• The Journal of Korean Physical Therapy
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• v.23 no.2
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• pp.7-15
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• 2011

Purpose: We investigated the relationship between the muscle activity and kinematic variables of the upper extremity during a push-up task on stable and unstable surfaces. Methods: We recruited 15 healthy subjects. Subjects completed the push-up task on stable and unstable surfaces. Surface electromyograms were recorded from the serratus anterior, upper trapezius, latissimus dorsi, infraspinatus to monitor changes in muscle activity. Markers for kinematic changes of elbow flexion, shoulder extension, shoulder retraction and scapular adduction were attached at C7, the T7 spinous process, both acromions, the scapula superior and inferior angle, the humerus lateral epicondyle, and the ulnar styloid process. Correlation coefficients between muscle activity and kinematic variables were analyzed by SPSS for Windows, version 15.0. Results: On the unstable surface, elbow flexion and shoulder extension increased with increasing muscle activity of serratus anterior, upper trapezius and infraspinatus. On the stable surface, shoulder retraction decreased with increasing muscle activity of serratus anterior and infraspinatus. Scapular adduction decreased with all types of increasing muscle activity, regardless of the support surface. Conclusion: Correlations between muscle activity and kinematic variables were observed on stable and unstable surfaces during a push-up task, while correlations between right and left variables were not clear. These finding suggest that it may be used to develop a rehabilitation program which could be effective in improving shoulder function in patients with shoulder problems.

• Physical Therapy Korea
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• v.26 no.4
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• pp.53-62
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• 2019

Background: Shoulder function is achieved by the coordinated movements of the scapula, humerus, and thoracic spine, and shoulder disorders can be associated with altered scapular kinematics. The trunk plays an important role as the kinematic chain during arm elevation. Objects: The purpose of this study was to determine the effects of thoracic hyperkyphosis on scapular orientation and trunk motion. Methods: Thirty-one subjects (15 in the ideal thorax group and 16 in the thoracic hyperkyphosis group) performed right-arm abduction and adduction movements in an unconstrained plane. The scapular orientation and trunk motion were recorded using a motion analysis system. Results: Those subjects with thoracic hyperkyphosis displayed greater scapular posterior tilting at a $120^{\circ}$ shoulder elevation, greater scapular internal rotation throughout the arm raising phase, and greater trunk axial rotation at the upper ranges of the shoulder elevation, compared to those subjects with an ideal thorax (p<.05). Conclusion: Thoracic hyperkyphosis can cause scapular instability, greater trunk rotation and greater scapular posterior tilting, and may contribute to preventing the achievement of a full range of humeral abductions in an unconstrained plane.

• Korean Journal of Applied Biomechanics
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• v.21 no.2
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• pp.243-252
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• 2011

The purpose of this study was to determine the effect of trunk posture on muscle activity and motion of scapular and scapulohumeral rhythm. Thirty-one healthy subjects performed right-arm abduction and adduction along the frontal plane while standing in both upright and flexed posture of trunk. Scapular upward rotation, anterior tilting and internal rotation ware recorded using a motion analysis system and muscle activity of upper trapezius, lower trapezius and serratus anterior ware recorded using surface electromyography during abduction and adduction in both trunk postures. then, scapulohumeral rhythm was calculated. Scapulohumeral rhythm and scapular posterior tilting in flexed posture was significantly decreased than in upright posture. Also, muscle activity of lower trapezius in flexed posture was significantly increased and serratus anterior was significantly decreased than in general posture. The result of this study revealed that flexed posture of trunk altered the muscle activity and kinematic of scapular. Measurement of trunk posture should be included the evaluation of dysfunction and disorder of shoulder girdle since rehabilitation of trunk posture is important to restore of upper limbs function.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.10 no.2
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• pp.23-29
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• 2012

Purpose : Purpose of this study was to investigate whether cervicothoracic posture was associated with scapula orientation and muscle activity during shoulder abduction. Methods : Cervicothoracic junction angle and thoracic kyphosis angle were measured in health twenty subjects. Then, scapular resting orientation and range of motion (upward/downward rotation, internal/external rotation) and muscle activity (upper trapezius, lower trapezius, serratus anterior) was determined using motion capture system and surface electromyography while subjects performed shoulder abduction. Results : Cervicothoracic junction angle was significantly associated with range of motion of scapular internal/external rotation during shoulder abduction. Thoracic kyphosis angle was significantly associated with scapular resting orientation of upward/downward rotation and average IEMG of lower trapezius. Conclusion : The result of this study shows that poor cervicothoracic posture is relationship with altered scapular kinematics cause of shoulder dysfunction. These findings suggested that cervicothoracic posture may be considered in occupation and exercise including arm elevation over head as well as used as predict factor to estimate shoulder dysfunction.

• Physical Therapy Korea
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• v.30 no.1
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• pp.59-67
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• 2023

Background: Posterior capsule tightness (PCT), commonly seen in overhead athletes, is a soft tissue adaptation that is also noted in non-throwers. PCT is associated with scapular and humeral kinematic alterations, significant restriction of shoulder internal rotation (IR) range of motion (ROM), and significant scapular anterior tilting. Sleeper and cross-body stretches (CBS) are suggested for PCT and IR deficits, and have been modified since introduction. A novel modified sleeper stretch (NMSS) was designed in this study to prevent the risk of anterior translation of the humeral head. Though the effects of posterior shoulder stretching exercise have been widely studies, to the best of our knowledge, no previous studies have investigated the effectiveness of posterior shoulder exercises in decreasing scapular anterior tilting. Objects: To compare the immediate effects of two posterior shoulder stretching exercises (NMSS and CBS) on scapular anterior tilting and shoulder IR ROM. Methods: Thirty-two subjects with anteriorly tilted scapula and IR deficits [mean age: 24.3 ± 2.5 years; 15 males and 17 females] participated in this study. Subjects were randomly assigned to either the NMSS or CBS groups. Scapular anterior tilting (at rest and at shoulder 60° active IR) and shoulder IR ROM were measured before and immediately after intervention. Results: Scapular anterior tilting significantly decreased, while the shoulder IR ROM significantly increased in both groups. However, there was no significant group-by-time interaction effect or significant difference between the groups. Conclusion: Both stretching exercises were effective in restoring shoulder IR ROM and decreasing scapular anterior tilting.

• Journal of the Korea Convergence Society
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• v.11 no.9
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• pp.325-332
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• 2020

This study aimed to identify the difference of scapular movements between tennis players with and without shoulder impingement syndrome(SIS) and to verify the effect of kinesiology taping applied to scapular. A total of 15 players were categorized in SIS group(n=7) and control(CON) group(n=8). The scapular movements evaluated using 3-dimensional motion analysis in the 5 events of the flat first serve before and after the application of taping. The male of SIS group(-7.31±1.19° and -5.28±1.08°, respectively) had tilted scapular more anteriorly compared to CON group(-0.98±5.38° and -0.44±3.52°, respectively) at the maximally humeral external rotation and the impact(Z=-2.309, p=.021 and Z=-2.309, p=.021, respectively). The scapular(-8.11±2.57°) of female in SIS group tilted more anteriorly than that of CON(-0.97±3.31°) group at the maximally humeral external rotation(Z=-2.121, p=.034). But the scapular movements had no statistical differences between before and after the application of taping.

• 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

• Clinics in Shoulder and Elbow
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• v.25 no.4
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• pp.265-273
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• 2022

Background: Massive rotator cuff tears (MRCTs) with subscapularis (SSC) tears cause severe shoulder dysfunction. In the present study, the influence of SSC tears on three-dimensional (3D) shoulder kinematics during scapular plane abduction in patients with MRCTs was examined. Methods: This study included 15 patients who were divided into two groups: supraspinatus (SSP) and infraspinatus (ISP) tears with SSC tear (torn SSC group: 10 shoulders) or without SSC tear (intact SSC group: 5 shoulders). Single-plane fluoroscopic images during scapular plane elevation and computed tomography (CT)-derived 3D bone models were matched to the fluoroscopic images using two-dimensional (2D)/3D registration techniques. Changes in 3D kinematic results were compared. Results: The humeral head center at the beginning of arm elevation was significantly higher in the torn SSC group than in the intact SSC group (1.8±3.4 mm vs. -1.1±1.6 mm, p<0.05). In the torn SSC group, the center of the humeral head migrated superiorly, then significantly downward at 60° arm elevation (p<0.05). In the intact SSC group, significant difference was not observed in the superior-inferior translation of the humeral head between the elevation angles. Conclusions: In cases of MRCTs with a torn SSC, the center of the humeral head showed a superior translation at the initial phase of scapular plane abduction followed by inferior translation. These findings indicate the SSC muscle plays an important role in determining the dynamic stability of the glenohumeral joint in a superior-inferior direction in patients with MRCTs.

• Physical Therapy Korea
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• v.31 no.2
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• pp.142-150
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• 2024

Background: Scapular dyskinesis (SD) is closely related to imbalance of the rotator cuff (RC) muscles. However, previous studies have only focused on isometric strength. To our knowledge, there has been no study examining potential differences in concentric and eccentric strength and functional strength ratio (FSR) of the RC muscles based on functional parameters related to throwing in with or without SD. Objects: This study aimed to determine whether there was a difference in the RC muscle strength and FSR between the dominant shoulder with SD and the non-dominant shoulder without SD in adolescent baseball players. Methods: Forty adolescent baseball players participated and classified types of SD based on movement patterns using the SD test by two examiners. The isokinetic concentric and eccentric peak torque of the internal rotation (IR) and external rotation (ER) were measured and quantified as peak torque to body weight (PT/BW). Also, the FSR was obtained by calculating the strength ratios of eccentric IR to concentric ER (IRecc/ERcon) and eccentric ER to concentric IR (ERecc/IRcon), respectively. Results: There was a significant decrease in the IR and ER PT/BW in the dominant shoulder with SD compared to the non-dominant shoulder without SD (p < 0.05), regardless of contraction types. However, no significant difference was observed in the FSR in both IRecc/ERcon and ERecc/IRcon ratios. Conclusion: The findings indicate that the isokinetic concentric and eccentric PT/BW of the IR and ER muscles were significantly lower in the dominant shoulder with SD than in the nonthrowing shoulder without SD. Therefore, when establishing a strategy for addressing RC muscle weakness in adolescent baseball players with SD, it is essential to consider an approach that accounts for scapular kinematic recovery.

• Physical Therapy Rehabilitation Science
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• v.6 no.4
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• pp.208-213
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• 2017

Objective: Despite reliable evidence of abnormal scapular motions increases, there is not yet sufficient evidence of abnormal humeral translations. This study aims to analyze the motion of the humeral head toward the scapula when the shoulder is actively abducted using the C-arm. Design: A case report. Methods: The participant was a healthy man without any limitation and pain during shoulder movement. The participant's shoulder was abducted; this movement in the frontal plane was measured using a C-arm (anterior-posterior view) and was analyzed with computer-aided design. The starting posture was $15^{\circ}$, and as the participant abducted his shoulder measurements were taken and analyzed at $30^{\circ}$, $60^{\circ}$, $90^{\circ}$, $120^{\circ}$, $150^{\circ}$, and ending at $165^{\circ}$. A line was drawn perpendicularly to the line connecting the humeral head axis to the glenoid, and another line was drawn perpendiculary to the line connecting the scapular axis to the glenoid. The distance between the two lines measured is defined as the e value. Results: At the starting posture ($15^{\circ}$), the central axis of the humeral head was located 1.92 mm inferior to the central axis of the scapula. The humeral head was superiorly translated from the starting posture to $120^{\circ}$, and then, showed an inferior translation to the ending posture ($165^{\circ}$). Conclusions: The results of this study showed that the humeral head moved upward from the starting posture ($15^{\circ}$) up to $120^{\circ}$ indicating, superior translation, and it moved downward when the posture was past $120^{\circ}$, indicating inferior translation.