• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.93-99
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• 1998

We measured the glenohumeral and scapulothoracic movements during abduction of the arm in the coronal plane with radiologic analysis in the 30 shoulders of normal male adults who were without pain, limitation of motion, and history of trauma. In the resting position, the glenoid cavity of the scapula faced somewhat superiorly in over 80 percents of the individuals, the mean superior tilting was 5.7 degrees. The mean total scapulothoracic movement was 65.8 degrees and the mean total glenohumeral movement was 106.8 degrees during abduction of arm in the coronal plane. The mean ratio of the glenohumeral movement to the scapulothoracic movement was 1.6 and this GH/ST ratio was decreased toward the extreme abduction. When the arm was abducted, external rotation of the humeral head occurred and this external rotation was increased smoothly during 0 degree through 90 degrees, but steeply above 90 degrees. The acromiohumeral interval was 10.9 mm at the resting positon, and this interval decreased during the arm abduction. The superior migration of the humeral head was 3.1 mm while abducting the arm. Our measurement of the relationships of glenohumeral and scapulothoracic movements at the coronal plane would be useful in the understandings of the biomechanics of shoulder, but further study would be required for the analysis of the three dimensional relationship because of the limitation of our two dimensional analysis.

• The Journal of Korean Physical Therapy
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• v.32 no.1
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• pp.14-20
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• 2020

Purpose: This study examined the effects of early stabilization exercise focused on the scapulothoracic joint on the recovery of surgical patients due to rotator cuff tear. Methods: The subjects were 30 patients divided randomly into two groups. Group I consisted of 15 patients who practiced shoulder joint stabilization exercises, including glenohumeral joint movement. Group II consisted of 15 patients who practiced scapulothoracic joint stabilization exercises, excluding glenohumeral joint movement. The duration of stabilization exercise was 30 minutes for one day, five days a week, and five weeks. To measure the dependent variables, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, range of motion (ROM), dynamometer of measured grip were used. Results: The DASH, ROM, and grip power were compared. A significant difference was observed before the intervention in each group (p<.05), and there was no significant difference between group I and group II (p>.05). Conclusion: Both shoulder joint and scapulothoracic joint stabilization exercises were effective after the intervention compared to preintervention, but there was no difference between the two groups. Unlike many recent studies on the initiation of stabilization exercises, this study allays the concerns between the advantages of 'early exercise' and oppositions of previous studies about 'early exercise'. Nevertheless, further research regarding these subjects is needed.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.221-229
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• 1998

We measured, with manual goniometer, the active and passive arc of motion of the shoulder in 31 healthy male subjects who were right-hand dominant and who ranged in age from twenty to thirty-one years. Among ten directions through the four motion plane, the range of motion on the dominant side were significantly smaller than those on the non-dominant side in the motion of six directions. We also measured the motion fraction of the glenohumeral and scapulothoracic movement using fluoroscope in 30-degree intervals of arm elevation in the scapular plane. The ratio of glenohumeral to scapulothoracic movement(θGH/θST) was 1.6 for the full range of motion in scapular plane. At the lower angles of abduction, scapulothoracic movement was slight compared with glenohumeral movement. The motion fraction of scapulothoracic joint was increased from 60-degree to 150 degree of arm angle especially between 120 to 150 degree. During arm elevation, scapula was also extended from 42 degrees to 20 degrees tilting as well as internal rotation. The measuring technique of glenohumeral to scapulothoracic movement(θGH/θST) with fluoroscopy could be applied to the simple radiographic measurement at the out-patient clinic in order to identify the pathology and recovery of shoulder motion after treatment.

• 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.

• Journal of radiological science and technology
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• v.29 no.2
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• pp.57-62
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• 2006

Purpose : This study was to understand about the measurement of shoulder motion fraction and motion ratio. We proposed the radiological criterior of glenohumeral and scapulothoracic movement ratio. Materials and Methods : We measured the motion fraction of the glenohumeral and scapulothoracic movement using CR(computed radiological system) of arm elevation at neutral, 90 degree, full elevation. Central ray was $15^{\circ},\;19^{\circ},\;22^{\circ}$ to the cephald for the parallel scapular spine, and the tilting of torso was external oblique $40^{\circ},\;36^{\circ},\;22^{\circ}$ for perpendicular to glenohumeral surface. Healthful donor of 100 was divided 5 groups by age(20, 30, 40, 50, 60). The angle of glenohumeral motion and scapulothoracic motion could be taken from gross arm angle and radiological arm angle. We acquired 3 images at neutral, $90^{\circ}$ and full elevation position and measured radiographic angle of glenoheumeral, scapulothoracic movement respectively. Results : While the arm elevation was $90^{\circ}$, the shoulder motion fraction was 1.22(M), 1.70(W) in right arm and 1.31, 1.54 in left. In full elevation, Right arm fraction was 1.63, 1.84, and left was 1.57, 1.32. In right dominant arm(78%), $90^{\circ} and Full motion fraction was 1.58, 1.43, in left(22%) 1.82, 1.94. In generation 20, $90^{\circ} and Full motion fraction was 1.56, 1.52, 30' was 1.82, 1.43, 40' was 1.23, 1.16, 50' was 1.80, 1.28, 60' was 1.24, 1.75. There was not significantly by gender, dominant arm and age. Conclusion : The criterior of motion fraction was useful reference for clinical dignosis the shoulder instability.

• PNF and Movement
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• v.3 no.1
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• pp.47-53
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• 2005

Purpose : To describes the important aspects of scapular movement and function used when applying PNF technique to the upper limb and scapular. Method : The scapular was a very important roles in the upper limb movement. This study summarizes the physiologic movement of scapular to the PNF upper extremity patterns or scapular patterns. Result : The shoulder joint has the most freedom of range of motion in the human body, composed of the glenohumeral joint, the subacromial joint, the acromioclavical joint, the sternoclavicular joint, the scapulothoracic joint, the costosternal joint, and the costovertebral joint. During upper limb movement, the scapular position change at the sternoclavicular joint and the acromioclavical joint. This concerted motion was characterized by scapulohumeral rhythm. In clinical situations, it is import to understand factors affect the scapulohumeral rhythm so that optimal evaluation and therapeutic intervention can be devised. Conclusions : The scapular movement depend on the proper and coordinated contraction of muscles. Physical therapists need to understand the normal scapular movement relationships of the scapulohumeral rhythm under different interventions for PNF techniques application.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.1
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• pp.1-7
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• 2015

PURPOSE: The aim of this study was to investigate the effects of distal movement on shoulder muscle activation during diagonal pattern of exercises. METHODS: Seventeen healthy male participants volunteered to participate. Five muscles of shoulder were investigated during standing performance of diagonal shoulder exercises with and without visual trace. Two patterns of the diagonal exercises were used as diagonal 1 flexion and extension (D1F-E), and diagonal 2 flexion and extension (D2F-E). Two way repeated measures analysis of variance was used, which the factor was the presence of distal movement and exercise variations. RESULTS: The average muscle activity values of the lower trapezius and anterior deltoid are higher with the D2F-E, compared to the D1F-E (p<.05). The distal movement effect was observed within included all muscles except the lower trapezius, which the values are significantly greater in exercise with distal movement (P<.05). All significant increase of the muscles during the exercise with distal movement condition showed over 0.9 for the observed power in present study. CONCLUSION: Present result suggested that the diagonal pattern of exercise with distal movement has additional advantages of activating the scapulothoracic muscle as well as glenohumeral muscles. In addition, the D2F-E exercise pattern is effective for activating lower trapezius and anterior deltoid muscles.

• Physical Therapy Korea
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• v.31 no.1
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• pp.72-78
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• 2024

Background: Limitations of shoulder range of motion (ROM), particularly shoulder internal rotation (SIR), are commonly associated with musculoskeletal disorders in both the general population and athletes. The limitation can result in connective tissue lesions such as superior labrum tears and symptoms such as rotator cuff tears and shoulder impingement syndrome. Maintaining the center of rotation of the glenohumeral joint during SIR can be challenging due to the compensatory scapulothoracic movement and anterior displacement of the humeral head. Therefore, observing the path of the instantaneous center of rotation (PICR) using the olecranon as a marker during SIR may provide valuable insights into understanding the dynamics of the shoulder joint. Objects: The aim of the study was to compare the displacement of the olecranon to measure the rotation control of the humeral head during SIR in individuals with and without restricted SIR ROM. Methods: Twenty-four participants with and without restricted SIR ROM participated in this study. The displacement of olecranon was measured during the shoulder internal rotation control test (SIRCT) using a Kinovea (ver. 0.8.15, Kinovea), the 2-dimensional marker tracking analysis system. An independent t-test was used to compare the horizontal and vertical displacement of the olecranon marker between individuals with and without restricted SIR ROM. The statistical significance was set at p < 0.05. Results: Vertical displacement of the olecranon was significantly greater in the restricted SIR group than in the control group (p < 0.05). However, no significant difference was observed in the horizontal displacement of the olecranon (p > 0.05). Conclusion: The findings of this study indicated that individuals with restricted SIR ROM had significantly greater vertical displacement of the olecranon. The results suggest that the limitation of SIR ROM may lead to difficulty in rotation control of the humeral head.