• 대한물리의학회지
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• 제10권4호
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• pp.113-121
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• 2015

PURPOSE: The purpose of this study was to determine the effect of shoulder external rotation on muscle activities of the scapular upward rotators during arm elevation. METHODS: Nineteen healthy subjects with no medical history of shoulder pain or upper extremity disorders were recruited for this study. Electromyography (EMG) was used to measure the muscle activities of the serratus anterior (SA), upper trapezius (UP), lower trapezius (LT) and infraspinatus (IS) muscles during arm elevation. The EMG activities were recorded while the subjects performed $90^{\circ}$ arm elevation with three different arm positions; palm down (PD), neutral position (NP), and palm up (PU). While seated in a chair, the subject was asked to raise the upper extremity in the sagittal plane in random order. Subjects performed $90^{\circ}$ arm elevations in three trials at each arm position. The mean EMG activity normalized by the maximal voluntary isometric contraction was analyzed across three arm positions. Repeated measures one-way ANOVA and the post hoc Bonferroni tests were used to determine the differences in muscle activities among the three arm positions. RESULTS: The EMG activities of the SA and IS were significantly greater in the PU condition than in the other conditions during arm elevation. No significant difference was noted between the NP and PD conditions during arm elevation. CONCLUSION: These results suggest that shoulder external rotation (palm up position) can be used to activate the SA. Therefore, we recommend a scapular protraction exercise in the palm up position for strengthening the SA.

• 대한통합의학회지
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• 제3권4호
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• pp.61-67
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• 2015

Purpose : The purpose of this study was to find out the effect of exercise on the angle and distance between scapular stability and McKenzie stretch exercise. Method : 30 volunteers took part in this experiment and we divided into three groups(experimental group A, experimental group B, control group C). Experimental group A performed scapular stabilization exercise and experimental group B performed McKenzie neck stretching exercise and control group didn't perform any exercise. Experimental group(A, B) received a total of 12 exercise session over a 4 week period (three times per week). Posture and craniovertebral angle changes of the neck using GPS measurements reported. Result : The CVA and distance change after exercise were significantly reduced in the experimental group A and B. Conclusion : Therefore, we have confirmed through experiments reducing a CVA and distance between scapular stabilization and McKenzie neck stretching exercises, whereby we would also be helpful to ensure the treatment of forward head posture.

• 대한물리치료과학회지
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• 제6권2호
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• pp.1041-1062
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• 1999

This study is to stimulate the model of which top notch muscle stimuli physical therapy has been made on the basis of GCM. GCM has been studied on the hypermobility & hypomobility pattern on the part of spine & extremity, and the body characteristics of four body types, which is the tilting of seal scapular & ilium. The purpose of this study is to analysize the type of GCM which has been focused on the spine & extremity for the patients having dysfunctions of neuromuscular system, being analysized the movement. The result of this study is as following; 1) The First hypothesis: The hypermobility & hypomobility pattern assorted by the tilting of scapular & ilium, as does the former study analysize was claimed that it would be in line with the pattern for hypermobility hypomobility and physical characteristics according to each body type at the percentage of at least 60(p<.001). 2) The 2nd hypothesis : Stimuli therapy of muscle dealing with physical characteristics and joint hypermobility hypomobility has the important role in restoring the deformity and keeping anatomical postural plumb alignment also it would a highly effects on correcting the body even though the stimuli area was limited to four areas and it was lack of time compared with those applied by general physical therapy(p<.001). As above the result, the top-notch type for physical therapy based on hypermobility hypomobility pattern by 4 body types which has been studied on tilting of scapular & ilium is more specificed and specialized than those of general physical therapy technologies. So this study will be believed to dedicate to restoration ideal anatomical postural plumb alignment based on spinal Manipulation and the concept of whole person as well as to being simple and effective to apply.

• 한국전문물리치료학회지
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• 제22권4호
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• pp.62-70
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• 2015

The aims of the current study were to assess reliability of range of motion (ROM) measurement of glenohumeral internal rotation (GIR) with a pressure biofeedback stabilization (PBS) method and to compare the reliability between manual stabilization (MS) and the PBS method. In measurement of pure glenohumeral joint motion, scapular stabilization is necessary. The MS method in GIR ROM measurement was used to restrict scapular motion by pressing the palm of the tester's hand over the subject's clavicle, coracoid process, and humeral head. The PBS method was devised to maintain consistent pressure for scapular stabilization during GIR ROM measurement by using a pressure biofeedback unit. GIR ROM was measured by 2 different stabilization methods in 32 subjects with GIR deficit using a smartphone clinometer application. Repeated measurements were performed in two test sessions by two testers to confirm inter- and intra-rater reliability. After tester A performed measurements in test session 1, tester B's measurements were conducted one hour later on the same day to assess the inter-rater reliability and then tester A performed again measurements in test session 2 for confirming the intra-rater reliability. Intra-class correlation coefficient (ICC) (2,1) was applied to assess the inter-rater reliability and ICC (3,1) was applied to determine the intra-rater reliability of the two methods. In the PBS method, the intra-rater reliability was excellent (ICC=.91) and the inter-rater reliability was good (ICC=.84). The inter-rater and intra-rater reliability of the PBS method was higher than in the MS method. The PBS method could regulate manual scapular stabilization pressure in inter- and intra-rater measuring GIR ROM. Results of the current study recommend that the PBS method can provide reliable measurement data on GIR ROM.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.597-604
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• 2009

Purpose: Compound tissue defects remain a challenge to reconstructive surgeons. The objective of this study was to introduce examples of successful reconstruction of compound defects of the head and neck and upper and lower limbs, using chimeric flaps based on the subscapular vascular system. Methods: We report 19 reconstruction cases using chimeric flaps based on the subscapular vascular system. The scapular flap, scapular fascia, scapular bone, parascapular flap, latissimus dorsi, latissimus dorsi perforator flap, latissimus dorsi myocutaneous perforator flap, serratus anterior, serratus anterior fascia, and rib bone were used as components for chimeric flaps. 12 cases had defects of the upper limb, three in the lower limb, three in the head and neck area, and one case had a defect of the thoracoabdominal wall. Results: Defect sizes ranged from $6{\times}8cm$ to $20{\times}22cm$. The component used most often for skin coverage was the latissimus dorsi perforator flap; for soft tissue bulk, the latissimus dorsi; for fascia coverage, the serratus anterior fascia flap; and for bone reconstruction, the scapular bone flap respectively. All cases were successfully reconstructed without additional operative procedures or flap necrosis. Conclusion: Because it is fairly easy to employ vascular pedicles of sufficient length and diameter, enabling the use of diverse types of tissue with various shapes and sizes, the use of chimeric flaps based on the subscapular vascular system allows one - stage reconstruction tailored to the characteristics of the defect area.

• 한방재활의학과학회지
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• 제29권4호
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• pp.117-126
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• 2019

To evaluate the effects of Korean medicine and Chuna treatment on patient with pain and limited range of motion (ROM) after scapular fracture. Patient was treated with Chuna manual therapy, acupuncture, herbal medicine, pharmacoacpuncture, cupping therapy and measured by ROM, visual analog scale (VAS), shoulder pain and disability index (SPADI), American shoulder elbow surgery scale (ASES), Korean shoulder score for instability (KSS). After the 3 weeks treatment, the patient's ROM, VAS, SPADI, ASES, KSS scores were improved. Rehabilitation program including Chuna manual therapy can be effectively used to improve scapular fracture patient's pain and symptom during rehabilitation period. Therefore it is recommended to use Chuna manual therapy for the improvement of movement and pain from fracture.

• 대한정형도수물리치료학회지
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• 제25권1호
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• pp.45-52
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• 2019

Background: Scapular dyskinesis is one of the risk factors for upper extremity injury in patients with chronic stroke. Taping can used as an adjunctive treatment for this. The aim of this study was to investigate the effects of rigid tape in conjunction with elastic tape and elastic tape only on shoulder pain, proprioceptor, and function of chronic stroke patients with scapular dyskinesis. Methods: Participants were randomly assigned to elastic tape (ET) group (n=10) and both tape (BT) group (n=10). Both ET and BT groups performed therapeutic exercise on the upper extremity with taping applied for 4 weeks. Therapeutic exercise was performed 30min/day, 5 times/week. Clinical outcome measures used Numerical pain rating scale with a faces pain scale for pain, angle at shoulder join position sense (JPS) for proprioceptor, and Fugl-meyer assessment upper extremity for function. Results: Clinical outcomes were measured at initial baseline, after 4weeks. There were statistically significant differences in pain, JPS, and function after 4 weeks in both groups (p<.05). There was no significant difference in pain and JPS between the groups, and There was a statistically significant difference in function in the BT group compared to the ET group (p<.05). Conclusions: This results suggest that accurate clinical assessment and appropriate taping can improve proprioceptor and function of the upper extremity in patients with chronic stroke.

• 대한정형도수물리치료학회지
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• 제25권1호
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• pp.29-36
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• 2019

Background: This study was conducted to investigate the effect of leg lift difference on the serratus anterior muscle and the upper trapezius muscle when a subject with winged scapula performs a scapula protraction exercise in a four-leg crawling posture. Method: Twenty normal adults and 20 subjects with winged scapula participated in the experiment. Surface EMG recordings were collected from serratus anterior muscle and back trapezius muscle during scapula protraction exercises. Scapular winging is measured with the lifting distance of scapula retraction to the back using an electronic digital caliper. In two groups of four-leg crawling posture, the two legs support, the dominant leg lifting, and the non-dominant leg lifting, including the scapula protraction, were performed. To examine the difference between groups in the variance analysis, the Bonferroni correction was used (significance level ${\alpha}=.017$). Statistical significance level ${\alpha}$ was .05. Results: There was a significant difference in serratus anterior muscle and upper trapezius muscle during push-up plus exercise in leg lifting in four-leg crawling posture, but there were no significant differences in muscle activity between serratus anterior muscle and upper trapezius muscle, and there was no significant difference according to the presence or absence of scapular winging. Conclusion: For the shoulder stability of the ipsilateral side with the serratus anterior muscle, the leg-lifting posture is effective in the four-leg crawling, and also when a subject with winged scapula chooses an exercise, lifting the ipsilateral side of leg with scapula protraction exercises at the same time may have a positive effect on scapula dysfunction.

• 대한물리의학회지
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• 제13권4호
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• pp.149-162
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• 2018

PURPOSE: The aim of this study was to investigate the effect of scapular dynamic taping on pain, disability, upper body posture, and range of motion (ROM) in the postoperative shoulder. METHODS: Twenty-two patients who underwent acromioplasty and rotator cuff repair surgery volunteered for this study. The subjects were randomly divided into an experimental group (EG, n=11) and a control group (CG, n=11). For the EG, exercise therapy, manual therapy, and scapular dynamic taping were applied for 6 weeks; for the CG, only exercise therapy and manual therapy were applied for 6 weeks. Shoulder pain, disability, upper body posture, and ROM were evaluated at baseline, after 3 weeks of intervention, and after 6 weeks of intervention. Assessment tools included quadruple visual analog scale (QVAS) for level of pain; shoulder pain and disability index (SPADI) for functional disability level; forward head angle (FHA), forward shoulder angle (FSA), and pectoralis minor index (PMI) for upper body posture; and ROM testing. RESULTS: Significant differences were observed between the EG and CG in SPADI total scores; internal rotation and external rotation ROM of the glenohumeral joint ; FSA ; and PMI. All groups showed statistically significant improvement in QVAS; SPADI; flexion; abduction; external rotation and internal rotation ROM of the glenohumeral joint; FSA; and PMI. CONCLUSION: These results suggest that, for patients who have undergone acromioplasty and rotator cuff repair surgery, the addition of scapular dynamic taping during therapy is effective for improvement of shoulder disability level, ROM, and upper body posture.

• PNF and Movement
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• 제11권2호
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• pp.49-56
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• 2013

Purpose : The purpose of this study was compared for rounded scapular between strechting on pectoralis minoor and strengthening on scapular stabilizer muscles. Methods : The main laboratory had an experiment of the exercise for rounded shoulder posture with 30 patients on a pectoralis minor stretching and scapula to stabilize the elastic band to divide into two groups in this study which were conducted. Results : Acromial height measured from changes of the rounded shoulder posture changes before and after workouts; stretching before exercise in the exercise group is from $94.19{\pm}3.47$ to after result of $94.84{\pm}3.19$, and the after exercise of an elastic band pre-exercise in the exercise group is from $93.60{\pm}3.42$ to $88.68{\pm}3.49$, dividing into two groups, which increased significantly. Compared to an acromial height variation results before and after workouts; stretching exercise group made $3.07{\pm}1.43$, $4.91{\pm}2.24$ and elastic band exercise group, $4.91{\pm}2.24$, which shows the difference between the two groups and was not statistically significant. Conclusion : Against a pectoralis minor that cause the findings of this study, RSP proximately shows serratus anterior and the strengthening of trapezius by exercises of the shoulder peaks which decrease in height arbitration scheme of a pectoralis minor stretching effect as shown. Therefore, it is expected RSP patients in clinical intervention methods combined with stretching exercises strengthens muscles against an elastic band exercise effective.