• Physical Therapy Korea
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• v.23 no.1
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• pp.65-71
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• 2016

Background: The unilateral prone arm lift (UPAL) is commonly used to exercise the lower trapezius muscle. However, overactivation of the upper trapezius can induce pain during UPAL exercises in subjects with upper trapezius tenderness. Objects: The purpose of this study was to investigate the effects of position of ipsilateral neck rotation (INR) on the inhibition of upper trapezius muscle activity and the facilitation of the lower trapezius muscle when performing UPAL exercises. Methods: In total, 19 subjects with upper trapezius tenderness were recruited for the study. Electromyographic (EMG) activity was measured in the upper, middle, and lower trapezius muscles during UPAL with and without INR position. Wilcoxon signed-rank test was used to compare EMG activity in the trapezius muscles and the muscle ratios. Results: EMG activity in the upper trapezius muscles was decreased significantly in the INR condition compared to without the position with INR during UPAL exercises (p<.05). EMG activity in the middle and lower trapezius was not significantly different between the with and without INR conditions (p>.05). However, the ratio of lower to upper trapezius activation showed a significant increase in the INR condition compared to the without INR condition (p<.05), indicating greater lower trapezius activation relative to the upper trapezius in the INR position than in the without INR position. Conclusions: The EMG results obtained in this study suggest that the position with INR reduced overactivation in the upper trapezius and improved muscle imbalance during lower trapezius exercises in individuals with upper trapezius tenderness.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.4
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• pp.1868-1872
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• 2019

Background: Lower trapezius muscle function is important for the prevention and treatment of shoulder injuries. However, scapular posterior tilt movement has been overlooked in lower trapezius strengthening exercise programs. Objective: To examine the effects of prone arm lifting with scapular posterior tilt (PALSPT) on trapezius muscles. Design: Crossover study Methods: 17 healthy males were recruited for participation in this study. Participants performed backward rocking diagonal arm lifting (BRDAL) and PALSPT. To train participants in scapular posterior tilt movements for PALSPT, visual biofeedback of scapular movements was provided using a motion sensor. Electromyography (EMG) activities of the middle and lower trapezius were recorded using a surface EMG system. Differences in middle and lower trapezius muscle activity between BRDAL and PALSPT exercises were analyzed. Results: Lower trapezius muscle activity was significantly greater during PALSPT than during BRDAL (p=.006). Although greater EMG activity was observed in the middle trapezius during PALSPT than during BRDAL, this difference was not significant (p=.055). Conclusions: The results of the present study indicate that scapular posterior tilt movements must be considered in lower trapezius muscle strengthening programs.

• The Journal of Korean Physical Therapy
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• v.31 no.2
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• pp.134-139
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• 2019

Purpose: This study examined the most effective exercise while performing shoulder abduction below ninety degrees. Methods: Thirty two healthy individuals (17 males, 15 females) participated and performed four exercises, 1) Posterior fly, 2) Prone row, 3) Modified prone cobra, and 4) External rotation in the prone position. Surface electromyography (sEMG) was used to measure the electrical activities for the lower, middle and upper fiber of trapezius and serratus anterior. Results: A significant difference in the muscle activities of the upper/middle/lower trapezius and serratus anterior was observed among the three different positions in terms of the PF (posterior fly), PR (prone row), and MPC (modified prone cobra) (p<0.05). In post-hoc analysis, the activities of the lower and upper trapezius were significantly higher than those of the upper trapezius and serratus anterior (p<0.05). In addition, in ERP (external rotation in prone), there was a significant difference in each activity of the muscles. Post-hoc results indicated that the upper trapezius showed greater EMG activity than the other three muscles. Conclusion: External rotation in the prone position revealed the highest activation of the lower trapezius compared to upper trapezius muscle activity. This may be particularly useful in isolating the lower trapezius in cases where excessive scapular elevation is noted. Therefore, the most effective lower trapezius exercise should be performed below ninety degrees of shoulder abduction.

• Physical Therapy Korea
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• v.21 no.4
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• pp.9-14
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• 2014

Violinists tend to position the neck asymmetrically to hold the violin between the chin and the left shoulder. Asymmetrical neck posture may induce unilateral neck pain. Previous studies have suggested that individuals with unilateral neck pain exhibit reduced muscle strength of the lower trapezius, but no study has investigated violinists with unilateral neck pain. To this end, we recruited 18 violinists with unilateral neck pain for the present study in which the side on which neck pain was experienced, pain duration, and intensity were recorded. Lower trapezius strength was measured bilaterally in each subject using a handheld dynamometer. Significant differences in lower trapezius strength were evident between the ipsilateral and contralateral sides of neck pain (p<.05). No significant association between neck pain intensity or duration, and the extent of a deficit in lower trapezius strength, was evident (both p>.05). The association between the sides of weakened lower trapezius strength and neck pain was significant (p<.05). In conclusion, violinists with unilateral neck pain exhibited significantly less lower trapezius strength on the ipsilateral compared to the contralateral side of the pain. Unilateral neck pain more frequently involved the left side of the neck, which is used to stabilize the violin during playing. Thus, our study suggests that a possible relationship exists between muscle weakness in the lower trapezius and neck pain.

• Physical Therapy Korea
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• v.22 no.1
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• pp.58-68
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• 2015

This study aimed to determine the effect of lower trapezius muscle strengthening exercises on pain, neck disability index (NDI), cervical range of motion (ROM), and lower trapezius muscle strength in patients with unilateral neck pain. Following baseline measurements, the subjects (N=40) with unilateral neck pain were randomized into one of two 5 weeks exercise intervention groups: a experimental group (EG, $n_1=20$) that received strength training of the lower trapezius muscles or a control group (CG, $n_2=20$) that received routine physical therapy program. Each group participated in the intervention for 30 minutes, 3 times a week, for 5 weeks. All participants performed 2 repetitions of each intervention per day. The numeric pain rating scale for pain, NDI, ROM, and lower trapezius strength were recorded both pre- and post-intervention for both groups. Paired t-tests were used to determine significant changes post-intervention compared with pre-intervention and independent t-tests were used to analyze differences in the dependent variables between the 2 groups. After the 5-weeks intervention, both groups experienced significantly decreased pain and disability level (p<.05) and significantly increased cervical flexion, extension, lateral flexion, and rotation ROM (p<.05). The EG that received strength training of the lower trapezius muscles showed greater improvements in pain and functional disability level, cervical rotation, and lower trapezius strength than the CG (p<.05). These results suggest that a lower trapezius strengthening exercises reduce neck pain and neck disability level and enhance cervical ROM and lower trapezius strength level in patients with unilateral neck pain.

• Journal of Korean Physical Therapy Science
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• v.28 no.1
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• pp.46-53
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• 2021

Background: The purpose of this study was to investigate the effect of taping applied to the lower trapezius on the upper trapezius muscle tone, pain intensity, cervical rotation range of motion in chronic upper trapezius pain patients. Design: Case-control study. Methods: Twenty subjects with chronic upper trapezius pain were classified into an experimental group and a control group. The experimental group applied lower trapezius facilitation taping and the control group applied sham taping. Taping Before and after the application of taping, muscle tone, pain intensity, and cervical rotation range of motion of the upper trapezius were measured. Results: In the experimental group, there were significant differences in the pressure pain threshold and muscle tone before and after taping. In the comparison between groups, there was a significant difference in muscle tone between the experimental group and the control group. Conclusion: The application of the lower trapezius facilitation taping was found to be effective in reducing the pressure threshold and muscle tone of the upper trapezius. Therefore, it is expected that more effective treatment can be provided by adding lower trapezius facilitation taping to the treatment protocol for patients with chronic shoulder pain.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.4
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• pp.81-90
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• 2015

PURPOSE: The purpose of this study was to compare the muscle architecture of serratus anterior and lower trapezius using rehabilitative ultrasound imaging (RUSI) in affected and unaffected side of chronic stroke patients. METHODS: The participants were thirty five patients with stroke hemiplegia in this study. RUSI was used to measure the muscle thickness of the serratus anterior and lower trapezius muscles. We compared the muscle thickness according to affected side and sex, determined the reliability of the measurement image. Independent t-test, intra-class correlation coefficient (ICC) and standard error of measurement (SEM) were used for statistical analysis. RESULTS: Significant difference in muscle thickness of serratus anterior was observed between affected and unaffected side (p<.001). Muscle thickness according to gender showed a significant difference in unaffected side of serratus anterior (p<.05). Compare asymmetry ratio of serratus anterior and lower trapezius muscle thickness showed a significant difference (p<.001). ICC for intra-reliability was .944~.962 in serratus anterior and .873~.925 in lower trapezius muscle thickness, respectively. SEM was .001~.004 in serratus anterior and .002~.008 in lower trapezius muscle. CONCLUSION: This study, using RUSI, showed significant difference in muscle thickness of serratus anterior in affected and unaffected side of stroke patients. RUSI is a practical tool for measuring soft-tissue thickness in the scapular region muscle of stroke.

• Physical Therapy Korea
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• v.19 no.3
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• pp.31-39
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• 2012

The lower trapezius muscle is an important stabilizer and primary mover of the scapula. The potential use of ultrasound imaging to evaluate scapular muscle function warrants investigation. The purpose of this study is to use ultrasound imaging for determining the effectiveness of 4 different isometric exercises for maximally activating the lower trapezius muscles in healthy subjects. Twenty-eight (14 men and 14 women) volunteers were recruited for this study. Thickness measurements of the lower trapezius muscles were recorded during 4 exercises: latissimus pulldown (LP), prone V-raise (PV), prone row (PR), and modified prone cobra (MP). Lower trapezius muscle thickness was measured 3 times by 2 investigators at a point 3 cm lateral to the lateral edge of the T8 spinous process. The order of 4 exercise execution was randomized for each participant. To identify statistical significance, one-way ANOVA with repeated measures was used with the significance level of .05. Intraclass correlation coefficient (ICC) for intra-reliability was .86~.98 and inter-rater reliability .83~.96 for the lower trapezius, respectively (p<.01). Thickness changes in the lower trapezius muscles between the relaxed and contracted states in men were as follows: LP ($7.37{\pm}2.68mm$, 182%), MP ($4.69{\pm}1.74mm$, 167%), PV ($4.52{\pm}1.47mm$, 149%), and PR ($3.84{\pm}1.72mm$, 133%). In women the values were as follows: LP ($4.64{\pm}1.24mm$, 163%), MP ($2.79{\pm}.81mm$, 131%), PV ($2.78{\pm}.85mm$, 129%), and PR ($2.21{\pm}1.26$ mm, 100%). Thickness of the lower trapezius muscles significantly differed between exercises in both the gender (p<.01). The LP was the most effective exercise for increasing the activation of the lower trapezius muscle in both the gender. We recommend performing the LP exercise for strengthening the lower trapezius muscles.

• The Journal of Korean Physical Therapy
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• v.32 no.2
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• pp.101-106
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• 2020

Purpose: This study examined the effects of the directions of neck rotation on the muscle activity of the upper trapezius and lower trapezius while rotating a shoulder externally. Methods: Twenty-five healthy males participated in this study. The subjects were asked to rotate their shoulder externally with 90° shoulder abduction and 90° elbow flexion in three different neck rotations (neutral, ipsilateral, and contralateral) in the prone position. The muscle activities of the upper and lower trapezius were measured using surface electromyography. One way repeated measures ANOVA was used to compare the muscle activity of the upper and lower trapezius depending on the different neck turning directions. Results: In the upper trapezius, turning the neck in the ipsilateral direction while turning a shoulder externally decreased the muscle activity significantly, but the muscle activity was increased significantly by turning the neck in the contralateral direction. On the other hand, in the lower trapezius, turning the neck in the ipsilateral direction increased the muscle activity significantly, but the muscle activity was decreased significantly by turning the neck in the contralateral direction decreased it significantly. Conclusion: When someone has an imbalance of shoulder function, turning the neck in the ipsilateral direction while turning the shoulder externally in the prone position is effective in decreasing the activity of the upper trapezius and increasing the activity of the lower trapezius. Therefore, these results could be used as basic evidence for researching patients with shoulder problems.

• Physical Therapy Korea
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• v.17 no.1
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• pp.77-85
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• 2010

This study was conducted to find the effects of scapular taping on muscle activities of the scapular rotators and upper trapezius pain in subjects with upper trapezius pain. Fifteen male subjects were recruited from Yonsei University for this study. Muscle activity of upper trapezius, lower trapezius, and serratus anterior was measured using surface electromyography. Visual analog scale was used for measuring upper trapezius pain. The subjects were asked to maintain $90^{\circ}$ shoulder flexion position with holding a 1 kg dumbbell in standing position. Scapular taping was applied over the muscle belly of the upper trapezius and attached parallel with the lower trapezius muscle fibers. For normalization, % maximal voluntary isometric contraction (%MVIC) was conducted. Paired t-test was applied to compare the muscle activities of scapular rotator and upper trapezius pain before and after applying the scapular taping. The muscle activity of the upper trapezius muscle and serratus anterior decreased significantly after tape application (p<.05). However, no significant difference was observed in lower trapezius muscle. The level of pain in the upper trapezius muscle significantly decreased after tape application (p<.05). The results of this study suggest that scapular taping can be used an additional therapy for reducing muscle activity of upper trapezius, serratus anterior and upper trapezius pain during shoulder flexion in patient with upper trapezius pain.