the shoulder posture and movement dysfunction may sometimes result in compression of neurovascular structures in the shoulder and arm. There is a clear link between reduced proprioceptive input, altered motor unit recruitment and the neurovascular compression. This report start with understanding of the impaired alignment, movement patterns and neuromuscular compression of the shoulder girdle by movement impairment to approach method of the movement dysfunction.

• PNF and Movement
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• 제16권1호
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• pp.43-50
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• 2018

Purpose: This study examined the effects of a shoulder-strengthening exercise on muscle strength of shoulder flexors and extensors of caregivers. Methods: The study consisted of 19 caregivers (2 males and 17 females) employed by Medical Center B. All the participants took part in an 8-week shoulder muscle strengthening exercise, based on previous studies. In the first week, the subjects took part in a stretching exercise enhance the range of motion. In the second week, they participated in an exercise aimed at improving shoulder blade stability. From the third to seventh weeks, a resistance exercise of different intensities was applied in a phased manner. Finally, in the eight week, the subjects took part in plyometric exercise. Peak torque, average power, and total work of shoulder flexors and extensors in both sides were measured before and after the exercise at an angular speed of 120deg/sec using an isokinetic device. Wilcoxon's singed-ranks test was conducted to analyze differences in muscle strength before and after the intervention. Results: After the exercise, there was a significant improvement in peak torque and average power of flexors of the right arm. After the exercise, peak torque, total work, and average power showed a significant improvement in the flexors of the left arm (p<0.05). However, there was no statistically significant difference in extensor muscle strength in either arm after the exercise. Conclusion: Shoulder flexors of caregivers are utilized frequently in the workplace. Implementation of extensor-strengthening exercises, in addition to flexor-strengthening exercises, can contribute to reducing the incidence rate of shoulder injuries among caregivers.

• 한국전문물리치료학회지
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• 제28권3호
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• pp.208-214
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• 2021

Background: The CKCUES test evaluates the functional performance of the shoulder joint. The CKCUES test scores CKC exercises of the upper limbs to examine shoulder stability. Although the CKCUES test provides quantitative data on functional ability and performance, no study has determined the relationship between CKCUES scores and SA and TB muscle strength. Objects: The objective of this study is to determine the relationship between the CKCUES test scores and the strength of the SA and TB muscles in the CKCUES and unilateral CKCUES tests. Methods: Sixty-six healthy male volunteers participated in the study. A Smart KEMA strength sensor measured SA and TB muscle strength. Two parallel lines on the floor indicated the initial hand placement to start CKCUES tests. For 15 seconds, the subject raises one hand and reaches over to touch the supporting hand, then returns to the starting position. Results: The correlation between the CKCUES test scores and the strength of the SA was strong (r = 0.650, p < 0.001), and the TB was moderate (r = 0.438, p < 0.001). The correlation between the unilateral CKCUES test and the strength of the SA of the supporting side was strong (r = 0.605, p < 0.001), and swing side was strong (r = 0.681, p < 0.001). The correlation between the unilateral CKCUES test and the strength of the TB of the supporting side was moderate (r = 0.409, p < 0.001), and swing side was moderate (r = 0.482, p < 0.001). Conclusion: Our study showed that the CKCUES test had a strong association with isometric strength of SA and moderate association with that of TB. These findings suggest that the CKCUES test can evaluate the function of the SA. Moreover, the unilateral CKCUES test can evaluate unilateral shoulder function.

• 한국전문물리치료학회지
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• 제28권3호
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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.

• 대한임상전기생리학회지
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• 제2권1호
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• pp.93-100
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• 2004

Shoulder impingement syndrome is cause by the collision of acromion, acrominoclaviclar joint, coracoacromino ligament, coracoid process and synovial sac, biceps brachiialis tendon, rotator cuff muscle. Treatment for Shoulder impingement syndrome is genetally classified into two different methods; preservative method and operational method. Operational method includes rotator cuff sutura, anterior acromioplasty, arthroscope decompression. Preservative method includes rest, medicinal therapy, physical therapy. Physical therapy concentrates on pain control, functional recovery and prevention of disease progress. It is also important for physical therapy to maintain the strength of rotator cuff. Strengthening rotator cuff decreases the collision and helps the stability of shoulder joint. In conclusion, it must be aware that shoulder impingement syndrome and some other shoulder problem demand different treatment, which results in a better outcome.

• 한국전문물리치료학회지
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• 제30권3호
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• pp.237-244
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• 2023

Background: The external rotation (ER) exercise in performed at a 90° abduction of the shoulder joint is an effective to strengthen the infraspinatus. However, failure of the humeral head to control axial rotation during exercise can be increased the posterior deltoid over activity. Biofeedback training is an effective method of promoting motor learning and control it could look forward to activate the infraspinatus selectively by controlling the humeral head during exercise. Objects: The aim of this study was investigated that whether biofeedback for axial rotation was effective to activate selectively the infraspinatus during ER exercise. Methods: The 15 healthy males participated, and all subjects performed both ER exercise in a sitting position with shoulder abducted 90° under conditions with and without axial rotation biofeedback. Exercise was performed in a range of 90° ER, divided into three phases: concentric, isometric, and eccentric. The infraspinatus and posterior deltoid muscle activity were observed using surface electromyography. Results: Both infraspinatus activity (p < 0.01) and infraspinatus to posterior deltoid activity ratio (p = 0.01) were significantly higher with biofeedback however, posterior deltoid activity was significantly lower with biofeedback (p = 0.01). The infraspinatus muscle activity and muscle activity ratio were the highest in the isometric contraction type, and there were significant differences for all contraction types (p < 0.05). Whereas, the posterior deltoid activity was the lowest in the isometric contraction type, and showed a significant difference between isometric and other two contraction types (p < 0.05), but no significant different between concentric and eccentric contraction. Conclusion: Our results indicate that the axial rotation biofeedback during sitting ER exercise might be effective method to activating selective infraspinatus muscle and recommended to enhance the dynamic stability of the shoulder joint.

• 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.

• 한국전문물리치료학회지
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• 제24권1호
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• pp.19-29
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• 2017

Background: Patients after rotator cuff (RC) surgery experienced pain, weakness and limited of motion of the shoulder. Physical therapists have used heat therapy, electrotherapy, range of motion (ROM) exercise and other methods to treat patients after RC surgery. In addition, functional taping is also used to support joint movement and to increase shoulder joint stability. Objects: The purpose of this study was to determine the initial effects of functional taping using non-elastic tape on pain, strength and ROM of the shoulder following RC surgery. Methods: Forty-eight patients with who underwent RC surgery volunteered for this study. The subjects were randomly divided into an experimental group (EG, $n_1=25$) and a control group (CG, $n_2=23$). First, non-allergic tape was applied to the shoulder to prevent skin irritation. The EG applied functional taping using non-elastic tape and the CG applied sham taping using elastic tape. Assessment tools included the shoulder pain and disability index for functional activity score, visual analog scale for level of pain, shoulder muscle strength, hand grip strength and ROM testing. Results: Pain score in the both group significantly decreased (p<.05), and change in pain score of in the EG increased significantly than in the CG (p<.05). Shoulder strength and ROM in the both group significantly increased (p<.05). Especially external rotation and extension of the shoulder ROM in the EG increased significantly more than in the CG (p<.05), but the rate of change in the two groups showed no significant difference. Conclusion: These results suggest that functional taping using non-elastic tape was initially effective in decreasing pain score level in patients with RC surgery.