We measured the glenohumeral and scapulothoracic movements during abduction of the arm in the coronal plane with radiologic analysis in the 30 shoulders of normal male adults who were without pain, limitation of motion, and history of trauma. In the resting position, the glenoid cavity of the scapula faced somewhat superiorly in over 80 percents of the individuals, the mean superior tilting was 5.7 degrees. The mean total scapulothoracic movement was 65.8 degrees and the mean total glenohumeral movement was 106.8 degrees during abduction of arm in the coronal plane. The mean ratio of the glenohumeral movement to the scapulothoracic movement was 1.6 and this GH/ST ratio was decreased toward the extreme abduction. When the arm was abducted, external rotation of the humeral head occurred and this external rotation was increased smoothly during 0 degree through 90 degrees, but steeply above 90 degrees. The acromiohumeral interval was 10.9 mm at the resting positon, and this interval decreased during the arm abduction. The superior migration of the humeral head was 3.1 mm while abducting the arm. Our measurement of the relationships of glenohumeral and scapulothoracic movements at the coronal plane would be useful in the understandings of the biomechanics of shoulder, but further study would be required for the analysis of the three dimensional relationship because of the limitation of our two dimensional analysis.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
/
v.12
no.1
/
pp.27-36
/
2006
The purpose of this study was to compare the effects of Mulligan method and PNF method on the pain and limitation of range of motion in patients with frozen shoulder. The subjects of this study were 20 patients, 10(50%) males and 10(50%) females. They visited clinic for physical treatment within 6 months after onset of shoulder pain and limitation of range of motion with frozen shoulder. One group was applied with Mulligan method and other group was with PNF method. The patient were treated 5 times session weekly for 6 weeks from March 4th, 2002. And each treatment session was 15min. with physiotherapy. The pain was measured by visual analogue scale (V AS) and rage of motion (ROM) of flexion, abduction, external rotation, internal rotation were measured by goniometer. The data was analysed by paired T-test and independent T-test. The results of this study were summarized as follow : 1. The ROM of Mulligan method group increase in after treatment in comparison with ROM in before treatment, it is significant increase. Although the V AS of MMG decrease in before than after treatment, it is significant difference. 2. There is significant difference in before and after treatment of ROM of shoulder flexion, abduction, internal rotation, external rotation between PNF method group. The V AS of PMG is decreasing in before than after treatment, it is significant difference. 3. There is significant difference in before movement and after movement ROM of flexion, abduction, internal rotation, external rotation and VAS between Mulligan method session and PNF method session then the scale which measured by Mulligan method was more increased than that of PNF method. The results showed that both Mulligan method and PNF method were effective in pain reduce and ROM increase, but Mulligan method was superior to PNF method in ROM increase and pain reduce.
The purpose of this study was to investigate the relations between the segments of the body, the three dimensional anatomical angle during One Hand Backhand Stroke and Two Hand Backhand in tennis. For the movement analysis three dimensional cinematographical method(APAS) was used and for the calculation of the kinematic variables a self developed program was used with the LabVIEW 6.1 graphical programming(Johnson, 1999) program. By using Eular's equations the three dimensional anatomical Cardan angles of the joint and racket head direction were defined. 1. In three dimensional maximum linear velocity of racket head the X axis and Y axis(horizontal direction) showed $-11.04{\pm}2.69m/sec$, $-9.31{\pm}0.49m/sec$ before impact, the z axis(vertical direction) maximum linear velocity of racket head did not show at impact but after impact this will resulted influence upon hitting ball. It could be suggest that Y axis velocity of racket head influence on ball direction and z axis velocity influence on ball spin after impact. The stance distance between right foot and left foot was mean $75.4{\pm}5.86cm$ during one hand backhand stroke and $72.6{\pm}4.67cm$ during two hand backhand stroke. 2. The three dimensional anatomical angular displacement of trunk in interna rotation-external rotation showed most important role in backhand stroke. and is follwed by flexion-extension. the three dimensional anatomical angular displacement of trunk did not show significant difference between one hand backhand stroke and two hand backhand stroke but the three dimensional anatomical angular displacement of trunk was bigger than one hand backhand stroke. 3. while backhand stroke, the flexion-extension and adduction-abduction of right shoulder joint showed significant different between one hand backhand stroke and two hand backhand stroke. the three dimensional anatomical angular displacement of right shoulder joint showed more flex and abduct in one hand backhand stroke. 4. The three dimensional anatomical angular displacement of left shoulder showed flexion, adduction, and external rotation at impact. after impact, The angular displacement as adduction-abduction of left shoulder changed motion direction as abduction. angular displacement of left shoulder as flexion-extension showed bigger than the right shoulder.
Thirty normal adults were tested to measure the electrical activity of the anterior (AD), middle (MD), and posterior portion (PD) of the deltoid muscle and sternal portion of the pectoralis major muscle (PM) during the performance of four upper extremity PNF diagonal patterns with elbow flexion angle in $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$. The PNF patterns in which these muscles function optimally have been theoretically advanced by Kabat and further described by Knott and Voss. They theorize that the MD should be most active with shoulder flexion, abduction, and external rotation (D2F); the PD with shoulder extension, abduction, and internal rotation (D1E); the AD with shoulder flexion, adduction, and external rotation (D1F); and the PM with shoulder extension, adduction and internal rotation (D2E). The patterns were performed through range of motion, with an isometric contraction performed in the shortened range. When the EMG activity of AD, MD, PD and PM in its optimal patterns was measured, it does not have significant difference among fixed elbow flexion angle $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$ (p>.05). In addition, suggestions were made for study of patients who exhibit imbalance of muscle strength and have muscle weakness.
Kim, Jwa-Jun;Kim, Dae-Kyung;Kim, Jae-Yong;Shin, Jae-Wook;Park, Se-Yeon
PNF and Movement
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v.17
no.2
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pp.207-214
/
2019
Purpose: Although multi-directional reaching exercises are commonly used clinically, the effects of specific movement directions on the muscle systems of the lower extremities have not been explored. We therefore investigated lower extremity muscle activity during reaching exercises with different sagittal and horizontal plane movements. Methods: The surface electromyography responses of the bilateral rectus femoris, tibialis anterior, peroneus longus, and gastrocnemius muscles were measured during reaching exercises in three directions in the horizontal plane (neutral, $45^{\circ}$ horizontal shoulder adduction, and $45^{\circ}$ abduction) and three directions in the sagittal plane (neutral, $120^{\circ}$ flexion, and $60^{\circ}$ flexion). A total of 20 healthy, physically active participants completed six sets of reaching exercises. Two-way repeated ANOVA was performed: body side (ipsilateral and contralateral) was set as the intra-subject factor and direction of reach as the inter-subject factor. Results: Reaching at $45^{\circ}$ horizontal shoulder adduction significantly increased the activity of the contralateral rectus femoris and gastrocnemius muscles, while $45^{\circ}$ horizontal shoulder abduction activated the ipsilateral rectus femoris and gastrocnemius muscles. The rectus femoris activity was significantly higher with reaching at a $120^{\circ}$ shoulder flexion compared to the other conditions. The gastrocnemius activity decreased significantly as the shoulder elevation angle increased from $60^{\circ}$ to $120^{\circ}$. Conclusion: Our results suggest that multi-directional reaching stimulates the lower extremity muscles depending on the movement direction. The muscles acting on two different joints responded to the changes in reaching direction, whereas the muscles acting on one joint were not activated with changes in reaching direction.
Background: This study investigates the effects of neuromuscular electrical stimulation (NMES) in preventing deltoid atrophy during the first 12 weeks after arthroscopic rotator cuff repair. Methods: Eighteen patients undergoing arthroscopic repair of a medium-sized rotator cuff tear by a single surgeon, were randomized into two groups: NMES and transcutaneous electrical nerve stimulation (TENS). Each group used the respective device for 6 weeks after surgery. Pain was measured at baseline, 6, and 12 weeks postoperatively, using the visual analogue scale (VAS); range of motion (ROM), abduction strength and functional scores were measured at baseline and 12 weeks postoperatively. Deltoid thickness and cross-sectional areas were measured using magnetic resonance imaging at 12 weeks postoperatively. Results: At 12 weeks post-surgery, no statistically significant difference was observed between the NMES and TENS groups in the pain VAS, the Disabilities of the Arm, Shoulder and Hand score, ROM, and abduction strength. Postoperative decrease in the thickness of the anterior, middle, and posterior deltoid, at the level just below the coracoid, was -2.5%, -0.7%, and -6.8%, respectively, in the NMES group, and -14.0%, -2.6%, and -8.2%, respectively, in the TENS group (p=0.016, p=0.677, and p=0.791, respectively). At the level of the inferior glenoid tubercle, postoperative decrease in area of the deltoid was -5.4% in the NMES group and -14.0% in the TENS group, which was significantly different (p=0.045). Conclusions: NMES has the potential for reducing deltoid atrophy after arthroscopic rotator cuff repair, suggesting that NMES might help minimize postoperative atrophy after various shoulder surgeries.
Park, Kyu-Tae;Park, Yeon-Ju;Jeon, Jeongwoo;Hong, Jihoen;Yu, Jaeho;Kim, Jinseop;Kim, Seong-Gil;Lee, Dongyeop
Journal of The Korean Society of Integrative Medicine
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v.10
no.2
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pp.177-185
/
2022
Purpose : The purpose of this study was to compare the effect of additional isometric contraction of trunk, shoulder, and hip muscles during abdominal crunch exercise on abdominal muscle thickness and to identify the most effective intervention for core muscle activation. Methods : This study was conducted on 22 healthy male adults. Subjects performed three types of crunch exercises (abdominal crunches accompanied by internal and external isometric rotation of the hip, horizontal shoulder adduction and abduction, and rotation of the trunk). The thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) were evaluated using ultrasonography. The collected data used one-way repeated ANOVA statistics. Wilcoxon signed-rank test of nonparametric statistics was used for post-test analysis. Results : The IO thickness was significantly lower than general abdominal crunch when shoulder adduction was added (p<.05). The crunch with shoulder abduction, hip external rotation, and ipsilateral trunk rotation was significantly higher than the abdominal crunch (p<.05). The EO thickness was significantly greater in the crunch with hip external rotation than in the abdominal crunch (p<.05). Conclusion : The level of contraction in abdominal muscles appears to vary when isometric contractions of the trunk, shoulder, and hip muscles are added to the abdominal crunch exercise. Therefore, the use of isometric contractions of other joints to selectively induce contraction of the abdominal muscles may be considered.
Background: Posterior shoulder tightness, which is a problem mainly seen in patients with shoulder impingement syndrome, disrupts the scapulohumeral rhythm between the humerus and scapulae. Objects: The aim of this study was to compare the effects of joint mobilization and stretching on shoulder muscle activity and internal rotation range of motion (ROM) of the glenohumeral joint in patients with impingement syndrome with posterior shoulder tightness. Methods: The research subjects included 22 in-patients with impingement syndrome with posterior shoulder tightness. They were randomly divided into two groups: one group (12 patients) was treated with joint mobilization and the other group (10 patients) was treated with stretching for the posterior shoulder tightness. Each treatment was performed five times a week for two weeks, and there were 15 sessions for each treatment. The ROM of the internal rotation and muscle activities of shoulder joint were evaluated pretest and posttest in each group. Electromyography data were collected from the upper, middle, and lower trapezius and serratus anterior during shoulder abduction of 90°, 120°, and 150°. Results: Both the joint mobilization and stretching groups showed significant decreases in muscle activity in the upper, middle, and lower trapezius on the posttest (p < 0.05). There was a significant difference in serratus anterior at 150° (p < 0.05), but there was no significant difference between group in post-hoc analysis (p > 0.025). The internal rotation ROM was significantly increased in the stretching group compared to that in the joint mobilization group (p < 0.025). Conclusion: This study found that both joint mobilization and stretching for posterior shoulder tightness were effective in muscle activity during arm abduction, also in order to increase internal rotation ROM of shoulder joint, stretching was effective in patients with impingement syndrome with posterior tightness.
Purpose: This study was to identify the effect of Cervical Kyongrak Massage on Shoulder pain, shoulder Exercise Range and Mood in the elderly. Method: This study used a quasi-experimental pre-test and post-test design. Data were collected from 13 April to 30 June in 2003. There were 58 elderly subjects,(30 experimental group, 28 control group) in Pusan. The experimental group took Kyongrak Massage at Cervical Kyonghyul sites around neck and shoulder for 10 minutes daily during 5days. Result: In the experimental group, shoulder pain(t=-9.80, p=.000), shoulder exercise Range (Flexion t=3.10, p=.003; Abduction t=7.95, p=.000; External Rotation t=5.00, p=.000) and Mood(t=-9.80, p=.000) were significantly better than control group after Cervical Kyongrak Massage. Conclusion: These findings indicate that Cervical Kyongrak Massage may be an effective adjunct therapy for improving shoulder pain, shoulder exercise range and mood, and is considered as a independent and available nursing intervention for elderly.
This paper reports treatment effect by Thera-Band for two cases of Frozen shoulder. The purpose of study was to introduce treatment effect by Thera-Band for frozen shoulder. Case 1 Total amount of an increase of range of motion of shoulder joint were about 55 degrees in flexion, 60 degrees in abduction and 50 degrees in external rotation and the majority of those improvements were accomplished during three weeks of treatment by Thera-Band. Case 2 Range of motion of shoulder joint were accomplished Normal Range of Motion during one week of treatment by Thera-Band.
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