• Title/Summary/Keyword: Shoulder Position

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Radiologic Comparison of Humeral Position according to the Implant Designs Following Reverse Shoulder Arthroplasty: Analysis between Medial Glenoid/Medial Humerus, Lateral Glenoid/Medial Humerus, and Medial Glenoid/Lateral Humerus Designs

  • Cho, Nam Su;Nam, Ju Hyun;Hong, Se Jung;Kim, Tae Wook;Lee, Myeong Gu;Ahn, Jung Tae;Rhee, Yong Girl
    • Clinics in Shoulder and Elbow
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    • v.21 no.4
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    • pp.192-199
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    • 2018
  • Background: The currently available reverse shoulder arthroplasty (RSA) designs can be classified into medial glenoid/medial humerus (MGMH), lateral glenoid/medial humerus (LGMH), and medial glenoid/lateral humerus (MGLH) prosthesis designs. The purpose of this study was to radiologically analyze the effect of different RSA designs on humeral position following RSA. Methods: A total of 50 patients who underwent primary RSA were retrospectively analyzed. Among 50 patients, 33 patients (group A: MGMH) underwent RSA with Aequalis system (Wright, Inc, Bloomington, MN, USA), 6 (group B: LGMH) with Aequalis system using bony increased offset, and 11 (group C: MGLH) with Aequalis Ascend Flex system. The acromiohumeral distance, acromioepiphyseal distance (AED), lateral humeral offset (LHO), LHO from the center of rotation ($LHO^{COR}$), and deltoid length were radiologically measured to quantify the distalization and lateralization of the humerus. Results: The increment in postoperative AED was $19.92{\pm}3.93mm$ in group A, $24.52{\pm}5.25mm$ in group B, and $25.97{\pm}5.29mm$ in group C, respectively (p=0.001). The increment in postoperative LHO was $0.13{\pm}6.30mm$, $8.00{\pm}12.14mm$, and $7.42{\pm}6.88mm$, respectively (p=0.005). The increment in postoperative $LHO^{COR}$ was $20.76{\pm}6.06mm$, $22.04{\pm}5.15mm$, and $28.11{\pm}4.14mm$, respectively (p=0.002). Conclusions: The radiologic analysis of the effect of different RSA designs on humeral position following RSA showed significant differences in the increment in postoperative AED, LHO, and $LHO^{COR}$ between the 3 groups. Therefore, MGLH design seems to be more effective for humeral distalization and lateralization compared to original Grammont design.

Influence of Pre-Emptive Scapular Posterior Tilt on Scapular Muscle Activation and Scapulohumeral Movements during Shoulder Horizontal Abduction in the Prone Position

  • Kim, Sujung;Kang, Minhyeok
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.4
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    • pp.2173-2177
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    • 2020
  • Background: Shoulder horizontal abduction in the prone position (SHAP) has been reported as an effective exercise to strengthen the lower trapezius. However, the effects of pre-emptive scapular posterior tilt on scapular muscle activity and scapulohumeral movements during SHAP have not been examined. Objectives: To examine the effect of the addition of scapular posterior tilt on muscle activity of the trapezius and posterior deltoid, and scapular posterior tilt and shoulder horizontal abduction, during SHAP. Design: Cross-sectional study. Methods: Fifteen healthy male subjects performed two types of SHAP: general and modified SHAP (SHAP combined with pre-emptive scapular posterior tilt). To perform modified SHAP, pre-emptive scapular posterior tilt training was performed prior to the modified SHAP. Muscle activity of the middle and lower trapezius and posterior deltoid, and the amount of scapular posterior tilt and shoulder horizontal abduction, were measured during two types of SHAP. Results: Muscle activity of the lower trapezius and scapular posterior tilt was significantly increased during the modified SHAP, while muscle activity of the posterior deltoid and the amount of shoulder horizontal abduction were significantly decreased. However, the middle trapezius muscle activity did not change during the modified SHAP. Conclusion: The SHAP with pre-emptive scapular posterior tilt can be useful to strengthen the lower trapezius.

A Study on the Distribution of VOC Concentrations by Attachment Position of Air Samplers for Working Environment Measurement (작업환경측정 시료 채취기의 부착 위치에 따른 유기화합물의 농도 분포에 관한 연구)

  • Kwon, Yung-Gyu;Won, Jung Il;Jang, Hyung Seok;Sim, Sang-hyo
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.25 no.3
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    • pp.328-337
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    • 2015
  • Objectives: The purpose of this study is to investigate differences in concentration according to the position at the left or right shoulder within a 30 cm of radius of workers' respirators and provide basic data for the establishment of an industrial health policy. Methods: Personal samples were collected from a total of 65 workers from 27 manufacturing firms in South Gyeongsang-do Province from November 5, 2011 to December 30, 2012 after classifying the laborers into left- and right-side groups. The organic compound samples were collected and analyzed in accordance with the NIOSH Manual of Analytical Methods (NMAM) 1501. Results: In terms of the concentration of organic compounds collected from both left and right shoulders at the position of workers' respirators, isobutyl acetate was the highest with 145 ppm at the left shoulder, followed by ethyl acetate (133.5 ppm) and toluene (38.13 ppm). At the right shoulder, on the contrary, ethyl acetate (149.3 ppm) was the highest, followed by toluene (46.26 ppm), xylene (29.63ppm) and isopropyl alcohol (28.06 ppm). Overall, the right shoulder was higher than the left shoulder in terms of concentrations. Conclusions: For the measurement of the working environment, workers' personal samples should be collected at the place closest to the respirator. In terms of the reduction of error, the attachment of two sample media is expected to reduce errors in exposure assessment.

Effect of Shoulder External Rotation on EMG Activity of the Scapular Upward Rotators during Arm Elevation (어깨관절 가쪽돌림이 팔을 올리는 동안 어깨뼈 위쪽돌림근의 근활성도에 미치는 영향)

  • Jung, Do-Young;Weon, Jong-Hyuck
    • Journal of the Korean Society of Physical Medicine
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    • v.10 no.4
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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.

Isolated Musculocutaneous Nerve Palsy after the Reverse Total Shoulder Arthroplasty

  • Kim, Sung-Guk;Choi, Chang-Hyuk
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.101-104
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    • 2016
  • Reverse total shoulder arthroplasty has been performed with promising results in rotator cuff tear arthropathy. However, the global complication of the reverse total shoulder arthroplasty is relatively higher than that of the conventional total shoulder arthroplasty. Neurologic complications after reverse total shoulder arthroplasty are rare but there are sometimes remaining sequelae. The cause of the neurologic complication is multifactorial, including arm traction, position and the design of the implant. Most cases of neurologic palsy following reverse total shoulder arthroplasty occur in the axillary nerve and the radial nerve. The authors report on a case of a 71-year-old man with isolated musculocutaneous nerve palsy after reveres total shoulder arthroplasty with related literature.

Effects of Sling Exercise using Neurac Technic on Shoulder Stabilization Muscles According to the Surface during Crawling Position (네발기기 자세에서 지지면에 따라 뉴렉기법을 적용한 슬링이 어깨 안정화 근육에 미치는 영향)

  • Chun, Hye-Lim;Kim, Kyung-Hun
    • Journal of Korean Physical Therapy Science
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    • v.25 no.2
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    • pp.24-34
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    • 2018
  • Purpose: The purpose of this study was to assess how much neurac technic affects the stability muscles of the shoulder according to the supporting surface in crawling position. Method: 29 healthy adult males participated in this experiment. The experiment consists of 2 experimental groups and 1 control group. It is conducted for 3 weeks. Each group exercised for 7 seconds and then rested for 3 seconds. Using EMG, the average value of serratus anterior, upper trapezius, and lower trapezius was repeated three times. Experimental group 1 conducted push up plus exercise applied neurac technic with sling on unstable supporting surface. Experimental group 2 conducted push up plus exercise applied neurac technic with sling on stable supporting surface. Control group conducted the push up plus exercise on stable supporting surface. One-way ANOVA was used for statistical analysis. Result: It was noticeable that the result of Experimental group 1 affects stability muscles of more than Experimental group 2 and Control group. Conclusion: Push up plus position applied neurac technic with sling on unstable supporting surface was the most effective in activating the stability muscles of the shoulder.

Will Prone Trunk Extension Affect Scapular and Thoracic Kinematics and Muscle Activities During Scapular Posterior Tilting Exercise in Subjects With Round Shoulder and Flexed Posture?

  • Shin, A-reum;Lee, Ji-hyun;Kim, Da-eun;Cynn, Heon-seock
    • 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.

Effect of Neck Rotating Directions on the Muscle Activity of Upper and Lower Trapezius during Shoulder External Rotation

  • Shin, Yong Wook;Kim, Chi Hwan;Han, Jin Tae
    • The Journal of Korean Physical Therapy
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    • v.32 no.2
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    • pp.101-106
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    • 2020
  • Purpose: This study examined the effects of the directions of neck rotation on the muscle activity of the upper trapezius and lower trapezius while rotating a shoulder externally. Methods: Twenty-five healthy males participated in this study. The subjects were asked to rotate their shoulder externally with 90° shoulder abduction and 90° elbow flexion in three different neck rotations (neutral, ipsilateral, and contralateral) in the prone position. The muscle activities of the upper and lower trapezius were measured using surface electromyography. One way repeated measures ANOVA was used to compare the muscle activity of the upper and lower trapezius depending on the different neck turning directions. Results: In the upper trapezius, turning the neck in the ipsilateral direction while turning a shoulder externally decreased the muscle activity significantly, but the muscle activity was increased significantly by turning the neck in the contralateral direction. On the other hand, in the lower trapezius, turning the neck in the ipsilateral direction increased the muscle activity significantly, but the muscle activity was decreased significantly by turning the neck in the contralateral direction decreased it significantly. Conclusion: When someone has an imbalance of shoulder function, turning the neck in the ipsilateral direction while turning the shoulder externally in the prone position is effective in decreasing the activity of the upper trapezius and increasing the activity of the lower trapezius. Therefore, these results could be used as basic evidence for researching patients with shoulder problems.