• Clinics in Shoulder and Elbow
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• 제8권2호
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• pp.105-109
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• 2005

Purpose: To Analyze the exit site of pin inserted at the anterior glenoid rim in the reconstruction of the Bankart lesion and SLAP lesion using transglenoid suture technique. Materials and Methods: In the twenty adult right cadeveric scapula, insertions of pin were performed using guide at the position of 1, 2, 3 O'clock of glenoid rim. We measured the exit site of dorsal surface of the scapula by medial distance from sagittal plane of lateral border of scapular spine and the vertical distance from posterior border of the scapular spine. Results: When the pin was inserted caudally within 10 degree, at the position of 1, 2, 3 O'clock, the medial distance from lateral border of the scapula is averaged 29.4, 19.2, 34.0 mm respectively and the vertical distance from posterior border of the scapular spine is averaged 15.0, 18.6, 17.2 mm respectively. When the pin was inserted caudally within 20-30 degree, the medial distance is averaged 14.6, 14.2, 15.8 mm respectively and the vertical distance is averaged 31.6, 31.9, 32.1 mm respectively. Conclusion: When the pin was inserted caudally within ten degrees using the guide, the pin exit appeared at the more medial side of the base of scapular spine and the more inferior of scapular spine. This can make the firm suture tied over scapular spine during repair SLAP and the Bankart lesion, and also prevent the injury of suprascapular nerve.

• PNF and Movement
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• 제14권2호
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• pp.131-137
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• 2016

Purpose: The purpose of this study was to compare muscle activities in the frontal plane and scapular plane of the middle fiber and lower fiber of the trapezius muscle at different shoulder abduction angles. Methods: Twenty male and female students in their 20s participated in this study. Each subject maintained shoulder abduction at $75^{\circ}$, $90^{\circ}$, $125^{\circ}$, and $160^{\circ}$ in a standing position and repeated motions three times each in the frontal plane and the scapular plane. While maintaining the motions for 10 seconds in each posture, surface electromyography (EMG) was used to measure muscle activity of the middle fiber and lower fiber of the trapezius muscle. The collected EMG data were normalized using maximal voluntary isometric contraction (MVIC). Differences in muscle activity of the middle fiber and lower fiber of the trapezius muscles according to the angles at each plane were statistically processed using repeated measured analysis of variance, and an independent t-test was used to examine the differences between the two planes at each angle. Results: Muscle activity of the middle and lower trapezius during shoulder abduction in the frontal plane and scapular plane significantly increased as the angles increased (p<.05). However, muscle activity of the middle trapezius was significantly lower in the scapular plane than in the frontal plane for all shoulder abduction angles (p<.05). Conclusion: The results of this study suggest that during shoulder abduction, angles should be different according to the goals, and for training during an acute phase or early phase for functional recovery, it is more efficient to perform the training in the scapular plane than in the frontal plane.

• 대한한의학회지
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• 제20권3호
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• pp.115-126
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• 1999

OBJECTIVES: In order to study the effect of scapular girdle taping on hemiplegic shoulder pain, a clinical study was performed. . METHODS: Forty patients with hemiplegic shoulder pain were randomized into two groups. Twenty patients underwent a standard acupuncture treatment for shoulder pain (named control group). The other twenty patients underwent the same acupuncture treatment, but scapular girdle taping was added after acpuncture treatment (named sample group). Tapes were applied to the supraspinatus, infraspinatus, deltoid and pectoris major muscles. Shoulder pain was measured with a visual analog scale. The acupuncture treatment was performed daily for 3 weeks, and the scapular girdle taping was performed for 3 weeks in the frequency of 2 times a week. RESULTS: In terms of improvement of pain, the sample group showed statistically meaningful decrease after 3 times treatment compared with control group (P<0.05). In terms of improvement of pain with shoulder subluxation, the sample group showed a statistically meaningful decrease after 3 treatments compared with the control group (P<0.05). CONCLUSIONS: These results support that scapular girdle taping is significantly effective in reducing hemiplegic shoulder pain.

• The Korean Journal of Pain
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• 제32권4호
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• pp.307-312
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• 2019

Background: The aim of this study was to clarify the topographical relationships between the dorsal scapular nerve (DSN) and the dorsal scapular artery (DSA) in the interscapular region to identify safe and convenient injection points related to DSN blockade. Methods: Thirty shoulders of embalmed Korean cadavers and 50 live subjects were used for dissection and ultrasound (US) analysis. Results: The running patterns of the DSA and DSN in the interscapular region were classified into 3 types. Type I was defined as nerves that were medial to the artery and parallel without changing location (80.0% of specimens). In type II (13.3%), the nerve and artery traversed one another only one time over their entire length. In type III (6.7%), the nerve and artery traversed one another, resembling a twist. Above the level of the scapular spine, the nerve was always medial to the artery. Below the scapular spine, the number of arteries was obviously decreased. Most of the arteries were lateral to the medial border of the scapula, except at the level of the superior angle of the scapula artery (SA). The positional tendency of the DSN toward the medial or lateral sides from the medial border of the scapula was similar. In US imaging of live subjects, the DSA was most observed at the level of the SA (94.0%). Conclusions: Results of this study enhance the current knowledge regarding the pathway of the DSN and DSA and provide helpful information for selective diagnostic nerve blocks in the interscapular region.

• 한국전문물리치료학회지
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• 제28권4호
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• pp.256-265
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• 2021

Background: Individuals with scapular winging may have proprioceptive dysfunction which is important for motor control and causes shoulder instability. Reduced serratus anterior (SA) and lower trapezius (LT) muscle activity accompanied by over-active upper trapezius (UT), and pectoralis major (PM) may be contributing factors. Flexi-bar (FB) exercise may be used to increase joint position sense (JPS) and alter the target muscle activities. Objects: This study aimed to investigate the immediate effects of flexi-bar exercise prior to knee push-up plus (FPK) versus knee push-up plus (KPP) on JPS and muscle activity of SA, LT, UT, and PM in subjects with scapular winging. Methods: Eighteen subjects with scapular winging were recruited. JPS was investigated at baseline, after KPP and after FPK. Passive and active JPS errors were calculated by isokinetic equipment. Surface electromyography was used to record muscle activities during KPP and FPK. One-way repeated-measures analysis of variance and post hoc analyses were used to analyze the JPS error measured at baseline, after KPP and after FPK. Paired t-tests were used to compare muscle activities between KPP and FPK. Results: Passive JPS error was significantly decreased after KPP (p = 0.005) and after FPK (p = 0.003) compared to the baseline. Active JPS error was also significantly decreased after KPP (p = 0.016) and after FPK (p = 0.012) compared to the baseline. There was no significant difference in the passive and active JPS errors between KPP and FPK. SA activity during FPK was significantly increased (p = 0.024), and LT activity during FPK was significantly increased (p = 0.006). There were no significant differences in the UT and PM activity. Conclusion: FB might be recommended to immediately improve passive and active JPS and to selectively increase SA and LT muscle activities during KPP in individuals with scapular winging.

• 한국전문물리치료학회지
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• 제28권3호
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• pp.194-199
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• 2021

Background: The scapulo-thoracic musculatures including serratus anterior (SA), upper trapezius and lower trapezius can provide shoulder stability and functional shoulder movement. Objects: The muscle activities of upper and lower SA were compared during three different scapular protraction exercises in healthy individuals in sitting position. Methods: Twenty-five healthy subjects were participated. Electromyography device was used to measure muscle activity of upper and lower SA and trapezius muscles. Each subject was asked to perform three different scapular protraction exercises (scapular protraction [SP], SP with self-resistance [SPSR], SPSR with hand-exerciser [SPSRH]) in random order. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Results: The muscle activity of lower SA muscle was significantly different among three conditions (SP vs. SPSR vs. SPSRH) (p < 0.01). The lower SA muscle activity was significantly greater during SPSRH compared to SP and SPSR, which required joint stability more than SP and SPSR (p < 0.01). Conclusion: SPSRH exercise can be recommended to facilitate the muscle activity of lower SA. In addition, the intramuscular variation in the upper and lower SA during scapular protraction exercise is required to consider the effective rehabilitation.

• 산업융합연구
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• 제21권4호
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• pp.123-131
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• 2023

이 연구는 일반 푸시업과 무릎 푸시업, 벽 푸시업 운동시 어깨 안정근의 활성도 차이를 알아보는데 목적이 있다. 연구대상은 어깨관절에 통증이 없고 푸시업 운동을 하지 않은 대학생 남자 8명을 대상으로 하였으며, 어깨 안정근의 활성도를 알아보기 위하여 표면 근전도를 이용하여 위등세모근, 아래등세모근, 중간등세모근, 앞톱니근, 앞세모근, 뒤세모근, 큰가슴근, 가시아래근에 부착하였다. 일반 푸시다운은 무릎 푸시다운과 벽 푸시다운 보다 근활성도가 유의하게 더 큰 것으로 나타났다. 푸시업 동작에서는 앞톱니근과 가시아래근이 다른 어깨안정근에 비해 근활성도가 유의하게 더 컸으며, 일반 푸시업 동작이 무릎 푸시업과 벽 푸시업 보다 근활성도가 유의하게 더 큰 것으로 나타났다. UT/LT 비율에서는 무릎 푸시다운이 벽 푸시다운 보다 유의하게 낮았으며, UT/SA 비율은 푸시다운과 푸시업 모두 통계적으로 유의한 차이는 없었다. 결론적으로 푸시업과 푸시다운 동작 시에는 앞톱니근과 앞어깨세모근, 가시아래근이 다른 어깨안정근보다 근활성도가 높고, 일반적인 푸시업 운동이 무릎 푸시업과 벽 푸시업 운동보다 근활성도 측면에서는 더 효과적이다. 그러나 푸시다운을 할 경우에는 어깨안정화를 위해 무릎을 굽힌 상태에서 푸시다운을 하는 것이 더 효과적인 것으로 사료된다.

• Clinics in Shoulder and Elbow
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• 제26권2호
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• pp.148-155
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• 2023

Background: Although visual examination and palpation are used to assess shoulder motion in clinical practice, there is no consensus on shoulder motion under dynamic and static conditions. This study aimed to compare shoulder joint motion under dynamic and static conditions. Methods: The dominant arm of 14 healthy adult males was investigated. Electromagnetic sensors attached to the scapular, thorax, and humerus were used to measure three-dimensional shoulder joint motion under dynamic and static elevation conditions and compare scapular upward rotation and glenohumeral joint elevation in different elevation planes and angles. Results: At 120° of elevation in the scapular and coronal planes, the scapular upward rotation angle was higher in the static condition and the glenohumeral joint elevation angle was higher in the dynamic condition (P<0.05). In scapular plane and coronal plane elevation 90°-120°, the angular change in scapular upward rotation was higher in the static condition and the angular change in scapulohumeral joint elevation was higher in the dynamic condition (P<0.05). No differences were found in shoulder joint motion in the sagittal plane elevation between the dynamic and static conditions. No interaction effects were found between elevation condition and elevation angle in all elevation planes. Conclusions: Differences in shoulder joint motion should be noted when assessing shoulder joint motion in different dynamic and static conditions.

• 한국전문물리치료학회지
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• 제29권2호
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• pp.131-139
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• 2022

Background: Shoulder impingement syndrome, a major cause of shoulder pain, involves weakness of the scapular retractor muscles. The major scapular retractor muscles are the middle trapezius and rhomboid major muscles; however, the latter is excluded in most studies. Objects: We aimed to measure the thickness of the middle trapezius and rhomboid major muscles using an ultrasonic diagnostic imaging system while performing four different shoulder retraction exercises and comparing the thicknesses and ratio of the thicknesses of these muscles. Methods: The thickness of the middle trapezius and rhomboid major muscles was measured in 24 healthy adults using ultrasound. Muscle thickness was measured three times in the Reference posture and four times while performing four different exercises that involved scapular retraction. The averages and standard deviations of the measured muscle thicknesses were obtained and compared. The ratio of muscle thickness and rate of changes in muscle thickness between the reference posture and the four exercises were compared. Results: For both, male (n = 10) and female (n = 14), there was a significant difference in the thickness of the middle trapezius muscle between the reference posture and the four exercises (p < 0.05) and in the thickness of the middle trapezius and rhomboid major muscles between male and female (p < 0.05); however, there was no significant difference in the ratio of the thicknesses of these muscles. Although a significant difference in the rate of change in muscle thickness during the four exercises was noted, there was no significant difference in the ratio of change in muscle thickness. Conclusion: This study demonstrates the ratio of the thicknesses of the middle trapezius and rhomboid major muscles and the rate of change in their thickness during exercises involving scapular retraction in healthy people in their 20s-30s.

• 대한방사선기술학회지:방사선기술과학
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• 제28권3호
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• pp.203-209
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• 2005

목 적 : 견갑골의 골절 유 무와 외상에 의한 탈구를 진단하는데 있어 견갑골의 정측면상의 영상을 얻는 것이 매우 중요하다. 본 연구의 목적은 견갑골 측방향 촬영시 한국인 성인을 대상으로 견갑골의 정측면상을 얻는데 가장 적합한 회전 각도를 알아보는데 있다. 대상 및 방법 : 견갑골의 촬영을 위해 내원한 환자 30명(여 8명)을 대상으로 하였고 이들의 평균연령은 35.4세(15세부터 66세)였다. 수동각도기의 거상각도를 $32^{\circ}$, $37^{\circ}$, $42^{\circ}$로 하여 전 후방향 촬영하였다. 영상의 평가는 전문가 5명이 내측연과 외측연의 완전겹침이 있는 영상은 4점, 내측연과 외측연이 불완전 겹침이 있는 영상은 3점, 견갑골체 내측연과 외측연이 겹침이 없는 영상은 2점, 내측연과 외측연이 사방향으로 나타난 영상은 1점으로 4단계로 나누어 blind test를 하여 평가하였다. 결 과 : 평가한 각도별 평균점수는 $32^{\circ}$가 $1.53{\pm}0.39$점, $37^{\circ}$가 $3.83{\pm}0.15$점, $42^{\circ}$가 $2.17{\pm}0.43$ 점으로 나타났다. 또한 가슴둘레가 100 cm이상인 군과 100 cm이하인 군 간에는 유의한 차이가(p<0.05) 없었고, 남자와 여자 간에도 역시 유의한 차이가 없는 것으로 나타났다. 결론 및 고찰 : 지금까지 견갑골 정측면상을 얻는데 적합한 환자의 회전각도에 관한 연구가 없었으나, 본 연구를 통해 검사측을 $37^{\circ}$회전하며 검사측 상완골을 반대쪽으로 들며 촬영하는 것이 한국인 성인에서 견갑골의 정측면상을 얻는데 가장 적합하다는 결론을 얻었다. 본 연구 결과는 향후 견갑골의 측방향 촬영을 하는데 유용할 것으로 사료된다.