• Annals of Clinical Neurophysiology
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• 제8권1호
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• pp.88-90
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• 2006

Pneumothorax after needle electromyography is a rare complication, which usually associated with examination of diaphragmatic and intercostal muscles. However, by the literatures, it can also occur with supraspinatus, serratus anterior and paraspinal muscles. We experienced a case of pneumothorax after cervical paraspinal muscle needle electromyography. From the anatomical vulnerability of pneumothorax during needle insertion, we emphasized the importance of avoiding this complication.

• Archives of Plastic Surgery
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• 제34권5호
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• pp.622-627
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• 2007

Purpose: Although the autogenous tissue transfer has been the mainstay of the breast reconstruction, concern for the donor site morbidity can lead to the superseded method using tissue expander with implant or permanent expander-implant. However, the additional procedure of tissue expansion possibly cause discomfort and raise the cost. We tried to verify the efficacy of using the saline-filled breast implant by itself for the safe and convenient immediate breast reconstruction modality if the patients have small, round and non-ptotic breasts and the sufficient breast skin can be saved with mastectomy. Methods: From July 2002 to July 2005, 29 breasts of 26 patients were restored only with the saline-filled breast implant immediately after the skin sparing or nipple-areolar skin sparing mastectomy in Asan Medical Center. A pocket with pectoralis major and serratus anterior muscle was created and the implant was covered with this muscle pocket. Simultaneous contralateral augmentation was performed in patients whose mastectomy specimen weighed less than 100g. Results: Using only the saline-filled breast implant resulted in the successful reconstruction with few complications including partial necrosis of nipple areolar skin (five cases, 17.2%), capsular contracture (three cases, 10.3%), hematoma (one case, 3.4%), depigmentation of areolar skin (one case, 3.4%), hypertrophic scar (one case, 3.4%), which were all healed by conservative management. There were no significant complications such as implant exposure and subsequent removal. Conclusion: Immediate breast reconstruction only with the saline-filled breast implant can be a satisfactory alternative option for the patients whose breast is small, round and non-ptotic, especially when the nipple-areolar skin of the breast is preserved in the mastectomy.

• 대한물리의학회지
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• 제13권3호
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• pp.75-80
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• 2018

PURPOSE: Scapular stability is very important to arm function during activities of daily living. The push-up plus exercise is commonly used to stabilize the shoulder muscles. In the present study, we designed an elastic shoulder band (ESB) that could be used with the push-up plus exercise and studied muscle activities of the serratus anterior (SA) and the lower and the upper trapezius (LT and UT) on stable and unstable support. METHODS: Fifteen healthy people participated in this study. Three muscles were investigated using surface EMG with and without the ESB on stable and unstable support. All subjects performed each trial three times for 7 seconds per set and rested for 30 seconds. Repeated one-way ANOVA was used for statistical analyses. RESULTS: The EMG activity of the SA was significantly different during the push-up plus exercise on stable support with the ESB compared with that on unstable support without the ESB (p<.05). However, there were no differences in the activities of UT and LT on stable and unstable support (p>.05). CONCLUSION: The ESB was effective for the activity of SA during the push-up plus exercise on stable support; therefore, it has the potential for use by people during push-up plus exercises. However, further studies are required to investigate the rehabilitation tools for patients with shoulder instability.

• 대한정형도수물리치료학회지
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• 제22권1호
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• pp.51-58
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• 2016

Background: Evidence for effective management of scapular downward rotation syndrome is limited. The present study was performed to compare the scapular muscle activation through 4weeks wall slide exercise and sling slide exercise in subjects with scapular downward rotation syndrome. Methods: Twenty-two subjects with scapular downward rotation syndrome participated in the study. Surface electromyography data were collected from the upper and lower trapezius, serratus anterior and pectoralis major during shoulder flexion of $60^{\circ}$, $90^{\circ}$ and $120^{\circ}$ in the sagittal plane. The alignment of the scapula was measured using radiographic analysis. Subjects were assessed pre and post a 4 weeks exercise (wall slide, sling slide). The significance of the difference in pre- and post-exercise within each groups was assessed using a paired t-test. The significant difference between wall- and sling-exercise was used a independent t-test. Results: In the wall slide group, the muscle activity of upper trapezius decreased significantly during shoulder flexion at $60^{\circ}$, $90^{\circ}$ and $120^{\circ}$ after 4 weeks, and the muscle activity of serratus anterior increased significantly at all angles. Also, the muscle activity of pectoralis major decreased significantly at $90^{\circ}$ and $120^{\circ}$. Conclusions: Based on such results, it can be said that wall slide exercise is effective than sling slide exercise for the subjects with scapular downward rotation syndrome.

• 대한정형도수물리치료학회지
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• 제22권1호
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• pp.17-25
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• 2016

Purpose: This study was aimed to determine the effects of thoracic spine thrust manipulation on muscle activities of the scapular upward rotators and middle deltoid, active range of motion (AROM), shoulder pain, and rounded shoulder posture in young adults with rounded shoulder. Methods: The subjects were 30 young adults (14 males, 16 females) with rounded shoulder. Thirty subjects were randomly assigned to an experimental (manipulation) and control (placebo) groups of fifteen subjects respectively. The manipulation group received the manipulation (high velocity, low amplitude), which was performed by a physical therapist with the subject in the supine position and with the arms crossed over the chest and hands passed over the shoulders. For the sham group, the same procedure was performed, with the exception that the high-velocity thrust was not applied. Measurements were taken before and after the intervention. Muscle activity of upper and lower trapezius, serratus anterior, middle deltoid was measured using surface electromyography. Visual analog scale (VAS) was used for shoulder pain. Goniometry was used for shoulder abduction active range of motion (AROM). Straight edge was used for supine rounded shoulder posture (RSP) distance. Results: The muscle activity of the upper trapezius, lower trapezius and middle deltoid muscle increased significantly after the intervention (p<.05). However, no significant difference was observed in serratus anterior muscle (p>.05). The VAS was significantly decreased and AROM significantly increased after the intervention (p<.05). The distance of RSP were not significant (p>.05). The control group showed no differences before and after the intervention (p>.05). Conclusion: The results of this study suggest that thoracic spine thrust manipulation can be an effective component of treatment plan to improve pain and function.

• 한국전문물리치료학회지
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• 제21권2호
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• pp.48-56
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• 2014

The aim of this study to investigate the effects of craniocervical flexion on muscle activities of scapular upward rotators during push-up plus exercise in subjects with winging scapula. Eighteen males with scapular winging were recruited, and each subject performed knee push-up plus and other exercises, in two conditions (craniocervical flexion vs. natural head positions). A surface electromyography (EMG) was used to measure upper trapezius (UT), serratus anterior (SA), and lower trapezius (LT) muscle activity. A paired t-test was used to determine the statistical significance between the different condition with/without applying of craniocervical flexion. UT EMG activity significantly decreased and SA EMG activity significantly increased during knee push-up plus involving the craniocervical flexion compared to the natural head position. However, no significant differences (p>.05) were found in the activity of the LT muscle. The UT/SA ratios with and without craniocervical flexion showed a significant difference (p<.05). These results showed that the knee push-up plus other exercises performed with craniocervical flexion could strengthen the serratus anterior muscle and minimize the activity of the UT muscle.

• The Journal of Korean Physical Therapy
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• 제25권2호
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• pp.56-63
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• 2013

Purpose: This study was conducted in order to examine how an effective rehabilitation exercise program influences the activity of shoulder muscles, and to help the clinical application of a rehabilitation program, for prevention and relief of pain, adhesion, and joint stiffness of patients who undergo rotator cuff repair. Methods: Nine test subjects were placed randomly into each group for a total of 27 subjects and exercise program interventions according to the group were conducted for six weeks, after which maximum voluntary isometric contraction (%MVIC) value was re-measured for supraspinatus muscle, infraspinatus muscle, serratus anterior muscle, and middle deltoid muscle in all groups in order to compare changes in muscle activity before and after the experiment in order to perform comparative analysis of changes in muscle activity between groups, based on which four experimental hypotheses were confirmed. Results: Changes in muscle activity according to %MVIC showed a statistically significant difference (p<0.01) (p<0.001) in all muscles, except the middle deltoid muscle, and post-verification results showed that changes in muscle activity according to %MVIC were greater in test groups I and II, compared with the control group, for the supraspinatus muscle, infraspinatus muscle, and serratus anterior muscle. Conclusion: Therefore, rehabilitation through use of the methods described above should be applied efficiently in clinical settings and more research in development of much more efficient rehabilitation program interventions must be conducted.

• The Journal of Korean Physical Therapy
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• 제30권3호
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• pp.84-89
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• 2018

Purpose: Therapeutic climbing has become very popular today, with it being reported as a new method for preventing and treating orthopedic trauma to the shoulder joint. However, objective studies on its effects on the musculoskeletal system are still lacking. The objective of the present study was to investigate the effects of wall inclination during therapeutic climbing on the muscle activity around the shoulder joint. Methods: In this study, the participants performed movements at three different inclination angles of $0^{\circ}$, $+15^{\circ}$, and $-15^{\circ}$. sEMG was performed to measure the activities of five different muscles around the shoulder joint (biceps brachii, serratus anterior, upper trapezius, middle trapezius, and lower trapezius muscles). Results: Biceps brachii muscle showed a significant increase at $-15^{\circ}$, as compared to $0^{\circ}$ (p<0.01), and the serratus anterior also showed a significant increase at $-15^{\circ}$, as compared to $0^{\circ}$ (p<0.05). Moreover, the middle and lower trapezius muscles also showed a significant increase at $-15^{\circ}$, as compared to $0^{\circ}$ (p<0.001). Compared to $0^{\circ}$, all muscles showed decreased values at $15^{\circ}$, but the differences were not statistically significant (p>0.05). Conclusion: Therapeutic climbing may be a new therapeutic approach that can increase muscle strength and coordination in the sensory nervous system, since it can be used as a tool that promotes active movement by altering wall inclination and causing the user to generate movements according to the existing situation.

• 대한물리의학회지
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• 제8권1호
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• pp.41-48
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• 2013

PURPOSE: This study was to determine the effect of the plane of movement (sagittal plane vs. scapular plane) and shoulder flexion angle ($90^{\circ}$ vs. $130^{circ}$) during scapular protraction exercises in healthy subjects by investigating the elecromyographic (EMG) activities of the serratus anterior (SA), upper trapezius (UT), and pectoralis major (PM). METHODS: Twenty-one healthy subjects participated in this study. Subjects performed maximal scapular protraction at the $90^{\circ}$ or $130^{\circ}$ shoulder flexion angles in the sagittal or scapular planes. Surface EMG was recorded from the SA and UT, and PM muscles. Dependent variables were examined by 2 (plane) ${\times}$ 2 (angle) repeated measures of analysis of variance (ANOVA). RESULTS: Significantly increased EMG activities in the SA and UT were found during scapular protraction exercise at the $130^{\circ}$ shoulder flexion angle in the sagittal and scapular plane. Also, EMG activity of the PM significantly decreased at the $130^{\circ}$ shoulder flexion angle in the sagittal plane and the $90^{\circ}$ and $130^{\circ}$ shoulder flexion in the scapular plane. CONCLUSION: we recommend scapular protraction exercise at the $90^{\circ}$ shoulder flexion in the sagittal plane to selectively strengthen the SA muscle with limitation of upper trapezius activity and at the $130^{\circ}$ shoulder flexion in the scapular plane to selectively strengthen the SA muscle with limitation of pectoralis major activity.

• 대한물리의학회지
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• 제10권4호
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• pp.113-121
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• 2015

PURPOSE: The purpose of this study was to determine the effect of shoulder external rotation on muscle activities of the scapular upward rotators during arm elevation. METHODS: Nineteen healthy subjects with no medical history of shoulder pain or upper extremity disorders were recruited for this study. Electromyography (EMG) was used to measure the muscle activities of the serratus anterior (SA), upper trapezius (UP), lower trapezius (LT) and infraspinatus (IS) muscles during arm elevation. The EMG activities were recorded while the subjects performed $90^{\circ}$ arm elevation with three different arm positions; palm down (PD), neutral position (NP), and palm up (PU). While seated in a chair, the subject was asked to raise the upper extremity in the sagittal plane in random order. Subjects performed $90^{\circ}$ arm elevations in three trials at each arm position. The mean EMG activity normalized by the maximal voluntary isometric contraction was analyzed across three arm positions. Repeated measures one-way ANOVA and the post hoc Bonferroni tests were used to determine the differences in muscle activities among the three arm positions. RESULTS: The EMG activities of the SA and IS were significantly greater in the PU condition than in the other conditions during arm elevation. No significant difference was noted between the NP and PD conditions during arm elevation. CONCLUSION: These results suggest that shoulder external rotation (palm up position) can be used to activate the SA. Therefore, we recommend a scapular protraction exercise in the palm up position for strengthening the SA.