• PNF and Movement
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• 제14권2호
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• pp.131-137
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• 2016

Purpose: The purpose of this study was to compare muscle activities in the frontal plane and scapular plane of the middle fiber and lower fiber of the trapezius muscle at different shoulder abduction angles. Methods: Twenty male and female students in their 20s participated in this study. Each subject maintained shoulder abduction at $75^{\circ}$, $90^{\circ}$, $125^{\circ}$, and $160^{\circ}$ in a standing position and repeated motions three times each in the frontal plane and the scapular plane. While maintaining the motions for 10 seconds in each posture, surface electromyography (EMG) was used to measure muscle activity of the middle fiber and lower fiber of the trapezius muscle. The collected EMG data were normalized using maximal voluntary isometric contraction (MVIC). Differences in muscle activity of the middle fiber and lower fiber of the trapezius muscles according to the angles at each plane were statistically processed using repeated measured analysis of variance, and an independent t-test was used to examine the differences between the two planes at each angle. Results: Muscle activity of the middle and lower trapezius during shoulder abduction in the frontal plane and scapular plane significantly increased as the angles increased (p<.05). However, muscle activity of the middle trapezius was significantly lower in the scapular plane than in the frontal plane for all shoulder abduction angles (p<.05). Conclusion: The results of this study suggest that during shoulder abduction, angles should be different according to the goals, and for training during an acute phase or early phase for functional recovery, it is more efficient to perform the training in the scapular plane than in the frontal plane.

• 대한물리의학회지
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• 제13권4호
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• pp.149-162
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• 2018

PURPOSE: The aim of this study was to investigate the effect of scapular dynamic taping on pain, disability, upper body posture, and range of motion (ROM) in the postoperative shoulder. METHODS: Twenty-two patients who underwent acromioplasty and rotator cuff repair surgery volunteered for this study. The subjects were randomly divided into an experimental group (EG, n=11) and a control group (CG, n=11). For the EG, exercise therapy, manual therapy, and scapular dynamic taping were applied for 6 weeks; for the CG, only exercise therapy and manual therapy were applied for 6 weeks. Shoulder pain, disability, upper body posture, and ROM were evaluated at baseline, after 3 weeks of intervention, and after 6 weeks of intervention. Assessment tools included quadruple visual analog scale (QVAS) for level of pain; shoulder pain and disability index (SPADI) for functional disability level; forward head angle (FHA), forward shoulder angle (FSA), and pectoralis minor index (PMI) for upper body posture; and ROM testing. RESULTS: Significant differences were observed between the EG and CG in SPADI total scores; internal rotation and external rotation ROM of the glenohumeral joint ; FSA ; and PMI. All groups showed statistically significant improvement in QVAS; SPADI; flexion; abduction; external rotation and internal rotation ROM of the glenohumeral joint; FSA; and PMI. CONCLUSION: These results suggest that, for patients who have undergone acromioplasty and rotator cuff repair surgery, the addition of scapular dynamic taping during therapy is effective for improvement of shoulder disability level, ROM, and upper body posture.

• 대한정형도수물리치료학회지
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• 제27권3호
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• pp.37-46
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• 2021

Background: The increase in the activity of the upper trapezius (UT) muscle and decrease in the activity of the serratus anterior (SA) and lower trapezius (LT) muscle produce an abnormal scapulohumeral rhythem. Therefore, the SA is the focus of therapeutic exercise protocols for the rehabilitation. This study aimed to compare the activity of the muscles according to resistance levels during protraction exercise. Methods: Thirteen healthy 20 to 30 years old male and female subjected participated in the study. All subjects performed the scapular protraction exercise with the weights of 0, 5, and 10kg, combined with horizontal shoulder abduction and adduction. The electromyography data of the SA, UT, and pectoralis major (PM) during the exercise were recorded using surface electrodes. The ratios of PM/SA and UT/SA were calculated. Repeated one-way ANOVA was used to determine the statistical significance. Results: There was a significant difference in the muscle activity of the SA and PM (p<.05). Specifically, SA had the highest activity and PM had the lowest activity at an abduction resistance 10kg (p<.01). There was a significant difference in the ratios of UT/SA and PM/SA (p<.05). The ratio of PM/SA was the lowest at the abduction resistance of 10kg (p<.01). Conclusion: According to this study, for the selective activation of the serratus anterior, protraction exercises should be applied as a method of adding resistance to protraction and horizontal abduction.

• 대한통합의학회지
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• 제11권1호
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• pp.131-140
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• 2023

Purpose : The purpose of this study is to find out which shoulder abduction angle among the three representative angles of lower trapezius strengthening exercises most effectively improves rounded shoulder posture. Methods : Thirty-one people with rounded shoulders, the subjects of this study, were selected. With the use of a random number table, group A was randomly assigned to a Y-type exercise, group B to a T-type exercise, and group C to an MPC exercise. In the prone position, both arms are abducted at the angles suggested for each group (145 °, 90 °, and 45 °, respectively), and the hands are holding dumbbells to assume a functional posture. With the start signal, the thumb raised the arm to the sky and the arm is raised to the level of the ear for 10 seconds and then returned to the original position. Each week, the strength required was increased by changing the resistance weight, number of times, and set, and the exercise was performed three times a week for a total of four weeks. Results : There was a significant difference in the change in shoulder height of each group after four weeks of exercise in comparison to the amount of change in height before and after exercise in all groups (p<.05). However, no significant difference was observed between all groups in the change in muscle activity of the lower trapezius muscle in each group following four weeks of exercise (p>.05). Conclusion : The results of this study showed that the three lower trapezius strengthening exercises have a positive effect on the improvement of rounded shoulders. In consideration of these results, it is therefore proposed that the various lower trapezius strengthening exercises be applied in parallel during physical therapy for patients with rounded shoulders in clinical practice.

• PNF and Movement
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• 제21권1호
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• pp.75-86
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• 2023

Purpose: This study aims to determine the effect of proprioceptive neuromuscular facilitation (PNF) pectoralis minor stretching and lower trapezius strengthening exercise on posture change, shoulder range of motion (ROM), and pain in rotator cuff repair patients with a rounded shoulder posture (RSP). Methods: Following baseline measurements, the subjects (n = 25) with rotator cuff repair were randomized into two groups: the PNF group (n = 13), which engaged in PNF pectoralis minor stretching and lower trapezius strengthening exercise, and the control group (n = 12), which received traditional physical therapy. Each group participated in the intervention five times per week for two weeks. The RSP values for the postural changes, flexion and abduction ROM, and visual analogue scales (VASs) of both groups were recorded at both pre- and post-intervention. In addition, before and after the intervention, a paired t-test was conducted to compare the within-group changes and an independent t-test to compare the between-group differences. Results: After the two-week intervention, both groups experienced significantly decreased RSP and VAS values (p < 0.05) and a significantly increased ROM (p < 0.05). Meanwhile, the PNF group showed greater improvements in RSP, ROM, and VAS than the control group (p < 0.05). Conclusion: These results suggest that PNF pectoralis minor stretching and lower trapezius strengthening exercise reduce posture and shoulder pain and enhance ROM in rotator cuff repair patients with RSP.

• 대한정형도수물리치료학회지
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• 제30권2호
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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

• 한국운동역학회지
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• 제18권2호
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• pp.85-94
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• 2008

본 연구의 목적은 3명의 우수 골프선수를 대상으로 아이언 클럽(3, 6, 9번)의 스윙 동작을 3차원적으로 비교 분석하고, 이의 분석에 따른 요인들을 정량적으로 제시하여 선수 및 일반 골퍼들이 바람직한 아이언 스윙 동작을 배우는데 기초자료를 제공하는데 있다. 3차원 영상분석을 실시하여 다음과 같은 결론을 도출하였다. 1. 각 클럽별로 전체 스윙 시간에는 큰 차이를 보이지 않았으며, 각 국면별 시간도 거의 유사하게 나타났다. 2. 각 클럽별로 어드레스와 임팩트시 머리위치 변화는 차이가 없었다. 3. 클럽의 길이에 따른 차이를 제외하면 각 클럽별로 오른 무릎관절 각도변화는 유사하게 나타났다. 4. 각 클럽별로 고관절의 회전각도 변화는 약간의 차이가 나타났다. 5. 각 클럽별로 어드레스와 임팩트 동작시 어깨관절의 회전각도와 동일하게 만들어 주어 스윙의 정확도를 높이고, 탑스윙시 어깨회전 각도를 $90^{\circ}$이상 유지하여 스윙의 회전력을 높이는 것으로 나타났다. 6. 클럽이 짧을수록 상체전경 각도가 약간의 차이로 커지는 것으로 나타났으며 어드레스와 탑스윙, 임팩트 동작시상체전경 각도가 $30-36^{\circ}$의 형태를 유지하면서 스윙을 하였다.

• Clinics in Shoulder and Elbow
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• 제11권2호
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• pp.131-136
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• 2008

목적: Parsonage-Turner syndrome은 어깨나 어깨 주위에 급작스럽게 발생하는 심한 동통과 연이어 나타나는 견관절 부위 근육 마비 증상을 주소로 하는 드문 질환이다. 이에 저자들이 경험한 환자군의 임상양상을 문헌 고찰과 함께 보고하고자 한다. 대상 및 방법: 2005년 12월부터 2008년 7월까지 Parsonage-Tuner syndrome으로 진단된 6명을 대상으로 의무 기록과 전화 설문을 통하여 자료를 수집하였다. 남자가 5명, 여자가 1명 이었다. 평균 나이는 43.3세(범위, 20~68세)였으며, 평균 추시 기간은 19.1개월(범위, 14~27개월)이었다. 결과: 견갑부의 극심한 통증은 발병 후 1일에서 3주간 지속되었고, 그 후 점차 감소하여 평균 3.3주(범위, 2~5주)이내 최소화 되었다. 통증 발생 후 평균 4주(범위, 2~7주)에 이환된 근육에 점진적인 근력 감소가 나타났으며, 추적 기간 동안 1명의 환자는 예전의 근력을 완전히 회복 하였고, 5명은 점차 회복 중이었다. 근전도 검사가 감별 진단에 가장 도움이 되었다. 결론: Parsonage-Turner syndrome은 비교적 양호한 예후를 갖는 질환으로, 이에 대한 숙지는 이 질환을 진단 및 치료하는데 도움이 될 것으로 생각한다.

• 한국방사선학회논문지
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• 제6권5호
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• pp.383-388
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• 2012

본 연구에서는 로딩셀기구를 이용하여 어깨관절의 아래, 앞, 뒤쪽 방향으로 칼텐본-에비엔즈컨셉 미끄러뜨림 치료등급 II와 III 적용 시 남녀, 미끄러뜨림 방향 그리고 미끄러뜨림 등급에 따라 적용되는 힘의 크기를 비교해보고자 하였다. 남녀에 따른 부하량 차이를 비교한 결과 아래쪽미끄러뜨림 II/III등급(Caudal Grade II/III), 앞쪽미끄러뜨림 II/III등급(Ventral Grade II/III), 뒤쪽미끄러뜨림 II/III등급(Dorsal Grade II/III) 모두 여자에 비해 남자의 부하량이 유의하게 높았다(p<.05). 치료방향에 따른 부하량 차이를 비교한 결과 등급II(Grade II)와 등급III(Grade III) 모두에서 아래쪽(Caudal)에 비해 앞쪽(Ventral)과 뒤쪽(Dorsal)에서 부하량이 유의하게 높았다(p<.05). 치료등급에 따른 부하량 차이를 비교한 결과 아래쪽(Caudal), 앞쪽(Ventral) 그리고 뒤쪽(Dorsal) 모두에서 등급II(Grade II)에 비해 등급 III(Grade III)에서 부하량이 유의하게 높게 나타났다(p<.05). 위 결과로부터 위팔어깨관절(glenohumeral joint)의 아래, 앞, 뒤 방향에 대한 미끄러뜨림(gliding) II/III 적용 시 같은 등급에서 적용되는 힘의 크기가 방향과 성별에 따라 다름을 알 수 있었다.

• 한국전문물리치료학회지
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• 제27권1호
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• pp.38-44
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• 2020

Background: Posterior shoulder tightness, which is a problem mainly seen in patients with shoulder impingement syndrome, disrupts the scapulohumeral rhythm between the humerus and scapulae. Objects: The aim of this study was to compare the effects of joint mobilization and stretching on shoulder muscle activity and internal rotation range of motion (ROM) of the glenohumeral joint in patients with impingement syndrome with posterior shoulder tightness. Methods: The research subjects included 22 in-patients with impingement syndrome with posterior shoulder tightness. They were randomly divided into two groups: one group (12 patients) was treated with joint mobilization and the other group (10 patients) was treated with stretching for the posterior shoulder tightness. Each treatment was performed five times a week for two weeks, and there were 15 sessions for each treatment. The ROM of the internal rotation and muscle activities of shoulder joint were evaluated pretest and posttest in each group. Electromyography data were collected from the upper, middle, and lower trapezius and serratus anterior during shoulder abduction of 90°, 120°, and 150°. Results: Both the joint mobilization and stretching groups showed significant decreases in muscle activity in the upper, middle, and lower trapezius on the posttest (p < 0.05). There was a significant difference in serratus anterior at 150° (p < 0.05), but there was no significant difference between group in post-hoc analysis (p > 0.025). The internal rotation ROM was significantly increased in the stretching group compared to that in the joint mobilization group (p < 0.025). Conclusion: This study found that both joint mobilization and stretching for posterior shoulder tightness were effective in muscle activity during arm abduction, also in order to increase internal rotation ROM of shoulder joint, stretching was effective in patients with impingement syndrome with posterior tightness.