• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2007년도 제15차 대한견주관절학회 및 제3차 Mayo Asia Elbow Club 합동 학술대회
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• pp.9-10
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• 2007

• 대한물리치료과학회지
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• 제8권1호
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• pp.907-915
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• 2001

The purpose of this study is to effectively treat low back pain for the out patients who have been treated at the oriental hospital. Sorting the low back pain patients into four types based on scapular and ilium tilting hyper/hypo mobility characteristics, it has used several kinds of acupuncture stimuli on the 4 motor points of limb skeletal muscles, analyzing the acupuncture treatment on the 12 acupuncture points with which oriental hospitals has given to the low back pain patients and comparing with this effect. It has been analyzed how effectively the acupuncture stimuli has been contributed to the low back pain patients who suffered from skeletal muscles of spinal limb thorax abdominal and spinal skeletal system. The results are as follows. 1. There has been changes after treatment in both the control and experimental groups for low back pain patients, but the latter has been more increased in changes than the former. 2. There were much effects on the balanced restorations for spinal skeletal muscle in both the control group and experimental one, but on terms of restoration degree, the degree of the experimental group was higher than that of the control group. 3. Both the contrastive treatment and the experimental one have been contributed to the balanced restoration for all of the limb thorax abdominal muscles, but there were a few differences in terms of the way for restoration and the effects for improvement according to body types. 4. On both the control and the experimental group, spinal skeletal system has been restored with balance, but the experimental group has been higher effective on the balanced restoration than the one of the control group. Considering these results both the control and the experimental treatments have been contributed to the balanced restorations for all of low back pain patients who were suffering from skeletal muscles of spinal limb thorax abdominal and spinal skeletal system, but the contribution degree for the experimental group has been higher than that of the control group.

• The Journal of Korean Physical Therapy
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• 제32권3호
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• pp.157-162
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• 2020

Purpose: This study was to evaluate several tasks performed at a high intensity in terms of their ability to elicit EMG activity in the serratus anterior by comparing the EMG activities of the serratus anterior, upper trapezius, and lower trapezius muscles during six tasks combined shoulder flexion with rotation. Methods: Fifteen healthy males were recruited to this study. Each subject was instructed to assume a sitting position without back support and asked to flex (90° or 120°) the right shoulder and protract the scapula in the sagittal plane with maximal external rotation; to assume a neutral position; or to internally rotate the glenohumeral joint. The EMG data were collected from the serratus anterior (SA), upper trapezius (UT), and lower trapezius (LT) muscles were normalized to maximum voluntary isometric contraction. The UT/LT and UT/SA muscle activity ratios in each task were assessed by calculating the surface EMG. Data were analyzed by two-way repeated-measures analysis of variance, with the level of significance set at p<0.05. Results: The results of this study, shoulder flexion with external rotation resulted in low upper trapezius/serratus anterior and upper trapezius/lower trapezius ratios and a relatively high level of serratus anterior activation. Conclusion: Shoulder flexion with external rotation used herein may be considered as important for clinical interventions aimed at selectively increasing SA strengthen and clinical selection of exercises for improving glenohumeral joint and scapulothoracic control.

• 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.

• The Korean Journal of Pain
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• 제29권3호
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• pp.179-184
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• 2016

Background: Recently, ultrasound has been commonly used. Ultrasound-guided interscalene brachial plexus block (IBPB) by posterior approach is more commonly used because anterior approach has been reported to have the risk of phrenic nerve injury. However, posterior approach also has the risk of causing nerve injury because there are risks of encountering dorsal scapular nerve (DSN) and long thoracic nerve (LTN). Therefore, the aim of this study was to evaluate the risk of encountering DSN and LTN during ultrasound-guided IBPB by posterior approach. Methods: A total of 70 patients who were scheduled for shoulder surgery were enrolled in this study. After deciding insertion site with ultrasound, awake ultrasound-guided IBPB with nerve stimulator by posterior approach was performed. Incidence of muscle twitches (rhomboids, levator scapulae, and serratus anterior muscles) and current intensity immediately before muscle twitches disappeared were recorded. Results: Of the total 70 cases, DSN was encountered in 44 cases (62.8%) and LTN was encountered in 15 cases (21.4%). Both nerves were encountered in 10 cases (14.3%). Neither was encountered in 21 cases (30.4%). The average current measured immediately before the disappearance of muscle twitches was 0.44 mA and 0.50 mA at DSN and LTN, respectively. Conclusions: Physicians should be cautious on the risk of injury related to the anatomical structures of nerves, including DSN and LTN, during ultrasound-guided IBPB by posterior approach. Nerve stimulator could be another option for a safer intervention. Moreover, if there is a motor response, it is recommended to select another way to secure better safety.

• 한국전문물리치료학회지
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• 제23권4호
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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 $120^{\circ}$.

• Physical Therapy Rehabilitation Science
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• 제5권2호
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• pp.95-100
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• 2016

Objective: The purpose of this study was to investigate effects of hand grip strength on the muscle activation of shoulder joint in breast cancer patients. Design: Cross-sectional study. Methods: Ten breast cancer patients who agreed to active participation were included. These patients were operated with either conservative surgery or segmental mastectomy, and then were treated with radiation therapy and chemotherapy. The activity of the upper trapezius, lower trapezius, supraspinatus and serratus anterior muscle were measured using surface electrodes during 4 hand gripping tasks (lowered their arms in standing position, 0%, 30%, and 50% of maximum voluntary contraction) in the scapular abduction plane. Results: The results were analyzed using a one-way repeated measures ANOVA. There was a significant difference in the lower trapezius and supraspinatus muscles according to grip strength, lower trapezius and supraspinatus muscles showed significantly difference according to grip strength (p<0.05). The result of the muscle activation according to hand strength (0%, 30%, and 50%) it showed a significant difference between the upper trapezius and supraspinatus in 0% grip strength (p<0.05). In addition, it did not show a significant difference between muscles in 30%, 50% hand strength. Conclusions: This study showed an increase in shoulder muscle activation with increasing hand grip strength with the upper trapezius muscle being more activated than other muscles in 0% grip strength. The finding of this study suggests usefulness for development of preventative measures and rehabilitation strategies for increasing shoulder motor function in patients with breast cancer.

• 한국전문물리치료학회지
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• 제17권4호
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• pp.8-15
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• 2010

This study was designed to investigate the effect of different hand positions on scapulothorcic muscle activities during push-up plus exercises. Fourteen healthy males performed push-up plus exercises under three conditions (neutral, $90^{\circ}$ internally rotated, and $90^{\circ}$ externally rotated hand positions), during which the activities of the serratus anterior, pectoralis major, and upper trapezius muscles were recorded using surface electromyography. The statistical significance at three different hand positions was tested by repeated one-way ANOVA. The mean activities of the serratus anterior increased and the mean activities of the pectoralis major decreased in the order of neutral hand position, internally rotated hand position, and externally rotated hand position. There was a significant difference during push-up plus between neutral and externally rotated hand positions as well as in the serratus anterior/pectoralis major activity ratio (p<.0.5). However, no significant differences were found in the activity of the upper trapezius muscle or the serratus anterior/upper trapezius activity ratio. We suggest that the push-up plus exercise performed in the externally rotated hand position could a beneficial strategy for selective strengthening of the serratus anterior muscle, while minimizing the activity of the pectoralis major muscle.

• 대한물리의학회지
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• 제10권4호
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• pp.81-90
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• 2015

PURPOSE: The purpose of this study was to compare the muscle architecture of serratus anterior and lower trapezius using rehabilitative ultrasound imaging (RUSI) in affected and unaffected side of chronic stroke patients. METHODS: The participants were thirty five patients with stroke hemiplegia in this study. RUSI was used to measure the muscle thickness of the serratus anterior and lower trapezius muscles. We compared the muscle thickness according to affected side and sex, determined the reliability of the measurement image. Independent t-test, intra-class correlation coefficient (ICC) and standard error of measurement (SEM) were used for statistical analysis. RESULTS: Significant difference in muscle thickness of serratus anterior was observed between affected and unaffected side (p<.001). Muscle thickness according to gender showed a significant difference in unaffected side of serratus anterior (p<.05). Compare asymmetry ratio of serratus anterior and lower trapezius muscle thickness showed a significant difference (p<.001). ICC for intra-reliability was .944~.962 in serratus anterior and .873~.925 in lower trapezius muscle thickness, respectively. SEM was .001~.004 in serratus anterior and .002~.008 in lower trapezius muscle. CONCLUSION: This study, using RUSI, showed significant difference in muscle thickness of serratus anterior in affected and unaffected side of stroke patients. RUSI is a practical tool for measuring soft-tissue thickness in the scapular region muscle of stroke.

• 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.