• Physical Therapy Korea
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• v.29 no.2
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• pp.106-116
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• 2022

Background: Shoulder external rotation exercises are commonly used to improve the stabilizing ability of the infraspinatus. However, during exercise, excessive activation of the posterior deltoid compared to the infraspinatus causes the humeral head to move anteriorly in an abnormal position. Many researchers have emphasized selective activation of the infraspinatus during shoulder external rotation exercise. Objects: This study aims to delineate the optimal exercise method for selective activation of infraspinatus by investigating the muscle activities of the infraspinatus and posterior deltoid according to the four shoulder exercise methods and two forearm positions. Methods: Thirty healthy individuals participated in this study. The participants were instructed to perform shoulder external rotation exercises following four exercise methods: sitting external rotation (SIER); standing external rotation at 90° abduction (STER); prone external rotation at 90° abduction (PRER); side-lying external rotation (SLER), and two forearm positions (neutral, supinated). The electromyography (EMG) signal amplitude was measured during each exercise. Surface EMG signals were recorded from the posterior deltoid, infraspinatus, and biceps brachii. Results: EMG results of the infraspinatus and posterior deltoid in PRER, were significantly higher than that of the other exercises (p < 0.01). The EMG ratio (infraspinatus/posterior deltoid) in SIER was significantly higher than that of the other exercises. EMG activation of the posterior deltoid in SIER, PRER, and SLER was significantly higher in neutral than in supinated (p < 0.01). Furthermore, the EMG of the infraspinatus in SIER was significantly higher in neutral than in supinated (p < 0.01). The EMG ratio (infraspinatus/ posterior deltoid) in SIER was significantly higher in neutral than in supinated (p < 0.05.) Contrarily EMG ratios in PRER and SLER were significantly higher in supinated than in neutral (p < 0.05). Conclusion: The results show that clinicians should consider these exercise methods and forearm positions when planning shoulder external rotation exercises for optimal shoulder rehabilitation.

• Physical Therapy Korea
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• v.24 no.4
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• pp.77-83
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• 2017

Background: Shoulder external rotation exercises are commonly used to improve the stabilizing ability of the infraspinatus. Although the side-lying wiper exercise (SWE) is the most effective shoulder external rotation exercise to maximize infraspinatus activity, the effect of adduction force on the infraspinatus and posterior deltoid has not been demonstrated. Objects: This study was conducted to investigate whether horizontal adduction force increases infraspinatus activity and decreases posterior deltoid activity. Methods: Twenty-eight healthy subjects (male: 21, female: 7; $age=23.5{\pm}1.8years$; $height=170.1{\pm}7.4cm$; $weight=69.4{\pm}9.6kg$) were recruited. Subjects were asked to perform the SWE under two conditions: (1) general SWE and (2) SWE with adduction force using pressure biofeedback. Surface electromyography (EMG) signals of the infraspinatus and posterior deltoid were recorded during SWE. Paired t-tests were used to compare the EMG activity of the infraspinatus and posterior deltoid between the two conditions. Results: Posterior deltoid muscle activity was significantly decreased following SWE with adduction force ($7.53{\pm}4.52%$) relative to general SWE ($11.68{\pm}8.42%$) (p<.05). However, there was no significant difference in the infraspinatus muscle activity between the SWE with adduction force ($28.33{\pm}12.16%$) and the general SWE ($26.54{\pm}13.69%$) (p>.05). Conclusion: Horizontal adduction force while performing SWE is effective at decreasing posterior deltoid activity.

• Clinics in Shoulder and Elbow
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• v.20 no.1
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• pp.30-36
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• 2017

Background: Isolated infraspinatus tear is very rare and clinical features are not as well known, therefore the purpose of this study was to evaluate clinical characteristics and outcomes of isolated infraspinatus tear that authors experienced. Methods: Authors reviewed 288 cases of full-thickness rotator cuff tear involving infraspinatus between 2010 and 2015, and retrospectively analyzed six cases of isolated infraspinatus tear. Perioperative clinical characteristics, postoperative functional outcomes of 6 months were investigated. Functional evaluation included visual analogue scale (VAS), range of motions, American Shoulder and Elbow Surgeons (ASES) score, and Constant score. Results: Calcific tendinitis was accompanied in 4 cases (66.7%). Three of them received steroid injection or aspiration or extracorporeal shockwave therapy. Mean preoperative pain VAS was 7.1 (range, 5-9), and mean postoperative pain VAS at 6 months later was 1.6 (range, 0-5). Preoperative muscle strength by isokinetic muscle performance test showed 52% deficit of abduction and 37.6% deficit of external rotation. All 6 patients had arthroscopic repair of the infraspinatus tendon. All the patients at the 6 months follow-up exhibited clinical improvement in the Constant score (67.8 [range, 45-77] to 89.3 [range, 81-100], p=0.029), and ASES score (52.3 [range, 30-77] to 90.0 [range, 80-100], p=0.002). There was no healing failure on imaging. Conclusions: Isolated infraspinatus tendon tear was frequently accompanied by calcific tendinitis, but pathophysiologic relationship should need more study. To rule out neurogenic etiology, magnetic resonance imaging and electromyography would be helpful. Arthroscopic infraspinatus tendon repair and supraspinatus debridement showed relatively good result in painful shoulder.

• Journal of Animal Science and Technology
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• v.63 no.5
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• pp.1169-1181
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• 2021

We investigated the comparative physicochemical attributes, oxidative stability, and microbial characteristics of 28 days dry-aged meat in between boneless sirloin (gluteus medius) and bone-in T-bone steaks (infraspinatus) muscles from Korean Native Hanwoo Steer (KNHS). Results reveal that regardless of the muscles, dry-aging increased protein content and water-holding capacity (WHC) (p < 0.05). Meat from infraspinatus-aged muscle led to darker meat with higher pH values than un-aged meat (p < 0.05). However, fat content, CIE a^*, and CIE b^* remained unchanged in both muscles at aging. At aged meat, thiobarbituric acid reactive substances (TBARS) values from bone-in infraspinatus muscle was 2.5-fold higher than boneless gluteus medius muscle (p < 0.05). Dry-aging led to an increase in the contents of total unsaturated fatty acids (UFAs), monounsaturated fatty acids (MUFAs), and UFA/saturated fatty acids (SFA) in both muscles (p < 0.05). Furthermore, gluteus medius aged muscle concentrated with olic acid (C18:1) compared to infraspinatus aged muscle. Irrespective of the muscles, dry-aging enhanced the total free amino acids (FAAs) as well as tasty, and bitter amino acid contents whereas decreased the tasty/bitter amino acids (p < 0.05). Aromatic amino acid, tryptophan that converted to serotonin was 2-fold higher in boneless gluteus medius muscle than bone-in infraspinatus muscle at pre and post aging processes (p < 0.05). Aged Infraspinatus muscle increased total bacteria (p < 0.05) while no salmonella spp. was detected in both muscles. Taken together, our study confirms that 28 days dry-aging profiling the quality characteristics of boneless sirloin (gluteus medius) and bone-in T-bone steaks (infraspinatus) distinctly while gluteus medius aged steak performs better owing to oxidative stability and functional compounds than infraspinatus aged steak.

• PNF and Movement
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• v.21 no.1
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• pp.139-146
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• 2023

Purpose: The aim of this study is to provide basic information to create an efficient training program to improve shoulder stability and function in patients with injuries and in patients having undergone surgery of the supraspinatus and infraspinatus muscles, which have a relatively high incidence of injury in shoulder joint disease. Further, independent activities of the supraspinatus and infraspinatus muscles were investigated according to forearm rotation and the neutral and lateral rotation postures. Methods: The activities of the supraspinatus and infraspinatus muscles were measured using surface electromyography in 22 healthy adults in Busan, and isokinetic muscle strength measurement equipment was used to measure muscle strength during shoulder lateral rotation. The subjects performed lateral rotation of the shoulder in three different forearm postures (neutral, supine, prone) to measure shoulder muscle activity and lateral rotation strength. Results: The independent activity ratio (% Isolation) of the supraspinatus and infraspinatus muscles during lateral rotation of the shoulder joint demonstrated a significant difference (p<0.05) according to the change in forearm posture. Conclusion: The supraspinatus muscle showed independent activity ranging from highest to lowest in the order of pronation, neutral, and supination of the forearm, while the independent activity of the infraspinatus muscle ranged from highest to lowest in the order of neutral, supination, and pronation of the forearm. Therefore, the most active forearm positions for the supraspinatus and infraspinatus muscles are pronation and neutral, respectively.

• Physical Therapy Korea
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• v.30 no.3
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• pp.237-244
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• 2023

Background: The external rotation (ER) exercise in performed at a 90° abduction of the shoulder joint is an effective to strengthen the infraspinatus. However, failure of the humeral head to control axial rotation during exercise can be increased the posterior deltoid over activity. Biofeedback training is an effective method of promoting motor learning and control it could look forward to activate the infraspinatus selectively by controlling the humeral head during exercise. Objects: The aim of this study was investigated that whether biofeedback for axial rotation was effective to activate selectively the infraspinatus during ER exercise. Methods: The 15 healthy males participated, and all subjects performed both ER exercise in a sitting position with shoulder abducted 90° under conditions with and without axial rotation biofeedback. Exercise was performed in a range of 90° ER, divided into three phases: concentric, isometric, and eccentric. The infraspinatus and posterior deltoid muscle activity were observed using surface electromyography. Results: Both infraspinatus activity (p < 0.01) and infraspinatus to posterior deltoid activity ratio (p = 0.01) were significantly higher with biofeedback however, posterior deltoid activity was significantly lower with biofeedback (p = 0.01). The infraspinatus muscle activity and muscle activity ratio were the highest in the isometric contraction type, and there were significant differences for all contraction types (p < 0.05). Whereas, the posterior deltoid activity was the lowest in the isometric contraction type, and showed a significant difference between isometric and other two contraction types (p < 0.05), but no significant different between concentric and eccentric contraction. Conclusion: Our results indicate that the axial rotation biofeedback during sitting ER exercise might be effective method to activating selective infraspinatus muscle and recommended to enhance the dynamic stability of the shoulder joint.

• The Journal of Korean Physical Therapy
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• v.19 no.6
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• pp.43-47
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• 2007

Purpose: This study examined the effect of electro-acupuncture stimulation of the infraspinatus and teres major on the shoulder function reduction. The subjects consisted of 20 female patients with a shoulder dysfunction. Methods: The 20 female patients with shoulder dysfunction participated voluntary in this research. 10 minute electro-acupuncture stimulation (frequency: 5Hz, Intensity: below the pain threshold) with Infra-red therapy, 3 times per week given to the patients' Trigger point of the infraspinatus and teres major. The Visual Analog Scale (VAS), Apley's Scratch Test and Global Perceived Effect Scale (GPES) were examined before alter six applications. Results: There was a significant decrease in the VAS (p<0.05) and Apley's Scratch Test (p<0.05). In addition, there was statistically significant increase in the Global Perceived Effect Scale (p<0.05). Therefore, the infraspinatus and teres major is a very important muscle for the shoulder function. Conclusion: This data will be used to develop a treatment method for patients with a shoulder dysfunction. These results suggest that the electro-acupuncture stimulation into the infraspinatus and the teres major Trigger point is an effective intervention for patients with shoulder dysfunction and pain.

• 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.

• Physical Therapy Rehabilitation Science
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• v.11 no.3
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• pp.335-343
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• 2022

Objective: This study aimed to investigate the effects of ischemic compression treatment (ICT) or low-level laser therapy (LLLT) applied to the trigger points of the infraspinatus muscle on shoulder pain and function in patients with shoulder pain. Design: A randomized clinical trial Methods: Thirty patients with shoulder pain were randomly allocated into the ICT group (n=15) or LLLT groups (n=15). ICT was performed on three myofascial trigger points (MTrPs) of the infraspinatus muscle twice a week for 4 weeks (eight sessions), with 5 minutes of treatment per trigger point. LLLT was performed similarly. Shoulder pain was assessed using the visual analogue scale (VAS) and pain pressure threshold (PPT), and shoulder function was assessed using the Korean Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, rotator cuff strength, and range of motion (ROM) of shoulder flexion and abduction. Results: Significant changes in VAS score and PPT were found after the intervention in both groups (p<0.05). Significant changes were observed in the Korean DASH score, rotator cuff strength, and ROM of shoulder flexion (p<0.05) but not in the ROM of shoulder abduction (p<0.05). There were no significant differences between the two groups. Conclusions: This study showed that both ICT and LLLT applied on the MTrPs of the infraspinatus muscle were effective for relieving shoulder pain and improving shoulder functions in patients with shoulder pain.