• 한국전문물리치료학회지
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• 제24권1호
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• pp.61-70
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• 2017

Background: Scapular winging is a prominence of the entire scapular medial border, mainly caused by insufficient activity of the serratus anterior (SA) and imbalance of scapulothoracic muscles. Push-up plus (PUP) exercise has been commonly used to increase SA muscle activity. The facilitation of abdominal muscle may affect scapular muscle activity by myofascial connections. Thus, the sequential activation of the turnk muscles is suggested to facilitate the transition of proper force from upper limb and restore force couple of scapular muscles. The abdominal drawing-in maneuver (ADIM) has been effective in improving activation of the deep trunk muscles during movement. Objects: The aim of this study was to determine the effect of ADIM on the activity of the upper trapezius (UT), lower trapezius (LT), and SA during PUP exercises in subjects with scapular winging. Methods: Fourteen men with scapular winging (determined as a of distance between the scapular medial border and thoracic wall over 3 cm) volunteered for our study. The subjects performed the PUP exercise with and without ADIM. Surface electromyography was used to collect the electromyography data of the UT, LT, and SA. A scapulometer was used to measure the amount of scapular winging. Results: SA activity was significantly greater and scapular winging significantly lower during the PUP exercise with ADIM than during those without ADIM. Conclusion: PUP exercise with ADIM can be used as an beneficial method to improve SA activation and to reduce the amount of scapular winging in subjects with scapular winging.

• PNF and Movement
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• 제18권2호
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• pp.245-254
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• 2020

Purpose: The study investigated the effects of extracorporeal shock wave therapy with myofascial release techniques (ESWT+MFR) on pain, movement, and function in patients with myofascial pain syndrome. Methods: Forty participants with upper trapezius trigger points were recruited and randomly allocated to two groups: an experimental group (n = 20) and a control group (n = 20). The experimental group performed the ESWT+MFR, and the control group performed only myofascial release techniques. Each group was treated for 15 minutes, twice a week for four weeks. Pain was assessed using a visual analogue scale and a pressure pain threshold measure. Movement was assessed by cervical range of motion, and cervical and shoulder function were assessed on the Constant-Murley Scale and the Neck Disability Index before and after treatment. Results: The results indicate statistically significant improvements in the two groups on all parameters after intervention as compared to baseline (p < 0.05). As compared to the control group, the experimental group showed statistically significant improvements on the visual analogue scale and pressure pain threshold, cervical range of motion (except rotation), and on the Neck Disability Index (p < 0.05). Conclusion: The ESWT+MFR is more effective than myofascial release techniques for pain, movement, and function in patients with myofascial pain syndrome and would be clinically useful for physical therapists treating myofascial pain syndrome.

• 한국응급구조학회지
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• 제19권3호
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• pp.19-32
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• 2015

Purpose: This study examined the effect of wearing personal protective equipment (PPE) on cardiopulmonary resuscitation (CPR), positive airway pressure, and the posture of emergency medical technicians (EMTs) when conducting CPR. Methods: Twenty 119 EMTs performed 30:2 CPR on a manikin for 4 min. Imaging data were digitized with Kwon3D XP (version 4.0). Data were collected by analyzing the motion when starting in one cycle, such as pressing to the maximum and in the final position (relaxed), and were analyzed with SPSS 18.0. Results: The angle of the elbow joints was significantly reduced (p < .05). The trunk angle was statistically significantly (p < .01, p < .001) increased. The angular velocities of the shoulder joint and left elbow joint were reduced (p > .05). The angular velocity of the trunk was significantly reduced in the starting and maximum compression postures. The hand-escape time was increased. The average compression depth was increased but not significantly (p > .05). The positive airway pressure was reduced (p > .05). Conclusion: The angle of the elbow joints and the angular velocity of the trunk were reduced, and the angle of the trunk was increased. The success of CPR and positive airway pressure was reduced.

• 한국전문물리치료학회지
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• 제26권4호
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• pp.29-34
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• 2019

Background: The serratus anterior is one of the most important muscle for maintaining good scapular alignment in the shoulder joint. The pectoralis major and upper trapezius may also compensate for weak serratus anterior muscles. The push-up plus exercise has been identified as the optimal exercise for maximum activation of the serratus anterior. Objects: The purpose of this study was to examine differences in surface electromyography (EMG) activity of upper trapezius, pectoralis major, and serratus anterior muscles during push-up plus exercises on variously angled surfaces in subjects with winged scapula. Methods: Sixteen subjects with winged scapula (male=5, female=11) volunteered for this study. The subjects performed push-up plus exercise on four different tilt angles, namely $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, and $90^{\circ}$. EMG activities in the serratus anterior, upper trapezius, and pectoralis major muscles during performance of push-up plus exercise were measured in all subjects. Data were processed from repeated measures one-way analysis of variance. Results: There was significant difference in the muscle activity of the serratus anterior on the different surface angles (p<.05). The results of the post-hoc analysis showed significantly greater serratus anterior muscle activity on a surface at a $0^{\circ}$ angle than at others tilt angles (p<.05). There was also significant difference in the ratio of serratus anterior to upper trapezius and serratus anterior to pectoralis major across the four surfaces (p<.05), and post-hoc analysis showed significantly greater values on the $0^{\circ}$ surface than on other tilts (p<.05). Conclusion: This study found that performing push-up plus exercises on a flat surface with $0^{\circ}$ and $30^{\circ}$ tilt angle achieves high activation of the serratus anterior muscle for selective strengthening. It can also take into account the sequential application, which is first performed at a $30^{\circ}$ and at a $0^{\circ}$ tilt angle for and effective but not excessive muscle activation.

• PNF and Movement
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• 제3권1호
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• pp.1-15
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• 2005

Objective : The purpose of this study was to evaluate the influence of a community based group exercise intervention on motor functional capacity. To evaluate the immediate(post-treatment) effects after 6-weeks exercise program on the group exercise intervention(PNF and Circuit exercise). Methods : Subjects-Included persons with stroke who were living in the community. Thirty-seven subjects were randomly assigned to the PNF, Circuit exercise and control group participated in a repeated measures design that evaluated the subjects with pre-treatment, post-treatment(6 weeks). Functional ability outcome measures assessed the motor assessment scale(MAS) and EMG. Both treatment groups participated in exercise cJass three times a week for 6 weeks. Group programs focused on balance, functional motor capacity and walking ability. The PNF program was modified PNF pattem and techniques with emphasis on functional tasks when possible, as well as stretching of the more affected limb particularly in the more affected shoulder. The Circuit program with subjects completing practice at a selies of work station as well as participating in walking races and relay with other members of the group. Results : Compared with the control group, the treatment group had larger improvements in the motor function ability after 6 weeks treatment and Post-treatment test scores were more significant than the pre-treatment score. 1. Motor function were assessed by using MAS, sit to stand, walking and upper function were assessed pre-treatment versus post-treatment measures revealed a statically significant(p<.05). There were significant differences between the groups. Compared with the control group, the treatment group had larger improvements. 2. In the treatment groups, demonstrated difference in the electromyographic activation of biceps, triceps, quadriceps and tibialis anterior muscles on the paretic side in the response to the reaching arm movement and stepping motion in stance. The difference in muscle activation improvement were not statically significant. Conclusion : The results of this study showed that the PNF and Circuit group exercise intervention can improve motor functional ability. This study suggests that the PNF and Circuit exercise programs is appropriate for community-based group exercise principles. It leads to gain and maintain potential function for disabled persons after stroke in the community.

• 대한정형도수물리치료학회지
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• 제24권2호
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• pp.1-7
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• 2018

Background: This study was carried out to investigate the effect of mulligan taping group and repeated measurement group on muscle activity and grip strength of adult with forward head posture. Methods: Thirty adults with forward head posture were randomly assigned to each of 15 mulligan taping and repeat measurement groups. The mulligan taping group measured the pre-test and post-test muscle activity and the grip strength three times and compared the mean values. The repeat group was repeatedly measured and measured before and after the experiment, The collected data were analyzed using SPSS statistical program. Results: There was no significant difference between mulligan taping group and repeated measurement group in changes of muscle activity. There was a significant difference between mulligan taping group and repeated measurement group in changes of grip strength. Conclusions: Mulligan taping was applied to an adult with forward head posture, there was no significant change in muscle activity of flexor carpi radialis and palmaris longus, but it seems to improve hand function by re-aligned of nearby muscles by maintaining scapular stability.

• 대한의용생체공학회:의공학회지
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• 제43권4호
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• pp.241-250
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• 2022

It is known that chronic pain and injury of upper limb joint tissue in manual wheelchair users is usually caused by muscle imbalance, and the propulsion speed is reported to increase this muscle imbalance. In this study, kinematic variables, electromyography, and ultrasonographic images of the upper limb were measured and analyzed at two different propulsion speeds to provide a quantitative basis for the risk of upper extremity joint injury. Eleven patients with spinal cord injury for the experimental group (G_E) and 27 healthy adults for the control group (G_C) participated in this study. Joint angles and electromyography were measured while subjects performed self-selected comfortable and fast-speed wheelchair propulsion. Ultrasound images were recorded before and after each propulsion task to measure the acromiohumeral distance (AHD). The range of motion of the shoulder (14.35 deg in G_E; 20.24 deg in G_C) and elbow (5.25 deg in G_E; 2.57 deg in G_C) joints were significantly decreased (p<0.001). Muscle activation levels of the anterior deltoid, posterior deltoid, biceps brachii, and triceps brachii increased at fast propulsion. Specifically, triceps brachii showed a significant increase in muscle activation at fast propulsion. AHD decreased at fast propulsion. Moreover, the AHD of G_E was already narrowed by about 60% compared to the G_C from the pre-tests. Increased load on wheelchair propulsion, such as fast propulsion, is considered to cause upper limb joint impingement and soft tissue injury due to overuse of the extensor muscles in a narrow joint space. It is expected that the results of this study can be a quantitative and objective basis for training and rehabilitation for manual wheelchair users to prevent joint pain and damage.

• 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.

• 한국전자통신학회논문지
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• 제9권3호
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• pp.311-322
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• 2014

본 연구의 목적은 최근 IT환경에서 소방관의 건강 관련 삶의 질에 대하여 작업 관련 근골격계 질환의 영향을 평가하고자 하였다. 평가는 구조화된 설문지를 이용하였으며, 직접 대면 면담 방식으로 진행되었다. 연구는 전체 366명의 소방관이 참여하였다. 평가 방법은 근골격계 질환의 증상에 대한 평가를 위해 NIOSH의 증상 표를 이용한 자가 평가식 설문지로 측정하였으며, 건강관련 삶의 질의 평가를 위해 SF-36을 근거로 측정하였다. 근골격계 질환의 유병률은 상지에서 38.0%, 허리에서 35.5%, 하지에서 21.6%이었으며, 59.3%에서 신체의 두 부위 이상에서 증상이 발생하였다. 근골격계 질환의 증상을 갖는 소방관은 상지에 근골격계 질환의 증상을 갖지 않는 소방관보다 감정 기복 제한을 제외한 삶의 질의 7 범주에서 유의한 낮은 점수를 보였다. 반면에 근골격계 질환의 증상을 갖는 소방관은 하지나 허리에 근골격계 질환의 증상을 갖지 않는 소방관보다 삶의 질의 모든 범주에서 유의한 낮은 점수를 보였다. 이러한 결과는 근골격계 질환이 삶의 질에 부정적 효과를 갖음을 유추할 수 있다. 따라서 소방관에서 근골격계 질환의 예방은 건강 관련 삶의 질을 향상하기 위한 효과적인 중재적 전략으로 고려할 수 있을 것이다.

• 대한의용생체공학회:의공학회지
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• 제33권4호
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• pp.184-193
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• 2012

Many studies have reported that housework done using household appliances may affect biomechanical characteristics of the musculoskeletal system. The purpose of this study was to investigate the effects of housework done using a pulsator washing machine on joints and muscles. We calculated joint torques and muscle strengths on the basis of an experimental/virtual three-dimensional motion analysis for six healthy females using the pulsator washing machine at different heights (H) and depths (D) of the inside drum (H (mm){\times}D (mm), Trial1: $962.5{\times}609.4$, Trial2: $962.5{\times}624.4$, Trial3: $982.5{\times}644.4$, Trial4: $995.5{\times}642.4$, Trial5: $1015.5{\times}677.4$). The joint torques and muscle strengths tended to be considerably different during torso flexion in the sagittal plane for all the trials. The maximum joint torques for the thoracic vertebra, left ankle, and right shoulder measured in Trial4 were significantly higher than those measured in the other trials (p < 0.05); in addition, those for the thoracic vertebra and both ankles measured in Trial5 were significantly higher than those measured in the other trials (p < 0.05). The maximum muscle strengths for the left trapezius muscle and both tibialis anterior muscles measured in Trial5 were significantly higher than those measured in the other trials (p < 0.05). These results indicate that housework done using a pulsator washing machine may affect joint torques and muscle strengths, and these effects are dependent on the height and/or depth of the inside drum of the pulsator washing machine.