• PNF and Movement
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• 제21권1호
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• pp.87-94
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• 2023

Purpose: The present study aims to investigate the effects of a diagonal exercise pattern on selective activation of the upper extremity muscles using both normalization and isolation methods. Methods: In total, 17 asymptomatic subjects participated in this study. During the two diagonal patterns of exercise (diagonals 1 and 2), muscular activities of the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), anterior deltoid (AD), and infraspinatus (IS) were measured. The collected data were analyzed in two ways, according to the dominance of muscle activities (%Isolation) and according to normalized activities (%MVIC). Results: There were significant differences in LT, SA, AD, and IS between %MVIC and %Isolation (p<0.05), and the diagonal 1 pattern of exercise showed significantly more LT activities compared with the diagonal 2 pattern (p<0.05). Further, except for LT, there were no significant differences in muscle activities between the diagonal 1 and 2 exercises. Conclusion: The present study suggests that a diagonal pattern of exercise is advantageous for strengthening shoulder muscles, but caution is needed when applying to patients requiring selective strengthening. Regarding both the concentric and eccentric phases of exercise, there was no significant difference in muscular activation, except in LT, between the two diagonal patterns of exercises.

• 대한중풍순환신경학회지
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• 제11권1호
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• pp.89-98
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• 2010

This study was performed to investigate the effectiveness of trigger point needling and oriental medical treatment to shoulder pain patients in stroke sequelae with three aspects of pain and range of motion, muscle strength. Trigger point needling was applied to 3 patients on supraspinatus, infraspinatus, deltoid, subscapularis muscle. For evaluating treatment, visual analog scale(VAS), passive range of motion(PROM), muscle strength evaluation(MSE) were checked. After treatment, VAS score of 1 cases were decreased. PROM of 1 case was improved and MSE of 2 cases were improved slightly. These results suggest that trigger point needling and oriental medical treatment were effective on shoulder pain patients in stroke sequelae and it is necessary to research more case with shoulder pain in stroke sequelae.

• 한국응용과학기술학회지
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• 제35권1호
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• pp.36-42
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• 2018

This study was to investigate the difference of muscle activities in trunk, upper arm, and shoulder during push-up exercise based on 3 types of different arm position(posterior position, PP; normal position, NP; and anterior position, AP) and to provide effective push-up arm position for each muscle development. Fifteen healthy males(age, $21.5{\pm}0.5years$; height, $172.7{\pm}1.0cm$; body mass, $70.5{\pm}1.3kg$; shoulder width, $42.3{\pm}0.6cm$; and BMI, $23.6{\pm}0.5kg/m^2$) participated in this study. PP, NP, and AP of the arm were used to conduct push-up exercise and 8 muscles(deltoideus p. acromialis: DA; pectoralis minor: PMI; pectoralis major: PMA; serratus anterior: SA; biceps brachii: BB; triceps brachii: TB; latissimus dorsi: LD; and infraspinatus: IS) of right side were selected to measure muscle activities. Total 9 counts of push-up exercise were conducted and EMG data signals of 5-time(from $3^{th}$ to $7^{th}$) push-up movement were used for measuring muscle activities. PP push-up exercise showed that there was a significantly higher muscle activity of DA, PMI, PMA, SA, BB, LD, and IS(p<.05) and AP push-up exercise showed a significantly higher TB activity(p<.05). It would be suggested that different arm position evokes various muscle activities when conducting push-up exercise. PP would be the best push-up arm position for inducing various trunk, upper arm, and shoulder muscle activities compared to NP and AP.

• 대한통합의학회지
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• 제9권2호
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• pp.13-21
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• 2021

Purpose : Instrument-assisted soft tissue mobilization (IASTM) has been widely used to improve pain and range of motion. However, research on IASTM using vibration stimulation is lacking. Therefore, this study investigates how IASTM using vibration stimulation affects chronic pain on muscle activity and flexibility of the shoulders. Methods : A total of 20 patients with chronic shoulder pain were divided into the experimental group and the control group. The experimental group (n=10) used vibration stimulus for IASTM, while the control group (n=10) used general IASTM. For six weeks, this training lasted for 30 min a day, twice a week. Muscle activity was evaluated using the surface electromyograph. The back and reach test was used to assess flexibility, the visual analogue scale to measure pain, and the paired t-test to compare the groups before and after the experiment. An independent ANCOVA was conducted to assess differences in the degree of transition between the two groups before and after the experiment. Results : Significant differences in muscle activity, flexibility, and pain in both groups before and after the experiment (p<0.05) were observed, as well as in the muscle activity of the pectoralis major and associated pain (p<0.05). however, muscle activity and flexibility of the upper trapezius and infraspinatus were not significantly different between groups (p>0.05). Conclusion : This study confirms the importance of IASTM using vibration. Design and manufacture of IASTM using vibration based on our results would be useful in the management of shoulder pain, Further clinical evidence are needed.

• Clinics in Shoulder and Elbow
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• 제26권2호
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• pp.131-139
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• 2023

Background: Massive rotator cuff tears (RCTs) are complicated by muscle atrophy, fibrosis, and intramuscular fatty degeneration, which are associated with postoperative tendon-to-bone healing failure and poor clinical outcomes. We evaluated muscle and enthesis changes in large tears with or without suprascapular nerve (SN) injury in a rat model. Methods: Sixty-two adult Sprague-Dawley rats were divided into SN injury (+) and SN injury (-) groups (n=31 each), comprising tendon (supraspinatus [SSP]/infraspinatus [ISP]) and nerve resection and tendon resection only cases, respectively. Muscle weight measurement, histological evaluation, and biomechanical testing were performed 4, 8, and 12 weeks postoperatively. Ultrastructural analysis with block face imaging was performed 8 weeks postoperatively. Results: SSP/ISP muscles in the SN injury (+) group appeared atrophic, with increased fatty tissue and decreased muscle weight, compared to those in the control and SN injury (-) groups. Immunoreactivity was only positive in the SN injury (+) group. Myofibril arrangement irregularity and mitochondrial swelling severity, along with number of fatty cells, were higher in the SN injury (+) group than in the SN injury (-) group. The bone-tendon junction enthesis was firm in the SN injury (-) group; this was atrophic and thinner in the SN injury (+) group, with decreased cell density and immature fibrocartilage. Mechanically, the tendon-bone insertion was significantly weaker in the SN injury (+) group than in the control and SN injury (+) groups. Conclusions: In clinical settings, SN injury may cause severe fatty changes and inhibition of postoperative tendon healing in large RCTs. Level of evidence: Level Basic research, controlled laboratory study.

• The Korean Journal of Pain
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• 제19권2호
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• pp.299-302
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• 2006

Segmental zoster paresis is characterized by focal, asymmetric motor weakness in the myotome corresponding to the dermatome of the rash. A 73-year-old man, who presented with severe right shoulder pain and shoulder girdle muscle weakness, was diagnosed with segmental zoster paresis involvement of the C5⁣-C6 motor roots as a complication of herpes zoster. Girdle muscles (supraspinatus, deltoid and infraspinatus) atrophy had developed in his right shoulder. An MRI showed rotator cuff tearing in his right shoulder; therefore, an arthroscopic rotator cuff repair was performed. Herein, this case is presented to emphasize the importance of considering post-herpetic segmental motor paresis in the differential diagnosis of acute painful motor weakness of the upper extremities.

• Physical Therapy Rehabilitation Science
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• 제11권2호
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• pp.145-153
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• 2022

Objective: The purpose of this study was to evaluate the Electromyography (EMG) of the upper limb during reaching tasks according to two heights in the sitting position. Design: Cross sectional design Methods: Fifteen hemiplegia, fifteen elderly, and fifteen healthy subjects have participated in this study. The targets (90% length of the subject's arm) were located at the two heights (the eye and xiphoid process). We have recorded EMG signals of seven upper limb muscles (anterior deltoid (AD), posterior deltoid (PD), pectoralis major (Pec), infraspinatus (Inf), supraspinatus (Sup), biceps brachii (Bi), triceps brachii (Tri)). The dependent variables were movement time(s), modulation ratio, working ratio, and the co-contraction ratio of the hemiplegia, elderly, and healthy at the reaching task. Two-way repeated-measures ANOVA (2-heights) was analyzed with the LSD post hoc test. Results: The study results were as follows: (1) The movement time to the target during reaching movement was significantly longer for the hemiplegia and elderly groups compared to the healthy group. (2) The modulation rate was significantly higher at eye height than the xiphoid height in AD, PD, Pec, Inf, Bi muscles, and the hemiplegia group and elderly group were significantly lower than the healthy group. Additionally, the modulation ratio showed a significant interaction between heights and groups. Conclusions: It is expected that the variables using the muscle contraction characteristics, the evaluation method of this study, can be used as an electromyography-based feedback method that can be objectively evaluated and quantified in clinical practice.

• 대한정형도수물리치료학회지
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• 제13권1호
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• pp.67-72
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• 2007

Anatomy: The rotator cuff comprises four muscles-the subscapularis, the supraspinatus, the infraspinatus and the teres minor-and their musculotendinous attachments. The subscapularis muscle is innervated by the subscapular nerve and originates on the scapula. It inserts on the lesser tuberosity of the humerus. The supraspinatus and infraspinatus are both innervated by the suprascapular nerve, originate in the scapula and insert on the greater tuberosity. The teres minor is innervated by the axillary nerve, originates on the scapula and inserts on the greater tuberosity. The subacromial space lies underneath the acromion, the coracoid process, the acromioclavicular joint and the coracoacromial ligament. A bursa in the subacromial space provides lubrication for the rotator cuff. Etiology: The space between the undersurface of the acromion and the superior aspect of the humeral head is called the impingement interval. This space is normally narrow and is maximally narrow when the arm is abducted. Any condition that further narrows this space can cause impingement. Impingement can result from extrinsic compression or from loss of competency of the rotator cuff. Syndrome: Neer divided impingement syndrome into three stages. Stage I involves edema and/or hemorrhage. This stage generally occurs in patients less than 25 years of age and is frequently associated with an overuse injury. Generally, at this stage the syndrome is reversible. Stage II is more advanced and tends to occur in patients 25 to 40 years of age. The pathologic changes that are now evident show fibrosis as well as irreversible tendon changes. Stage III generally occurs in patients over 50 years of age and frequently involves a tendon rupture or tear. Stage III is largely a process of attrition and the culmination of fibrosis and tendinosis that have been present for many years. Treatment: In patients with stage I impingement, conservative treatment is often sufficient. Conservative treatment involves resting and stopping the offending activity. It may also involve prolonged physical therapy. Sport and job modifications may be beneficial. Nonsteroidal anti - inflammatory drugs(NSAIDS) and ice treatments can relieve pain. Ice packs applied for 20 minutes three times a day may help. A sling is never used, because adhesive capsulitis can result from immobilization.

• Investigative Magnetic Resonance Imaging
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• 제20권4호
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• pp.224-230
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• 2016

Purpose: The purpose of this study was to compare the grade of fatty degeneration and atrophy of rotator cuffs on immediate postoperative MRI to those on preoperative MRI in patients with rotator cuff tears. Materials and Methods: Seventy patients were included in this study, who received arthroscopic rotator-cuff repair and underwent both preoperative magnetic resonance imaging (MRI) and immediate postoperative MRI in our institution. Fatty degeneration of rotator cuffs and the atrophy of supraspinatus muscles were evaluated with T1 oblique sagittal images in the Y-shaped view. Fatty degeneration was evaluated using a Goutallier classification system, and the atrophy of supraspinatus muscles was evaluated using a modified tangent sign and a visual occupation ratio. Results: From 70 patients, a total of 100 tendons were repaired: 18, 69, and 13 tendons were treated for subscapularis, supraspinatus, and infraspinatus, respectively. The Goutallier grades (P = 0.012), modified tangent signs (P = 0.000), and visual occupation ratios (P = 0.000) of supraspinatus muscles were significantly decreased in immediate postoperative MRIs when compared to preoperative MRIs. In immediate postoperative MRIs, the Goutallier grades of supraspinatus muscles were decreased by one grade in 18.8% (n = 13) of the patients, and the atrophy of supraspinatus muscles was improved by one grade in 26.1% (n = 18) for modified tangent signs and 21.7% (n = 15) for visual occupation ratios. However, fatty infiltration by the Goutallier grades of subscapularis (P = 1.000) and infraspinatus (P = 0.157) muscles were not significantly changed after arthroscopic surgery. Conclusion: Immediate postoperative MRIs showed a significant improvement of fatty degeneration and muscle atrophy in supraspinatus muscles when compared to preoperative MRIs.

• 대한인간공학회지
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• 제34권1호
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• pp.11-18
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• 2015

Objective: The aim of this study was to understand the effects of phone weight on the typing performance and muscle recruitment in the neck and upper extremity while typing a text message with dominant hand. The iPhone4 and iPhone5 were compared due to their 28-gram differences in weight. Background: Too much use of a cellular phone can lead the musculoskeletal disorders in the upper extremity. Phone makers tend to make their new models bigger, lighter, faster and smarter. Method: Fourteen healthy volunteers without any history of neuromuscular disorders or ongoing pain who used their smartphone more than one year were recruited. A 112g phone (iPhone5) and a 142g phone (iPhone4) were used for typing the lyric of the Korean national anthem with their dominant hand. Typing duration, the typing error, the perceived fatigue, and preference was investigated. Muscle recruitment and the resting gap of neck (middle trapezius and levator scapula), shoulder (infraspinatus and mid deltoid), elbow (biceps brachii and brachioradialis), thumb (extensor and abductor policis brevis) were collected using surface electromyography. Typing error was counted and typing speed was calculated in characters per min. The data were analyzed using a paired t-test and chi-square (${\chi}^2$) analysis for the effects of phone weight on the typing performance parameters and muscle recruitment. Results: Typing text message with iPhone5 took longer but had less muscle recruitment in brachioradialis, and extensor policis brevis muscles. Lighter weight of iPhone5 made biceps brachii to rest less without increasing the mean %EMG. Conclusion/Application: Findings of this study can be valuable information for phone designers to develop more productive device and for smartphone users to prevent the musculoskeletal disorders in the upper extremities.