• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.41-46
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• 1998

Microvascular free tissue transfer technique is widely accepted for reconstruction of extensive soft tissue defects on the extremities. The system of flap based on the subscapular artery and vein provides the widest ways of composite free flaps. The possible flaps that can be harvested based on this single vascular pedicle include the scapular and parascapular skin flaps, the serratus anterior and latissimus dorsi muscular flaps, the lateral scapular bone flap, the latissimus dorsi-rib flap, and the serratus anterior-rib flap. This combined flap is available to mutiple tissue defects or complex defects because it can incorporated with skin, muscle and bone flaps. A strikig advantage is the independent vascular pedicles of each components, which allow freedom in orientation of each components. So, it can be freely applied to any forms of three demensional defects on the upper and lower extremities. The combination of scapular cutaneous flap and latissimus dorsi musculocutaneous flap can be resurfaced for massive cutaneous defects on the extremities. We report the use of the combined scapular and latissimus dorsi free flap in seven patients to reconstruct massive deefcts on the extremities. There was no flap failure and little complications and disadvantages. The anatomy of this flap is reviewed and the indication and advantages are discussed.

• The Journal of Korean Physical Therapy
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• v.30 no.6
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• pp.218-223
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• 2018

Purpose: The purpose of this study was to evaluate the impact of active vibration exercise on the neck pain, disability index, and muscle activity of patients with forward head posture. Methods: A total of 24 patients were randomly assigned to an experimental group or a control group (n=12 each). The experimental group performed active vibration exercise using a flexi-bar for 20 minutes a day, five times a week for four weeks. The study measured patient neck pain using a visual analog scale, neck pain related disability using the neck disability index, and muscle activity using electromyography. Results: The intragroup comparison showed significant differences in the visual analog scale score, neck disability index score and upper trapezius, lower trapezius and serratus anterior muscle activity values among patients in the experimental group. The intergroup comparison showed that differences in the visual analog scale score, neck disability index score and upper trapezius, lower trapezius and serratus anterior muscle activity values in the control group. Conclusion: This study showed that active vibration exercise was effective in improving the neck pain, disability index, and muscle activity of patients with forward head posture.

• Physical Therapy Rehabilitation Science
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• v.10 no.2
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• pp.106-111
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• 2021

Objective: This study covered the effect of stabilization exercise on muscle activity, shoulder painanddisability index(SPADI) oftheelderly people with chronic shoulder pain by tele-rehabilitation village hall in rural area. Design: A randomized controlled trial. Methods: The study subjects are 29 elders with chronic shoulder pain aged over 65-year-old who reside in the rural area (experimental group: 14 elders and control group: 15). The elderly people in the experimental group were asked to perform shoulder stabilization exercise 60 minutes per one time for 4 weeks and three times in a week and the others in the control group were asked to receive education related to pain management for the initial one time. Before and after the experiment, we measured the subjects' muscle activity of upper trapezius, serratus anterior and the lower trapezius. In addition, SPADI is measured through the questionnaire. Results: Compared to the control group, the experimental group showed significant differences in the muscle activity of the three muscles (upper trapezius, serratus anterior, lower trapezius), and SPADI. Conclusions: It is found that shoulder stabilization exercise is effective in muscleactivity, pain and ability of the elderly people through tele-rehabilitation service. This study should be used for improving the quality of the elderly people's lives through active tele-rehabilitation service for areas where have poor medical benefits.

• PNF and Movement
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• v.20 no.2
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• pp.215-222
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• 2022

Purpose: The purpose of this study was to compare the effects of passive scapular upward rotation and posterior tilt and active scapular posterior tilt on the muscle activity of the upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA). Methods: Fifteen healthy subjects performed general arm elevation, arm elevation with passive scapular upward rotation and posterior tilt, and arm elevation with active scapular posterior tilt. For active scapular posterior tilt, the subjects were trained in this movement using visual biofeedback and a motion sensor. During each arm elevation condition, electromyography was used to measure the muscle activity of the UT, LT, and SA. The measured data were analyzed using a one-way repeated ANOVA. Results: LT muscle activity was significantly increased during arm elevation with active scapular posterior tilt compared to both general arm elevation and arm elevation with passive scapular upward rotation and posterior tilt (p < 0.05). SA muscle activity was greater during arm elevation with passive scapular upward rotation and posterior tilt than during general arm elevation (p < 0.05). There was no significant change in UT muscle activity among the tested arm elevation conditions (p > 0.05). Conclusion: Performing arm elevation with active scapular posterior tilt and performing arm elevation with passive scapular upward rotation and posterior tilt may be useful strategies for increasing muscle activation of the LT and SA, respectively.

• Physical Therapy Korea
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• v.15 no.4
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• pp.34-42
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• 2008

This study aimed to examine whether McConnell taping for deltoid inhibition affects the Electromyographic (EMG) activity of shoulder girdle muscles during arm elevation. Ten young healthy men were randomly assigned to an experimental and control groups of five men each. For the experimental group, we performed taping for deltoid inhibition on the skin over anterior and posterior deltoids with non-elastic specific tape, and sham-taping with non-elastic under-tape for the control group. Surface EMG measurements were performed three times (before, during and after the tapings) at upper and lower trapezius, mid-deltoid, and serratus anterior muscles while elevating dominant aim with loading and unloading conditions. In deltoid inhibition taping group, there were significant differences in EMG activity of mid-deltoid (p<.05) and serratus anterior (p<.05) muscles during arm elevation with loading. During arm elevation without loading, the EMG activity was significantly decreased for MD in the McConnell taping group (p<.05). The findings indicate that deltoid inhibition taping can modify the activation patterns in shoulder girdle muscles as well as in deltoid muscle. in clinical setting. it may be effectively used for the management of patients with shoulder dysfunction.

• Korean Journal of Applied Biomechanics
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• v.21 no.2
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• pp.243-252
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• 2011

The purpose of this study was to determine the effect of trunk posture on muscle activity and motion of scapular and scapulohumeral rhythm. Thirty-one healthy subjects performed right-arm abduction and adduction along the frontal plane while standing in both upright and flexed posture of trunk. Scapular upward rotation, anterior tilting and internal rotation ware recorded using a motion analysis system and muscle activity of upper trapezius, lower trapezius and serratus anterior ware recorded using surface electromyography during abduction and adduction in both trunk postures. then, scapulohumeral rhythm was calculated. Scapulohumeral rhythm and scapular posterior tilting in flexed posture was significantly decreased than in upright posture. Also, muscle activity of lower trapezius in flexed posture was significantly increased and serratus anterior was significantly decreased than in general posture. The result of this study revealed that flexed posture of trunk altered the muscle activity and kinematic of scapular. Measurement of trunk posture should be included the evaluation of dysfunction and disorder of shoulder girdle since rehabilitation of trunk posture is important to restore of upper limbs function.

• Physical Therapy Korea
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• v.25 no.4
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• pp.1-8
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• 2018

Background: Round shoulder posture, results from excessive flexed posture of the thorax, is defined as a position of scapular protraction, anterior tipping, and downward rotation. However, previous studies have focused on only passive position of the thorax during scapular posterior tilting (SPT) and have not reported on SPT combined with correction of flexed posture. Objects: The aim of this study was to compare effects of SPT and SPT with prone trunk extension (SPT + PTE) on activities of the lower trapezius, serratus anterior, and thoracic erector spinae and degree of posture in subjects with round shoulder and flexed posture. Methods: Fifteen subjects with round shoulder and flexed posture were recruited. The caliper was used to measure the degree of round shoulder and flexed posture. Electromyography was performed to collect data of muscle activities. Paired t-test was used to compare two exercise (${\alpha}=.05$). Results: When SPT + PTE was applied, the degree of round shoulder posture (p=.001) and flexed posture (p=.039) significantly decreased compared with that when SPT was applied. The lower trapezius activity significantly increased in the SPT + PTE condition compared with that in the SPT condition (p=.026). There were no significant differences in serratus anterior activity between SPT + PTE and SPT. The thoracic erector spinae activity significantly increased in the SPT + PTE condition compared with that in the SPT condition (p=.014). Conclusion: SPT + PTE might be one of the effective methods to enhance activities of lower trapezius and thoracic erector spinae, and to reduce round shoulder posture and flexed posture in subjects with round shoulder and flexed posture.

• Horticultural Science & Technology
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• v.34 no.6
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• pp.940-958
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• 2016

The objective of this study was to analyze the kinematic and kinetic characteristics of two horticultural activities: seed sowing and planting plant. Thirty-one male university students (aged $26.2{\pm}2.0years$) participated in this study. Kinematic factors (movement times, peak velocity, joint angles, and grasp patterns) were assessed using a three-dimensional motion analysis system while the subjects performed the horticultural activities. Kinetic factors (muscle activation of eight upper-limb muscles: the anterior deltoid, serratus anterior, upper trapezius, infraspinatus, latissimus dorsi, biceps brachii, brachioradialis, and flexor carpi radialis) were assessed using surface electromyography. The acts of seed sowing and planting plant were comprised of five tasks which included six types of phases: reaching, grasping, back transporting, forward transporting, watering, and releasing. The movement times, peak velocity, joint angles, and grasp patterns were significantly different across the tasks involved in the horticultural activities. All eight muscles of the upper limbs were utilized during the horticultural activities, and the muscle activation of the serratus anterior was the highest compared to that of the other muscles tested. The kinematic and kinetic characteristics of these horticultural activities showed similar characteristics to reaching and grasping rehabilitation training and daily living activities. The present study provides reference data for common horticultural activities using a kinematic and kinetic analysis.

• Physical Therapy Korea
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• v.26 no.3
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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.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1275-1279
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• 1990

Esophagopleural fistula is a rare complication that should be suspected in all patients with recurrent empyema following pneumonectomy and in whom a bronchopleural fistula can be excluded. In late postpneumonectomy esophagopleural fistula, diagnosis is difficult due to its rarity and no specific symptom and sign, but we have experienced a man who had suffered dysphagia and odynophagia. In surgical treatment of late postpneumonectomy esophageal fistula, closure of empyema space is of prime importance. We have adopted a type of latissimus dorsi muscle and serratus anterior muscle flap transposition We present here this technique and result obtained in patient with late postpneumonectomy esophagopleural fistula.