• Physical Therapy Korea
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• v.14 no.2
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• pp.44-52
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• 2007

This study was carried out to compare the muscle activities of the shoulder stabilizers between persons with and without winging scapular during push-up plus exercise (adds the scapular protraction to the general push-up exercise). For this study, eleven males with winging scapular and eleven healthy males were recruited. Surface electromyographic (EMG) activity was recorded from the serratus anterior, upper trapezius, lower trapezius, infraspinatus, and pectoralis major while the subjects performed the push-up plus. Each push-up plus was subdivided into three phases according to the elbow position which was measured using the 3-D motion analysis system: elbow flexion (EF), elbow extension (EE), and shoulder protraction phases (SP). Two-way repeated measure ANOVA (phase ${\times}$ group) were used for statistical analysis. There was significant phase by group interaction only on the EMG composition ratio of the serratus anterior (p>.05). The EMG composition ratio of the serratus anterior was significantly higher in SP than in either EF or EE however, it was not different between winging scapular and normal groups. For both groups, the EMG composition ratio of upper trapezius, lower trapezius, and pectoralis major was significantly different across the phases of push-up plus, but the infraspinatus EMG composition ratio was not. For both groups, in EF and EE phases, the EMG composition ratio of both pectoralis major and serratus anterior were relatively higher than that of other muscles. However, in both groups, the EMG composition ratio of the serratus anterior became much more predominant than that of the pectoralis major. In addition, infraspinatus activated greater than pectoralis major. These results showed that the push-up plus exercise is effective to selectively strengthen the serratus anterior for both individuals with and without winging scapular, but not equally effective for other shoulder stabilizers.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.4
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• pp.65-70
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• 2016

PURPOSE: This study aimed to compare the electromyography (EMG) activity for the middle deltoid (MD) and upper trapezius (UT) muscles in various shoulder abduction angles in patients with adhesive capsulitis (AC). METHODS: A total of 15 subjects participated in the study: 6 without AC (control group) and 9 with AC (AC group). The muscle activities of the UT and MD were measured using EMG during maximal static shoulder abductions in both groups. Each subject performed three repetitions of horizontal abduction at $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, and $90^{\circ}$ of the shoulder abduction angle in a sitting position. The measurement data from the middle 3-seconds of the 5-second periods were used. The mean value of three separate sets of measurements was used in the data analysis. For each muscle, independent t-tests were performed to determine group differences. A measured repeated-measures ANOVA was performed using Bonferroni's post-hoc test. RESULTS: The muscle activity of the UT was significantly greater in the AC group; than in the control group (p<.05). The muscle activity of the MD was significantly lower in the AC group; than in the control group (p<.05). The greatest level of muscle activity for both the MD and UT was demonstrated at the $0-60^{\circ}$ and $0-90^{\circ}$ of shoulder abduction angles in the AC group. CONCLUSION: These findings showed that low muscle activation of the MD may contribute to hyperactivity of the UT during shoulder abduction in AC patients.

• Physical Therapy Korea
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• v.19 no.4
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• pp.38-45
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• 2012

The aim of this study is to compare the effect of abdominal drawing-in maneuver (ADIM) on lower trapezius (LT), serratus anterior (SA), and erector spinae (ES) muscle activity during arm lifts in prone and standing positions. Twenty healthy subjects were recruited, and NoraxonTeleMyo 2400T was used to collect electromyographic signals from the LT, SA, and ES muscles. A two-way repeated analysis of variance (ANOVA) used a significance level of .05. If a significant interaction was found, pairwise comparisons were performed with a Bonferroni adjustment (.05/4=.013). The results of the study were as follows: 1) In LT, no significant ADIM by position interaction was found ($F_{1,19}$=.356, p=.558). There was a significant main effect for ADIM. LT muscle activity with ADIM was significantly greater compared with muscle activity without ADIM ($F_{1,19}$=82.863, p<.001). There was also a significant main effect for position. LT muscle activity in the prone position was greater compared with muscle activity in the standing position ($F_{1,19}$=116.401, p<.001). 2) In SA, significant ADIM by position interaction was found ($F_{1,19}$=8.687, p=.008). There were significant differences in all pairwise comparisons. The greatest SA muscle activity was observed in the standing position with ADIM. 3) In ES, significant ADIM by position interaction was found ($F_{1,19}$=122.473, p<.001). The lowest ES muscle activity was elicited in the standing position with ADIM. Based on these results, ADIM is advocated in the prone position to increase LT muscle activity. In addition, it is concluded that arm lifts in the standing position with ADIM offer the most favorable combination for reducing ES muscle activity and increasing SA muscle activity.

• Physical Therapy Korea
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• v.26 no.3
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• pp.1-10
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• 2019

Background: Winged scapular (WS) causes muscle imbalance with abnormal patterns when moving the arm. In particular, the over-activation of the upper trapezius (UT) and decrease in activity of the lower trapezius (LT) and serratus anterior (SA) produce abnormal scapulohumeral rhythm. Therefore, the SA requires special attention in all shoulder rehabilitation programs. In fact, many previous studies have been devoted to the SA muscle strength training needed for WS correction. Objects: The purpose of this study was to investigate the effect of shoulder girdle muscle and ratio according to the angle of shoulder abduction and external weight in supine position. Methods: Twenty three WS patients participated in this experiment. They performed scapular protraction exercise in supine position with the weights of 0 kg, 1 kg, 1.5 kg, and 2 kg at shoulder abduction angles of $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, and $90^{\circ}$. The angle and weight applications were randomized. Surface electromyography (EMG) was used to collect the EMG data of the SA, pectoralis major (PM), and UT during the exercise. The ratio of PM/SA and UT/SA was confirmed. Two-way repeated analyses of variance were used to determine the statistical significance of SA, PM, and UT and the ratios of PM/SA and UT/SA. Results: There was a significant difference in SA according to angle (p<.05). Significant differences were also identified depending on the angle and weight (p<.05). The angle of abduction at $0^{\circ}$, $30^{\circ}$ and weight of 2 kg showed the highest SA activity. However, there was no significant difference between PM and UT (p>.05). There was a significant difference between PM/SA and UT/SA in ratio of muscle activity according to angle (p<.05). Significant differences were found at PM/SA angles of $30^{\circ}$, $60^{\circ}$ and $90^{\circ}$ (p<.05). For UT/SA, significant difference was only observed at $90^{\circ}$ (p<.05). Conclusion: Based on the results of this study, in order to strengthen the SA, it was found to be most effective to use 1 and 1.5 kg weights with abduction angles of $0^{\circ}$ and $30^{\circ}$ at shoulder protraction in supine position.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.1
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• pp.51-58
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• 2016

Background: Evidence for effective management of scapular downward rotation syndrome is limited. The present study was performed to compare the scapular muscle activation through 4weeks wall slide exercise and sling slide exercise in subjects with scapular downward rotation syndrome. Methods: Twenty-two subjects with scapular downward rotation syndrome participated in the study. Surface electromyography data were collected from the upper and lower trapezius, serratus anterior and pectoralis major during shoulder flexion of $60^{\circ}$, $90^{\circ}$ and $120^{\circ}$ in the sagittal plane. The alignment of the scapula was measured using radiographic analysis. Subjects were assessed pre and post a 4 weeks exercise (wall slide, sling slide). The significance of the difference in pre- and post-exercise within each groups was assessed using a paired t-test. The significant difference between wall- and sling-exercise was used a independent t-test. Results: In the wall slide group, the muscle activity of upper trapezius decreased significantly during shoulder flexion at $60^{\circ}$, $90^{\circ}$ and $120^{\circ}$ after 4 weeks, and the muscle activity of serratus anterior increased significantly at all angles. Also, the muscle activity of pectoralis major decreased significantly at $90^{\circ}$ and $120^{\circ}$. Conclusions: Based on such results, it can be said that wall slide exercise is effective than sling slide exercise for the subjects with scapular downward rotation syndrome.

• Journal of Pharmacopuncture
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• v.12 no.2
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• pp.41-50
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• 2009

Although Chronic tension-type headache(CTTH) is one of the most common symptom in primary headache, there is no definite mechanisms. But muscular factors and psychological factors is supposed to be related with CTTH according to many other studies and pressure pain threshold(PPT) is used to measure muscular factors. Methods 1. We performed this study with 63 patients fulfilling the International Headache Societ criteria for chronic tension-type headache and 20 healthy control group and measured the PPT of temporal muscle and trapezius muscle. 2. We investigated the correlation between clinical characteristic and PPT. 3. Each of the CTTH groups and Control group is divided to four group again - HNP, Spondylosis, Sprain, Normal according to Cervical spine X-ray. Results 1. The PPT of temporal muscle and trapezius muscle in the CTTH is significantly lower than that of Control. 2. In CTTH group, the PPT has significant positive relation with duration of headache and continued time of headache. And the PPT has significant inverse relation with Frequency of headache and Level of headache. 3. In CTTH group, spondylosis group has the highest PPT and normal group is second. And there are significant difference between spondylosis group and the others. Conclusion : We found that PPT is strongly significant to measure muscular factor in CTTH.

• Physical Therapy Korea
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• v.29 no.2
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• pp.165-170
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• 2022

Background: The serratus anterior (SA) muscle prevents scapular winging (SW) by stabilizing the medial border of the scapula during arm movement. The upper trapezius (UT) and lower trapezius (LT) muscles may compensate for the weak SA muscle in individuals with SW during shoulder flexion. However, there is no study to examine whether compensation by UT and LT occurs in individuals with SW. Objects: This study compared the muscle activities of UT, LT, and SA as well as the SA/UT activity ratio between individuals with and without SW during shoulder flexion with load. Methods: This study recruited 27 participants with SW (n = 14) and without SW (n = 13). Electromyography data of the SA, UT, and LT muscles and SA/UT activity ratio were recorded and analyzed during shoulder flexion with 25% load of the maximal shoulder flexion force. Independent t-test was used to compare the UT, LT, and SA muscle activities and SA/UT ratio between the groups with and without SW; statistical significance was set at α of 0.05. Results: SA activity was significantly lesser in the group with SW than in the group without SW. However, there were no significant differences in the UT and LT activities and SA/UT activity ratio between the two groups. Conclusion: The SA activity was lesser in the group with SW than in the group without SW with 25% load of the maximal shoulder flexion force, but there was no compensatory muscle activity of the UT and LT observed. Therefore, further studies are warranted to clarify the compensatory strategy of scapular stabilization in individuals with SW during shoulder flexion under other heavy load conditions.

• Journal of The Korean Society of Integrative Medicine
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• v.5 no.3
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• pp.21-28
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• 2017

Purpose: The purpose of this study was to investigate the effects of three exercise programs on forward head posture. Methods: Ninety-five individuals were recruited to assess the of the pectoralis minor muscle. Of these, 36 individuals with pectoralis minor muscles were selected and randomly divided into three groups: a functional massage group, a stretching group, and a stretching and muscle strengthening group. The exercise program consisted of sessions four times per week for two weeks. The length of pectoralis minor and the activity of the trapezius muscles were measured using electromyography. Forward head posture was assessed using the craniovertebral angle (CVA) and the cranial rotation angle (CRA) pre-, during and post-treatment. Result: Significant improvements were observed in pectoralis minor length, CRA, and CVA post-treatment in all groups (p<0.05, p<0.01, p<0.001). However, only the activity of the lower trapezius demonstrated a statistically significant difference post-treatment. There were no significant differences between the groups. Conclusion: The findings of this study suggest that all three exercise programs were effective in improving forward head posture and the length of pectoralis minor post-treatment.

• Korean Journal of Applied Biomechanics
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• v.21 no.1
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• pp.57-65
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• 2011

This research was conducted to biomechanically analyze Tippelt motion in parallel bars, and establish technical understanding. To achieve that goal, the performances of the Tippelt acts carried out by five world top-class national gymnasts in the parallel bars 3-dimensional cinematographic analysis and EMG analysis were conducted and following conclusion were obtained. The Tippelt motions of excellent national gymnasts perform tap motion through the down swing of a large circular movements, and perform kick-out motion rapidly extending shoulder joint angle and hip joint angle with the trunk in a position close to perpendicular position at the vertical downwardness of the grasping the bars. At this time, if handstand starting the movement is too delayed or rapidly down swung, it was shown that from the initial falling, unnecessary muscular power was wasted in trapezius, anterior deltoid, erector spinae, latissimus dorsi, upper rectus abdominis, lower rectus abdominis. The muscular parts in tap motion generating muscle action potential were pectoralis major, rectus femoris, upper rectus abdominis, lower rectus abdominis, and those in kick-out motion were upper rectus abdominis, lower rectus abdominis, trapezius and anterior deltoid.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.11 no.2
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• pp.71-82
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• 2005

The couple force of the scapular stabilizers for upward rotation that include the upper and lower trapezius, serratus anterior muscles is essential to maintain the stability of shoulder joint. But if there is an imbalance of these muscles, it would occur many problems of shoulder joint. A push-up plus exercise with an unstable support is used in order to increase the muscle activity and stimulate the proprioception of shoulder joint. The purpose of this study was to compare the muscle activity of upper and lower trapezius, serratus anterior muscles and to determine which exercise is more effective when subjects perform push-up plus exercise in the stable support and unstable support. 15 healthy subjects and 15 painful subjects with injury of shoulder joint participated in this study. Surface electromyography data were collected during plus phase of push-up plus exercise. The types of push-up plus exercise were composed of three conditions. Stable type is subjects performed the push-up plus exercise on the fixed support and unstable type 1 is on the sling without shaking and unstable type 2 is on the sling with shaking by tester's manual. The upper and lower trapezius activities of injured group were higher than uninjured group at three measure conditions, but serratus anterior activities were not. The UT/SA ratio of injured group was higher than uninjured group at three measure conditions. The serratus anterior activities were most high at unstable 2 measure in both groups. The UT/SA ratio was most low at unstable 2 measure condition in injured group only. The present result revealed that push-up plus exercise in the unstable support with shaking which took most high serratus anterior activities and most low of UT/SA ratio is optimal cure method that can improve the imbalance of the scapular stabilizer.