• 한국전문물리치료학회지
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• 제26권3호
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• pp.1-10
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• 2019

Background: Winged scapular (WS) causes muscle imbalance with abnormal patterns when moving the arm. In particular, the over-activation of the upper trapezius (UT) and decrease in activity of the lower trapezius (LT) and serratus anterior (SA) produce abnormal scapulohumeral rhythm. Therefore, the SA requires special attention in all shoulder rehabilitation programs. In fact, many previous studies have been devoted to the SA muscle strength training needed for WS correction. Objects: The purpose of this study was to investigate the effect of shoulder girdle muscle and ratio according to the angle of shoulder abduction and external weight in supine position. Methods: Twenty three WS patients participated in this experiment. They performed scapular protraction exercise in supine position with the weights of 0 kg, 1 kg, 1.5 kg, and 2 kg at shoulder abduction angles of $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, and $90^{\circ}$. The angle and weight applications were randomized. Surface electromyography (EMG) was used to collect the EMG data of the SA, pectoralis major (PM), and UT during the exercise. The ratio of PM/SA and UT/SA was confirmed. Two-way repeated analyses of variance were used to determine the statistical significance of SA, PM, and UT and the ratios of PM/SA and UT/SA. Results: There was a significant difference in SA according to angle (p<.05). Significant differences were also identified depending on the angle and weight (p<.05). The angle of abduction at $0^{\circ}$, $30^{\circ}$ and weight of 2 kg showed the highest SA activity. However, there was no significant difference between PM and UT (p>.05). There was a significant difference between PM/SA and UT/SA in ratio of muscle activity according to angle (p<.05). Significant differences were found at PM/SA angles of $30^{\circ}$, $60^{\circ}$ and $90^{\circ}$ (p<.05). For UT/SA, significant difference was only observed at $90^{\circ}$ (p<.05). Conclusion: Based on the results of this study, in order to strengthen the SA, it was found to be most effective to use 1 and 1.5 kg weights with abduction angles of $0^{\circ}$ and $30^{\circ}$ at shoulder protraction in supine position.

• PNF and Movement
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• 제5권2호
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• pp.1-10
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• 2007

Purpose : The purpose of this study was conducted to find treatment of forward head posture and shoulder instability with proprioceptive neuromuscular facilitation concept. Methods : This is literature study with books, seminar note and international course. Results : Forward head posture and shoulder instability has related each other. Forward head posture will make muscle instability, weakness and stiffness on neck and shoulder girdle. It will make pain also. Important muscle are suboccipital muscles, omohyoid muscle, sternoclaidomastoid muscle, scaleni, pectoralis minor, levator scapular and digastric. Conclusion : Treatment of the forward head posture and shoulder instability is provided. It is that treatment of stiff muscle with eccentric muscle work, muscle elongation, muscle strengthening at the structure level and at the functional level for daily activities.

• 대한약침학회지
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• 제7권2호
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• pp.57-64
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• 2004

This study was carried to identify the component of Small Intestine Meridian Muscle in human, dividing the regional muscle group into outer, middle, and inner layer. the inner part of body surface were opened widely to demonstrate muscles, nerve, blood vessels and the others, displaying the inner structure of Small Intestine Meridian Muscle. We obtained the results as follows; 1. Small Intestine Meridian Muscle is composed of the muscle, nerve and blood vessels. 2. In human anatomy, it is present the difference between a term of nerve or blood vessels which control the muscle of Meridian Muscle and those which pass near by Meridian Muscle. 3. The inner composition of meridian muscle in human arm is as follows ; 1) Muscle ; Abd. digiti minimi muscle(SI-2, 3, 4), pisometacarpal lig.(SI-4), ext. retinaculum. ext. carpi ulnaris m. tendon.(SI-5, 6), ulnar collateral lig.(SI-5), ext. digiti minimi m. tendon(SI-6), ext. carpi ulnaris(SI-7), triceps brachii(SI-9), teres major(SI-9), deltoid(SI-10), infraspinatus(SI-10, 11), trapezius(Sl-12, 13, 14, 15), supraspinatus(SI-12, 13), lesser rhomboid(SI-14), erector spinae(SI-14, 15), levator scapular(SI-15), sternocleidomastoid(SI-16, 17), splenius capitis(SI-16), semispinalis capitis(SI-16), digasuicus(SI-17), zygomaticus major(Il-18), masseter(SI-18), auriculoris anterior(SI-19) 2) Nerve ; Dorsal branch of ulnar nerve(SI-1, 2, 3, 4, 5, 6), br. of mod. antebrachial cutaneous n.(SI-6, 7), br. of post. antebrachial cutaneous n.(SI-6,7), br. of radial n.(SI-7), ulnar n.(SI-8), br. of axillary n.(SI-9), radial n.(SI-9), subscapular n. br.(SI-9), cutaneous n. br. from C7, 8(SI-10, 14), suprascapular n.(SI-10, 11, 12, 13), intercostal n. br. from T2(SI-11), lat. supraclavicular n. br.(SI-12), intercostal n. br. from C8, T1(SI-12), accessory n. br.(SI-12, 13, 14, 15, 16, 17), intercostal n. br. from T1,2(SI-13), dorsal scapular n.(SI-14, 15), cutaneous n. br. from C6, C7(SI-15), transverse cervical n.(SI-16), lesser occipital n. & great auricular n. from cervical plexus(SI-16), cervical n. from C2,3(SI-16), fascial n. br.(SI-17), great auricular n. br.(SI-17), cervical n. br. from C2(SI-17), vagus n.(SI-17),hypoglossal n.(SI-17), glossopharyngeal n.(SI-17), sympathetic trunk(SI-17), zygomatic br. of fascial n.(SI-18), maxillary n. br.(SI-18), auriculotemporal n.(SI-19), temporal br. of fascial n.(SI-19) 3) Blood vessels ; Dorsal digital vein.(SI-1), dorsal br. of proper palmar digital artery(SI-1), br. of dorsal metacarpal a. & v.(SI-2, 3, 4), dorsal carpal br. of ulnar a.(SI-4, 5), post. interosseous a. br.(SI-6,7), post. ulnar recurrent a.(SI-8), circuirflex scapular a.(SI-9, 11) , post. circumflex humeral a. br.(SI-10), suprascapular a.(SI-10, 11, 12, 13), first intercostal a. br.(SI-12, 14), transverse cervical a. br.(SI-12,13,14,15), second intercostal a. br.(SI-13), dorsal scapular a. br.(SI-13, 14, 15), ext. jugular v.(SI-16, 17), occipital a. br.(SI-16), Ext. jugular v. br.(SI-17), post. auricular a.(SI-17), int. jugular v.(SI-17), int. carotid a.(SI-17), transverse fascial a. & v.(SI-18),maxillary a. br.(SI-18), superficial temporal a. & v.(SI-19).

• 한국전문물리치료학회지
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• 제25권1호
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• pp.62-70
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• 2018

Background: Sitting posture influences movements of scapulothoracic and glenohumeral joints and changes the shoulder muscle activities. The development and maintenance of correct sitting posture is important for the fundamental treatment of shoulder pain during rehabilitation. Objects: The purpose of this study was to investigate the effects of the sitting postures and the shoulder movements on shoulder muscle activities for both male and female. Methods: Twenty-eight subjects without shoulder-related diseases participated in this experiment. The subjects had randomly adopted three different sitting postures (upright posture, preferred posture, maximum slouched posture) and shoulder flexion angles in scapular plane ($30^{\circ}$, $90^{\circ}$, $120^{\circ}$). Surface electrodes were collected from upper trapezius (UT), anterior deltoid (AD), and posterior deltoid (PD) and the active shoulder range of motion was measured in each sitting posture and shoulder flexion angle. Results: The active range of motions of the shoulder external rotation and the flexion in the scapular plane decreased from the upright posture to the maximum slouched posture (p<.05, mixed-effect linear regression with random intercept, Tukey post-hoc analysis). All muscles showed the highest EMG activities at $120^{\circ}$ shoulder flexion with the maximum slouched posture and did not show the gender differences. Conclusion: Increased shoulder muscle activities may become the potential risk factor for the shoulder impairment and pain if people continuously maintain the maximum slouched posture. Therefore, an upright position is necessary during shoulder exercises, as well as in activities of daily living, including motions involving lifting the arms.

• 대한정형도수물리치료학회지
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• 제27권3호
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• pp.37-46
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• 2021

Background: The increase in the activity of the upper trapezius (UT) muscle and decrease in the activity of the serratus anterior (SA) and lower trapezius (LT) muscle produce an abnormal scapulohumeral rhythem. Therefore, the SA is the focus of therapeutic exercise protocols for the rehabilitation. This study aimed to compare the activity of the muscles according to resistance levels during protraction exercise. Methods: Thirteen healthy 20 to 30 years old male and female subjected participated in the study. All subjects performed the scapular protraction exercise with the weights of 0, 5, and 10kg, combined with horizontal shoulder abduction and adduction. The electromyography data of the SA, UT, and pectoralis major (PM) during the exercise were recorded using surface electrodes. The ratios of PM/SA and UT/SA were calculated. Repeated one-way ANOVA was used to determine the statistical significance. Results: There was a significant difference in the muscle activity of the SA and PM (p<.05). Specifically, SA had the highest activity and PM had the lowest activity at an abduction resistance 10kg (p<.01). There was a significant difference in the ratios of UT/SA and PM/SA (p<.05). The ratio of PM/SA was the lowest at the abduction resistance of 10kg (p<.01). Conclusion: According to this study, for the selective activation of the serratus anterior, protraction exercises should be applied as a method of adding resistance to protraction and horizontal abduction.

• The Korean Journal of Pain
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• 제5권2호
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• pp.239-248
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• 1992

Two hundred sisty five patients who complained of neck pain with stiffness and pain of the suprascapular area were studied. In most cases the anatomical locations of pain were in the levator scapulae muscles or trapezius muscles. Hyperactivity of dorsal scapular nerve or spinal accessory nerve which innervate those muscles was thought to be responsible for these pains. The hyperactivity of the nerves may be due to the spasm of the sternocleidomastoid muscle and the scalenus medius muscle which the nerves meet during their courses to the levator scapulae or trapezius muscles. Therefore, spasmolytic treatment on the scalenus medius provided effective relief for neck or shoulder pain.

• The Journal of Korean Physical Therapy
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• 제22권5호
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• pp.1-8
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• 2010

Purpose: This study aimed to provide a scientific basis for effects of the push-up plus exercise program on scapular position and on muscle activity in individuals with rounded shoulder posture (RSP). Methods: The supine method was applied to 46 potential subjects, of which 30 with RSP were selected. Subjects with RSP were divided into two groups: a gender push-up plus group as the experimental group a pectoralis minor self.stretch group as the control group. RSP data after 4 weeks of each intervention were obtained and analyzed to measure the activities of the 3 muscles. Results: The two groups differed significantly with regard to EMG changes in the serratus anterior (p<0.05). The EMG results indicated a significant reduction in the activity of the upper trapezius in the experimental group (p<0.05). EMG results indicated a significant increase in the activity of the serratus anterior after the intervention (p<0.05). EMG results of the subjects in the control group indicated that the activity of the upper trapezius significantly decreased (p<0.05). The RSP values of the subjects in both groups were significantly decreased (p<0.00). Conclusion: An improvement in the strength of the serratus anterior, and in the stretch effectiveness of the pectoralis minor, as well as changes in the scapular position were observed after 4 weeks of push-up plus exercise by the subjects.

• 대한정형도수물리치료학회지
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• 제23권1호
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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.

• The Journal of Korean Physical Therapy
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• 제19권6호
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• pp.17-22
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• 2007

Purpose: To evaluate the quantitative isometric muscle strength of shoulder girdle and the test reliability using by the equipment, named 'IsoTrack', selected by authors in the former studies. Methods: Thirty healthy subjects (9 men, 21 women) were recruited in two sessions, one for intratester and intertester reliability tests and the other quantitative isometric muscle strength tests. The neck flexion, extension and scapular elevation muscle strength was measured using a force measuring device as IsoTract. Results: Intraclass correlation coefficients for intratester reliability of the all subjects ranging between 0.96 and 0.97. For intertester reliability, the ICC and Pearson correlation correspond to 0.84 and 0.78. We gauged muscle strength of shoulder girdle muscles based on it and indicated quantified isometric muscle strength of women and men in left and right side. Conclusion: We concluded that there were high reiliability of isometric muscle strength of neck and shoulder girdle. Also, we gauged muscle strength of shoulder girdle muscles based on it and indicated quantified isometric muscle strength in left and right side in women and men. So this findings may assist in the measure of whole body muscle strength.

• 대한통합의학회지
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• 제4권1호
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• pp.13-20
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• 2016

Purpose : The purpose of this study was to compare the effect of exercise on the neck muscles activities between scapular stability and McKenzie stretch exercise in the forward head posture subjects. Method : After measuring cervical alignment using the Global Posture System, 20 volunteers with forward head posture posture were selected and divided into two groups. The experimental group A(n=15) and Experimental group B(n=15) participated in respectively and McKenzie neck stretching exercise, three times per week for 4 weeks. The scapular stabilization exercise program was comprised middle and lower trapezius strength exercises and the stretching exercise program was comprised levator scapulae and upper trapezius stretching exercise. The activities of the muscles of the posterior neck was then measured using electromyography. Result : After the intervention, there was significant difference of a electromyography activity changes between the pre-test and post-test in the experimental group. Conclusion : This study showed that both scapular stabilization and McKenzie neck stretching exercises are more effective for reducing neck muscles activities.