• Archives of Plastic Surgery
• /
• v.48 no.1
• /
• pp.15-25
• /
• 2021

Thoracodorsal artery (TDA) flaps, ranging from the vascular-pedicled thoracodorsal artery perforator (TDAP) flap, the propeller TDAP flap, and the muscle-sparing latissimus dorsi (MSLD) flap to the conventional latissimus dorsi (LD) flap and the extended LD flap, can all be used for breast reconstruction. The aim of this paper and review is to share our experiences and recommendations for procedure selection when applying TDA-based flaps for breast reconstruction. We describe the different surgical techniques and our thoughts and experience regarding indications and selection between these procedures for individual patients who opt for breast reconstruction. We have performed 574 TDA flaps in 491 patients: 60 extended LD flaps, 122 conventional LD flaps, two MSLD flaps, 233 propeller TDAP flaps, 122 TDAP flaps, and 35 free contralateral TDAP flaps for stacked TDAP breast reconstruction. All the TDA flaps are important flaps for reconstruction of the breast. The LD flap is still an option, although we prefer flaps without muscle when possible. The vascular-pedicled TDAP flap is an option for experienced surgeons, and the propeller TDAP flap can be used in most reconstructive cases of the breast, although a secondary procedure is often necessary for correction of the pedicle bulk. The extended LD flap is an option for women with a substantial body mass index, although it is associated with the highest morbidity of all the TDA flaps. The MSLD flap can be used if the perforators are small or if dissection of the perforators is assessed to be hazardous.

• Journal of the Korean Society of Safety
• /
• v.16 no.2
• /
• pp.117-120
• /
• 2001

Low back pain has been known as the most frequent musuculoskeletal disorders in modern industrial society and cost by low back pain is increasing mon and more. The asymmetric lifting has been identified as a major risk factor of low back pain. In this study, the muscle activity and muscle exertion level during asymmetric load handling (without trunk flexion) was estimated. The results of normalized MVC measurement were decreased about 16％, 24％, 34％ respectively as the asymmetric angle was $30^{\circ}$, $60^{\circ}$, $90^{\circ}$. From the results of EMG measurement contralateral muscles were more active than ipsilateral muscles. RMSEMG values of right erector spinae muscles were decreased as the work posture went to 90$^{\circ}$ and those of left erector spinae muscles were increased until the asymmetric angle was 40$^{\circ}$ but decreased continually over 40$^{\circ}$. And for seven of subjects, activities of left and right latissimus dorsi muscles were maintained constantly, while for remainer, those were irregular.

• The Journal of Korean Physical Therapy
• /
• v.28 no.3
• /
• pp.195-200
• /
• 2016

Purpose: This study was designed to evaluate the effects of the different condition of leg support surface on the upper extremity and core muscle activity during the push-up exercise. Methods: Fifteen healthy subjects that were practicable push-ups were recruited in this study. Subjects were instructed the push-up exercise in the different condition of the leg support surface. Each condition of support surface was set to the high and lower, and the unstable and stable condition. Muscle activation was measured by using the surface electromyography (EMG), and recorded from the triceps brachii, serratus anterior, latissimus dorsi, rectus abdominis, abdominal external oblique, and erector spinea muscle. Results: In the results of experiments, there was no significant difference of muscle activation in upper extremity between the high unstable and high stable support surface. By contrast, muscle activation of the rectus abdominis and abdominal external oblique was significantly higher in the low unstable support surface, compared with those of the low stable support surface. It is well known that the core muscle was important to stabilization of trunk stability. Conclusion: This result demonstrates that the low and unstable support surface for the lower extremity was suited for training of core muscle for trunk stabilization during the push-up exercise.

• The Journal of Korean Physical Therapy
• /
• v.23 no.2
• /
• pp.7-15
• /
• 2011

Purpose: We investigated the relationship between the muscle activity and kinematic variables of the upper extremity during a push-up task on stable and unstable surfaces. Methods: We recruited 15 healthy subjects. Subjects completed the push-up task on stable and unstable surfaces. Surface electromyograms were recorded from the serratus anterior, upper trapezius, latissimus dorsi, infraspinatus to monitor changes in muscle activity. Markers for kinematic changes of elbow flexion, shoulder extension, shoulder retraction and scapular adduction were attached at C7, the T7 spinous process, both acromions, the scapula superior and inferior angle, the humerus lateral epicondyle, and the ulnar styloid process. Correlation coefficients between muscle activity and kinematic variables were analyzed by SPSS for Windows, version 15.0. Results: On the unstable surface, elbow flexion and shoulder extension increased with increasing muscle activity of serratus anterior, upper trapezius and infraspinatus. On the stable surface, shoulder retraction decreased with increasing muscle activity of serratus anterior and infraspinatus. Scapular adduction decreased with all types of increasing muscle activity, regardless of the support surface. Conclusion: Correlations between muscle activity and kinematic variables were observed on stable and unstable surfaces during a push-up task, while correlations between right and left variables were not clear. These finding suggest that it may be used to develop a rehabilitation program which could be effective in improving shoulder function in patients with shoulder problems.

• Journal of Chest Surgery
• /
• v.28 no.4
• /
• pp.376-380
• /
• 1995

We experienced 17 skeletal muscle transpositions in chest surgery during the past 8 years. There were 3 female and 14 male patients with ranging from 5 to 71 years of age [ average 47.3 Seventeen patients underwent 27 musele flaps : 11 latissimus dorsi, 6 pectoralis major, 6 serratus anterior and 4 other muscles. An average of 2.0 previous operations was performed. Hospitalization averaged 24 days.Follow up ranged from 7 days to 45 months;There were two postoperative deaths; one, 20 days after from operation due to pneumonia and the other, 130 days after from operation due to cor pulmonale.Fifteen patients who were alive after operation had good results at the time of last follow up.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.29 no.2
• /
• pp.39-48
• /
• 2023

Background: The position of pitcher requires a lot of repetitive motion, and because of this, it is known that not only professional baseball players, but also middle and high school players are frequently exposed to injuries in baseball. The purpose of this study is to examine the differences in upper extremity muscle activity during repeated pitching and the activity of each muscle during repeated pitching by analyzing middle and high school pitchers, divided into groups by age. Methods: Twenty participants (10 middle school male students and 10 high school male students) were recruited for this research. The outcome measures included neuromuscular motor control, including the upper trapezius (UT), triceps brachii (TB), deltoid (DT), latissimus dorsi (LD), biceps brachii (BB), pectoralis major(PM), extensor carpi radialis(ER), and flexor carpi radialis (FR). Results: The two-way analysis of varaince (ANOVA) was used to compare the muscle activity variables between the middle school and high school students. The one-way ANOVA was used to compare the muscle activity variables within time differences each groups. Conclusion: Our results provided promising clinical evidence that guide for upper extremity muscles to increase pitching efficiency in middle and high school base ball players.

• Physical Therapy Korea
• /
• v.24 no.2
• /
• pp.1-8
• /
• 2017

Background: Individuals with spinal cord injury (SCI) rely on their upper limbs for body-lifting activity (BLA). While studies have examined the electromyography (EMG) and kinematics of the shoulder joints during BLA, no studies have considered foot position during BLA. Objects: This study compared the effects of different foot positions during BLA on the shoulder muscle activities, peak plantar pressure, knee flexion angle, and rating perceived exertion in individuals with SCI. Methods: The study enrolled 13 mens with motor-complete paraplegic SCI, ASIA (American Spinal Injury Association) A or B. All subjects performed BLA with the feet positioned on the wheelchair footrest and on the floor independently. Surface EMG was used to collect data from the latissimus dorsi, pectoralis major, serratus anterior, and triceps brachii. The peak plantar pressure was measured using pedar-X and the knee flexion angle with Image J. Borg's rating perceived exertion scale was used to measure the physical activity intensity level. The paired t-test was used to compare the shoulder muscle activities, peak plantar pressure, knee flexion angle, and rating perceived exertion between the two feet positions during BLA. Results: The activity of the latissimus dorsi, pectoralis major, serratus anterior, and triceps brachii and rating perceived exertion decreased significantly and the peak plantar pressure and knee flexion angle increased significantly when performing BLA with the feet positioned on the wheelchair footrest compared with on the floor (p<.05). Conclusion: These findings suggest that individuals with SCI may perform BLA with the feet positioned on the wheelchair footrest for weight-relief lifting to decrease the shoulder muscle activities and the rating perceived exertion and to increase the peak plantar pressure and the knee flexion angle.

• Korean Journal of Applied Biomechanics
• /
• v.16 no.4
• /
• pp.1-12
• /
• 2006

This research was to know EMG tendency on increasing record in snatch weightlifting. In order to perform this research, we choiced 3 man national weightlifters, EMG analysis were executed on 8 major muscle(Latissimus Dorsi, Trapezius, Anterior Deltoid, Posterior Deltoid, Gastrocenemius, Vastus Medialis, Erector spinae, Abdominal). First trial record of athletics is 80% of each maximal record and increase the $5{\sim}10kg$ gradually. In this study, EMG signal scale of all muscle except posterior Deltoid muscle don't increased according to increasing the barbell weight, This showed a difference between general recognition and experiment result. In posterior Deltoid muscle, EMG signal scale increased according to increasing the barbell weight. It was assumed that EMG signal of protagonist shows possibility of linear increasing if motion have a consistency. It was assumed that In present, In order to increase one's record to $5{\sim}10kg$, Motion consistency training is more effective training method than increasing the muscle force.

• Korean Journal of Applied Biomechanics
• /
• v.28 no.3
• /
• pp.187-191
• /
• 2018

Objective: The purpose of the present study is to investigate the effect of a muscle activity by applying the complex exercise method of sling in accordance with the provision of various vibration intensities for paraplegia-spinal cord injury. Method: The subjects of the study were 15 men in their 40s and 50s with lower limb disabilities and low potential risk, who were randomly divided into a sling exercise group (SG n=4), a sling with low frequency vibration group (SLVG n=4), a sling with mid-frequency vibration group (SMVG n=4), and a sling with high frequency group (SHVG n=4) in accordance with the provision of slings and vibration stimuli. The vibratory intensity provided was divided into low frequency (30 Hz), mid-frequency (50 Hz), and high frequency (70 Hz). The anterior deltoid (AD), the posterior deltoid (PD), the pectoralis major (PM), the upper trapezius (UT), the latissimus dorsi (LD), and the multifidus (MF) were measured to compare and analyze muscle activity. Results: The closed kinetic chain (CKC) exercise to the shoulder joint showed higher muscle activity in most muscles for the SMVG, and statistically significant differences in the anterior deltoid (AD), the pectoralis major (PM), and the multifidus (MF) in particular. Conclusion: The intermediate frequency (50 Hz) string vibration was the effective vibration stimuli for Closed kinetic chain (CKC) exercises.

• Journal of the Korean Arthroscopy Society
• /
• v.13 no.3
• /
• pp.212-219
• /
• 2009

Medially retracted large-sized rotator cuff tears includes large-sized tears, massive tears and irreparable tears. Generally arthroscopic repair or open repair of rotator cuff tears is used in reparable tears. However, arthroscopic repair requires long period practice and endurance. In irreparable tears, arthroscopic debridement, partial repair, latissimus dorsi transfer and retrograde arthroplasty can be the option. Arthoscopic debridement gives temporal relief who experienced improvement in pain and increase in range of motion after subacromial local anesthetic injection. Also arthroscopic partial repair gives good results in irreparable cases, especially in suprascapular nerve traction neurapraxia. Tendon transfer can be used in mild to moderate muscle weakness in shoulder abduction for long term treatment. Pectoralis major transfer can be used in anterosupeior tears and latissimus dorsi transfer can be used in posterosuperior tears. Reverse shoulder prosthesis is used in extreamly weakened shoulder pseudoparalysis. The authors discussed the method of arthroscopic repair in irreparable tears. The debridement, partial repair, and tendon transfer could be used in medially retracted large-sized rotator cuff tears.