• 한국전문물리치료학회지
• /
• 제28권3호
• /
• pp.194-199
• /
• 2021

Background: The scapulo-thoracic musculatures including serratus anterior (SA), upper trapezius and lower trapezius can provide shoulder stability and functional shoulder movement. Objects: The muscle activities of upper and lower SA were compared during three different scapular protraction exercises in healthy individuals in sitting position. Methods: Twenty-five healthy subjects were participated. Electromyography device was used to measure muscle activity of upper and lower SA and trapezius muscles. Each subject was asked to perform three different scapular protraction exercises (scapular protraction [SP], SP with self-resistance [SPSR], SPSR with hand-exerciser [SPSRH]) in random order. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Results: The muscle activity of lower SA muscle was significantly different among three conditions (SP vs. SPSR vs. SPSRH) (p < 0.01). The lower SA muscle activity was significantly greater during SPSRH compared to SP and SPSR, which required joint stability more than SP and SPSR (p < 0.01). Conclusion: SPSRH exercise can be recommended to facilitate the muscle activity of lower SA. In addition, the intramuscular variation in the upper and lower SA during scapular protraction exercise is required to consider the effective rehabilitation.

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

• 대한물리치료과학회지
• /
• 제29권3호
• /
• pp.48-55
• /
• 2022

Background: The purpose of this study is to examine the effect of push-up plus exercise on the changes in the thickness of the trapezius trapezius, serratus anterior and pectoralis major muscles involved in shoulder stability in various support surfaces. Design: Randomized controlled trial. Methods: The thickness change of the shoulder stabilizing muscle was measured using an ultrasound device. Corresponding t-test was performed to confirm the change within the group before the experiment and after 5 weeks. And one-way ANOVA was used to confirm the change between groups after 5 weeks. As a post hoc test, the least significant difference test was performed, and the significance level was set to a=0.05. Results: Changes in the thickness of the trapezius muscle within the group were significantly different between UPEG and SPEG after 5 weeks (p<0.05), and there was a significant difference between groups after 5 weeks (p<0.05). Changes in the thickness of the serratus anterior and pectoralis major muscle within the group were significantly different after 5 weeks in PEG, UPEG and SPEG (p<0.05), and the changes between the groups were significantly different in the serratus anterior muscle after 5 weeks (p<0.05). Conclusion: From the results of this study, it was found that the push-up exercise on an unstable support surface was effective for strengthening the trapezius upper and serratus anterior. This study intends to suggest the possibility of application as basic data for a push-up plus exercise program in clinical practice.

• Clinics in Shoulder and Elbow
• /
• 제18권4호
• /
• pp.229-236
• /
• 2015

Background: Twenty-six patients (12 male and 14 female) with symptomatic scapular winging caused by serratus anterior dysfunction were managed by split pectoralis major tendon transfer (sternal head) with autogenous hamstring tendon augmentation from 1998 to 2006. Methods: Twenty-five patients showed positive results upon long thoracic nerve palsy on electromyography. The mean duration of symptoms until surgery was 48 months (range, 12-120 months). Four patients had non-traumatic etiologies and 22 patients had traumatic etiologies. On follow-up assessment for functional improvement, a Constant-Murley score was used. Twenty-one patients were completely evaluated, while five patients who had less than 12 months of follow-up were excluded. Results: Pain relief was achieved in 19 of the 21 patients, with 20 patients showing functional improvement. The pain scores improved from 6.0 preoperatively to 1.8 postoperatively. The mean active forward elevation improved from $108^{\circ}$ (range, $20^{\circ}-165^{\circ}$) preoperatively to $151^{\circ}$ (range, $125^{\circ}-170^{\circ}$) postoperatively. The mean Constant-Murley score improved from 57.7 (range, 21-86) preoperatively to 86.9 (range, 42-98) postoperatively. A recurrence developed in one patient. Of the 21 patients, ten had excellent results, six had good results, four had fair results, and one had poor results. Conclusions: Most patients with severe symptomatic scapular winging showed functional improvement and pain relief with resolution of scapular winging.

• 한국전문물리치료학회지
• /
• 제15권2호
• /
• pp.38-43
• /
• 2008

To reduce winging scapula, various exercise protocols have been widely used by clinicians. Selective serratus anterior strengthening, and restoring balanced function, are especially recommended to reduce winging scapula. The purpose of this study was to investigate visual biofeedback using a real time video camera display system for monitoring scapular winging during arm lowering. For this study, 13 males with winging scapular were recruited during arm lowering. Electromyography (EMG) activity was recorded from the serratus anterior (SA) and upper trapezius (UT) of the right side and compared with normal EMG activity using a paired t-test. The study showed, through visual biofeedback, that EMG activity significantly increased in the SA and significantly decreased in the UT (p<.05). These results suggest that visual biofeedback can be recommended as an effective method for scapular eccentric control, to prevent scapular winging during arm lowering.

• The Journal of Korean Physical Therapy
• /
• 제23권2호
• /
• pp.7-15
• /
• 2011

Purpose: We investigated the relationship between the muscle activity and kinematic variables of the upper extremity during a push-up task on stable and unstable surfaces. Methods: We recruited 15 healthy subjects. Subjects completed the push-up task on stable and unstable surfaces. Surface electromyograms were recorded from the serratus anterior, upper trapezius, latissimus dorsi, infraspinatus to monitor changes in muscle activity. Markers for kinematic changes of elbow flexion, shoulder extension, shoulder retraction and scapular adduction were attached at C7, the T7 spinous process, both acromions, the scapula superior and inferior angle, the humerus lateral epicondyle, and the ulnar styloid process. Correlation coefficients between muscle activity and kinematic variables were analyzed by SPSS for Windows, version 15.0. Results: On the unstable surface, elbow flexion and shoulder extension increased with increasing muscle activity of serratus anterior, upper trapezius and infraspinatus. On the stable surface, shoulder retraction decreased with increasing muscle activity of serratus anterior and infraspinatus. Scapular adduction decreased with all types of increasing muscle activity, regardless of the support surface. Conclusion: Correlations between muscle activity and kinematic variables were observed on stable and unstable surfaces during a push-up task, while correlations between right and left variables were not clear. These finding suggest that it may be used to develop a rehabilitation program which could be effective in improving shoulder function in patients with shoulder problems.

• The Journal of Korean Physical Therapy
• /
• 제31권2호
• /
• pp.134-139
• /
• 2019

Purpose: This study examined the most effective exercise while performing shoulder abduction below ninety degrees. Methods: Thirty two healthy individuals (17 males, 15 females) participated and performed four exercises, 1) Posterior fly, 2) Prone row, 3) Modified prone cobra, and 4) External rotation in the prone position. Surface electromyography (sEMG) was used to measure the electrical activities for the lower, middle and upper fiber of trapezius and serratus anterior. Results: A significant difference in the muscle activities of the upper/middle/lower trapezius and serratus anterior was observed among the three different positions in terms of the PF (posterior fly), PR (prone row), and MPC (modified prone cobra) (p<0.05). In post-hoc analysis, the activities of the lower and upper trapezius were significantly higher than those of the upper trapezius and serratus anterior (p<0.05). In addition, in ERP (external rotation in prone), there was a significant difference in each activity of the muscles. Post-hoc results indicated that the upper trapezius showed greater EMG activity than the other three muscles. Conclusion: External rotation in the prone position revealed the highest activation of the lower trapezius compared to upper trapezius muscle activity. This may be particularly useful in isolating the lower trapezius in cases where excessive scapular elevation is noted. Therefore, the most effective lower trapezius exercise should be performed below ninety degrees of shoulder abduction.

• PNF and Movement
• /
• 제11권1호
• /
• pp.55-62
• /
• 2013

Purpose : This study was assessed muscle activity and onset time in trunk and upper extremity on functional reaching. Methods : The participant was 18 female(young 10, old 8). As functional reaching, we collection data by using EMG(MP150) on transverse abdominis, external oblique, erector spinae, deltoid middle and serratus anterior. Results : 1) In functional reaching, transverse abdominis, external oblique, erector spinae and deltoid middle muscle activity was augmented on old female(p>.05). Serratus anterior was augmented on young female(p>.05). 2) In functional reaching, transverse abdominis and erector spinae muscle onset time is significantly faster old female than young female(p<.05). External oblique and serratus anterior muscle onset time is faster old female than young female(p>.05). 3) As increase of age muscle activity of external oblique was more increased that we found .511 a coefficient correlation and onset time more faster on transverse abdominis and erector spinae were each -.492 and -.554 coefficient correlation. Conclusion : The muscle activity and onset time was difference in functional reaching according to ageing and task context. It is necessary concentration and attention to old female than young female. Therefore, these results suggest that importance of anticipatory postural control and selective strategy of postural control.

• 대한정형도수물리치료학회지
• /
• 제11권2호
• /
• pp.71-82
• /
• 2005

The couple force of the scapular stabilizers for upward rotation that include the upper and lower trapezius, serratus anterior muscles is essential to maintain the stability of shoulder joint. But if there is an imbalance of these muscles, it would occur many problems of shoulder joint. A push-up plus exercise with an unstable support is used in order to increase the muscle activity and stimulate the proprioception of shoulder joint. The purpose of this study was to compare the muscle activity of upper and lower trapezius, serratus anterior muscles and to determine which exercise is more effective when subjects perform push-up plus exercise in the stable support and unstable support. 15 healthy subjects and 15 painful subjects with injury of shoulder joint participated in this study. Surface electromyography data were collected during plus phase of push-up plus exercise. The types of push-up plus exercise were composed of three conditions. Stable type is subjects performed the push-up plus exercise on the fixed support and unstable type 1 is on the sling without shaking and unstable type 2 is on the sling with shaking by tester's manual. The upper and lower trapezius activities of injured group were higher than uninjured group at three measure conditions, but serratus anterior activities were not. The UT/SA ratio of injured group was higher than uninjured group at three measure conditions. The serratus anterior activities were most high at unstable 2 measure in both groups. The UT/SA ratio was most low at unstable 2 measure condition in injured group only. The present result revealed that push-up plus exercise in the unstable support with shaking which took most high serratus anterior activities and most low of UT/SA ratio is optimal cure method that can improve the imbalance of the scapular stabilizer.

• 한국전문물리치료학회지
• /
• 제13권4호
• /
• pp.39-46
• /
• 2006

The purpose of this study was to determine the effects of slump sitting postures on the masticatory, neck, shoulder, and trunk muscles associated with work-related musculoskeletal disorders (WRMD). Eleven healthy adults (age, $23.3{\pm}2.7$ yrs; height, $174.0{\pm}4.1$ cm; weight, $61.4{\pm}6.6$ kg) participated in this study. The participants were free of injury history and neurologic deficits in the masticatory, neck muscles and upper extremities at the time of participation. The subjects were asked to perform erect and slump sitting postures under the guidance of physical therapists. The surface electromyography (EMG) was recorded from the anterior temporalis, masseter, upper trapezius, serratus anterior, middle trapezius, L3 paraspinal, external abdominal oblique, gluteus maximus muscles of 11 adults as they performed visual terminal display work, which are known as the weakened and tightened muscles owing to WRMD. The recorded signals were averaged and normalized to the mean amplitude of the EMG signal obtained during submaximal reference voluntary contractions. The results of study were as follows: The masseter, upper trapezius, serratus anterior, middle trapezius, L3 paraspinal, external abdominal oblique muscles significantly differed in the slump sitting posture (p<.05). The muscle activities of the serratus anterior, middle trapezius muscle, and external abdominal oblique were significantly lower and that of the masseter, upper trapezius, L3 paraspinal muscles were significantly higher. Further research is needed to assess the motor control problems and the function of the deep muscles in posture stability of patients with WRMD.