• Physical Therapy Rehabilitation Science
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• v.10 no.4
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• pp.503-511
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• 2021

Objective: This study compared pain, muscle power (MP), muscle thickness (MT), and normalized position of the scapula (POS) between general physical therapy and general physical therapy with strengthening exercises of the lower trapezius in patients with rounded shoulder and chronic neck pain. Design: Randomized controlled trial. Methods: The participants were 30 patients of W hospital in Gangnamgu, Seoul, with rounded shoulders who were diagnosed with chronic neck pain. Rounded shoulder was defined as a distance between the surface and acromion of >1 inch in the supine position. The participants were assigned to an experimental group (n=15) and a control group (n=15). The experimental group completed four types of strengthening exercises program for 15 minutes, twice weekly, for a total of 5 weeks. Soft tissue mobilization (STM), cervical extension flexion rotation (CEFR), and physical modality were also performed in both groups. Results: The degree of pain was assessed using the numerical rating scale (NRS), MP was measured a handheld dynamometer, MT was measured by ultrasound, and POS was measured using a tapeline. Significant between-group differences were observed in VAS, MP, MP, and POS. Significant changes were observed in the experimental group for VAS, MP, MT, and POS. Conclusions: Based on the results of this study, it was indicated that lower trapezius strengthening exercises performed together with general physical therapy was significantly improved in pain, MP, MT, and POS in patients with rounded shoulder and chronic neck pain compared to when general physical therapy was performed alone.

• PNF and Movement
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• v.18 no.1
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• pp.107-116
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• 2020

Purpose: To investigate the effects of electromyography (EMG) biofeedback on the muscle activity of the trapezius, shoulder pain, function, and range of motion (ROM) in patients with subacromial impingement syndrome (SAIS). Methods: Sixteen patients (9 males and 7 females) with SAIS participated voluntarily. The main outcome measures were muscle activity of the trapezius, shoulder pain (VAS), ROM, and the shoulder pain and disability index (SPADI). Exercises with EMG biofeedback consisted of shoulder flexion in a standing position, shoulder external rotation in a side-lying position, and shoulder horizontal abduction in a prone position. Post measurements were taken immediately after EMG biofeedback training. Results: Middle and lower trapezius activity, as well as ROM, was significantly increased by exercise with EMG biofeedback (p<0.05). In addition, VAS and SPADI scores significantly decreased post-EMG biofeedback training (p<0.05). Conclusion: EMG biofeedback intervention is an effective exercise for SAIS patients to restore activity of the middle and lower trapezius and to improve pain, shoulder function, and ROM.

• International journal of advanced smart convergence
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• v.8 no.2
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• pp.211-217
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• 2019

This study is designed to reduce worker fatigue, improve efficiency and provide a functional working environment based on previous studies that pain occurs in the shoulder area, especially the upper trapezius muscle, when the keyboard height is not appropriate. In this study, the height of the keyboard is four, the height of the elbow and desk is the same height, the height of the desk is 3cm lower than the elbow, the height of the desk is 6cm high, and the height is 9cm high. When working on the keyboard, the wrist and forerunner were organized into four groups of 10 people so that the height was different for each group. When the height of the keyboard is given in various ways compared to the height of the elbow of the subject, it is verified whether there is a difference in the RMS (Root Mean Square) of the upper trapezius muscle. The results of this study showed that the muscle activity of the upper trapezius muscle cap was significant only in the left and right keyboard height -4cm, 0cm, +4cm, +8cm group, but the difference in muscle activity was not significant in the rest group. The first study will require a study of the control of the factors affecting the tension of the subjects, the measurement of muscle activity against various muscles, and whether the length of the shoulder and fingertips of the subject affect muscle activity according to the keyboard type.

• Physical Therapy Korea
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• v.20 no.1
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• pp.47-54
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• 2013

The purpose of this study was to compare the immediate effects of upper trapezius muscle stretching in more tensed position (MTP) and less tensed position (LTP) on the change of range of motion (ROM) for neck rotation, and the ROM for conjunct neck motions at end-range of neck rotation toward the painful side in patients with unilateral neck pain. Eighteen patients with unilateral neck pain were recruited for the study's MTP group, and 18 age-, weight- and gender-matched patients with unilateral neck pain were recruited for LTP group. The ROM changes in active neck primary and conjunct motions were measured using a cervical ROM inclinometer in the sitting position. Our results showed that both upper trapezius stretching method in MTP and LTP were significantly effective in increasing the ROM of neck rotation toward painful side in patients with unilateral neck pain. However, a significantly greater increase in the ROM for neck rotation and a further decrease in conjunct neck extension during neck rotation toward the painful side were shown in MTP group, compared to LTP group. The upper trapezius stretching in MTP is useful in increasing the ROM of neck rotation and decreasing the range of conjunct neck extension during neck rotation toward the painful side in patients with unilateral neck pain.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.1
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• pp.17-25
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• 2016

Purpose: This study was aimed to determine the effects of thoracic spine thrust manipulation on muscle activities of the scapular upward rotators and middle deltoid, active range of motion (AROM), shoulder pain, and rounded shoulder posture in young adults with rounded shoulder. Methods: The subjects were 30 young adults (14 males, 16 females) with rounded shoulder. Thirty subjects were randomly assigned to an experimental (manipulation) and control (placebo) groups of fifteen subjects respectively. The manipulation group received the manipulation (high velocity, low amplitude), which was performed by a physical therapist with the subject in the supine position and with the arms crossed over the chest and hands passed over the shoulders. For the sham group, the same procedure was performed, with the exception that the high-velocity thrust was not applied. Measurements were taken before and after the intervention. Muscle activity of upper and lower trapezius, serratus anterior, middle deltoid was measured using surface electromyography. Visual analog scale (VAS) was used for shoulder pain. Goniometry was used for shoulder abduction active range of motion (AROM). Straight edge was used for supine rounded shoulder posture (RSP) distance. Results: The muscle activity of the upper trapezius, lower trapezius and middle deltoid muscle increased significantly after the intervention (p<.05). However, no significant difference was observed in serratus anterior muscle (p>.05). The VAS was significantly decreased and AROM significantly increased after the intervention (p<.05). The distance of RSP were not significant (p>.05). The control group showed no differences before and after the intervention (p>.05). Conclusion: The results of this study suggest that thoracic spine thrust manipulation can be an effective component of treatment plan to improve pain and function.

• Physical Therapy Korea
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• v.21 no.2
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• pp.67-73
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• 2014

The aim of this study was to compare the activity of the upper trapezius (UT) and serratus anterior (SA) and ratio of UT to SA during shoulder elevations. Ten subjects with UT pain (UTP) and 13 subjects without UTP participated in this study. Subjects with a UTP of over five in a pain intensity visual analogue scale (0-10 ㎝) for more than 2 months and latent myofascial trigger points (MTrPs) in the UT muscle were included in the UTP group. Electromyography (EMG) data of UT and SA at 1st and 10th elevations were analyzed. Two-way repeated analyses of variance were used to compare the EMG activity of UT and SA and the ratio of UT to SA during shoulder elevations between groups with and without UTP. There was a significant increase in UT/SA ratio in the group with UTP compared to the group without UTP (p=.01). The activity of UT and SA measured at the 10th elevation was significantly greater than that in the first elevation (p<.05). The activity of SA was significantly greater in the group without UTP than the group with UTP (p=.03). However, there was no significant difference between groups with and without UTP in terms of UT activity (p=.28). These results indicate that UTP may have relevance to the increased muscle activity ratio of UT to SA during shoulder elevations.

• Physical Therapy Korea
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• v.29 no.2
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• pp.131-139
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• 2022

Background: Shoulder impingement syndrome, a major cause of shoulder pain, involves weakness of the scapular retractor muscles. The major scapular retractor muscles are the middle trapezius and rhomboid major muscles; however, the latter is excluded in most studies. Objects: We aimed to measure the thickness of the middle trapezius and rhomboid major muscles using an ultrasonic diagnostic imaging system while performing four different shoulder retraction exercises and comparing the thicknesses and ratio of the thicknesses of these muscles. Methods: The thickness of the middle trapezius and rhomboid major muscles was measured in 24 healthy adults using ultrasound. Muscle thickness was measured three times in the Reference posture and four times while performing four different exercises that involved scapular retraction. The averages and standard deviations of the measured muscle thicknesses were obtained and compared. The ratio of muscle thickness and rate of changes in muscle thickness between the reference posture and the four exercises were compared. Results: For both, male (n = 10) and female (n = 14), there was a significant difference in the thickness of the middle trapezius muscle between the reference posture and the four exercises (p < 0.05) and in the thickness of the middle trapezius and rhomboid major muscles between male and female (p < 0.05); however, there was no significant difference in the ratio of the thicknesses of these muscles. Although a significant difference in the rate of change in muscle thickness during the four exercises was noted, there was no significant difference in the ratio of change in muscle thickness. Conclusion: This study demonstrates the ratio of the thicknesses of the middle trapezius and rhomboid major muscles and the rate of change in their thickness during exercises involving scapular retraction in healthy people in their 20s-30s.

• Physical Therapy Rehabilitation Science
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• v.1 no.1
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• pp.40-48
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• 2012

Objective: The aim of this study was to compare sling exercise group to McKenzie exercise group in patients with chronic neck pain. Design: Two group pretest-posttest design. Methods: Twenty subjects who have chronic neck pain were randomly divided into sling exercise group (n=10) and McKenzie exercise (n=10). Sling exercise group (n=10) received sling exercise for 30 minutes per day, twice a week over a 4 week period. And the other group were exercised McKenzie exercise (n=8) for 30 minutes per day, twice a week over a 4 week period. Neck disability index (NDI), Visual analog scale (VAS), algometer, digital manual muscle tester (MMT) and cervical muscle strength and cervical range of motion (ROM) are closely measured to identify the effect of sling exercise and McKenzie exercise. Results: For NDI, VAS, algometer on both trapezius, both rotation of cervical muscle strength, both lateral flexion of cervical muscle strength, cervical extension of ROM and both lateral flexion of ROM were significantly increased after intervention in sling exercise group (p<0.05), For VAS, algometer on both trapezius, left (Lt.) rotation of cervical muscle strength, Lt. lateral flexion of cervical muscle strength, cervical flexion and extension of ROM and Lt. lateral flexion of ROM were significantly increased after than before intervention in McKenzie exercise group (p<0.05). Conclusions: These study outcomes clearly support the notion that sling and McKenzie exercise improved pain, Muscle strength and ROM of patients with chronic neck pain. These results suggest that sling and McKenzie exercise program is suitable for chronic neck pain.

• Journal of Korean Physical Therapy Science
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• v.19 no.4
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• pp.1-6
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• 2012

Purpose : The current research examines the muscle activity that happens during scaling practice subject to 20 dental hygienic students with musculoskeletal pain and then propose a basic data according to the working attitude of the Dental Hygienist. Method : The Nordic-style questionnaire is used to define experimental group with musculoskeletal pain and control group. During the scaling the surface EMG device is used to measure the muscle activity of experimental and control group. Study design : The surface EMG is measure RMS(root mean square) of suboccipital muscle, biceps brachii, upper trapezius, and brachioradialis muscle activity. Results : In the experimental group, the RMS of upper trapezius and brachioradialis is increased during scaling practice(p<0.05), but the control group's RMS is not changed(p>0.05). Conclusion : Musculoskeletal pain may contribute to increase muscle activity of neck & arm during scaling practice. In the future we think there is a need to raise the office efficiency by subjecting to dental hyginiest that are in the clinics and performing experiments.

• PNF and Movement
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• v.19 no.1
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• pp.137-146
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• 2021

Purpose: The study aimed to determine the effect of proprioceptive neuromuscular facilitation (PNF) lower trapezius muscle strengthening exercise on pain, cervical range of motion (ROM), and neck disability index (NDI) in patients with chronic neck pain. Methods: Following baseline measurements, the subjects (n = 30) with chronic neck pain were randomized into two groups: the PNF group (n = 15) that received PNF strength training of the lower trapezius muscles or a control group (n = 15) that received gentle palpation of the skin. Each group participated in the intervention for 30 min, three times per week for six weeks. The visual analogue scale for pain, ROM, and NDI of both groups were recorded at both pre- and post-intervention. Paired t-tests were used to determine significant changes in the post-intervention compared with pre-intervention, and independent t-tests were used to analyze differences in the dependent variables between the two groups. Results: After the six-week intervention, both groups experienced significantly decreased pain and NDI (p < 0.05) and significantly increased cervical flexion, extension, lateral flexion, and rotation ROM (p < 0.05). The PNF group that received PNF strength exercise of the lower trapezius muscles showed greater improvements in pain and NDI and cervical rotation of ROM than those of the control group (p < 0.05). Conclusion: These results suggest that the PNF lower trapezius strengthening exercise reduces neck pain and disability level and enhances cervical ROM in patients with chronic neck pain.