• Physical Therapy Korea
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• v.19 no.2
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• pp.12-19
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• 2012

The purpose of this study was to assess the influence of scapular alignment on the electromyographic (EMG) activity of the trapezius in people with a short pectoralis minor muscle. For the study, we recruited 15 volunteers who had positive results for short on a pectoralis minor muscle length test. We measured the EMG activity of the upper, middle and lower trapezius muscles. The participants lifted their dominant arm to ear level with the thumb up toward the ceiling in the prone position on a table with the shoulder at a flexion angle of 180 degrees and a horizontal abduction angle of 120 degrees. Scapula was manually aligned by an experienced physical therapist prior to arm lift for the scapular alignment condition. A paired t-test was used to compare the effects of scapular alignment on the EMG activity of the trapezius muscles. The EMG activity of the lower trapezius muscle was significantly increased during the test with the scapular alignment compared to that without scapular alignment (p<.05), while the upper trapezius and middle trapezius exhibited no significant difference between the two conditions (p>.05). The findings of this study suggest that a scapular alignment may alter the recruitment of the lower trapezius muscle during arm lifting in the prone position in people with a short pectoralis minor muscle.

• The Journal of Korean Physical Therapy
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• v.21 no.2
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• pp.23-29
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• 2009

Purpose: This study examined the effects of the symmetrical scapular alignment on the weight bearing of hemiplegic patients in the standing position. Methods: PALM (PALpation Meter) test and Gaitview AFA-50 were used to measure the skeletal alignment of the scapula and the weight bearing loaded on the affected and unaffected sides before and after training. The data was analyzed using a paired t-test on the SPSS 12.0 program for descriptive statistics. A p value <0.05 was considered significant. Results: The mean difference in the scapular alignments on sup. & mid. & inf. area in the hemiplegic side before and after training was $0.93\pm0.50cm$ and $0.58\pm0.43cm$, respectively. There was a significant decrease after training rather than that before (p<0.05). The mean weight bearing on the foot area in the hemiplegic patients before and after training was $9.12\pm5.51N/cm^2$ and $4.36\pm4.11N/cm^2$, respectively,. There was a significant decrease after training rather than that before (p<0.05). The scapuar alignments and weight bearing data on the standing position were grouped around the average (to central point) in the distribution graph. Conclusion: These findings suggest that the symmetrical scapular alignment can serve as an effective means of improving the weight bearing ability of hemiplegic patients.

• Physical Therapy Korea
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• v.23 no.4
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• pp.38-46
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• 2016

Background: Shoulder stabilization commonly involves two components: the glenohumeral stabilization exercise (GSE) and scapular stabilization exercise (SSE). Despite the fact that the shoulder stabilization has advantageous merit, to our knowledge, only a few studies have compared the superior of the GSE and the SSE. Objects: The purpose of this study was to assess the effects of GSE in patients with nonspecific shoulder pain. Methods: Thirty subjects with nonspecific shoulder pain were randomly divided into an experimental group and control group, each with 15 patients. The experimental group used an GSE, whereas the control group did SSE. All subjects were measured in shoulder stability, scapular symmetric alignment, pain, muscle power, and range of motion before and after the intervention. Results: GSE resulted in significantly better shoulder stability (p=.046, from $8.67{\pm}7.54$ score to $13.93{\pm}9.40$) in the experimental group compared with SSE in the control group. However, no significant effects were observed for scapular symmetric alignment including the angles of inferior scapular distance (p=.829) and inferior scapular height difference (p=.735), pain (p=.113), muscle power including shoulder flexion (p=.723) and abduction (p=.897) and range of motion including shoulder flexion (p=.853) and abduction (p=.472). Conclusion: These findings suggest that GSE may be more effective in increasing the shoulder stability than the SSE in patients with nonspecific shoulder pain, probably through a centralization effect on the shoulder mechanism.

• The Journal of Korean Physical Therapy
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• v.30 no.1
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• pp.8-13
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• 2018

Purpose: The present study was to investigate effects of scapular position and pain on a trunk stabilization exercise with gym ball for patients with arthroscopic rotator cuff repair. Methods: Subjects were patients after 2 weeks of rotator cuff repairs. Subjects were randomly assigned to conservative treatment group (CTG, n=10) or trunk stabilization with gym ball group (SBG, n=10), and participated one of those groups for 2 weeks. Measurements about pain and scapular position were assessed in before and after treatment programs. Results: Pain reduced in both rest and night in SBG compared to CTG. In the case of scapular position, decreased scapular retraction (increased protraction) was found in CTG and vice versa in SBG. Reduced scapular anterior tilting was also found on SBG. Conclusion: The present study showed that early performed trunk stabilization with gym ball could bring a scapular alignment that increases subacromial space and reduces pain. This suggests early trunk stabilization with gym ball programs to restore shoulder functions for patients with rotator cuff repair.

• Physical Therapy Korea
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• v.24 no.4
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• pp.60-67
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• 2017

Background: Scapular downward rotation syndrome (SDRS) is a common scapular alignment impairment that causes insufficient upward rotation and muscle imbalance, shortened levator scapulae (LS) and rhomboid, and lengthened serratus anterior (SA) and trapezius. A modified shrug exercise (MSE), performing a shrug exercise with the shoulders at $150^{\circ}$ abduction, is known as an effective exercise to increase scapular stabilizer muscle activation. Previous studies revealed that scapular exercise are more effective when combined with trunk stabilization exercises in decreasing scapular winging and increasing scapular stabilizer muscle activation. Objects: The purpose of our study was to clarify the effect of MSE with or without trunk stabilization exercises in subjects with SDRS. Methods: Eighteen volunteer subjects (male=10, female=8) with SDRS were recruited for this experiment. All subjects performed MSE under 3 different conditions: (1) MSE, (2) MSE with an abdominal draw-in maneuver (ADIM), and (3) MSE with an abdominal expansion maneuver (AEM). The muscle thickness of the lower trapezius (LT) and the SA were measured using an ultrasonography in each condition. Electromyography (EMG) data were collected from the LT, LS, SA, and upper trapezius (UT) muscle activities. Data were statistically analysed using one-way repeated analysis of variance at a significance level of .05. Results: The muscle thickness of the LT and the SA were the significant different in the MSE, MSE with ADIM (MSE+ADIM) and MSE with AEM (MSE+AEM) conditions (p<.05) In both LT and SA, the order of thick muscle thickness was MSE+AEM, MSE+ADIM, and MSE alone. No significant differences were found in the EMG activities of the SA, UT, LS, and LT in all condition. Conclusion: In conclusion, MSE is more beneficial to people with SDRS when combined with trunk stabilization exercises by increased thickness of scapular stabilizer muscles.

• Journal of Korean Physical Therapy Science
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• v.26 no.2
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• pp.38-45
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• 2019

Purpose: This study purpose to comparison the effects of passive scapular alignment exercise and hold & relaxation technique on craniovertebral angle (C1~C7) with forward head posture due to using variety bag and using computer in healthy subjects. Design: Randomized Controlled Trial. Methods: 22 subjects were divide into two groups: PSAEx group and H/R group two groups. After exercise, the CVA were measured using C7 and tragus. Collected data were statistically analyzed by SPSS 20.2 Results: There were significant differences pre and post the exercise. Conclusion: PSAEx and H/R technique was effective to correct a abnormal CVA posture. The result of this study may helpful as basic data for orthopedic physical therapy.

• Journal of Korean Physical Therapy Science
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• v.6 no.2
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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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.1
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• pp.51-58
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• 2016

Background: Evidence for effective management of scapular downward rotation syndrome is limited. The present study was performed to compare the scapular muscle activation through 4weeks wall slide exercise and sling slide exercise in subjects with scapular downward rotation syndrome. Methods: Twenty-two subjects with scapular downward rotation syndrome participated in the study. Surface electromyography data were collected from the upper and lower trapezius, serratus anterior and pectoralis major during shoulder flexion of $60^{\circ}$, $90^{\circ}$ and $120^{\circ}$ in the sagittal plane. The alignment of the scapula was measured using radiographic analysis. Subjects were assessed pre and post a 4 weeks exercise (wall slide, sling slide). The significance of the difference in pre- and post-exercise within each groups was assessed using a paired t-test. The significant difference between wall- and sling-exercise was used a independent t-test. Results: In the wall slide group, the muscle activity of upper trapezius decreased significantly during shoulder flexion at $60^{\circ}$, $90^{\circ}$ and $120^{\circ}$ after 4 weeks, and the muscle activity of serratus anterior increased significantly at all angles. Also, the muscle activity of pectoralis major decreased significantly at $90^{\circ}$ and $120^{\circ}$. Conclusions: Based on such results, it can be said that wall slide exercise is effective than sling slide exercise for the subjects with scapular downward rotation syndrome.

• Clinics in Shoulder and Elbow
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• v.21 no.4
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• pp.186-191
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• 2018

Background: To determine the normal range of humeral head positioning on magnetic resonance imaging (MRI). Methods: We selected normal subjects (64 patients; group A) to study the normal range of humeral head positioning on the glenoid by MRI measurements. To compare the MRI measurement method with the computed tomography (CT), we selected group B (70 patients) who underwent both MRI and CT. We measured the humeral-scapular alignment (HSA) and the humeral-glenoid alignment (HGA). Results: The HSA in the control group was $1.47{\pm}1.05mm$, and the HGA with and without reconstruction were $1.15{\pm}0.65mm$ and $1.03{\pm}0.59mm$, respectively, on MRI. In the test group, HSA was $2.67{\pm}1.47mm$ and HGA with and without reconstruction was $1.58{\pm}1.16mm$ and $1.49{\pm}1.08mm$, on MRI. On CT, the HSA was $1.72{\pm}1.01mm$, and HGA with and without reconstruction were $1.54{\pm}0.96mm$ and $1.59{\pm}0.93mm$, respectively. HSA was significantly different according to image modality (p=0.0006), but HGA was not significantly different regardless of reconstruction (p=0.8836 and 0.9234). Conclusions: Although additional CT scans can be taken to measure decentering in patients with rotator cuff tears, reliable measurements can be obtained with MRI alone. When using MRI, it is better to use HGA, which is a more reliable measurement value based on the comparison with CT measurement (study design: Study of Diagnostic Test; Level of evidence II).

• 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.