• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.111-117
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• 2001

Introduction : The Functional muscle transfer is used to reconstruct the injuried muscle and paralysis of the shoulder. Especially transfer of the trapezius has been the treatment of choice but it has disadvantages of inadequate function and deformed contour, and instability of humeral head in case of acromion resection. We report an operation for shoulder reconstruction after wide resection of malignant fibrous histiocytoma, using rotational latissimus dorsi flap and review the operation method and clinical outcome. Materials and Methods : A patient, 53 year old, with malignant fibrous histiocytoma in the acromioclavicular joint area had been underwent wide excision, including the deltoid, clavicular head of pectoralis major, part of trapezius, lateral 1/3 of clavicle and acromion including scapular spine. The rotational latissimus dorsi flap with its neurovascular pedicle was dissected and then placed over the resected area and transfer of muscle attached at coracoid process was done to achieve stability of the humeral head. The range of motion of the shoulder and test of muscle power were evaluated for functional outcome. Total follow-up period is 2 years 11 months. Results : At last follow-up, the range of motion of the shoulder is abduction $90^{\circ}$, flexion $90^{\circ}$, internal rotation $40^{\circ}$, external rotation $50^{\circ}$ and the muscle power is 4 grade in all direction and then we obtained good functional results. There are no complications such as instability or subluxation of the humeral head and deformed contour and he is a disease-free survival state. Conclusions : The transfered latissimus dorsi flap provides adequate lever arm and stabilization and covering of the humeral head by sufficient muscle volume and width. This procedure can be useful not only for the paralysed deltoid reconstruction but also for use in reconstructive surgery after wide resection of the shoulder for malignant tumor.

• PNF and Movement
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• 제13권1호
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• pp.1-7
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• 2015

Purpose: This study aimed to examine the activity of the shoulder flexor and extensor when hold-relax and contraction-relax techniques were applied with shoulder joint flexion. Methods: The subjects of this study were 15 healthy women. With the shoulder joint flexion at $0^{\circ}$ and $90^{\circ}$, hold-relax and contraction-relax techniques were applied for the same submaximal resistance to measure the activities of the deltoid muscle anterior fiber, deltoid muscle posterior fiber, pectoralis major fiber, and latissimus dorsi muscle with surface electromyography. An independent t-test was conducted in order to compare activities of each muscle according to the two techniques. Results: When the hold-relax and contraction-relax techniques were applied with the shoulder joint flexion at $0^{\circ}$, the activities of the shoulder flexor and extensor were not significantly different, but the activity of the flexor was higher when the contraction-relax technique was applied than when the hold-relax technique was applied. When the hold-relax and contraction-relax techniques were applied with the shoulder joint flexed at $90^{\circ}$, the activities of the shoulder flexor and extensor were not significantly different, but the activity of the extensor was relatively higher than when the flexor was at $0^{\circ}$ Conclusion: When the hold-relax and contraction-relax techniques were applied with the shoulder joint flexion at $0^{\circ}$, the activities of the shoulder flexor and extensor were not significantly different, but the activity of the flexor was higher when the contraction-relax technique was applied than when the hold-relax technique was applied. When the hold-relax and contraction-relax techniques were applied with the shoulder joint flexed at $90^{\circ}$, the activities of the shoulder flexor and extensor were not significantly different, but the activity of the extensor was relatively higher than when the flexor was at $0^{\circ}$.

• 한국운동역학회지
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• 제32권4호
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• pp.128-133
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• 2022

Objective: This study was executed to compare and analyze shoulder muscle activation while using an inelastic bar and elastic bar during overhead press exercise. The stability and coordination of shoulder joints will be investigated by measuring and analyzing the EMG of the upper and lower arm muscles. Method: A total of 20 university male students were recruited by dividing into 2 groups; 10 elastic bar participants (age: 20.17 ± 0.41 yrs, height: 174.31 ± 3.34 cm, weight: 74.68 ± 5.65 kg) and 10 inelastic bar participants (age: 20.09 ± 0.23 yrs, height: 173.53 ± 4.11 cm, weight: 75.32 ± 3.31 kg) participated in this study. Results: The EMG analysis results of the four muscles measured in this study showed that there was no difference between the left and right muscles between the groups in Upper Trapezius muscle. In Deltoid, Infraspinatus, and Rectus Abdominis muscles, the elastic bar group was significantly higher than the inelastic bar group between groups, and there was no difference between left and right. Conclusion: Among the four muscles measured in this study, there was no difference between left and right in Deltoid, Infraspinatus, and Rectus Abdominis, but the elastic bar showed significantly higher muscle activity than the inelastic bar. Therefore, it was found that the elastic bar increases muscle activation during exercise than the inelastic bar, and in particular, it further increases muscle activation of the arms and torso, and exercise using the elastic bar can increase neuromuscular stabilization.

• 한국전문물리치료학회지
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• 제25권1호
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• pp.62-70
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• 2018

Background: Sitting posture influences movements of scapulothoracic and glenohumeral joints and changes the shoulder muscle activities. The development and maintenance of correct sitting posture is important for the fundamental treatment of shoulder pain during rehabilitation. Objects: The purpose of this study was to investigate the effects of the sitting postures and the shoulder movements on shoulder muscle activities for both male and female. Methods: Twenty-eight subjects without shoulder-related diseases participated in this experiment. The subjects had randomly adopted three different sitting postures (upright posture, preferred posture, maximum slouched posture) and shoulder flexion angles in scapular plane ($30^{\circ}$, $90^{\circ}$, $120^{\circ}$). Surface electrodes were collected from upper trapezius (UT), anterior deltoid (AD), and posterior deltoid (PD) and the active shoulder range of motion was measured in each sitting posture and shoulder flexion angle. Results: The active range of motions of the shoulder external rotation and the flexion in the scapular plane decreased from the upright posture to the maximum slouched posture (p<.05, mixed-effect linear regression with random intercept, Tukey post-hoc analysis). All muscles showed the highest EMG activities at $120^{\circ}$ shoulder flexion with the maximum slouched posture and did not show the gender differences. Conclusion: Increased shoulder muscle activities may become the potential risk factor for the shoulder impairment and pain if people continuously maintain the maximum slouched posture. Therefore, an upright position is necessary during shoulder exercises, as well as in activities of daily living, including motions involving lifting the arms.

• 대한한의학회지
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• 제39권4호
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• pp.121-125
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• 2018

Objectives: This study was carried out to analyse Hand Greater Yang Skin in human. Methods: Hand Greater Yang meridian was labeled with latex in the body surface of the cadaver. And subsequently body among superficial fascia and muscular layer were dissected in order to observe internal structures. Results : A depth of Skin encompasses a common integument and a immediately below superficial fascia, this study established Skin boundary with adjacent structures such as relative muscle, tendon as compass. The Skin area of the Hand Greater Yang in human are as follows: The skin close to 0.1chon ulnad of $5^{th}$ nail angle, ulnad base of $5^{th}$ phalanx, ulnad head of $5^{th}$ metacapus(relevant muscle: abductor digiti minimi muscle), ulnad of hamate, tip of ulnar styloid process(extensor carpi ulnaris tendon), radiad of ulnar styloid process, 2cm below midpoint between Sohae and Yanggok(extensor carpi ulnaris), between medial epicondyle of humerus and olecranon of ulnar(ulnar nerve), The skin close to deltoid muscle, trapezius muscle, platysma muscle, inner muscles such as teres major muscle, infraspinatus muscle, supraspinatus muscle, levator scapulae muscle, splenius cervicis muscle, splenius capitis muscle, sternocleidomastoid muscle, digastric muscle, stylohyoid muscle, zygomaticus major muscle, auricularis anterior muscle. Conclusions: The Skin area of the Hand Greater Yang from the anatomical viewpoint seems to be the skin area outside the superficial fascia or muscles involved in the pathway of Hand Greater Yang meridian, collateral meridian, meridian muscle, with the condition that we consider adjacent skins.

• 디지털융복합연구
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• 제10권9호
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• pp.435-441
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• 2012

본 연구는 정상 성인을 대상으로 광범위한 어깨관절 각도의 팔자세 유형에서 여러 가지 손의 쥐기 강도의 차이에 따라 어깨주위근 활성도를 측정하여, 직업과 관련된 어깨 손상을 예방하고 치료하는데 유용한 기초임상자료로 제공하고자 한다. 팔자세의 유형에 따라 다양한 강도로 쥐기를 시행 할 때 어깨 주위 근육의 활성도를 알아보기 위해 모든 대상자들은 MVC를 측정하였고 동일한 자세에서 어깨관절 $0^{\circ}$, $90^{\circ}$, $160^{\circ}$에서 각각 최대 쥐기 강도의 30%, 50%, 70%를 무작위로 실시하여 팔자세의 유형에서 쥐기강도에 따른 앞세모근, 가시위근, 위등세모근, 가시아래근의 %MVC를 구하여 어깨근 활성도를 알아보았다. 팔자세의 유형에 따른 각 집단의 %MVC를 비교하기 위하여 $0^{\circ}$에서 최대 힘의 30%, 50%, 70%로 쥐기를 비교한 결과 앞세모근, 가시위근, 위등세모근, 가시아래근 간의 근활성도에서는 유의한 차이가 나타나지 않았으나, $90^{\circ}$와 $160^{\circ}$에서는 앞세모근, 가시위근, 위등세모근, 가시아래근에서 유의한 차이가 나타났으며(p<.001). 사후검정결과 모든 각도에서 앞세모근과 가시아래근의 근활성도가 높게 나타났으며, 위등세모근의 근활성도는 가장 낮게 나타났다. 다양한 산업현장의 근로 여건 등을 고려하여 과도한 손의 움직임은 안정성과 가동성에 기여를 하는 어깨주위 근육들에 손상을 초래할 수 있다. 본 연구에서는 특히 가시아래근의 경우 팔의 각도가 클수록 그리고 쥐기 힘이 커질수록 근활성도가 증가 하는 양상을 보였다. 이러한 양상은 머리위로 손을 올려 사용하는 작업현장에서의 어깨손상예방과 손상된 근육을 선택적으로 재활하는 측면에서 기초 임상 자료로 활용 될 수 있을 것이다.

• 대한안전경영과학회지
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• 제11권3호
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• pp.79-85
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• 2009

In this study, the effects of psychosocial stress (box color and precision demand) on muscle activity were evaluated in laboratory setting. Eight subjects performed sagittally symmetric lifting tasks. Box color (yellow, black), precision demand (yes, no), and box weight (5%MVC, 10%MVC, 15 %MVC) were varied and surface EMG signals from seven muscles(medial deltoid right, biceps brachii right, lateral triceps right, latissimus dorsi right, erector spinae right, external oblique right, internal oblique right) were recorded. EMG signals were band-pass filtered($10{\sim}400\;Hz$), rectified, RMS smoothed and normalized (NEMG). Analysis of variance tests were conducted on the total NEMG (TNEMG: the sum of the seven muscles' NEMGs) and on the individual muscle's NEMGs. Box color had no effect on the TNEMG and on the seven muscles activities(p>0.05). When precision demand was required at the end point of lifts, the mean NEMG showed higher values than no precision demand conditions: TNEMG (14% increase) and medial deltoid(40% increase), biceps brachii(10% increase), lateral triceps(26% increase), latissimus dorsi(25% increase) muscles. Those increases showed more conspicuous as the box weight increased in the muscles of medial deltoid, lateral triceps, and latissimus dorsi.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2009년도 제17차 학술대회
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• pp.74-74
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• 2009

The purpose of this study was to estimate force of muscles that constituted the rotator cuff during elevation motion in scapula plane, using a skeletal muscle model and quantitatively evaluate rotator cuff function in vivo. A healthy volunteer was measured with an open MR and CT system at elevation positions in scapula plane (MR: $30^{\circ}$, $60^{\circ}$, $90^{\circ}$, $120^{\circ}$, $150^{\circ}$, CT: $0^{\circ}$). After reconstruction three-dimensional MRI-based and CT-based bone surface models, matched each models with registration technique. Then supraspinatus, infraspinatus, subscapularis, teres minor, deltoid (anterior, middle, posterior portions) represented as plural lines. These lines were proportional to physiologic cross-sectional area (PCSA) and defined straight line to bind origin and insertion. Force of supraspinatus became greatest at $59^{\circ}$ of elevation. Subsequently force of deltoid middle portion became greatest at $89^{\circ}$ of elevation. Infraspinatus and subscapularis were active at the meantime. In addition, supraspinatus was active during elevation. These results resembled clinical finding and were proved force couples that contribute to mobility and stability of shoulder complex.

• Clinics in Shoulder and Elbow
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• 제23권2호
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• pp.100-104
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• 2020

Function and strength of the deltoid muscle are important in reverse shoulder arthroplasty (RSA). Moreover, location and shape of the acromion, clavicle, and scapular spine, which are origins of the deltoid muscle, are also important. The frequency of os acromiale is 5% to 15%; however, it is rare in the Asian population, affecting approximately 0.7% of Koreans. RSA has rarely been reported in patients with os acromiale. We present a case series of two patients with cuff tear and arthropathy combined with os acromiale who underwent RSA. From 2016 to 2018, two patients with os acromiale who presented with pain and limited range of motion (ROM) underwent RSA with cuff tear arthropathy using the subscapularis-sparing deltopectoral approach. Their ROM, visual analog scale (VAS), and satisfaction were evaluated before and after surgery. In both patients, VAS decreased, ROM increased, and postoperative satisfaction increased. There were no specific complications due to os acromiale. The VAS, ROM, and satisfaction of patients improved after surgery compared with values before surgery. However, careful attention must be given during surgery to ensure optimal repair and recovery.

• 대한인간공학회지
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• 제27권3호
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• pp.33-41
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• 2008

The goal of this study was to compare wrist posture, muscular loads and perceived comfort among wearable wrist rest (WR), general wrist rest(GR), no wrist rest(NR) during keyboard and mouse use. Thirteen subjects performed text editing task in three test conditions: wearable wrist rest(WR), general wrist rest(GR), no wrist rest(NR). During text editing task, the right wrist posture was recorded by an electrogoniometer and the muscle activity in upper trapezius, anterior deltoid, extensor digitorum, extensor carpi ulnaris were recorded by electromyography. After all of the tests, the subjects rated perceived comfort. Working with wearable wrist rest(WR), compared to no wrist rest(NR) and general wrist rest(GR), decreased wrist radial/ulnar deviation and also decreased muscle activity in upper trapezius and anterior deltoid. At the same time, in work with wearable wrist rest(WR), the subjects rated more comfort at 5 of 8 body locations(shoulder, upper arm, wrist, hand, body).