• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.1
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• pp.31-41
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• 2017

Background: The purpose of this study was investigate the effects of scapular posture correction taping in painful shoulders with breast cancer women. Method: This study was carried out with a total 35 breast cancer survivors. The subjects were randomized into women a breast cancer taping group (BT, n=15), a breast cancer posture group (BP, n=16). Outcomes such as the Quadruple Visual Analogue Scale, the Shoulder Pain and Disability Index, the muscle strength, and the Quality of Life Questionnaire-cancer were measured before the training and at 4 weeks and 12 weeks after intervention. Result: There were significant variations shoulder pain, dysfunction and Range of Motion among the groups and between points in time (p<.05). However, there was no significant difference upper extremity posture between BT and BP. There were significant variations all ROM muscle strength between the groups and between points in time (p<.05). Conclusion: Applying taping treatment to breast cancer patients proved to decrease in pain and significant in dysfunction. There were significant increase in range of motion.

• Physical Therapy Korea
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• v.30 no.2
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• pp.160-168
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• 2023

Background: Individuals with scapular winging have a weak serratus anterior (SA) muscle, and to compensate, the pectoralis major (PM) and upper trapezius (UT) muscles excessively activate, which can cause upper extremity dysfunction. This study aimed to compare the effects of isometric horizontal abduction (IHA) on SA, PM, and UT muscle activity, as well as the SA/PM and SA/UT muscle activity ratios during knee push-up plus (KPP) at 90° and 120° of shoulder flexion. Objects: This study aimed to compare the effects of IHA on SA, PM, and UT muscle activity, as well as the SA/PM and SA/UT muscle activity ratios during KPP at 90° and 120° of shoulder flexion. Methods: This study, conducted at a university research laboratory, included 20 individuals with scapular winging. Participants performed KPP with and without IHA at 90° (KPP90) and 120° (KPP120) of shoulder flexion. SA, PM, and UT muscle activity were measured using surface electromyography. Results: PM activity in KPP90 with IHA was significantly lower than KPP90 and in KPP120 was significantly lower than KPP90. UT activity was significantly greater with IHA than without IHA and at 120° than 90° of shoulder flexion. SA/PM muscle activity ratio was significantly higher in KPP90 with IHA than without IHA and in KPP120 than in KPP90. SA/UT muscle activity ratio was significantly lower with IHA than without IHA. Conclusion: KPP90 with IHA and KPP120 are effective exercises to reduce PM activity and increase SA/PM muscle activity ratio. However, applying IHA in KPP90 also reduces SA/UT muscle activity ratio, implying that it would be preferable to apply KPP120 in individuals overusing their UT muscles.

• Physical Therapy Korea
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• v.25 no.3
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• pp.39-50
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• 2018

Background: High string instrument (violin, viola) players are at high risk for developing musculoskeletal problems. In particular, a higher prevalence of shoulder problems has been reported. However, evidence of the effectiveness of therapeutic exercise for musicians with this condition is lacking until now. Objects: This case series study investigated the effect of a specific exercise program on shoulder pain, dysfunction, and posture of professional orchestral high string musicians. Methods: Five professional orchestral high string players with shoulder pain participated in this study. A six-week specific exercise program focus on scapular stability for shoulder pain consisted of scapular muscle exercise. Physical examinations for pain and dysfunction, posture were performed, were identified among all subjects before starting the exercise program. Results: The results revealed that shoulder pain decreased by 67.86% and the effect of pain on instrument play decreased by 63.33%. The shoulder pain and disability Index and the performing arts module-quick disability of the arm, shoulder and hand scale decreased by 71.72% and 51.61% respectively. The exercise program improved function and posture. Conclusion: A specific exercise program for high string players was effective in managing shoulder pain. This case series is intended to provide empirical data on the effectiveness of an exercise program aimed at assessing the effect of exercise on pain, dysfunction, and posture of professional orchestra musicians associated with specific instrument groups.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.1
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• pp.1975-1980
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• 2020

Background: It has been argued that changes in muscle activity in the upper trapezius and serratus anterior may or may not cause shoulder joint pain and dysfunction. Objective: To investigate the effects of active vibration exercise on muscle activity regarding scapular stabilization using a flexi-bar. Design: A randomized controlled trial. Methods: A total of 24 subjects were randomly assigned to a flexi-bar group with active vibration and general stick group with non-active vibration. Both groups performed the same four action programs for 6 weeks, three times a week for 30 minutes at a time. The upper trapezius muscle, middle trapezius muscle, lower trapezius muscle and serratus anterior muscle of the dominant side was measured by electromyography before and after the 6 weeks of exercise. The independent t-test and paired t-test were used to analyze data. Results: There was a significant difference between groups in upper trapezius muscle and serratus anterior muscle activity after exercise (P<.05). Also, there was a significant difference in upper trapezius muscle and serratus anterior muscle activity before and after exercise in the flexi-bar group (P<.05). Conclusion: This study demonstrates that active vibration exercise using a flexi-Bar contribute to reduce the activity of the upper trapezius muscle and promote the activity of the serratus anterior muscle.

• Clinics in Shoulder and Elbow
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• v.24 no.1
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• pp.42-52
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• 2021

Reverse shoulder arthroplasty is an ideal treatment for glenohumeral dysfunction due to cuff tear arthropathy. As the number of patients treated with reverse shoulder arthroplasty is increasing, the incidence of complications after this procedure also is increasing. The rate of complications in reverse shoulder arthroplasty was reported to be 15%-24%. Recently, the following complications have been reported in order of frequency: periprosthetic infection, dislocation, periprosthetic fracture, neurologic injury, scapular notching, acromion or scapular spine fracture, and aseptic loosening of prosthesis. However, the overall complication rate has varied across studies because of different prosthesis used, improvement of implant and surgical skills, and different definitions of complications. Some authors included complications that affect the clinical outcomes of the surgery, while others reported minor complications that do not affect the clinical outcomes such as minor reversible neurologic deficit or minimal scapular notching. This review article summarizes the processes related to diagnosis and treatment of complications after reverse shoulder arthroplasty with the aim of helping clinicians reduce complications and perform appropriate procedures if/when complications occur.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.13 no.1
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• pp.45-53
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• 2018

Objectives: This report aimed to provide an introduction to the analysis of the Biolinkage System. Methods: During diagnosis, the Biolinkage System was first classified into Type I & Type II according to the Patric's Test and the Pelvic Twist Analysis; the two types were then sub-classified into Step I, II, III according to the Thompson's sacrum test, Patrick's test, Scapular Fixation Test, and Pelvic Twist Analysis. During treatment, the sacrum-axis-temporomandibular joints were used in Step I, the hip joint-fourth cervical or scapular-occiput were used in Step II, and lastly the thoracic cage is used in Step III. Conclusions: The Biolinkage System is useful in the examination of somatic dysfunction.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.1
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• pp.29-36
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• 2019

Background: This study was conducted to investigate the effect of leg lift difference on the serratus anterior muscle and the upper trapezius muscle when a subject with winged scapula performs a scapula protraction exercise in a four-leg crawling posture. Method: Twenty normal adults and 20 subjects with winged scapula participated in the experiment. Surface EMG recordings were collected from serratus anterior muscle and back trapezius muscle during scapula protraction exercises. Scapular winging is measured with the lifting distance of scapula retraction to the back using an electronic digital caliper. In two groups of four-leg crawling posture, the two legs support, the dominant leg lifting, and the non-dominant leg lifting, including the scapula protraction, were performed. To examine the difference between groups in the variance analysis, the Bonferroni correction was used (significance level ${\alpha}=.017$). Statistical significance level ${\alpha}$ was .05. Results: There was a significant difference in serratus anterior muscle and upper trapezius muscle during push-up plus exercise in leg lifting in four-leg crawling posture, but there were no significant differences in muscle activity between serratus anterior muscle and upper trapezius muscle, and there was no significant difference according to the presence or absence of scapular winging. Conclusion: For the shoulder stability of the ipsilateral side with the serratus anterior muscle, the leg-lifting posture is effective in the four-leg crawling, and also when a subject with winged scapula chooses an exercise, lifting the ipsilateral side of leg with scapula protraction exercises at the same time may have a positive effect on scapula dysfunction.

• Physical Therapy Korea
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• v.23 no.4
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• pp.55-62
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• 2016

Background: The functioning of the serratus anterior (SA) muscle is essential to normal scapulohumeral rhythm during forward flexion (FF) of the shoulder. Also, SA weakness and overuse of the upper trapezius (UT) is observed in patients with shoulder dysfunction and trapezius myalgia. We designed a combination exercise involving FF and scapular protraction with resistance (CFFSP) to activate the SA muscle and to deactivate the UT muscle. Objects: The purpose of this study was to determine whether or not CFFSP would be more effective in activating the SA muscle than FF alone and FF with scapular protraction (FFP). Methods: Nineteen subjects (12 men and 7 women) participated in this study and performed FF, FFP, and CFFSP at $120^{\circ}$. Surface electromyography was applied to the SA, UT, and pectoralis major (PM) muscles, as was one-way analysis of variance (ANOVA) with repeated measures. Statistical significance was set at .05. Bonferroni adjustment was used to counteract the problem of multiple comparisons, with a statistical level of significance of .017 (.05/3). Results: A statistically significant difference was found in relation to the three positions for the SA muscle (p<.001) and the SA/UT ratio (p=.005) using ANOVA. Significantly different results, depending on the position, were also demonstrated using the Bonferroni post-hoc test for the SA muscle ($FF=28.27{\pm}16.20$, $FFP=45.66{\pm}15.81$, and $CFFSP=62.4{\pm}27.21$) and for the SA/UT ratio ($FF=3.04{\pm}2.14$, $FFP=3.61{\pm}2.38$, and $CFFSP=5.95{\pm}3.01$). Significant differences between the three positions was not found regarding the average amplitude of SA/PM muscle ratio (SA/PM: p=.060). Conclusion: We recommend the use of CFFSP to strengthen the SA muscle at $120^{\circ}$.

• 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.

• The Journal of Korean Physical Therapy
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• v.24 no.6
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• pp.388-392
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• 2012

Purpose: Muscle imbalance between upper trapezius (UT) and serratus anterior (SA) during arm elevation is a factor causing shoulder dysfunction. However, there is no study to compare the muscle activities of the UT and middle deltoid (MD). The purpose of this study was to compare the muscle activities of the UT and MD between with and without elevation of shoulder girdle (ESG) during shoulder abduction. Methods: The subjects without (control group=9) or with (ESG group=8) participated in this study. The muscle activities of the UT and MD were measured using a electromyography during $90^{\circ}$ shoulder abducted position in both group. The data in middle of 3-second of the 5-second periods were used. The mean value of three trials was used in the data analysis. For each muscle, independent t-tests were performed to compare for group differences. Results: The muscle activity of UT was significantly greater in ESG group, compared to that of the control group (p<0.05). The muscle activity of MD was significantly smaller in ESG group, compared to that of the control group (p<0.05). Conclusion: These findings showed that low muscle activation of MD as well as SA may contribute to hyperactivity of UT during arm elevation.