• Clinics in Shoulder and Elbow
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• 제1권2호
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• pp.167-174
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• 1998

Since the first description by Cotton, there have been sporadic reports about the inferior subluxation of the shoulder. Nevertheless there is still a lack of consensus regarding the mechanism of occurrence, evolution and treatment. We have experienced six cases of inferior sublusation(five cases after trauma and one case after surgery) which resolved over time. Analysis of the clinical informations including serial radiographs, data from clinical examination and electromyography(EMG) revealed the following results. All the five post-traumatic inferior subluxations were noted in women with an average age of 59 years after direct trauma resulting in fracture of the proxiaml hrnerus(4) or clavicle(1), of which nerve injury was proven by EMG in three. One case occurred after Bankart repair by stretch injury to the axillary nerve. The presenting symptom was unusually severe pain on passive motion. Absence of anterior or posterior displacement wasl confirmed by radiographs. All the cases seemed to have delayed onset of subluxation except one. The subluxed hu.meral head was concentrically reduced at an average 11 weeks(range 3-23 weeks) from the supposed time of occurrence and the acromiohumeral interval measUred on the standing anteroposterior radiographs decreased to 9.4 mm ftom 23 mm. Improvement of pain paralled the reduction. In conclusion, the most common cause of transient inferior subluxation was nerve injury in ou~ series and the prognosis was excellent, however protraction of recovery or leaving permanent subluxation would be possible if .the injured nerve is unrecoverable.

• 대한물리의학회지
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• 제10권4호
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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.

• The Journal of Korean Physical Therapy
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• 제30권1호
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• pp.8-13
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• 2018

Purpose: The present study was to investigate effects of scapular position and pain on a trunk stabilization exercise with gym ball for patients with arthroscopic rotator cuff repair. Methods: Subjects were patients after 2 weeks of rotator cuff repairs. Subjects were randomly assigned to conservative treatment group (CTG, n=10) or trunk stabilization with gym ball group (SBG, n=10), and participated one of those groups for 2 weeks. Measurements about pain and scapular position were assessed in before and after treatment programs. Results: Pain reduced in both rest and night in SBG compared to CTG. In the case of scapular position, decreased scapular retraction (increased protraction) was found in CTG and vice versa in SBG. Reduced scapular anterior tilting was also found on SBG. Conclusion: The present study showed that early performed trunk stabilization with gym ball could bring a scapular alignment that increases subacromial space and reduces pain. This suggests early trunk stabilization with gym ball programs to restore shoulder functions for patients with rotator cuff repair.

• 대한물리의학회지
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• 제8권3호
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• pp.369-378
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• 2013

PURPOSE: The purpose of present study was to ascertain how the activity of the serratus anterior muscle, the upper trapezius muscle and the pectoral major muscle was affected while the upper arm was being flexed at 70, 90 and 110 degrees respectively in a closed kinetic chain exercise (wall push up plus) and an open kinetic chain exercise (static hug). METHODS: Sixteen healthy young men subjects participated in the study. Surface electromyography (EMG) data were collected from the dominant-side muscles during a closed kinetic chain exercise and an open kinetic chain exercise. The activity of each muscle was measured quantitatively, and by the use of the two-way repeated ANOVA, the data were compared with each other according to exercises and shoulder flexion angles. RESULTS: Results indicated that the closed kinetic chain exercise did not interact with the open kinetic chain exercise (p>.05). In both the closed kinetic chain exercise and the open kinetic chain exercise, the activity of the serratus anterior muscle became different significantly according to angles (p<.05). Its activity increased in order of 70, 90 and 110 degrees (p<.05). In both exercises and all angles, muscle activity was significantly higher in the serratus anterior muscle than in the upper trapezius muscle and the pectoral major muscle (p<.05). CONCLUSION: The above results show that there is a need to selectively control the exercise stress of the serratus anterior muscle in the case of the patients with the shoulder impingement syndrome characterized by the winged scapula, insufficient scapular protraction and upward rotation.

• The Journal of Korean Physical Therapy
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• 제33권4호
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• pp.179-186
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• 2021

Background: Patients with advanced asthma and chronic obstructive pulmonary disease (COPD) have postural deviations such as thoracic hyperkyphosis, forward shoulder posture (FSP) due to an increase in head and cervical protraction, reduced shoulder range of motion and a corresponding increase in scapula elevation and upward rotation. Unlike congenital vertebral kyphosis that are permanent and rigid deformities with bony and other structural deformations which cause respiratory impairment, these deformities in these patients may be more flexible. Since the thoracic hyperkyphosis has been implicated as having adverse health consequences it is necessary to evaluated the relationship between thoracic kyphosis and cardiopulmonary functions of patients with COPD and asthma. Methods: It was a cross-sectional analytical study. Eighty-four eligible patients with COPD and asthma were recruited from the Respiratory Unit, Department of Medicine, Lagos University Teaching Hospital (LUTH), and basic anthropometric parameters, pulmonary parameters, cardiovascular parameters, thoracic kyphosis (Cobb) angle and presence of respiratory symptoms of participants were assessed. Data was analyzed using SPSS version 20. Results: There was no significant correlation between the thoracic kyphosis and selected pulmonary parameters (Forced Expiratory Volume in one second (FEV1, p=0.36), Forced Vital Capacity (FVC, p=0.95), Peak Expiratory Flow Rate (PEFR, p=0.16), Thoracic expansion (TE, p=0.27)/cardiovascular parameters (Systolic Blood Pressure (SBP, p=0.108), Diastolic Blood Pressure (DBP, p=0.17) and Pulse Rate (PR, p=0.93) as well as the respiratory symptoms (SGRQ scores, p=0.11) in all subjects. Conclusion: There was no relationship between thoracic kyphosis and selected pulmonary/cardiovascular parameters as well as respiratory symptoms in patients with COPD and asthma.

• 한국전문물리치료학회지
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• 제31권1호
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• pp.55-62
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• 2024

Background: The serratus anterior (SA) is a muscle that performs protraction of the scapulothoracic joint and plays a role in stabilizing the scapula. Imbalances or weaknesses in SA activation are associated with a variety of shoulder dysfunctions, making selective SA strengthening important for rehabilitation. Objects: We aimed to compare the muscle activation of the pectoralis major (PM), SA, external oblique (EO), and internal oblique (IO) during the push-up plus (PUP) exercise with isometric hip adduction (HA) and abdominal drawing-in maneuver (ADIM). Methods: Nineteen healthy male participants performed three PUP exercises: standard PUP, PUP with ADIM, and PUP with HA. Surface electromyography was used to measure and analyze the muscle activity for PM, SA, EO, and IO. Results: PUP with HA showed the lowest PM activity and highest SA activity, and no significant difference was observed between PUP and PUP with ADIM. PUP with ADIM showed significantly the highest EO and IO activity, followed by PUP with HA and PUP. Additionally, PUP with HA showed the lowest PM/SA ratio, and no significant difference was noted between PUP and PUP with ADIM. Conclusion: PUP with HA was able to show high SA muscle activity while reducing PM muscle activity. In addition, PUP with HA can lead to higher EO and IO muscle activity than standard PUP. This exercise could be used as a practical exercise method to selectively strengthen SA and improve scapular muscle stability during early shoulder rehabilitation.

• 한국의류학회지
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• 제29권12호
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• pp.1595-1607
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• 2005

3차원 스캐너를 통한 인체 측정치는 다양한 분야에서 사용되고 있다. 본 연구는 이러한 3차원 측정치의 정확성과 신뢰도를 조사하기 위한 것이다. 이를 위해 TECMATH사의 VITUS 전신 스캐너로 인체를 측정, ScanWorX Body Measure 소프트웨어를 이용하여 항목을 측정 한 값과 직접 인체측정 에 의해 얻어진 값을 비교하였다. 피험자는 평균 체형의 미국 여대생 25명이며 기준 자세와 일상생활에 많이 쓰이는 $135^{\circ}$ 양팔들기, 어깨 구부리기, 어깨 들어올리기의 3가지 동적 자세를 실험 동작으로 하여 체표의 길이 및 둘레의 변화를 측정하였다. 기준 자세와 135"양팔 들기에 대한 측정치 비교에서 두 가지 측정법에 의한 항목들의 차이는 $-2\~20mm$였으나 두 동작 모두에서 목둘레만이 유의한 차이가 있는 것으로 나타났다. 또한 길이항목보다 둘레항목에서 좀 더 큰 차이를 보였다. 실험 동작에 의해 상반신 18개의 측정항목들은 유의한 체표변화를 나타내었으며 특히 어깨길이, 겨드랑앞벽사이길이, 겨드랑뒤벽사이길이 그리고 견봉사이길이에서 뚜렷한 변화가 나타났다. 그러나 두 측정 법에 따른 체표변화 차이는 없었다. 어깨 구부리기와 어깨 들어올리기 동작시에는 스캔 측정을 3회 반복함으로써 3차원 측정치의 신뢰도를 조사하였는데 모든 항목에서 3회 반복된 측정치가 통계적으로 동일한 것으로 나타났다. 또한 ScanWorX소프트웨어의 가상적 도구인 Body Measure와 자동 프로그램인 ScanWorX Tailor의 측정치를 비교한 결과 자동 측정치가 더 큰 값을 보였고 사용한 프로그램에 따른 유의한 차이를 나타내는 항목들이 나타났다. 이상의 결과로 3차원 인체 측정기를 사용함으로써 짧은 시간에 동작을 촬영하고 이에 대한 측정치를 얻을 수 있어 편리함과 신뢰도에 있어서 장점을 가짐을 확인할 수 있었다. 그러나 좀 더 다양한 분석과 정확한 결과를 얻기 위해서는 의복 분야에 유용한 자동 프로그램의 개발과 3차원 인체 측정기간의 호환성의 문제들이 요구된다고 할 수 있다.