• Journal of Chest Surgery
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• 제57권3호
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• pp.291-299
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• 2024

Background: Postoperative pain management following minimally invasive repair of pectus excavatum (MIRPE) remains a critical concern due to severe post-procedural pain. Promising results have been reported for cryoanalgesia following MIRPE; however, its invasiveness, single-lung ventilation, and additional instrumentation requirements remain obstacles. Serratus anterior plane block (SAPB) is a regional block technique capable of covering the anterior chest wall at the T2-9 levels, which are affected by MIRPE. We hypothesized that SAPB would be a superior alternative pain control modality that reduces postoperative pain more effectively than conventional methods. Methods: We conducted a retrospective study of patients who underwent MIRPE between March 2022 and August 2023. The efficacy of pain control was compared between group N (conventional pain management, n=24) and group S (SAPB, n=26). Group N received intravenous patient-controlled analgesia (IV-PCA) and subcutaneous local anesthetic infusion. Group S received bilateral continuous SAPB with 0.3% ropivacaine after a bilateral bolus injection of 30 mL of 0.25% ropivacaine with baseline IV-PCA. Pain levels were evaluated using a Visual Analog Scale (VAS) at 1, 3, 6, 12, 24, 48, and 72 hours postoperatively and total intravenous rescue analgesic consumption by morphine milligram equivalents (MME). Results: Mean VAS scores were significantly lower in group S than in group N throughout the 72-hour postoperative period (p<0.01). Group S showed significantly lower MME at postoperative 72 hours (group N: 108.53, group S: 16.61; p<0.01). Conclusion: SAPB improved immediate postoperative pain control in both the resting and dynamic states and reduced opioid consumption compared to conventional management.

• The Journal of Korean Physical Therapy
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• 제27권5호
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• pp.325-331
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• 2015

Purpose: This study attempts to understand the effect of stabilization exercise of biofeedback scapular on muscle activity and functional evaluation of the upper extremity in stroke patients. Methods: Patients were divided into two groups; a biofeedback scapular stabilization exercise group comprised of 8 patients and a task-oriented training group including another 8 patients, and 30-minute exercise was performed 5 times a week for 8 weeks. Electromyogram was used to measure muscular activity of lower trapezius, deltoid middle, and serratus anterior. Fugl-Meyer Assessment and Manual Function Test were used to evaluate functions of the muscles mentioned. Results: Significant difference was observed in the comparison group before and after exercise in muscular activity of lower trapezius, deltoid middle, and serratus anterior, Fugl-Meyer Assessment, and Manual Function Test. Conclusion: Therefore, we could see that biofeedback scapular stabilization exercise is more effective than task-oriented training in facilitating muscle activation and functional capacity of upper limb.

• The Korean Journal of Pain
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• 제5권1호
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• pp.63-68
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• 1992

One hundred and four patients who complained of chest pain or back pain in the region between scapular were studied. In most cases, anatomical location of pain was in the rhomboid or serratus anterior muscle. Hyperactivity of dorsal scapular nerve or long thoracic nerve which innervate those muscles was thought to be responsible for the pain. The hyperactivity of the nerves may be due to the spasm of the scalenus medius muscle which the nerves meet during their course to the rhomboid or serratus anterior muscles. Therefore, spasmolytic treatment including trigger point injection, physical therapy, laser therapy, or NSAIDs may be effective for the treatment of chest pain or back pain.

• The Journal of Korean Physical Therapy
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• 제27권4호
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• pp.246-251
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• 2015

Purpose: The purpose of this study was to compare activities of shoulder girdle muscles according to types of closed chain exercise in the sixties. Methods: The subjects consisted of 15 persons in their sixties. Muscle activity of the pectoralis major, deltoid middle, deltoid posterior, upper trapezius, lower trapezius, and serratus anterior were measured using electromyography according to shape of the support base and angle of shoulder flexion. According to types of closed chain exercises, muscles activities were compared by paired t-test. Significance level to verify statistical significance was .05. SPSS win (ver. 22.0) program was used for statistical analysis. Results: Muscle activities of the pectoralis major, middle deltoid, trapezius lower, and serratus anterior showed significant difference according to types of closed chain exercise (p<0.05). Conclusion: According to types of closed chain exercises of the shoulder girdle, muscle activities of the pectoralis major, deltoid middle, posterior and lower trapezius showed change of muscle activities.

• 한국운동역학회지
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• 제18권4호
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• pp.143-149
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• 2008

본 연구의 목적은 다운증후군 아동들의 T-ball 스윙 중에 작용하는 근육의 활동을 규명하는 것이다. 다운증후군을 가진 남자 아동 5명을 대상으로 T-ball 스윙 중에 중요하게 작용하는 pectoralis major, upper serratus, lat dorsi, anterior deltoid, rhomboids, infraspinatus, posterior deltoid의 근육활동을 노락슨 8채널 무선 근전도 측정시스템을 사용하여 시작-백스윙, 백스윙-임팩트, 임팩트-팔로스루 구간으로 나누어 분석하였다. 다운증후군 아동들은 정상아동 및 성인선수들보다 시작-백스윙 구간 및 백스윙-임팩트 구간에서 오른쪽 및 왼쪽 상체 부위의 근육활동이 더 두드러지게 나타났다. 반면에 임팩트-팔로스루 구간에서는 정상아동 및 성인선수들에 비해 더 적은 근육활동이 나타났다. 특히 임팩트 후 팔로스루 구간에서 어깨 수평 내전근인 pectoralis major와 견갑골 외전 및 상방 회전근인 upper serratus 근육의 활동 강화가 필요한 것으로 나타났다.

• 한국전문물리치료학회지
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• 제17권1호
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• pp.77-85
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• 2010

This study was conducted to find the effects of scapular taping on muscle activities of the scapular rotators and upper trapezius pain in subjects with upper trapezius pain. Fifteen male subjects were recruited from Yonsei University for this study. Muscle activity of upper trapezius, lower trapezius, and serratus anterior was measured using surface electromyography. Visual analog scale was used for measuring upper trapezius pain. The subjects were asked to maintain $90^{\circ}$ shoulder flexion position with holding a 1 kg dumbbell in standing position. Scapular taping was applied over the muscle belly of the upper trapezius and attached parallel with the lower trapezius muscle fibers. For normalization, % maximal voluntary isometric contraction (%MVIC) was conducted. Paired t-test was applied to compare the muscle activities of scapular rotator and upper trapezius pain before and after applying the scapular taping. The muscle activity of the upper trapezius muscle and serratus anterior decreased significantly after tape application (p<.05). However, no significant difference was observed in lower trapezius muscle. The level of pain in the upper trapezius muscle significantly decreased after tape application (p<.05). The results of this study suggest that scapular taping can be used an additional therapy for reducing muscle activity of upper trapezius, serratus anterior and upper trapezius pain during shoulder flexion in patient with upper trapezius pain.

• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.106-111
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• 2016

Purpose: The aim of this study is to determine the effect of glenohumeral (GH) rotation position in modified knee push-up plus exercise (MKPUP) by examining the surface electromyography (EMG) amplitude in serratus anterior (SA), pectoralis major (PM), and upper trapezius (UTz) and the activity ratio of each muscle. Methods: A total of 22 healthy subjects volunteered for the study. Each subject performed the MKPUP at $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$ of GH joint internal rotation. EMG of the SA and PM, UTz was compared between GH rotation positions and each muscle activity ratio. EMG was used to measure the muscle activity in terms of ratios to maximal voluntary isometric contraction (MVIC). Results: The difference in EMG activity during the exercise in three GH joint internal rotation positions was observed with the SA and the PM. The greater the GH joint internal rotation angle was, the lower the activity of the PM. In contrast, the SA showed higher activity. However, the activity of UT was similar under all conditions. The ratio of the SA and the PM was considerably greater at $90^{\circ}$ GH joint internal rotation than at $0^{\circ}$ and $45^{\circ}$. Conclusion: When excessive activation of the PM or imbalanced activation between the PM and the SA occurs, the MKPUP exercise is most effective at $90^{\circ}$ of GH joint internal rotation. Use of this position would be a beneficial strategy for selective strengthening of the SA and minimizing PM activation.

• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.88-94
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• 2016

Purpose: The purpose of this study was to compare therapeutic climbing exercise and general isometric exercise in patients with shoulder impingement syndrome. Methods: Among 20 adults, study subjects were arbitrarily classified into an experimental group of 10 and a control group of 10. The control group performed general isometric exercise (ISE) and the experimental group performed therapeutic climbing exercise (TC) (3 sets, 3 times per week for 8 weeks). To evaluate the effects of exercise, subjects were evaluated using a Disabilities of the arm, shoulder and hand score (DASH), a goniometer for range of motion, and shoulder activity measured serratus anterior, upper trapezius, and lower trapezius. Independent and paired t-test were used for comparison of the effect between groups. Results: DASH scores showed a significant decrease in both groups after 8 weeks of treatment (p<0.001) and significant difference was observed between the TC groups (p<0.01). Flexion and abduction were significantly increased after 8 weeks of treatment in the ISE group (p<0.001) and flexion, abduction, external and internal rotation were significantly increased after 8 weeks of treatment in the TC group (p<0.001). Serratus anterior and lower trapezius activity were significantly increased after 8 weeks of treatment (p<0.001) and upper trapezius activity was not significantly increased after 8 weeks of treatment in the ISE group (p>0.05). Serratus anterior, lower trapezius, and upper trapezius activity were significantly increased after 8 weeks of treatment in the TC group (p<0.001). Conclusion: Scapular stabilizing exercise using a therapeutic climbing exercise increases range of motion and decreases DASH, and increases activity of shoulder muscles in patients with impingement syndrome.

• 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.

• 한국운동역학회지
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• 제22권2호
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• pp.193-199
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• 2012

The purpose of this study was to investigate the activities of the serratus anterior (SA) and upper trapezius (UT) muscles during scapular protraction exercise with a dumbbell. Twenty-one healthy subjects with no medial history of shoulder pain or upper extremity disorders were recruited for this study. Subjects performed scapular protraction at $90^{\circ}$ and $130^{\circ}$ shoulder flexion with a dumbbell in supine and standing positions. The activities of the SA and UT were measured via surface electromyography (EMG) during 4 scapular protraction exercises. A 2 (angle) ${\times}$ 2 (position) repeated-measures analysis of variance (ANOVA) was used to compare the normalized activities of the SA and UT and the UT/SA ratio. The results showed that activities of both the SA and UT were the highest for the scapular protraction exercise at $130^{\circ}$ shoulder flexion in the standing position. However, the UT/SA ratio was the lowest for the exercise at $90^{\circ}$ shoulder flexion in supine position. Therefore, for selective activation of the SA muscle, we recommend performing the scapular protraction exercise with a dumbbell in the supine position at $90^{\circ}$ shoulder flexion.