• Clinics in Shoulder and Elbow
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• v.27 no.1
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• pp.52-58
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• 2024

Background: Deficiency in scapular muscle endurance (SME) is a risk factor for rotator-cuff-related shoulder pain (RCRSP). However, the exact relationship among SME, pain, and functionality remains unclear. This study aims to compare SME, pain, and functionality in RCRSP patients to those in age-sex-matched healthy controls. Methods: Twenty-three patients with RCRSP and 23 age-sex matched healthy controls were included in the study. SME was measured using a 1-kg dynamometer. Self-reported pain level was assessed using a visual analog scale. The Functional Impairment Test-Hand, Neck, Shoulder, and Arm (FIT-HaNSA) was also used to assess functional impairment. Results: The control group had higher SME and total FIT-HaNSA scores than the patient group (P<0.05). There was a statistically significant and positive correlation between SME and FIT-HaNSA scores in both groups (P<0.05). Conclusions: SME was affected by RCRSP. Pain and functional impairment were correlated with low SME.

• Proceedings of the Korean Society of Radiological Science
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• 2005.04a
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• pp.152.3-153
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• 2005

• The Journal of Korean Physical Therapy
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• v.22 no.5
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• pp.1-8
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• 2010

Purpose: This study aimed to provide a scientific basis for effects of the push-up plus exercise program on scapular position and on muscle activity in individuals with rounded shoulder posture (RSP). Methods: The supine method was applied to 46 potential subjects, of which 30 with RSP were selected. Subjects with RSP were divided into two groups: a gender push-up plus group as the experimental group a pectoralis minor self.stretch group as the control group. RSP data after 4 weeks of each intervention were obtained and analyzed to measure the activities of the 3 muscles. Results: The two groups differed significantly with regard to EMG changes in the serratus anterior (p<0.05). The EMG results indicated a significant reduction in the activity of the upper trapezius in the experimental group (p<0.05). EMG results indicated a significant increase in the activity of the serratus anterior after the intervention (p<0.05). EMG results of the subjects in the control group indicated that the activity of the upper trapezius significantly decreased (p<0.05). The RSP values of the subjects in both groups were significantly decreased (p<0.00). Conclusion: An improvement in the strength of the serratus anterior, and in the stretch effectiveness of the pectoralis minor, as well as changes in the scapular position were observed after 4 weeks of push-up plus exercise by the subjects.

• International Journal of Costume and Fashion
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• v.5 no.1
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• pp.1-13
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• 2005

Two hundreds of female aged 19 years old and up were recruited to evaluate the postural changes and bilateral variation of asymmetry over age. To find out the differences among the age group, subjects were classified into 5 groups, early young age(19-29), late young age(30-39), early middle age(40-49), late middle age(50-59), and old age(60-). 35 body measurements were taken by the 3-D body scanner which allowed us to take measurements which cannot be measured using traditional methods, including the shape of a cross section, slice area surface are, and volume. Bilateral variations were observed as a function of age; Depth of scapular point level, scapular point to center back, and blade angle. Postural change of anterior cervical angle, upper anterior thoracic angle, upper posterior thoracic angle, posterior cervical angle, and center back/center front ratio were also exhibited. In each measurements, subjects were classified into normal, and abnormal group. Percentiles of abnormal in shoulder line angle, blade angle, neck point $\∼$ acromial point $\∼$ scapular point, posterior cervical angle, and upper posterior thoracic angle were increased over age group. The upper body of lateral view was classified into 3 types of posture based on the previous research; straight, erect(leaning back), and stooped(bent forward). The percentiles of subjects who have straight postures were decreased as a function of age, but those of stooped postures were increased. Subjects who have erect postures did not so. The stooped posture group shows the big cervical fossa angle, anterior cervical angle, posterior cervical angle, upper posterior thoracic angle, and the small upper anterior thoracic angle comparing to the straight and erect posture group. These results could be apply for clothing construction reflecting the changes in back, shoulder, neck, and the bilateral asymmetry according to the target age group.

• The Korean Journal of Pain
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• v.29 no.3
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• pp.179-184
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• 2016

Background: Recently, ultrasound has been commonly used. Ultrasound-guided interscalene brachial plexus block (IBPB) by posterior approach is more commonly used because anterior approach has been reported to have the risk of phrenic nerve injury. However, posterior approach also has the risk of causing nerve injury because there are risks of encountering dorsal scapular nerve (DSN) and long thoracic nerve (LTN). Therefore, the aim of this study was to evaluate the risk of encountering DSN and LTN during ultrasound-guided IBPB by posterior approach. Methods: A total of 70 patients who were scheduled for shoulder surgery were enrolled in this study. After deciding insertion site with ultrasound, awake ultrasound-guided IBPB with nerve stimulator by posterior approach was performed. Incidence of muscle twitches (rhomboids, levator scapulae, and serratus anterior muscles) and current intensity immediately before muscle twitches disappeared were recorded. Results: Of the total 70 cases, DSN was encountered in 44 cases (62.8%) and LTN was encountered in 15 cases (21.4%). Both nerves were encountered in 10 cases (14.3%). Neither was encountered in 21 cases (30.4%). The average current measured immediately before the disappearance of muscle twitches was 0.44 mA and 0.50 mA at DSN and LTN, respectively. Conclusions: Physicians should be cautious on the risk of injury related to the anatomical structures of nerves, including DSN and LTN, during ultrasound-guided IBPB by posterior approach. Nerve stimulator could be another option for a safer intervention. Moreover, if there is a motor response, it is recommended to select another way to secure better safety.

• Physical Therapy Korea
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• v.23 no.4
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• pp.55-62
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• 2016

Background: The functioning of the serratus anterior (SA) muscle is essential to normal scapulohumeral rhythm during forward flexion (FF) of the shoulder. Also, SA weakness and overuse of the upper trapezius (UT) is observed in patients with shoulder dysfunction and trapezius myalgia. We designed a combination exercise involving FF and scapular protraction with resistance (CFFSP) to activate the SA muscle and to deactivate the UT muscle. Objects: The purpose of this study was to determine whether or not CFFSP would be more effective in activating the SA muscle than FF alone and FF with scapular protraction (FFP). Methods: Nineteen subjects (12 men and 7 women) participated in this study and performed FF, FFP, and CFFSP at $120^{\circ}$. Surface electromyography was applied to the SA, UT, and pectoralis major (PM) muscles, as was one-way analysis of variance (ANOVA) with repeated measures. Statistical significance was set at .05. Bonferroni adjustment was used to counteract the problem of multiple comparisons, with a statistical level of significance of .017 (.05/3). Results: A statistically significant difference was found in relation to the three positions for the SA muscle (p<.001) and the SA/UT ratio (p=.005) using ANOVA. Significantly different results, depending on the position, were also demonstrated using the Bonferroni post-hoc test for the SA muscle ($FF=28.27{\pm}16.20$, $FFP=45.66{\pm}15.81$, and $CFFSP=62.4{\pm}27.21$) and for the SA/UT ratio ($FF=3.04{\pm}2.14$, $FFP=3.61{\pm}2.38$, and $CFFSP=5.95{\pm}3.01$). Significant differences between the three positions was not found regarding the average amplitude of SA/PM muscle ratio (SA/PM: p=.060). Conclusion: We recommend the use of CFFSP to strengthen the SA muscle at $120^{\circ}$.

• Physical Therapy Korea
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• v.24 no.4
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• pp.29-37
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• 2017

Background: The serratus anterior (SA) muscle is one of the important muscles in the upward rotation of the scapula when the arm is raised. Insufficient muscle activity of the SA can cause deformation of the shoulder rhythm resulting in shoulder pathology. Objects: This study intends to compare SA and upper trapezius (UT) activity during the conventional wall-slide and push-up plus exercises for SA muscle strengthening and the scapular upward rotation (SUR) exercise. Methods: A total of 30 subjects participated in this study, and we measured the muscle activity of the SA and UT muscles during the wall-slide, push-up plus and SUR exercises. The one-way repeated ANOVA was used to compare SA and UT muscle activities during the 3 exercises. Results: During the SUR exercise, SA muscle activity was 79.88% maximum voluntary isometric contraction (MVIC), which was significantly higher than its activity during the other 2 exercises. The UT muscle activity was 47.53 %MVIC during the SUR exercise, indicating a significantly higher UT muscle activity than during the other 2 exercises. Conclusion: These findings suggest that the SUR exercise can maximize SA muscle activity to strengthen the SA while keeping UT muscle activity at an appropriate level.

• Archives of Reconstructive Microsurgery
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• v.1 no.1
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• pp.17-23
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• 1992

The authors analyzed the clinical results of the reconstructive surgery for injuried hand with microsurgery in 33 patients, 35 cases at the department of orthopaedic surgery, school of medicine, Kyung Hee university from 1985 to 1992 and the results were as followings. 1. There were 31 men and 4 women who had a mean age of 23 years(range, 3 to 44 years) and the follow up evaluations averaged 19 months. 2. The causes of the injury were machinery injury in 25 cases, traffic accident in 2, frostbite in 4, burn in 3 and fall down in 1. 3. For the reconstructive procedure, scapular free flap was applied in 6 cases, radial forearm flap in 7, dorsalis pedis free flap in 4, neurovascular island flap in 6, gracilis free flap in 1, wrap around flap in 6, toe to thumb in 5. 4. 32 cases(91.4%)were successful in reconstructive surgery with microsurgery exept the failure of scapular free flap in 2 cases and dorsalis pedis free flap in 1. 5. The causes of failure in scapular free flap were infection in 1 case and thrombosis in 1. In dorsalis pedis free flap, the cause of failure was infection. In the analysis of above results, the reconstruction with microsurgery was effective procedure for reconstruction of injuried hand.

• Korean Journal of Human Ecology
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• v.13 no.1
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• pp.153-158
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• 2004

With considerable development of comfortable and functional clothing in recent years, we need to evaluate the effects of garment pressure in daily wear on each parts of human body because the garment pressure is important to design the clothing. This study was designed to examine the effects of body postures on garment pressure on each parts of human body in the actual clothing conditions. All the data were collected from 50 volunteered subjects. The Garment pressure was measured in lune and December with 8 points CPMS clothing pressure system from scapular, upper am, elbow, under arm, front waist line, side waist line, abdomen, crista ilica, upper hip, middle hip, front thigh, back thigh, front knee and back knee. The postures of subjects were controlled with 3 positions such as standing (posture 1), sitting on the chair (posture 2), and sitting on the floor (posture 3) during measurement of clothing pressure. Clothing weights were more in men than in woman. It showed that clothing weights had no effects on the garment pressure. In this study, however, just the garment pressures on scapular and top of the hip increased significantly by clothing weight (p<. 05). Clothing horizontally pressed on scapular and top of hip but not on other parts. When subjects stood up, the garment pressure was the highest on the side waist. Especially, clothing pressure on the front waist point was lower than that of the left side waist. On the upper parts of the human body, the garment pressure of left side waist was the highest, and followed by front waist, crista ilica, and abdomen in order. When subjects were sitting on the chair, the garment pressure on the lower parts of the human body was the highest on the top of hip. When the subjects were sitting on the chair or on the floor, the surface area on their skin of hip and waist parts increased by postures. In addition, it showed that men felt more comfortable than women on higher clothing pressure level.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.1
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• pp.57-65
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• 2018

Background: This study examined the effects of nerve mobilization exercise and scapula postural correction exercise and scapula postural correction exercise after applying conservative physical therapy to frozen shoulder. Methods: Thirty-four outpatients were divided into a nerve mobilization exercise and scapula postural correction exercise group and scapula postural correction exercise group. Each group performed its own exercise 30 minutes per day, three times per week, for 6 weeks. Pain intensity was measured by the visual analogue scale. Range of motion was measured by the goniometer. The scapular position was measured by scapular index. Grasping power was measured by the Grip Track Commander. Measurements were made at baseline and six weeks after the intervention. Results: the visual analogue scale, range of motion (except lateral rotation), and grasping power for each group showed significant changes at baseline and six weeks after the intervention (p<.05). Significant differences were also evident between the two groups for these three measurements (p<.05). Conclusions: Nerve mobilization exercise & scapula postural correction exercise is more effective than scapula postural correction exercise for reducing pain intensity and increasing grasping power, scapular index and range of motion (except lateral rotation) in frozen shoulder syndrome patients.