• Journal of the Korean Society of Physical Medicine
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• v.8 no.3
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• pp.443-448
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• 2013

PURPOSE: In recent years, senior friendly device is growing rapidly because of population aging The study was designed to investigate the effects of table height of electronic bed on upper extremity and trunk EMG in elderly. METHODS: Thirty right-handed elderly without history of neurological and musculoskeletal dysfunction were participated in this study. Three heights of the table (3/3 height, 2/3 height, and 1/3 height between top of the shoulder and olecranon) were provided. During the eating performance, surface electromyography (EMG) was used to measure muscle activity, and electrodes were attached to the deltoid middle fiber, serratus anterior, suprapinatus, upper trapezius, rhomboideus, cervical part of longissimus, thoracic part of longissimus, lumbar part of longissimus on right. One way ANOVA was conducted for the statistical analysis. RESULTS: There were significant differences in deltoid middle fiber, suprapinatus, upper trapezius, rhomboideus, lumbar part of longissimus in the 3 different height of table (p<.05). The deltoid middle fiber, suprapinatus, upper trapezius, and lumbar part of longissimus were significantly increased in higher table than lower table(p<.05). And the rhomboideus was significantly decreased in higher table than lower table(p<.05). CONCLUSION: This study demonstrates that different height of table affect upper extremity and trunk muscle activity. The table height of olecranon is the best for elderly.

• International Journal of Contents
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• v.10 no.3
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• pp.90-95
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• 2014

The purpose of this study was to analyze the changes in muscle fatigue by using electromyography (EMG) measurements of the median frequency of shoulder muscles of patients who underwent rotator cuff repair, and to provide basic data for efficient exercise methods during rehabilitation after the repair. In the study, 24 male and 8 female patients who underwent rotator cuff repair performed continuous passive shoulder joint motion for 3 weeks and the median frequency of their shoulder muscles before and after the repair were compared using measurements by EMG. The infraspinatus, supraspinatus, and serratus anterior muscles showed significant differences in the changes in the median frequency before and after the repair. Significant differences were also found in the median frequency of the three muscles both before and after the repair. Additionally, the middle deltoid muscle had a lower median frequency than the supraspinatus muscle before the repair and the infraspinatus muscle had a lower median frequency than the middle deltoid muscle after the repair. It is expected that these results will serve as important data in developing rehabilitation exercise programs for the infraspinatus, supraspinatus, and serratus anterior muscles by compensating the middle deltoid muscle with the lowest muscle fatigue after the rotator cuff repair erase.

• Clinics in Shoulder and Elbow
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• v.23 no.1
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• pp.11-19
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• 2020

Background: The purpose of this study was to evaluate and compare deltoid origin status following large rotator cuff repair carried out using either an open or an arthroscopic method with a propensity score matching technique. Methods: A retrospective review of 112 patients treated for full-thickness, large rotator cuff tear via either a classic open repair (open group) or an arthroscopic repair (arthroscopic group) was conducted. All patients included in the study had undergone postoperative magnetic resonance imaging (MRI) and clinical follow-up for at least 12 and 18 months after surgery, respectively. Propensity score matching was used to select controls matched for age, sex, body mass index, and affected site. There were 56 patients in each group, with a mean age of 63.3 years (range, 50-77 years). The postoperative functional and radiologic outcomes for both groups were compared. Radiologic evaluation for postoperative rotator cuff integrity and deltoid origin status was performed with 3-Tesla MRI. Results: The deltoid origin thickness was significantly greater in the arthroscopic group when measured at the anterior acromion (P=0.006), anterior third (P=0.005), and middle third of the lateral border of the acromion level (P=0.005). The deltoid origin thickness at the posterior third of the lateral acromion was not significantly different between the arthroscopic and open groups. The arthroscopic group had significantly higher intact deltoid integrity with less scarring (P=0.04). There were no full-thickness deltoid tears in either the open or arthroscopic group. Conclusions: Open rotator cuff repair resulted in a thinner deltoid origin, especially from the anterior acromion to the middle third of the lateral border of the acromion, at the 1-year postoperative MRI evaluation. Meticulous reattachment of the deltoid origin is as essential as rotator cuff repair when an open approach is selected.

• Clinics in Shoulder and Elbow
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• v.22 no.4
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• pp.195-202
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• 2019

Background: This study investigates the effects of neuromuscular electrical stimulation (NMES) in preventing deltoid atrophy during the first 12 weeks after arthroscopic rotator cuff repair. Methods: Eighteen patients undergoing arthroscopic repair of a medium-sized rotator cuff tear by a single surgeon, were randomized into two groups: NMES and transcutaneous electrical nerve stimulation (TENS). Each group used the respective device for 6 weeks after surgery. Pain was measured at baseline, 6, and 12 weeks postoperatively, using the visual analogue scale (VAS); range of motion (ROM), abduction strength and functional scores were measured at baseline and 12 weeks postoperatively. Deltoid thickness and cross-sectional areas were measured using magnetic resonance imaging at 12 weeks postoperatively. Results: At 12 weeks post-surgery, no statistically significant difference was observed between the NMES and TENS groups in the pain VAS, the Disabilities of the Arm, Shoulder and Hand score, ROM, and abduction strength. Postoperative decrease in the thickness of the anterior, middle, and posterior deltoid, at the level just below the coracoid, was -2.5%, -0.7%, and -6.8%, respectively, in the NMES group, and -14.0%, -2.6%, and -8.2%, respectively, in the TENS group (p=0.016, p=0.677, and p=0.791, respectively). At the level of the inferior glenoid tubercle, postoperative decrease in area of the deltoid was -5.4% in the NMES group and -14.0% in the TENS group, which was significantly different (p=0.045). Conclusions: NMES has the potential for reducing deltoid atrophy after arthroscopic rotator cuff repair, suggesting that NMES might help minimize postoperative atrophy after various shoulder surgeries.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.4
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• pp.2173-2177
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• 2020

Background: Shoulder horizontal abduction in the prone position (SHAP) has been reported as an effective exercise to strengthen the lower trapezius. However, the effects of pre-emptive scapular posterior tilt on scapular muscle activity and scapulohumeral movements during SHAP have not been examined. Objectives: To examine the effect of the addition of scapular posterior tilt on muscle activity of the trapezius and posterior deltoid, and scapular posterior tilt and shoulder horizontal abduction, during SHAP. Design: Cross-sectional study. Methods: Fifteen healthy male subjects performed two types of SHAP: general and modified SHAP (SHAP combined with pre-emptive scapular posterior tilt). To perform modified SHAP, pre-emptive scapular posterior tilt training was performed prior to the modified SHAP. Muscle activity of the middle and lower trapezius and posterior deltoid, and the amount of scapular posterior tilt and shoulder horizontal abduction, were measured during two types of SHAP. Results: Muscle activity of the lower trapezius and scapular posterior tilt was significantly increased during the modified SHAP, while muscle activity of the posterior deltoid and the amount of shoulder horizontal abduction were significantly decreased. However, the middle trapezius muscle activity did not change during the modified SHAP. Conclusion: The SHAP with pre-emptive scapular posterior tilt can be useful to strengthen the lower trapezius.

• The Journal of Korean Physical Therapy
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• v.27 no.5
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• pp.325-331
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• 2015

Purpose: This study attempts to understand the effect of stabilization exercise of biofeedback scapular on muscle activity and functional evaluation of the upper extremity in stroke patients. Methods: Patients were divided into two groups; a biofeedback scapular stabilization exercise group comprised of 8 patients and a task-oriented training group including another 8 patients, and 30-minute exercise was performed 5 times a week for 8 weeks. Electromyogram was used to measure muscular activity of lower trapezius, deltoid middle, and serratus anterior. Fugl-Meyer Assessment and Manual Function Test were used to evaluate functions of the muscles mentioned. Results: Significant difference was observed in the comparison group before and after exercise in muscular activity of lower trapezius, deltoid middle, and serratus anterior, Fugl-Meyer Assessment, and Manual Function Test. Conclusion: Therefore, we could see that biofeedback scapular stabilization exercise is more effective than task-oriented training in facilitating muscle activation and functional capacity of upper limb.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.1
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• pp.17-25
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• 2016

Purpose: This study was aimed to determine the effects of thoracic spine thrust manipulation on muscle activities of the scapular upward rotators and middle deltoid, active range of motion (AROM), shoulder pain, and rounded shoulder posture in young adults with rounded shoulder. Methods: The subjects were 30 young adults (14 males, 16 females) with rounded shoulder. Thirty subjects were randomly assigned to an experimental (manipulation) and control (placebo) groups of fifteen subjects respectively. The manipulation group received the manipulation (high velocity, low amplitude), which was performed by a physical therapist with the subject in the supine position and with the arms crossed over the chest and hands passed over the shoulders. For the sham group, the same procedure was performed, with the exception that the high-velocity thrust was not applied. Measurements were taken before and after the intervention. Muscle activity of upper and lower trapezius, serratus anterior, middle deltoid was measured using surface electromyography. Visual analog scale (VAS) was used for shoulder pain. Goniometry was used for shoulder abduction active range of motion (AROM). Straight edge was used for supine rounded shoulder posture (RSP) distance. Results: The muscle activity of the upper trapezius, lower trapezius and middle deltoid muscle increased significantly after the intervention (p<.05). However, no significant difference was observed in serratus anterior muscle (p>.05). The VAS was significantly decreased and AROM significantly increased after the intervention (p<.05). The distance of RSP were not significant (p>.05). The control group showed no differences before and after the intervention (p>.05). Conclusion: The results of this study suggest that thoracic spine thrust manipulation can be an effective component of treatment plan to improve pain and function.

• 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.

• Journal of Biomedical Engineering Research
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• v.38 no.4
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• pp.143-152
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• 2017

The main purpose of this research was to examine the EMG characteristics of driver's upper limb and driving performance for operating accelerator and brake pedal by using four types of left hand control devices(Push/Pull, Push/Right angle, Push/Rock, Push/Twist) during simulated driving. The persons with disabilities in the lower extremity have problems in operation of the vehicle because of functional impairments for controlling accelerator and brake pedal. Therefore, if hand control device is used for adaptive driving controls in persons with lower extremity loss, the disabled people could improve their quality of mobility life by driving a car. Twenty subjects were involved in this research to assess driving performance and EMG activities for operating accelerator and brake pedal by using four types of left hand controls in driving simulator. We measured EMG responses of six muscles(posterior deltoid, middle deltoid, biceps, triceps, extensor carpi radialis, and flexor carpi radialis) during pulling and pushing movement with four types of left hand controls for acceleration and braking. STISim Drive 3 program was used for evaluation test of four types of left hand control devices in straight lane course for time to reach target speed and brake reaction time. While operating the four types of left hand controls for acceleration, EMG activities of posterior deltoid in normal subjects were significantly increased(p < 0.05) compared to the disabled subjects. It was also found that EMG responses of triceps and posterior deltoid were significantly increased(p < 0.05) when using the Push/Right angle type than Push/Pull type. While operating the four types of left hand controls for braking, EMG activities of flexor carpi radialis and triceps in subjects with disability were significantly increased(p < 0.05) compared to the normal subjects. It was shown that muscle responses of posterior deltoid, middle deltoid and triceps were significantly increased when using the Push/Right angle type than Push/Rock type. Time to reach target speed and brake reaction time in subjects with disability was increased by 2.5% and 4.6% on average compared to normal subjects. The person with disabilities showed a tendency to relatively slow performance in acceleration at the straight lane course.

• Journal of the Korean Arthroscopy Society
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• v.14 no.1
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• pp.49-52
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• 2010

Purpose: We introduce arthroscopically assisted mini-open rotator cuff repair using anterolateral approach. Operative Technique: Placing lateral decubitus position on general anesthesia, a standard arthroscopic glenohumeral examination is performed to evaluate lesions of shoulder joint through posterior and anterior portal. And then arthroscope is placed in the subacromial space and we evaluate the size of the torn tendon and perform arthroscopic acromioplasty through lateral portal. A 3 to 4 cm skin incision is performed from anterolateral edge of acromion to distal and dissected along to raphe between anterior and middle deltoid. A deltoid retractor is then placed, allowing direct visualization of the rotator cuff and humeral head. As torn tendon is tagged by traction suture, we try to anatomical reduction on the footprint and then perform single row or double row repair of the rotator cuff using suture anchors. To prevent avulsion of the deltoid from the acromion, additional sutures by bone tunnel with acromion and deltoid is performed. Conclusion: This technique is useful procedure to get direct approach to anterior portion of supraspinatus tendon and to need lesser deltoid retraction than portal extension approach due to dividing along to raphe between anterior and middle deltoid. Also it provide better visualization of the superior portion of subscapularis and infraspinatus.