• 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.

• Archives of Reconstructive Microsurgery
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• v.10 no.2
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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.

• Korean Journal of Community Nutrition
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• v.23 no.1
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• pp.28-37
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• 2018

Objectives: This study was conducted to identify differences in job stress, satisfaction and commitment of cooking employees working in hotel kitchens with and without HACCP systems. Methods: Culinary employees of 12 five-star hotels were surveyed and 504 valid data were used for SPSS analysis. Sub factors of working environment factors (job stress, job satisfaction, and job commitment) were examined for analysis. Results: The results showed that hotels that implemented the HACCP system had significantly higher values for the five sub factors of employee job stress (job demand, relationship conflict, organizational system, lack of job autonomy, and job instability; p<0.001). For the sub factors of job satisfaction (internal and external satisfaction) statistic showed a statistically significant value in hotels that did not implement the HACCP system (p<0.001). Job attachment and job importance, which are sub factors of job commitment, showed no difference in relation to the implementation of HACCP system, and job responsibility showed a higher p-value in hotels that did not implement HACCP (p<0.05). Conclusions: The results of the study indicate that culinary employees working at venues with HACCP systems have more job related stress, lower job satisfaction and partially less job commitment. Based on this outcome, venues that have already implemented or are planning to implement HACCP systems should consider the implications regarding their management of employees. Managerial policies that enhance autonomy, job stability, achievement, self-development, promotion, and compensation should also be implemented. Finally, meticulous attention and high investments into the work environment and human resources are necessary.

• Physical Therapy Korea
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• v.19 no.3
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• pp.105-114
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• 2012

This study was performed to compare the muscle activity of lumbar stabilizers between stoop and semi-squat lifting techniques at different lifting loads. Twenty healthy subjects (9 males, 11 females) were recruited for this study. Muscle activity of external obliques (EO), internal obliques (IO) and lumbar multifidus (LM) muscle was measured by surface electromyography during stoop and semi-squat lifting at different lifting loads (10%, 20%, and 30% of the subject's body weight). A one-way repeated measure ANOVA was applied. The results showed that EMG activity of EO was significantly increased with a load of 30% of body weight compared to 10% and 20% of body weight in both lifting techniques (p<.05). Muscle activity of LM was significantly increased in 20% compared to 10% and 30% compared to 10% of subject's body weight in stoop lifting and the muscle activity of LM was significantly increased in 20% compared to 10%, 30% compared to 20%, and 30% compared to 10% of the subject's body weight in semi-squat lifting (p<.05). However, there was no significant difference in activity of IO according to lifting loads in both lifting techniques. There were no significant differences in muscle activity of EO, IO, and LM between stoop and semi-squat technique (p>.05). Therefore, the results of this study suggested that the EO can contribute to increase the lumbar stability during stoop and semi-squat lifting at 30% of body weight rather than at lower loads, and the LM seems to act as counteractor to imposed loads during stoop and semi-squat lifting with increasing loads.

• Physical Therapy Korea
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• v.26 no.1
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• pp.67-74
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• 2019

Background: Uncontrolled lumbopelvic movement leads to asymmetric symptoms and causes pain in the lumbar and pelvic regions. So many patients have uncontrolled lumbopelvic movement. Passive support devices are used for unstable lumbopelvic patient. So, we need to understand that influence of passive support on lumbopelvic stability. It is important to examine that using the pelvic belt on abdominal muscle activity, pelvic rotation and pelvic tilt. Objects: This study observed abdominal muscle activity, pelvic rotation and tilt angles were compared during active straight leg raise (ASLR) with and without pelvic compression belt. Methods: Sixteen healthy women were participated in this study. ASRL with and without pelvic compression belt was performed for 5 sec, until their leg touched the target bar that was set 20 cm above the base. Surface electromyography was recorded from rectus abdominis (RA), internal oblique abdominis (IO), and external oblique abdominis (EO) bilaterally. And pelvic rotation and tilt angles were measured by motion capture system. Results: There were significantly less activities of left EO (p=.042), right EO (p=.031), left IO (p=.039), right IO (p=.019), left RA (p=.044), and right RA (p=.042) and a greater right pelvic rotation angle (p=.008) and anterior pelvic tilt angle (p<.001) during ASLR with pelvic compression belt. Conclusion: These results showed that abdominal activity was reduced while the right pelvic rotation angle and anterior pelvic tilt angle were increased during ASLR with a pelvic compression belt. In other words, although pelvic compression belt could support abdominal muscle activity, it would be difficult to control pelvic movement. So pelvic belt would not be useful for controlled ASLR.

• Journal of the Korean Society for Library and Information Science
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• v.55 no.1
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• pp.343-364
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• 2021

In this study, as examples of domestic libraries currently using the cloud-based library system, the main characteristics and issues that appeared in the experience of use divided into the processes of introduction, conversion, and operation of each system were investigated, and the results are as follows. First, it is said that new systems were introduced as alternatives to problems caused by the operation of the existing system, and the current products were selected because they were cost-effective. Second, the main issues in the conversion process were data migration work, implementation of existing service functions, and linking problems of internal and external systems in the library. Third, the main advantages identified in the operation process were cost reduction, simple installation and automatic management and maintenance, and convenient use in mobile devices. The main drawbacks were the difficulty of customizing that reflects the characteristics of the library, and the need for stability of the network. The disappeared role of the information technology librarian is the regular system inspection and maintenance support, and various new roles have been suggested. The responses of librarians and users to the new system were generally satisfied rather than dissatisfied.

• Sleep Medicine and Psychophysiology
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• v.6 no.1
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• pp.19-25
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• 1999

Sleep alters both breathing pattern and the ventilatory responses to external stimuli. These changes during sleep permit the development or aggravation of sleep-related hypoxemia in patients with respiratory disease and contribute to the pathogenesis of apneas in patients with the sleep apnea syndrome. Fundamental effects of sleep on the ventilatory control system are 1) removal of wakefulness input to the upper airway leading to the increase in upper airway resistance, 2) loss of wakefulness drive to the respiratory pump, 3) compromise of protective respiratory reflexes, and 4) additional sleep-induced compromise of ventilatory control initiated by reduced functional residual capacity on supine position assumed in sleep, decreased $CO_2$ production during sleep, and increased cerebral blood flow in especially rapid eye movement(REM) sleep. These effects resulted in periodic breathing during unsteady non-rapid eye movement(NREM) sleep even in normal subjects, regular but low ventilation during steady NREM sleep, and irregular breathing during REM sleep. Sleep-induced breathing instabilities are divided due primarily to transient increase in upper airway resistance and those that involve overshoots and undershoots in neural feedback mechanisms regulating the timing and/or amplitude of respiratory output. Following ventilatory overshoots, breathing stability will be maintained if excitatory short-term potentiation is the prevailing influence. On the other hand, apnea and hypopnea will occur if inhibitory mechanisms dominate following the ventilatory overshoot. These inhibitory mechanisms include 1) hypocapnia, 2) inhibitory effect from lung stretch, 3) baroreceptor stimulation, 4) upper airway mechanoreceptor reflexes, 5) central depression by hypoxia, and 6) central system inertia. While the respiratory control system functions well during wakefulness, the control of breathing is commonly disrupted during sleep. These changes in respiratory control resulting in breathing instability during sleep are related with the pathophysiologic mechanisms of obstructive and/or central apnea, and have the therapeutic implications for nocturnal hypoventilation in patients with chronic obstructive pulmonary disease or alveolar hypoventilation syndrome.

• Clinics in Shoulder and Elbow
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• v.22 no.2
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• pp.93-99
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• 2019

Background: Modified Phemister operation has been widely used for the treatment of acute acromioclavicular (AC) joint dislocation. Additionally, the use of suture anchor for coracoclavicular (CC) fixation has been reported to provide CC stability. This study was conducted to evaluate the clinical and radiological results of a modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation. Methods: Seventy-four patients underwent the modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation and were followed-up for an average of 12.3 months. The visual analogue scale (VAS), range of motion, Constant score, and Korean shoulder scoring system (KSS) were used for clinical assessment. Acromioclavicular interval (ACI), coracoclavicular distance (CCD), and acromioclavicular distance (ACD) were obtained to evaluate the radiological assessments. Results: At the last follow-up, the mean VAS Score was 1.7 points, the mean joint range of the forward flexion was $164.6^{\circ}$, external rotation at the side was $61.2^{\circ}$ and internal rotation to the posterior was a level of T12. The mean Constant score and the mean KSS was 82.7 points and 84.2 points, respectively. At the mean ACI, CCD, and ACD, significant differences were found preoperatively and at the last follow-up. When the ACI, CCD, and ACD were compared with the contralateral unaffected shoulder at the last follow-up, the affected shoulders had significantly higher values. Conclusions: The modified Phemister operation with CC ligament augmentation using suture anchor is clinically and radiologically effective at acute AC joint dislocation.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.1
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• pp.83-91
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• 2016

PURPOSE: There are several methods, such as the abdominal drawing-in maneuver (ADIM), maximal expiration (ME), and Kegel exercise, to strengthen the core muscles. However, to date no study has been conducted to compare the effects of the ADIM, ME, and Kegel exercise on the transverses abdominis (TrA), internal oblique (IO), external oblique (EO), and pelvic floor muscles (PFMs). The purpose of this study was to find out which of the three aforementioned exercises is most effective for contracting the core muscles. METHODS: The thickness of the TrA, IO, EO and PFMs was measured by ultrasonographic imaging during the ADIM, ME and Kegel exercise in 34 healthy participants. RESULTS: There was the significant difference between ADIM and Kegel exercise in the thickness of the TrA (p<0.05). There were the significant differences between ADIM and ME and between ME and Kegel exercise in the thickness of the IO and PFM (p<0.01). There was no significant activation in the thickness of the EO (p>0.05). Measurement reliability was assessed using intraclass correlation coefficients (ICC) and the standard error of measurement (SEM). An ICC value of >0.77 indicated that reliability measurements was good. CONCLUSION: Kegel exercise was the most effective exercise for the TrA and the PFM, and ME was the most effective exercise for the IO muscles.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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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.