• Journal of International Academy of Physical Therapy Research
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• v.11 no.2
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• pp.2071-2076
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• 2020

Background: Based on the understanding of the muscle activation relationship between the infraspinatus and posterior deltoid muscles to according to the angle of motion during external rotation on glenohumeral joint, effective shoulder joint strengthening exercise for the prevention and rehabilitation of shoulder injury due to muscle strength imbalance can be performed by achieving the ideal muscle activity ratio during exercise. Objectives: To compare and analyze the muscle activation changes and activity ratio of the infraspinatus and posterior deltoid muscles according to the glenohumeral external rotation angle. Design: Quasi-randomized trial. Methods: The study included 48 healthy male and female adults who provided informed consent for participation in the study. All the subjects performed isometric glenohumeral external rotation by setting the angle of motion to 30°, 45°, and 60° using a 5 kg resistance weight pulley. On surface electromyography, the differences in muscle activation and activity ratio between the infraspinatus and posterior deltoid muscles were investigated. Results: A significant difference in muscle activation was found in the comparison between the infraspinatus and posterior deltoid muscles according to the glenohumeral external rotation angle (P<.05). The muscle activation levels of the infraspinatus and posterior deltoid muscles were highest at the external rotation angles of 30° and 60°, respectively. The muscle activity ratio between the infraspinatus and posterior deltoid muscles also showed a significant difference (P<.05) and was highest at the shoulder external rotation angle of 30°. Conclusion: The findings of this study suggest that muscle activity is the highest at the shoulder external rotation angle of 30° in healthy individuals.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.1-7
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• 2019

PURPOSE: This study was conducted to investigate effects of shoulder adduction load on rotator cuff muscles, including the infraspinatus, during the external rotation exercise of shoulder. METHODS: This study investigated 16 healthy university students from Daegu University. Before the study started, all participants understood the content of this study. They signed an informed consent form. Five electrodes for surface electromyography (sEMG) were attached to their infraspinatus, middle deltoid, posterior deltoid, upper trapezius and pectoralis major. The participants then underwent the shoulder external rotation exercise with the shoulder adduction at three loads (0 mmHg, 20 mmHg and 40 mmHg) that were controlled using a stabilizer Pressure $Bio-feedback^{TM}$ device. The surface electrodes recorded the electromyographic data during the external rotation exercise of shoulder. RESULTS: The infraspinatus was most activated when the shoulder adduction pressure was 40 mmHg during the external rotation exercise of shoulder. The infraspinatus activation significantly increased when the shoulder adduction pressure intensity increased, while the middle deltoid activation and the posterior deltoid activation significantly decreased (p<.05). CONCLUSION: In conclusion, increases in shoulder adduction load intensity during shoulder external rotation exercises can have a positive effect on the infraspinatus, which consists of rotator cuff muscles, with minimal activity in the middle and posterior deltoid.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.186-192
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• 1998

This study was performed to evaluate the influences of the passive glenohumeral rotation on the scapulothoracic motion. We took anteroposterior radiograms of the right shoulders including the thoracic vertebrae with supine position in 10 normal male adults, at 0 degree abduction, 45 degrees abduction and 90 degrees abduction in scapular plane and in neutral rotation, maximal internal rotation and maximal external rotation in each abduction view. The scapulothoracic motion was measured as the distances between the vertical line drawn from the spinous process of the 7th cervical vertebra and the inferior and superior angles of the right scapula respectively. At 0 degree abduction, the distances were not changed in internal rotation relative to neutral rotation, but decreased significantly in external rotation, that is, the scapula shifts medially on external rotation. At 45 degrees abduction, the distances were increased significantly only in internal rotation, that is, the scapula shifts laterally on internal rotation. At 90 degrees abduction, the scapula rotated laterally on internal rotation and medially on external rotation. In conclusion, when a physician examines the rotation of the shoulder joint, he cannot exclude the scapulothoracic motion just by examining the patient with supine position. And we concluded that the rotatory movement of the shoulder is not solely contributed to the glenohumeral motion.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.19 no.2
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• pp.61-66
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• 2013

Background: This study tried to identify the bridge exercise posture for efficient exercise application by comparing muscle activity of buttocks and thighs according to internal-external rotation and pronation & supination in bridge exercise. Method: Nine males in their 20s living in D city were randomly selected as subjects. Muscles such as vastus medialis oblique (VMO), vastus lateralis (VL), semitendinosus (ST), biceps femoris (BF), gluteus maximus (GMAX), gluteus medius (GMED), tensor fasciae latae(TFL), and adductor longus (ADL) were measured using eight channel surface electromyogram (MyoSystem 1400A, Noraxon, USA) to measure muscle activity. Statistics process was performed through paired t test. Results: In the changes in electromyogram signals according to internal-external rotations according to internal-external rotation of shinbones, in most cases muscle activity was higher in external rotation than in internal rotation, but there was no statistical significance (p>.05). In particular, it was lower in TFL and ADL. There was no statistical significance in the comparison between two groups (p>.05). In the changes in electromyogram signals according to internal-external rotations according to pronation & supination of thighs, GMED showed significantly higher value in supination than in pronation (p>.05), and in ADL pronation is significantly higher than supination (p<.05). Conclusion: In internal-external rotation of shinbone and pronation & supination of thighs in bridge exercise, changes in muscle length can make effects on muscle activity of buttocks and thighs. Therefore, muscle strength enforcement program on buttocks and thighs through bridge exercise can make effects on patients with lower limb functional damages in clinical situations.

• Journal of muscle and joint health
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• v.19 no.3
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• pp.319-328
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• 2012

Purpose: The purpose of this study was to explore effects of a Cancer-overcome BeHaS exercise program that consists of exercise, education, and cognitive supports to improve shoulder external rotation, cancer coping, group cohesion in mastectomy patients. Methods: A one group pre-post test design was used. Thirty mastectomy patients from C Hospital participated in the supervised exercise program once a week for 8 weeks. Data were collected from May to July 2011 using self-administered questionnaires and physical measurement. SPSS/WIN 19.0 was used for the data analysis. Results: The mean age of participants was 53.7 and the mean postoperative period after the surgery was 12.93 months. There were significant differences in the shoulder external rotation, cancer coping, group cohesion between pre and post program. Conclusion: The results showed that cancer-overcome BeHaS exercise program was an effective nursing intervention for improving breast cancer patient's shoulder external rotation, cancer coping and group cohesion.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.2
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• pp.219-229
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• 2013

PURPOSE: The purpose of the study was to investigate a influence in Proprioceptive Neuromuscular Facilitation, and self-assisted ROM exercise of shoulder adhesive capsulitis. METHODS: The methods of the study was to investigate a change in range of motion (ROM), an increase in ROM, visual analogue scale (VAS) and disability questionnaire by Proprioceptive Neuromuscular Facilitation, and self-assisted ROM exercise on 32 patients who were diagnosed with shoulder adhesive capsulitis. RESULTS: There was no significant difference between the two groups who were treated in the Proprioceptive Neuromuscular Facilitation and self-assistive ROM exercise group for flexion, extension, internal rotation, external rotation, VAS and disability questionnaire. Both group's flexion, extension, internal ratation, and external rotation levels were significantly different before and after the treatment. And significant statistical decrease in VAS and disability was seen. The extension of the shoulder joint was closely related to external rotation (r=0.84). There was a close relationship between internal rotation and external rotation at the shoulder joint. There was no increased range of extension through the exercise method. However, flexion, extension, internal rotation, external rotation, VAS, and disability questionnaire of Proprioceptive Neuromuscular Facilitation groups were obviously higher than in the self-assisted ROM exercise group. CONCLUSION: Our study suggest that considering Proprioceptive Neuromuscular Facilitation for the patient who has shoulder adhesive capsulitis in clinic.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.6 no.1
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• pp.69-79
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• 2008

In this paper, the effects of the external-rotation exercise on the gait of hemiplegia was investigated. 26 patients with hemiplegia due to cerebrovascular accident participated in this study. Subjects were randomly assigned to experimental group(n=12) and control one(n=14). 12 subjects of the experimental group were received the external rotation reducing exercise on the mat with seating and supine posture after the general therapeutic exercise for hemiplegia. 14 subjects of the control group were received only general therapeutic exercise. The effects of external rotation reducing exercise were evaluated by measurements of gait velocity, cadence, stride length, step length and foot angle using ink-foot prints. The collected data were analyzed statistically based on Wilcoxon, Mann-Whitney and correlation analysis. After treatment of three weeks, it turned out that external rotation reducing exercise has the significant effect on foot angle(p<0.01). However the exercise has no statistically significant direct effect on the gait velocity, cadence, stride length and step length.

• Journal of Convergence for Information Technology
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• v.10 no.5
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• pp.188-197
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• 2020

This study was to investigate the effects of joint mobilization with two different electrotherapy methods on shoulder external rotation range of motion and pain in mastectomy patients. Thirty mastectomy patients were divided into STMG (joint mobilization+pain scrambler therapy, n=15) and TENMG (joint mobilization+transcutaneous electrical nerve stimulation, n=15). The measurements were performed shoulder external rotation range of motion (ROM), pain (VAS). In both groups, there was a significant difference in the shoulder external rotation ROM, pain after intervention (p <.05). STMG was more decrease in VAS score than TENMG (p <.05). There was no significant difference in shoulder external rotation ROM between the two groups. In order to decrease the pain of mastectomy patients, it was confirmed that STMG was more effective than TENMG.. It is thought that a control group is added to confirm various differences, and more subjects are needed.

• Clinical Pain
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• v.18 no.2
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• pp.76-81
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• 2019

Objective: To examine (1) the degree of reduction of passive range of motion (PROM) on the affected side compared to that on the unaffected side and (2) the degree of increase in PROM following intra-articular corticosteroid injection (IACI) in patients with frozen shoulder. Method: The medical records of 120 patients with frozen shoulder were retrospectively reviewed. PROM of the unaffected and affected shoulder (flexion, extension, abduction, internal rotation, external rotation) was compared, and changes in PROM of the affected shoulder after a single IACI (triamcinolone 20 mg) were evaluated after 12 weeks. Results: At the time of diagnosis, PROM of the affected shoulder was most limited in external rotation, followed by internal rotation, abduction, extension, and flexion, compared to that of the unaffected shoulder. Compared to before IACI, PROM of external rotation demonstrated the greatest increase compared to all the other movements after IACI. Conclusion: Limitation in PROM of the frozen shoulder at the time of diagnosis was greatest for external rotation. Moreover, external rotation experienced the greatest improvement after IACI. Our findings should help to further clarify the clinical characteristics of frozen shoulder, aid in its diagnosis, and allow the prediction of the effects of IACI.

• Clinics in Shoulder and Elbow
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• v.18 no.1
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• pp.13-20
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• 2015

Background: The purpose of this study is to assess the range of shoulder motion using an indirect evaluation method without physical examinations of patients based on questionnaires regarding several specific arm postures referenced by patient's own body parts. Methods: Nine criteria of specific shoulder motion including 4 forward flexion, 2 external rotation, and 3 internal rotation were decided as reference position which can represent a certain shoulder motion. Flexion contains postures such as lifting arm to waist-height, shoulder-height, eye-height, and raising arm above head with arm touching ears. External rotation comprises grasping ears and placing hands on back of the head. Vertebral height in internal rotation is determined by calculating the samples' motions, which are holding on to trouser belts, opposite-elbow, and scapula. These postures are included in questionnaires for patients to evaluate the validity and effectiveness of this indirect method. Results: The range of flexion was $77^{\circ}$ ($60^{\circ}$ to $100^{\circ}$), $96^{\circ}$ ($87^{\circ}$ to $115^{\circ}$), $135^{\circ}$ ($115^{\circ}$ to $150^{\circ}$), and $167^{\circ}$ ($150^{\circ}$ to $175^{\circ}$) when arms go up to waist, shoulder, eye, and high vertically. Range of external rotation was $39.6^{\circ}$ ($30^{\circ}$ to $50^{\circ}$) when grasping ears and $69.2^{\circ}$ ($60^{\circ}$ to $80^{\circ}$) with the hands on the back of the head. Range of internal rotation was L4 when placing trouser belts, T12 for holding opposite elbow, and T9 for reaching scapula. The mismatch rates of flexion, external rotation, and internal rotation were 11.6%, 9.6%, and 7.8%. Conclusions: The range of shoulder motion using this method is expected to be applied to an established shoulder scoring system which included shoulder motion evaluation item.