• 한국전문물리치료학회지
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• 제24권1호
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• pp.86-96
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• 2017

Background: Scapular dyskinesis is characterized by altered scapular position and motion. Specifically, excess activation of the Upper trapezius (UT) combined with decreased Lower trapezius (LT) and Serratus anterior (SA) have been observed. The Standard push-up plus exercise (SPP) is considered as a therapeutic exercise for increasing SA activity and maintaining the scapular kinematics. In addition, Using the Sling surface can lead to higher muscle activity. However, the advantage of an unstable surface has been uncertatin. Objects: To compare the activation of the UT, LT, and lower serratus anterior (LSA) muscles during various push-up plus exercises with and without sling in subjects with scapular dyskinesis. Methods: Total 18 male subjects with scapular dyskinesis were recruited. The UT, LT, and LSA electromyographic activities and the UT/LSA and UT/LT EMG activity ratios were measured during three push-up plus exercises with and without sling. Two-way repeated of analysis of variance was used to determine the statistical significance. Results: The UT activity was significantly lower in all postures without sling than that with sling. In addition, the LSA activity was significantly greater without than with sling, and significantly large in SPP, Low back supported push-up plus (LSPP), and Quadruped push-up plus. Additionally, the UT/LSA and UT/LT activity ratios were lower in SPP and LSPP without sling than with the other four push-up plus exercises. Conclusion: The push-up plus without sling were considered to decrease UT and increase LSA activity compared with exercises with sling. Furthermore, SPP without sling seems to be a more effective exercise for increasing LSA activity and lowering the UT/LSA and UT/LT activity ratios in scapular dyskinesis subjects.

• PNF and Movement
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• 제22권2호
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• pp.315-324
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• 2024

Purpose: The aim of this study was to compare the activation of shoulder stabilizer muscles to variations of manual resistance during three-dimensional shoulder rehabilitation exercises. Methods: A total of 13 participants were included in this study. To normalize each muscle's activity, a maximal isometric voluntary contraction was performed by all participants. After receiving 30 minutes of training in three-dimensional shoulder rehabilitation exercises, participants randomly performed PNF arm and scapular patterns according to the intensities of manual resistance. The activities of the upper trapezius, lower trapezius, and serratus anterior were measured during these patterns. All exercises were performed for five seconds, and the average of three seconds, excluding the first and last seconds, was used for data analysis. Results: Lower trapezius activity was significant among manual resistance intensities. In both the PNF arm and scapular patterns, using 80% manual resistance of maximum resistance showed higher activity of the lower trapezius muscle compared to 20% of the maximum resistance. Conclusion: It is expected that PNF arm and scapular patterns, with varying intensities of manual resistance, can be used for early rehabilitation of patients with shoulder impingement syndrome.

• Journal of Acupuncture Research
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• 제22권5호
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• pp.29-36
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• 2005

Objectives : This study is performed to understand the interrelation between 'Foot soyang muscle of the Gall bladder channel' and 'muscular system' on the basis of the link between meridian muscle theory and myofascial pain syndrome. Methods : We have researched some of oriental medical books about meridian muscle theory and western medical books about anatomical muscular system. Results & Conclusion : 1. Myofascial pain syndrome is the medical treatment which finds the start point of the pain in fascia and then treats it on the basis of object and concrete anatomical theory, so its application is needed for objectification of the oriental medicine. 2. There is a wide difference between myofascial pain syndrome and meridian muscle theory in that the former explains each muscle individually, while the latter classifies muscles systematically in the view of organism. 3. Foot soyang muscle contains Dorsal interosseous m, Extensor digitorum longus m, Musculus peroneus brevis, longus and, tertius, lliotibial tract, Vastus lateralis m, Gluteus m, Aximus m, Piriformis m, Tensor fasciae latae m, Gluteus minimus m, Obliquus internus & externus abdominis m, External & Internal intercostal m, Serratus anterior m, Pectoralis major m, Sternocleidomastoid m, Auricularis posterior m, Temporalis m, Masseter m, Orbicularis oculi m etc. on the basis of function and the nature of a disease reflected in muscle. 4. Foot soyang muscle keeps the balance of left md right of the body on the outside, while the Gall bladder keeps the balance of the JangBuKiHyeul(臟腑氣血) on the inside.

• Archives of Plastic Surgery
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• 제49권5호
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• pp.596-603
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• 2022

Background We suggested an easy and effective harvesting technique to avoid injury to tissues adjacent to the latissimus dorsi (LD). Methods Between 2007 and 2017, breast reconstruction was performed with an LD flap using the "bottom-up" technique. Medical records were retrospectively reviewed. Data on postoperative complications, results, and follow-up were obtained. Nine cadaveric dissections were performed to assess positional relationships between LD and adjacent muscles based on the ribs where relevant muscles and LD attach. Overall, 78 LD flaps were harvested without complications. Results Average age was 45.4 years. The mean operation time was 260minutes. There were no abnormalities or injuries in the adjacent fascia and muscles during the flap harvest. Drains were removed at an average of 21.9 days postoperatively. In all cadavers, there was conjoined fascia between the thoracolumbar and LD fasciae. The average level of the merging point between the LD and external oblique muscle (EOM) was 8.9 to 11.1 ribs. The average level of the overlapping point between the LD and serratus posterior inferior (SPI) was 9.5 to 11.1 ribs. Conclusions There are three dangerous zones during LD flap harvesting. The first zone is where the conjoined fascia encompasses the LD and thoracolumbar fasciae. The second zone is where the LD merges with the EOM and the serratus anterior. The third zone is the lower part where the LD merges with the SPI and EOM. The "bottom-up" technique enables a more meticulous and atraumatic operation by beginner flap surgeons.

• PNF and Movement
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• 제17권1호
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• pp.11-18
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• 2019

Purpose: This study verifies the muscle activity around the amputation site during proprioceptive neuromuscular facilitation (PNF) pattern exercise for the upper extremities on the non-amputated part in upper extremity amputees and provides basic data on effective exercise around an amputation site. Methods: Manual resistance was applied to the PNF upper extremity pattern of the non-amputated part to generate muscle activity around the amputation site. The resistance was adjusted to an intensity that could cause maximal isometric contraction. The muscle activity of the amputation site and the non-amputated part was measured using a surface electromyogram for the upper trapezius, middle trapezius, infraspinatus, serratus anterior, and pectoralis major. Results: During the scapular exercise in the painless range, the amputated side showed significantly lower muscle activity and a lower muscle contraction ratio compared with the non-amputated side. During the PNF pattern exercise in the painless range, the amputated side showed lower muscle activity and a lower muscle contraction ratio compared with the non-amputated side. When the direct scapular exercise of the amputated side was compared with the PNF pattern exercise of the non-amputated side, their muscle contraction ratios were similar. Conclusion: This study confirmed the effectiveness of the PNF pattern exercise of the non-amputated part as a way to indirectly train the injured site with no pain for rehabilitation of patients with serious body injuries, such as amputation. It is necessary to develop effective exercise programs for the rehabilitation of the amputation site based on the results of this study.

• The Korean Journal of Pain
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• 제29권3호
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• pp.179-184
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• 2016

Background: Recently, ultrasound has been commonly used. Ultrasound-guided interscalene brachial plexus block (IBPB) by posterior approach is more commonly used because anterior approach has been reported to have the risk of phrenic nerve injury. However, posterior approach also has the risk of causing nerve injury because there are risks of encountering dorsal scapular nerve (DSN) and long thoracic nerve (LTN). Therefore, the aim of this study was to evaluate the risk of encountering DSN and LTN during ultrasound-guided IBPB by posterior approach. Methods: A total of 70 patients who were scheduled for shoulder surgery were enrolled in this study. After deciding insertion site with ultrasound, awake ultrasound-guided IBPB with nerve stimulator by posterior approach was performed. Incidence of muscle twitches (rhomboids, levator scapulae, and serratus anterior muscles) and current intensity immediately before muscle twitches disappeared were recorded. Results: Of the total 70 cases, DSN was encountered in 44 cases (62.8%) and LTN was encountered in 15 cases (21.4%). Both nerves were encountered in 10 cases (14.3%). Neither was encountered in 21 cases (30.4%). The average current measured immediately before the disappearance of muscle twitches was 0.44 mA and 0.50 mA at DSN and LTN, respectively. Conclusions: Physicians should be cautious on the risk of injury related to the anatomical structures of nerves, including DSN and LTN, during ultrasound-guided IBPB by posterior approach. Nerve stimulator could be another option for a safer intervention. Moreover, if there is a motor response, it is recommended to select another way to secure better safety.

• 산업융합연구
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• 제21권4호
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• pp.123-131
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• 2023

이 연구는 일반 푸시업과 무릎 푸시업, 벽 푸시업 운동시 어깨 안정근의 활성도 차이를 알아보는데 목적이 있다. 연구대상은 어깨관절에 통증이 없고 푸시업 운동을 하지 않은 대학생 남자 8명을 대상으로 하였으며, 어깨 안정근의 활성도를 알아보기 위하여 표면 근전도를 이용하여 위등세모근, 아래등세모근, 중간등세모근, 앞톱니근, 앞세모근, 뒤세모근, 큰가슴근, 가시아래근에 부착하였다. 일반 푸시다운은 무릎 푸시다운과 벽 푸시다운 보다 근활성도가 유의하게 더 큰 것으로 나타났다. 푸시업 동작에서는 앞톱니근과 가시아래근이 다른 어깨안정근에 비해 근활성도가 유의하게 더 컸으며, 일반 푸시업 동작이 무릎 푸시업과 벽 푸시업 보다 근활성도가 유의하게 더 큰 것으로 나타났다. UT/LT 비율에서는 무릎 푸시다운이 벽 푸시다운 보다 유의하게 낮았으며, UT/SA 비율은 푸시다운과 푸시업 모두 통계적으로 유의한 차이는 없었다. 결론적으로 푸시업과 푸시다운 동작 시에는 앞톱니근과 앞어깨세모근, 가시아래근이 다른 어깨안정근보다 근활성도가 높고, 일반적인 푸시업 운동이 무릎 푸시업과 벽 푸시업 운동보다 근활성도 측면에서는 더 효과적이다. 그러나 푸시다운을 할 경우에는 어깨안정화를 위해 무릎을 굽힌 상태에서 푸시다운을 하는 것이 더 효과적인 것으로 사료된다.

• 한국전문물리치료학회지
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• 제24권3호
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• pp.30-39
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• 2017

Background: Scapular posterior tilt (SPT) is important in the prevention of abnormal scapular movement and pain during elevation of the arm. However, previous studies have overlooked increased upper trapezius (UT) muscle activity interrupting the normal force couple of scapular motion and compensation of levator scapulae (LS) muscle activated simultaneously with UT during SPT exercise. Objects: The purpose of this study was to compare the effects of modified SPT with depression exercise versus SPT exercise on serratus anterior (SA), lower trapezius (LT), UT, and LS muscle activities and the clavicular tilt angle, in subjects with rounded shoulder posture (RSP) and myofascial pain in the UT muscle region. Methods: Eighteen subjects with RSP were recruited and randomly allocated to 2 groups; 9 in the SPT group and 9 in the SPT with depression group. All subjects met the specific RSP criteria and had myofascial pain of UT region. Depending on the allocated group, subjects performed the assigned SPT exercise and EMG data were recorded during the each exercise. Clavicular tilt angle was defined as the angle between the line joining the medial and lateral end of the clavicle and a horizontal line. Results: The SA muscle activity was significantly greater in SPT with depression than with SPT exercise (p<.05). The UT, LS muscle activity and the clavicular tilt angle was significantly lower in SPT with depression than with SPT exercise (p<.05). Conclusion: These findings were insightful because the potential risk of pain from overactivation of the UT and LS was considered, in contrast with SPT exercise. SPT with depression exercise can be implemented as an effective method to facilitate scapular muscle activity for stability and to prevent myofascial pain in the neck and shoulder.

• Journal of Chest Surgery
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• 제51권4호
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• pp.273-276
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• 2018

We report the rare case of a 58-year-old woman who was diagnosed with fungal empyema thoracis combined with osteoradionecrosis. After 32 months of home care followed by open window thoracostomy, thoracoplasty with serratus anterior muscle transposition and a latissimus dorsi myocutaneous flap was performed successfully. Although thoracoplasty is now rarely indicated, it is still the treatment of choice for the complete obliteration of thoracic spaces.

• Parasites, Hosts and Diseases
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• 제29권4호
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• pp.403-406
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• 1991

서울에 거주하는 32세 가정주부가 좌하측 흉벽에 발생한 직경 약 3cm인 종괴를 제거하기 위하여 입원하였다. 종괴는 지난 3개월간 네번 켜졌다가 없어지고는 하였다. 수술 소견상 전거상근(전거상근)내에 육아종이 있었고 그 안에서 미성숙 간질 충체를 발견하였다. 이 증례를 우리나라의 인체 간질 감염 제11례로 보고한다. 간질의 이소기생중 가장 흔한 것으로 알려진 피하기생례로는 우리나라에서는 처음으로 경칩한 중례이며 앞으로 기생충성 피하종괴의 감별대상에 간질(간질) 감염도 고려하여야 한다고 생각한다.