• Physical Therapy Korea
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• v.19 no.4
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• pp.32-37
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• 2012

The purpose of this study was to investigate the quantitative data of downward pulling tension in subjects with scapular downward rotation syndrome (SDRS) before and after 6-week self scapular upward rotation exercise (SURE) program. Eleven subjects with bilateral SDRS. The downward pulling tension(DPT) was measured digital tension-meter. The tension force data were collected using a surface electromyography before and after a 6-week self-scapular SURE program. The significance of difference between pre- and post-program was assessed using a paired t-test, with the level of significance set at ${\alpha}$=.05. The results showed that significant differences between pre- and post-SURE program were found for DPT (p<.05). These findings suggest that 6-week self SURE program is effective for reducing DPT in subjects with SDRS. Additionally, our DPT measurement can be useful for maintaining shoulder position and providing quantitative data between pre- and post-SURE program during passive correction of scapular position test.

• Journal of Korean Physical Therapy Science
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• v.30 no.3
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• pp.14-22
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• 2023

Background: This study was to investigate the relationship between scapular downward rotation ratio (SDRR), lower trapezius (LT) muscle, and rounded shoulder angle (RSA) on each side in subjects with scapular downward rotation syndrome (SDRS). Design: Cross-sectional Study Methods: Fifteen subjects have participated in this study. The RSA and SDRR were assessed using a tape measure in standing posture. The RSA was computed by the angle made by two lines: one was the distance between the root of the scapula and the acromion, and the other was the distance between the acromion and the horizontal line in the root of the scapula. The SDRR was computed by two horizontal lines: one was the distance between the mid-line and root of the scapula, and the other was the distance between the mid-line and inferior angle of the scapula. LT muscle strength was performed in a prone position by the hand-held dynamometer. Results: There was a positive correlation between SDRR and LT strength in the less affected sides (r=.59; p=.02), however, there was no correlation between RSA and LT strength in the more affected sides (p>.05).

• 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.

• Physical Therapy Korea
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• v.21 no.3
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• pp.73-79
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• 2014

The purposes of the current study were to (1) estimate the inter-rater agreement for visual assessment of scapular downward rotation (SDR), (2) develop the scapular downward rotation index (SDRI) as a method to measure SDR objectively and quantitatively, and (3) analyze the intra- and inter-rater reliability of the SDRI. Twenty subjects with scapular downward rotation syndrome (SDRS) were recruited for this study. The visual assessment and the measurement for the SDRI were conducted by two examiners in two sessions each. The SDRI [$(a-b){\div}a{\times}100$] is calculated with the measurement of two linear distances: One is a perpendicular distance from the root of the scapular spine to the thoracic mid-line (a), and the other is a perpendicular distance from the inferior angle of the scapula to the thoracic mid-line (b). Cohen's kappa coefficient was calculated to estimate the inter-rater agreement for visual assessment. Intra-class correlation coefficients (ICCs) with a 95% confidence interval (CI), the standard error of measurement, and minimal detectable differences were calculated to assess intra- and inter-rater reliability of SDR measurement using the SDRI. The results indicated that the kappa coefficient of inter-rater agreement for visual assessment was fair (${\kappa}=.21$). The intra-rater reliability of SDR measurement using the SDRI was excellent for examiner 1 (ICC=.92, 95% CI=.78~.97) and good for examiner 2 (ICC=.82, 95% CI=.55~.93). The inter-rater reliability was moderate (ICC=.73, 95% CI=.32~.89). These findings showed that SDR measurement using the SDRI for subjects with SDRS may be considered reliable and better than the visual assessment.

• 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 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.25 no.4
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• pp.1-8
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• 2018

Background: Round shoulder posture, results from excessive flexed posture of the thorax, is defined as a position of scapular protraction, anterior tipping, and downward rotation. However, previous studies have focused on only passive position of the thorax during scapular posterior tilting (SPT) and have not reported on SPT combined with correction of flexed posture. Objects: The aim of this study was to compare effects of SPT and SPT with prone trunk extension (SPT + PTE) on activities of the lower trapezius, serratus anterior, and thoracic erector spinae and degree of posture in subjects with round shoulder and flexed posture. Methods: Fifteen subjects with round shoulder and flexed posture were recruited. The caliper was used to measure the degree of round shoulder and flexed posture. Electromyography was performed to collect data of muscle activities. Paired t-test was used to compare two exercise (${\alpha}=.05$). Results: When SPT + PTE was applied, the degree of round shoulder posture (p=.001) and flexed posture (p=.039) significantly decreased compared with that when SPT was applied. The lower trapezius activity significantly increased in the SPT + PTE condition compared with that in the SPT condition (p=.026). There were no significant differences in serratus anterior activity between SPT + PTE and SPT. The thoracic erector spinae activity significantly increased in the SPT + PTE condition compared with that in the SPT condition (p=.014). Conclusion: SPT + PTE might be one of the effective methods to enhance activities of lower trapezius and thoracic erector spinae, and to reduce round shoulder posture and flexed posture in subjects with round shoulder and flexed posture.