• The Journal of Korean Physical Therapy
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• v.28 no.3
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• pp.195-200
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• 2016

Purpose: This study was designed to evaluate the effects of the different condition of leg support surface on the upper extremity and core muscle activity during the push-up exercise. Methods: Fifteen healthy subjects that were practicable push-ups were recruited in this study. Subjects were instructed the push-up exercise in the different condition of the leg support surface. Each condition of support surface was set to the high and lower, and the unstable and stable condition. Muscle activation was measured by using the surface electromyography (EMG), and recorded from the triceps brachii, serratus anterior, latissimus dorsi, rectus abdominis, abdominal external oblique, and erector spinea muscle. Results: In the results of experiments, there was no significant difference of muscle activation in upper extremity between the high unstable and high stable support surface. By contrast, muscle activation of the rectus abdominis and abdominal external oblique was significantly higher in the low unstable support surface, compared with those of the low stable support surface. It is well known that the core muscle was important to stabilization of trunk stability. Conclusion: This result demonstrates that the low and unstable support surface for the lower extremity was suited for training of core muscle for trunk stabilization during the push-up exercise.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.3
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• pp.29-41
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• 2020

PURPOSE: The aim of this study was to provide evidence for the treatment of Forward Head and Rounded Shoulder Posture (FHRSP) using posture correction exercises by comparing muscle activity and onset time around the neck and shoulder area during an arm elevation task. METHODS: The subjects were divided into FHRSP (21 persons) and non-FHRSP (19 persons) groups to measure muscle activity and onset time of muscle contraction. Wireless surface electromyography was used to assess the muscle activity and onset time of the right and left sternocleidomastoid (SCM), splenius capitis, anterior deltoid, middle deltoid, serratus anterior, upper trapezius, pectoralis major, and infraspinatus during an arm elevation task. After the pre-measurement, the participants performed the postural correction exercises, and then the post-measurement was conducted. RESULTS: After the posture correction exercises, there were significant differences in the muscle activity and onset time of all muscles in the FHRSP group. The results of the comparison of the muscle onset time during an arm elevation task demonstrated that after the postural correction exercises, the muscle onset time was significantly reduced in the right and left SCM and left splenius capitis, but there were no significant changes in the onset time of other muscles. CONCLUSION: The results of this study help us understand the change in muscle activities and muscle contraction onset time in a person with FHRSP when lifting the arm and suggest the relevant basis to apply the posture correction exercise in clinical settings.

• Archives of Plastic Surgery
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• v.34 no.5
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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.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.3
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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.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.1
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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.

• The Journal of Korean Physical Therapy
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• v.26 no.6
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• pp.379-385
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• 2014

Purpose: This study was to determine the immediate effects of pulsed magnetic field (PMF) in subjects with upper trapezius (UT) trigger point (TrP). Methods: Fifteen subjects with UT TrP were recruited for the study's PMF group (pain threshold=$2.29kg/cm^2$), and 15 age-, weight-, and gender-matched subjects with UT TrP were recruited for control group (pain threshold=$2.25kg/cm^2$). Pressure algometer was used to measure pressure pain threshold on UT TrP and, cervical range of motion (ROM) inclinometer was used to measure cervical ROM. Surface electromyography was used to record UT, lower trapezius, and serratus anterior muscle activity and relative ratio during scapular plane abduction between pre- and post-treatment. Results: The PMF effectively improved pain threshold and concurrently increased ROM (rotation to the painful side, lateral flexion to the nonpainful side). In addition, the PMF may effectively deactivate UT activity during abduction and the muscle activity ratio between UT and serratus anterior. Conclusion: These findings provided empirical evidence that PMF can be an effective treatment method to reduce pain threshold, to increase cervical ROM, and deactivate UT activity in individuals with TrP.

• Physical Therapy Korea
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• v.30 no.1
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• pp.23-31
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• 2023

Background: Several factors contribute to shoulder pain, including abnormal neck posture, repeated use of the upper limbs, work involving raising the upper limbs above the head, and the effects of vibration. However, previous study has reported that constant vibration exposure could impact improvement of the stability on joints related with muscle recruitment and activation. For this difference reason, we need to verify for the complex study of relationship with repetitive upper limb movements, poor head posture, and constant vibration exposure. Objects: Our study was made to investigate the influence of vibration exposure on the shoulder muscle activity during forward-head and over-head tasks with isometric shoulder flexion. Methods: In a total of 22 healthy subjects, surface electromyography (EMG) data were collected from shoulder muscles (upper/lower trapezius, serratus anterior, and lumbar erector spinae) on tasks (neutral-head task [NHT], forward-head task [FHT], and over-head task [OHT]) with and without vibration exposure. Results: In all tasks, the EMG data of the upper trapezius and serratus anterior significantly increased with vibration exposure (p < 0.05). Furthermore, the EMG data of the lumbar erector spinae significantly increased with vibration exposure in the NHT and FHT (p < 0.05). Conclusion: We suggest that continuous vibration exposure during the use of hand-held tools in the tasks could be associated with harmful effects in the workplace. Lastly, we clinically need to examine the guidelines regarding the optimal posture and vibration exposure.

• 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.

• Physical Therapy Korea
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• v.15 no.2
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• pp.73-80
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• 2008

With the introduction of the video display terminal (VDT), the efficiency and productivity of work has improved. However, VDT syndrome is threatening the health of workers as a side effect of prolonged use of a VDT. Among various VDT syndromes, the musculoskeletal disorder, especially, the cumulative trauma disorder (CTD) is the common research topic related with upper extremities function. The aim of this study was to investigate the effect of the wrist-hand orthosis (WHO) on fatigue in middle deltoid, anterior deltoid, serratus anterior, and upper trapezius during one-hour computer keyboard typing. Twelve healthy subjects participated in this study. Surface electromyography was used to assess the localized muscle fatigue (LMF), and the LMF was calculated at 10 minutes, 20 minutes, 40 minutes, and 60 minutes in each muscle, with and without the WHO. Data were analyzed by paired t-test with a level of significance of .05. The results of this study are as follows: 1) At 10 minutes, the LMF decreased significantly with applied WHO in the middle deltoid, anterior deltoid, and upper trapezius (p=.001, p=.026, p=.019, respectively). 2) As the computer keyboard typing period increased, there were no significant LMF differences, except for the upper trapezius. Therefore, it can be concluded that the WHO can be applied to decrease the LMF for the initial 10 minute period in the middle deltoid, anterior deltoid, and upper trapezius' but that the long term effect of WHO in reducing the LMF was proven only in upper trapezius during continued computer keyboard typing.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.2
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• pp.17-27
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• 2015

PURPOSE: The purpose of this study was to compare the effects of three interventions (intervention by passive range of motion exercise plus manual cervical traction, Mulligan's joint mobilization, and strengthening exercises) after Kaltenborn's joint mobilization on the cervical spine alignment, and muscle activity in patients with a forward head posture. METHODS: The subjects were 39 students from H University in Chungnam and C University in Jeonbuk. The subjects in each group attended training sessions three times a week for four weeks. We used one-way ANOVA and Scheffe's post hoc test to compare values between groups, and used paired t-test to compare the values of the dependent variables within groups. RESULTS: The results showed that the active intervention group experienced a significant increase compared to the passive intervention group in terms of the craniovertebral angle, cervical lordosis angle, and had significant decreases compared to the passive intervention group in terms of the upper trapezius muscle activity. The active intervention group also had significant increases in craniovertebral angle and decreased anterior scalene muscle activity than the active-assistive intervention group. The active-assistive intervention group had significant decreases compared to the active intervention group in terms of the serratus anterior, levator scapulae, and splenius capitis muscle activity. CONCLUSION: It appears that the subjects with a forward head posture had significant improvements in the cervical lordosis angle, cranial rotation angle, craniovertebral angle, and muscle activity after intervention by Mulligan's joint mobilization (active-assistive intervention component) and strengthening exercises (active intervention component) after applying Kaltenborn's joint mobilization.