• Title/Summary/Keyword: Serratus anterior dysfunction

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Scapulothoracic Arthrodesis for Refractory Shoulder Dysfunction: A Retrospective Study of Indications and Functional Outcome

  • Chung, Soo-Tai;Warner, Jon J.P.
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2009.03a
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    • pp.208-208
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    • 2009
  • Eleven shoulders (9 patients) with refractory scapulothoracic dysfunction were treated with scapulothoracic arthrodesis between 2000 and 2006. Refractory shoulder dysfunction included facioscapulohumeral muscular dystrophy in five shoulders (3 patients), refractory scapular winging with long thoracic nerve palsy in one shoulder, scapular winging caused by serratus anterior palsy with trapezius dysfunction in one shoulder, post-surgical thoracic outlet syndrome due to medial clavicle resection in two shoulders, refractory scapular winging with spinal accessory nerve injury in one shoulder, and chronic trapezius rupture caused by cervical spine surgery in one shoulder. The mean active flexion was improved from 82 degrees preoperatively to 112 degrees postoperatively. The mean Constant score was improved from 27.2 points to 68.0 points. Two shoulders (1 patient) that had facioscapulohumeral muscular dystrophy had broken wires due to nonunion, and one patient had a reactive pulmonary effusion. In ten of the eleven shoulders, the patients were satisfied with their results. The scapulothoracic arthrodesis can cause significant pain relief and functional improvement in refractory scapulothoracic and/or shoulder dysfunction. By selecting patients that present with appropriate indications, and using experienced surgical technique through complete preoperative evaluation, we can diminish the complication rate and make good clinical outcomes.

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Effects of Deltoid Inhibition Taping on the Surface Electromyographic Activity of Shoulder Girdle Muscles During Upper Limb Elevation in Healthy Shoulders

  • Kim, Suhn-Yeop;Oh, Duck-Won;Kim, Taek-Yean;Nam, Soo-Jin;Yoo, Hwan-Suk
    • 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.

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Effect of Trunk Flexion on Muscle Activity, Motion of Scapular and Scapulohumeral Rhythm (몸통 굽힘이 어깨위팔리듬과 어깨뼈의 움직임 및 근육 활성도에 미치는 영향)

  • Park, Seung-Kyu;Han, Song-E;Kang, Jeong-Il;Lee, Joon-Hee;Yang, Dae-Jung
    • 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.

Immediate Effects of Flexi-bar Exercise With Knee Push-up Plus on Shoulder Joint Position Sense and Muscle Activity in Subjects With Scapular Winging

  • Kim, Seok-hyun;Cynn, Heon-seock;Baik, Seung-min
    • Physical Therapy Korea
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    • v.28 no.4
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    • pp.256-265
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    • 2021
  • Background: Individuals with scapular winging may have proprioceptive dysfunction which is important for motor control and causes shoulder instability. Reduced serratus anterior (SA) and lower trapezius (LT) muscle activity accompanied by over-active upper trapezius (UT), and pectoralis major (PM) may be contributing factors. Flexi-bar (FB) exercise may be used to increase joint position sense (JPS) and alter the target muscle activities. Objects: This study aimed to investigate the immediate effects of flexi-bar exercise prior to knee push-up plus (FPK) versus knee push-up plus (KPP) on JPS and muscle activity of SA, LT, UT, and PM in subjects with scapular winging. Methods: Eighteen subjects with scapular winging were recruited. JPS was investigated at baseline, after KPP and after FPK. Passive and active JPS errors were calculated by isokinetic equipment. Surface electromyography was used to record muscle activities during KPP and FPK. One-way repeated-measures analysis of variance and post hoc analyses were used to analyze the JPS error measured at baseline, after KPP and after FPK. Paired t-tests were used to compare muscle activities between KPP and FPK. Results: Passive JPS error was significantly decreased after KPP (p = 0.005) and after FPK (p = 0.003) compared to the baseline. Active JPS error was also significantly decreased after KPP (p = 0.016) and after FPK (p = 0.012) compared to the baseline. There was no significant difference in the passive and active JPS errors between KPP and FPK. SA activity during FPK was significantly increased (p = 0.024), and LT activity during FPK was significantly increased (p = 0.006). There were no significant differences in the UT and PM activity. Conclusion: FB might be recommended to immediately improve passive and active JPS and to selectively increase SA and LT muscle activities during KPP in individuals with scapular winging.

Comparison of the Muscle Activities of Upper Trapezius and Middle Deltoid between Subjects with and without Elevation of Shoulder Girdle during Arm Elevation

  • Weon, Jong-Hyuck;Jung, Do-Young
    • The Journal of Korean Physical Therapy
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    • v.24 no.6
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    • pp.388-392
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    • 2012
  • Purpose: Muscle imbalance between upper trapezius (UT) and serratus anterior (SA) during arm elevation is a factor causing shoulder dysfunction. However, there is no study to compare the muscle activities of the UT and middle deltoid (MD). The purpose of this study was to compare the muscle activities of the UT and MD between with and without elevation of shoulder girdle (ESG) during shoulder abduction. Methods: The subjects without (control group=9) or with (ESG group=8) participated in this study. The muscle activities of the UT and MD were measured using a electromyography during $90^{\circ}$ shoulder abducted position in both group. The data in middle of 3-second of the 5-second periods were used. The mean value of three trials was used in the data analysis. For each muscle, independent t-tests were performed to compare for group differences. Results: The muscle activity of UT was significantly greater in ESG group, compared to that of the control group (p<0.05). The muscle activity of MD was significantly smaller in ESG group, compared to that of the control group (p<0.05). Conclusion: These findings showed that low muscle activation of MD as well as SA may contribute to hyperactivity of UT during arm elevation.

Surface Electromyographic Measure in Patients with Winging Scapula (익상견갑 환자의 표면근전도 검사)

  • Kim, Chul Hyun;Lee, Yang Soo;Lee, Yong Boem;Rho, Jae Hyun;Lee, Zee Ihn
    • Annals of Clinical Neurophysiology
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    • v.7 no.2
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    • pp.124-126
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    • 2005
  • The effect of serratus anterior dysfunction is seen in the scapular winging. We report 2 cases with winging scapula clinically but do not reveal denervation potentials in needle electromyography. Surface myoelectric measurements of median frequency and root mean square values show difference in fatigability and amplitude in affected side.

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An Analysis on Upper Extremity and Trunk EMG of Elderly for Table Height Using Electronic Bed (고령자의 전동침대 사용 시 테이블 높이에 따른 상지와 체간의 근활성도 분석)

  • Lee, Myoung-Hee;Lee, Sang-Yeol
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.3
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    • pp.443-448
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    • 2013
  • PURPOSE: In recent years, senior friendly device is growing rapidly because of population aging The study was designed to investigate the effects of table height of electronic bed on upper extremity and trunk EMG in elderly. METHODS: Thirty right-handed elderly without history of neurological and musculoskeletal dysfunction were participated in this study. Three heights of the table (3/3 height, 2/3 height, and 1/3 height between top of the shoulder and olecranon) were provided. During the eating performance, surface electromyography (EMG) was used to measure muscle activity, and electrodes were attached to the deltoid middle fiber, serratus anterior, suprapinatus, upper trapezius, rhomboideus, cervical part of longissimus, thoracic part of longissimus, lumbar part of longissimus on right. One way ANOVA was conducted for the statistical analysis. RESULTS: There were significant differences in deltoid middle fiber, suprapinatus, upper trapezius, rhomboideus, lumbar part of longissimus in the 3 different height of table (p<.05). The deltoid middle fiber, suprapinatus, upper trapezius, and lumbar part of longissimus were significantly increased in higher table than lower table(p<.05). And the rhomboideus was significantly decreased in higher table than lower table(p<.05). CONCLUSION: This study demonstrates that different height of table affect upper extremity and trunk muscle activity. The table height of olecranon is the best for elderly.

The Effect of External Pelvic Compression on Shoulder and Lumbopelvic Muscle sEMG and Strength of Trunk Extensor During Push Up Plus and Deadlift Exercise (푸쉬업플러스와 데드리프트 운동 시 골반압박이 견관절과 요골반부 주위근의 근활성도와 체간 신전근 근력에 미치는 영향)

  • Huang, Tian-zong;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.25 no.3
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    • pp.1-11
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    • 2018
  • Background: Lumbopelvic stability is highly important for exercise therapy for patients with low back pain and shoulder dysfunction. It can be attained using a pelvic compression belt. Previous studies showed that external pelvic compression (EPC) enhances form closure by reducing sacroiliac joint laxity and selectively strengthens force closure and motor control by reducing the compensatory activity of the stabilizer. In addition, when the pelvic compression belt was placed directly on the anterior superior iliac spine, the laxity of the sacroiliac cephalic joint could be significantly reduced. Objects: This study aimed to compare the effects of EPC on lumbopelvic and shoulder muscle surface electromyography (EMG) activities during push-up plus (PUP) and deadlift (DL) exercise, trunk extensor strength during DL exercise. Methods: Thirty-eight subjects (21 men and 17 women) volunteered to participate in this study. The subjects were instructed to perform PUP and DL with and without the EPC. EMG data were collect from serratus anterior (SA), pectoralis major (PM), erector spinae (ES), and multifidus (MF). Trunk extensor strength were tested in DL exercise. The data were collected during 3 repetitions of all exercise and the mean of root mean square was used for analysis. Results: The EMG activities of the SA and PM were significantly increased in PUP with pelvic compression as compared with PUP without pelvic compression (p<.05). In DL exercise, a significant improvement in trunk extensor strength was observed during DL exercise with pelvic compression (p<.05). Conclusion: The results of this study indicate that lumbopelvic stabilization reinforced with external pelvic compression may be propitious to strengthen PUP in more-active SA and PM muscles. Applying EPC can improve the trunk extensor strength during DL exercise. Our study shows that EPC was beneficial to improve the PUP and DL exercise efficiency.

Comparison of Shoulder Stabilizer Muscle Activity on Push-up plus in Convergence in Various Posture (다양한 자세의 푸시업 플러스 융합 운동에 따른 어깨 안정근의 근활성도 비교)

  • Moon, Byoung-Hyoun;Kim, Ji-won
    • Journal of the Korea Convergence Society
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    • v.9 no.2
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    • pp.341-347
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    • 2018
  • The purpose of this study is to examine the change to the muscle activity from the serratus anterior(SA) of 5th and 7th, upper trapezius(UT), middle trapezius(MT) lower trapezius (LT), and pectoralis major(PM) when push-up plus exercise(PUP) is performed in four postures. 25 healthy, young participants performed various PUP convergence exercise(general posture, $90^{\circ}$, $120^{\circ}$ and BOSU). The muscle activity of the shoulder stability muscles was measured using a surface EMG analysis system during various PUP convergence exercise. One-way repeated-measure of ANOVA was conducted to comparison the activity of each muscle. There was significant difference in SA7, PM, UT, and MT (p <.05) during various PUP. The muscle activity of SA7 had a significance difference between PUP and $90^{\circ}PUP$ or BOSUPUP respectively (p <.05). The muscle activity of PM had a significance difference between $90^{\circ}PUP$ and PUP or BOSUPUP (p <.05). The muscle activity of UT had a significance differnce between $90^{\circ}PUP$ and PUP or BOSUPUP (p <.05). The muscle activity of MT had a significance differnce between $90^{\circ}PUP$ and PUP and also significantly difference PUP and $120^{\circ}PUP$(p <.05). These results suggest that general PUP can be a useful to improve to scapular stabilizer muscle in who has no shoulder dysfunction.

The Effectiveness of Upper Limb Offload Dynamic Taping Technique on Scapular Muscles Activation During Elevation in Healthy Subjects (상지 부하감소 다이나믹 테이핑 기법이 정상인의 어깨 올림 시 어깨뼈 주위근의 근활성도에 미치는 영향)

  • Huang, Tian-zong;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.27 no.2
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    • pp.93-101
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    • 2020
  • Background: For performing various movements well, cooperation between the muscles around the scapula and shoulder has been emphasized. Taping has been widely used clinically as a helpful adjunct to other physiotherapy methods for shoulder pathology and dysfunction treatment. Previous studies have evaluated the effect of taping techniques using dynamic tapes on shoulder function and pain. However, no study investigated the electromyographic (EMG) changes in the shoulder muscles. Objects: This study aimed to investigate the effect of the upper limb offload taping technique using a dynamic tape on EMG activities of the upper trapezius (UT), lower trapezius, serratus anterior (SA), and middle deltoid (MD) muscles during scaption plane elevation. Methods: A total of 26 healthy subjects (19.85 ± 6.40 years, male = 20) volunteered to participate in this study. The subjects were instructed to perform scaption elevation with and without dynamic taping on the shoulder. Shoulder elevation strength tests were performed at 100%, 75%, 50%, and 25%, for the maximal isometric contraction force. Results: There were statistically significant interaction effects between the taping application and shoulder scaption elevation force in EMG activities in the UT (p < 0.05) and MD (p < 0.05). EMG activities in the UT showed significant increases in 50%RVC (reference voluntary contraction, p < 0.05) and 25%RVC (p < 0.01). Furthermore, the EMG activity of the SA significantly increased in 50%RVC (p < 0.01) and 25%RVC (p < 0.01) after dynamic taping. For the MD, the EMG activity level significantly decreased in 100%RVC (p < 0.05). Conclusion: These results indicated that upper limb offload dynamic taping application affects the muscle activities of some shoulder muscles depending on different scaption elevation strength levels. Therefore, we suggest that the upper limb offload dynamic taping can be applied to the shoulders when patients need middle deltoid inhibition or upper trapezius facilitation, such as patients with shoulder impingement syndrome.