• Journal of the Korean Society of Physical Medicine
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• v.10 no.2
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• pp.9-16
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• 2015

PURPOSE: The objective of this study was to identify the effects of shoulder abduction strength and EMG activities of the selected scapular and shoulder muscles during isometric shoulder abduction. METHODS: Thirty-four healthy young females were recruited for this study. Surface EMG equipment with inline force sensor was used to determine the shoulder abductor strength and the activity of the serratus anterior (SA), upper trapezius (UT), lower trapezius (LT), and middle deltoid (MD) during three shoe heel height conditions: (1) barefoot, (2) 3-cm shoe heel height, and (3) 7-cm shoe heel height. RESULTS: Isometric shoulder strength showed statistically significant difference among the conditions (p<0.05), and post-hoc test showed lower strength during the 7-cm condition ($49.98{\pm}17.56kg$) than during the barefoot ($44.97{\pm}20.15kg$) and 3-cm conditions ($36.59{\pm}17.07kg$). Furthermore, EMG activities of the SA, UT, and MD appeared to be statistically significantly different among the conditions, with lower values in the 7-cm condition compared to the barefoot condition (p<0.05). EMG ratios (MD/UT and SA/UT) were lower during the 7-cm condition than during the barefoot condition (p<0.05). CONCLUSION: These findings suggest that isometric shoulder abduction strength and EMG activities of scapular and shoulder muscles may be adversely changed with increasing shoe heel height.

• Clinics in Shoulder and Elbow
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• v.22 no.3
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• pp.121-127
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• 2019

Background: Posterior decentering is not an uncommon finding on rotator cuff tear patients' shoulder magnetic resonance imaging. No previous study has reported on the relationship between posterior decentering and rotator cuff tear. Methods: We assessed patients' rotator cuff tear humeral head positions based on humeral-scapular alignment (HSA). Subjects were classified into centering and decentering groups based on a <2 mm or >2 mm HSA value, respectively. Differences in rotator cuff tear size, degree of tear, and fatty degeneration between the two groups were evaluated. Results: One hundred seventy-five patients (80 males, 95 females; mean age: $59.7{\pm}6.5$ years old) were selected as subjects (casecontrol study; level of evidence: 3). Tear size, degree of subscapularis tendon tear, and fatty degeneration of the supraspinatus, infraspinatus, and subscapularis muscles were significantly different between the two groups (p<0.001, p<0.001, p<0.001). Conclusions: The occurrence of decentering was related to rotator cuff tear size, degree of subscapularis tendon tear, and fatty degeneration of the rotator cuff muscles.

• The Journal of Korean Physical Therapy
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• v.35 no.3
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• pp.83-88
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• 2023

Purpose: This study was to investigate the effect of forward head posture (FHP) and round shoulder posture (RSP) on changes in muscle activities according to shoulder flexion and abduction tasks. Methods: Twenty-two male subjects with no history of neurological, musculoskeletal surgery or injuries, or pain in the spine region within the previous 3-month periods were recruited for this study. Craniovertebral angle (CVA) and Scapula Index were measured before performing 90° abduction and flexion tasks holding a 3kg dumbbell. Muscle activities were measured during the tasks. All measurements except height of the acromion were carried out in a sitting position at the height of the subject's knee angle of 90 degrees, and two tasks were randomly performed with the arm that the subject mainly use to throw the ball. The abduction and flexion angles were checked by the examiner using a goniometer beside the subject. Results: Correlation coefficient analysis between Scapular Index and upper trapezius muscle activity during shoulder abduction task showed significant positive correlation. No significant correlation was observed between CVA, Scapular Index, and other muscle activities. Conclusion: FHP showed increased muscle activation, making it difficult to change muscle activity under lower loads, and RSP was correlated with UT activation in shoulder abduction. Therefore, in the RSP, the loaded shoulder abduction is considered a potential risk factor for increasing shoulder muscle tension. This paper proposes an approach to treating RSP before FHP.

• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.436-445
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• 2022

Objective: Deformation of soft tissues around the neck and scapularcan caused by forward head posture(FHP), which has an uncomfortable effect on biomechanical changes in the scapula as well as functional disorders of the shoulder. However, studies related to direct FHP, biomechanical changes in the scapulafunction, and shoulder pain and disorder have not yet been conducted. Therefore, purpose of this study is to effect of decresedthe FHP on the shoulder function of the sacpular biomechanical examine the change in the shoulder painand disorder. Design: A randomized controlled trial Methods: The participants were 32adults(23.03±3.90 years) recruited and redivided randomly into Forward head posture corrective exercise(FHPCE) vs Control. The FHPCE group was proceeded according to the over load principle through 2steps biofeedback exercise and corrective exercise(n=16). The control (n=16) was TENS did not operated and padding 20 minute. This study was conducted 3 times a week for 4a weeks. Results: FHPCE group is improve in the results of craneocervical angle(p<0.05, 95% CI: 0.352, 4.073). In Mechanical changes of scapula in the shoulder flexion more significant improvement in FHPCE than control group[Axis X(p<0.05), Y(p<0.01), Z(p<0.01)], and shoulder abductionmore significant improvement in FHPCE than control group[xis X(p<0.01)], as well FHPCE showed significant increased in the results in the shoulder pain(p<0.05, 95% CI: -13.244, -1.566) Conclusions: This study suggected that FHP affects the biomechanical changes of the shoulder, and a new method for shoulder pain intervention

• The Journal of Korean Physical Therapy
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• v.17 no.4
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• pp.505-517
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• 2005

The Purposes of this study were to find complementary connectible new factors that analyzed correlation relate of Sasang Constitution and GCM Body Type in Static Posture and Dynamic Hyper/Hypo-mobility Pattern. Method of this study was asymtomatic volunteers 232(unmarried man and women), conducted from September 1 to December 31. In this main study progressing step diagnosised first, Constitution of Sasang medicine after being classified into four groups of Soyangin, Taeumin, Soeumin, Taeyangin diagnosis of GCM Body Type and progressed that related Static Posture and Dynamic Hyper/Hypo mobility Pattern. The results are as follows. Distribution of Sasang Medicine Constitution proved to be Taeyangin 13, Soyangin 66, Taeumin 67, Soeumin 86 respectively. Distribution of GCM Body Type proved I Body Type 72(31.0%), II Body Type 54(23.3%), III Body Type 89(38.4%), IV Body Type 17(7.3%). The distribution of Sasang Constitution according to GCM Body Type was that; I Body Type was distributed in the order Soeumin 34.7%(25), Taeumin 31.9%(23), Soyangin 30.6%(22), Soeumin 34.7%(25) is the most people. II Body Type was distribution of in the order Soeumin 42.6%(23), Soyangin 5.9%(14), Taeumin 24.1%(13), Soeumin 42.6%(23) is the most people. III Body Type was distribution of in the order Soeumin 37.1%(33), Taeumin 30.3%(27), Soyangin 28.1%(25), Soeumin 37.1% is the most people. IV Body Type proved high distribution each of Soeumin 29.4%(5) and Soyangin 29.4%(5). In case of main left side posture character of spine and limbs about I Body Type 72 persons with left scapular and ilium forward tilted pattern proved in the order high distribution iliac crest thigh and scapular high 70(97.2%), gluteal fold high and scapular abduction 69(95.8%), lumbar scoliosis 65(90.3%). Also, in case of right side posture character proved in the order high distribution deep gluteal fold 69(95.8%), umbilical deviation 68(94.4%). Incase of main left side posture character of spine and limbs about n Body Type 54 persons proved in the: order high distribution knee hyperextension 50(92.6%), shoulder deviation 49(90.7%) etc. Also, in case of right side posture character proved in the order high distribution pelvic deviation 53(98.1%), iliac crest thigh 52(96.3%), hip flexion and ankle inversion 51(94.4%) etc. In case of main left side posture character of spine and limbs about III Body Type 89 persons proved in the order high distribution shoulder deviation 87(97.8%), scapular abduction 86(96.6%), scapular high 85(95.5%) etc. And in case of right side posture character proved in the order high distribution pelvic deviation and iliac crest thigh 86(96.6%) etc. In case of main left side posture character of spine and limbs about IV Body Type 17 persons proved in the order high distribution pelvic deviation, lumbar sciliosis and lumbar lordosis increase 15(88.2%) etc. Also, in case of right side posture character proved in the order high distribution wrist dorsiflexion 16(94.1%), thickened achilles tendon etc.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.7 no.1
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• pp.29-34
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• 2009

Purpose : This study aims to investigate into the change in muscle power, pain and muscle tension upon application of extracorporeal shock wave therapy (ESWT) and ultrasound (US) at trigger point (TrP) of the Scapular inter angle. Methods : In total of 24 human subjects that experience pain upon stimulation at the scapular inter angle were recruited. They were divided into three groups: control, ESWT and US group. Each group was subjected to appropriate stimulation three times per week for four weeks except the control group which had no restrictions in lifestyle. The ESWT group was subjected to Extracorporeal Shock Wave Therapy with a 2 $cm^2$ head, 20 times at speed of application of 60 pulses/min and depth of intrusion of 25 mm Whereas the US group was subject to Ultra sound therapy with 1$cm^2$ head, 1 MHz in frequency, 1.5 W/$cm^2$ of strength with five minutes of continuous application. Measurements were performed immediately prior to and at the end of the experiment. Results : There was no statistical significance in the change in muscle tension and muscle power as well as the difference between both groups before and after the experiment. VAS and VRS, all of which indicates changes in pain level, had statistically significant differences between them in pretest posttest comparisons. However, ESWT was superior to US in terms of decreasing muscle tension and pain while increasing muscle power. Conclusion : This study has made it evident that ESWT is far more reasonable to apply to TrP.

• 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.

• Clinics in Shoulder and Elbow
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• v.17 no.2
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• pp.68-76
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• 2014

Background: Recently, reverse total shoulder arthroplasty (RTSA) has been accepted as a main treatment option in irreparable massive rotator cuff tear with cuff arthropathy. The purpose of this study was to evaluate the early complication incidence and the preliminary clinical results of RTSAs performed in single institute. Methods: Fifty-seven RTSAs (56 patients) were performed between April 2011 and March 2013. The indications for RTSA were cuff tear arthropathy and irreparable massive rotator cuff tear with or without pseudoparalysis. Exclusion criteria were revision, preoperative infections and fractures. At final follow-up, 45 shoulders were enrolled. Mean follow-up duration was 12.5 months (range, 6-27 months). The mean age at the time of surgery was 73.6 years (range, 58-87 years). All the patients were functionally accessed via Constant score, American Shoulder and Elbow Surgeons (ASES) score, pain and functional visual analogue scale (VAS) scores and active range of motion. Complications were documented as major and minor. Major complications include fractures, infections, dislocations, nerve palsies, aseptic loosening of humeral or glenoid components, or glenoid screw problems. Minor complications include radiographic scapular notching, hematomas, heterotopic ossification, algodystrophy, intraoperative dislocations, intraoperative cement extravasation, or radiographic lucent lines of the glenoid. Results: The mean Constant score increased from 31.4 to 53.8 (p < 0.001). The pain and functional VAS scores improved (5.2 to 2.7, p < 0.001, 4.0 to 6.7, p < 0.001) and active forward flexion improved from $96.9^{\circ}$ to $125.6^{\circ}$ (p = 0.011). One or more complications occurred in 16 (35.6%) of 45 shoulders, with one failure (2.2%) resulting in the removal of implants by late infection. The single most common complication was scapular notching (9 [20%]). There were 4 (8.9%) axillary nerve palsies postoperatively (n=3: transient n. palsy, n=1: Symptom existed at 11 months postoperatively but improving). Conclusions: In a sort term follow-up, RTSA provided substantial gain in overall function. Most common early complications were scapular notching and postoperative neuropathy. Although overall early complication rate was as high as reported by several authors, most of the complications can be observable without compromise to patients' clinical outcome. Long term follow-up is required to clarify the clinical result and overall complication rate.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2005.03a
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• pp.64-65
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• 2005

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.03a
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• pp.9-10
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• 2007