• The Journal of Korean Physical Therapy
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• v.28 no.2
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• pp.106-111
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• 2016

Purpose: The aim of this study is to determine the effect of glenohumeral (GH) rotation position in modified knee push-up plus exercise (MKPUP) by examining the surface electromyography (EMG) amplitude in serratus anterior (SA), pectoralis major (PM), and upper trapezius (UTz) and the activity ratio of each muscle. Methods: A total of 22 healthy subjects volunteered for the study. Each subject performed the MKPUP at $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$ of GH joint internal rotation. EMG of the SA and PM, UTz was compared between GH rotation positions and each muscle activity ratio. EMG was used to measure the muscle activity in terms of ratios to maximal voluntary isometric contraction (MVIC). Results: The difference in EMG activity during the exercise in three GH joint internal rotation positions was observed with the SA and the PM. The greater the GH joint internal rotation angle was, the lower the activity of the PM. In contrast, the SA showed higher activity. However, the activity of UT was similar under all conditions. The ratio of the SA and the PM was considerably greater at $90^{\circ}$ GH joint internal rotation than at $0^{\circ}$ and $45^{\circ}$. Conclusion: When excessive activation of the PM or imbalanced activation between the PM and the SA occurs, the MKPUP exercise is most effective at $90^{\circ}$ of GH joint internal rotation. Use of this position would be a beneficial strategy for selective strengthening of the SA and minimizing PM activation.

• The Journal of Korean Physical Therapy
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• v.28 no.2
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• pp.88-94
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• 2016

Purpose: The purpose of this study was to compare therapeutic climbing exercise and general isometric exercise in patients with shoulder impingement syndrome. Methods: Among 20 adults, study subjects were arbitrarily classified into an experimental group of 10 and a control group of 10. The control group performed general isometric exercise (ISE) and the experimental group performed therapeutic climbing exercise (TC) (3 sets, 3 times per week for 8 weeks). To evaluate the effects of exercise, subjects were evaluated using a Disabilities of the arm, shoulder and hand score (DASH), a goniometer for range of motion, and shoulder activity measured serratus anterior, upper trapezius, and lower trapezius. Independent and paired t-test were used for comparison of the effect between groups. Results: DASH scores showed a significant decrease in both groups after 8 weeks of treatment (p<0.001) and significant difference was observed between the TC groups (p<0.01). Flexion and abduction were significantly increased after 8 weeks of treatment in the ISE group (p<0.001) and flexion, abduction, external and internal rotation were significantly increased after 8 weeks of treatment in the TC group (p<0.001). Serratus anterior and lower trapezius activity were significantly increased after 8 weeks of treatment (p<0.001) and upper trapezius activity was not significantly increased after 8 weeks of treatment in the ISE group (p>0.05). Serratus anterior, lower trapezius, and upper trapezius activity were significantly increased after 8 weeks of treatment in the TC group (p<0.001). Conclusion: Scapular stabilizing exercise using a therapeutic climbing exercise increases range of motion and decreases DASH, and increases activity of shoulder muscles in patients with impingement syndrome.

• Physical Therapy Korea
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• v.24 no.4
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• pp.11-19
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• 2017

Background: Methods for exercising serratus anterior (SA) and upper trapezius (UT) muscles are important for the recovery of patients with various shoulder disorders, yet the efficacy of closed or open kinetic chain exercises have not yet been evaluated. Objects: The purpose of this study was to compare the activation of the SA and UT muscles during scapular protraction considering both closed and open kinetic chain exercises. Methods: Thirty subjects were randomly divided into experimental groups (closed kinetic chain exercise) and control groups (open kinetic chain exercise) in which scapular protraction was performed at $90^{\circ}$ or $125^{\circ}$ shoulder flexion. Electromyographic activity data were collected from the SA and UT muscles per position and exercise method. Results: Separate mixed 2-way analysis of variance showed significant differences in the activation of the SA (F1,28=6.447, p=.017) and the UT (F1,28=35.450, p=.001) muscles between the groups at $90^{\circ}$ and $125^{\circ}$ shoulder flexion. Also, the SA/UT ratio measures at $90^{\circ}$ and $125^{\circ}$ shoulder flexion significantly differed between the groups (F1,28=15.457, p=.001). That is, the closed chain exercise was more effective than open chain exercise for strengthening the SA muscle and controlling the UT muscle, $125^{\circ}$ of shoulder joint was more effective than $90^{\circ}$. Conclusion: The findings suggest that scapular protraction with shoulder $125^{\circ}$ flexion at the closed kinetic chain exercise may be more effective in increasing SA muscle activation and decreasing UT muscle activation as well as increasing the SA/UT ratio than open kinetic chain exercise.

• PNF and Movement
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• v.11 no.1
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• pp.55-62
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• 2013

Purpose : This study was assessed muscle activity and onset time in trunk and upper extremity on functional reaching. Methods : The participant was 18 female(young 10, old 8). As functional reaching, we collection data by using EMG(MP150) on transverse abdominis, external oblique, erector spinae, deltoid middle and serratus anterior. Results : 1) In functional reaching, transverse abdominis, external oblique, erector spinae and deltoid middle muscle activity was augmented on old female(p>.05). Serratus anterior was augmented on young female(p>.05). 2) In functional reaching, transverse abdominis and erector spinae muscle onset time is significantly faster old female than young female(p<.05). External oblique and serratus anterior muscle onset time is faster old female than young female(p>.05). 3) As increase of age muscle activity of external oblique was more increased that we found .511 a coefficient correlation and onset time more faster on transverse abdominis and erector spinae were each -.492 and -.554 coefficient correlation. Conclusion : The muscle activity and onset time was difference in functional reaching according to ageing and task context. It is necessary concentration and attention to old female than young female. Therefore, these results suggest that importance of anticipatory postural control and selective strategy of postural control.

• Physical Therapy Korea
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• v.24 no.4
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• pp.29-37
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• 2017

Background: The serratus anterior (SA) muscle is one of the important muscles in the upward rotation of the scapula when the arm is raised. Insufficient muscle activity of the SA can cause deformation of the shoulder rhythm resulting in shoulder pathology. Objects: This study intends to compare SA and upper trapezius (UT) activity during the conventional wall-slide and push-up plus exercises for SA muscle strengthening and the scapular upward rotation (SUR) exercise. Methods: A total of 30 subjects participated in this study, and we measured the muscle activity of the SA and UT muscles during the wall-slide, push-up plus and SUR exercises. The one-way repeated ANOVA was used to compare SA and UT muscle activities during the 3 exercises. Results: During the SUR exercise, SA muscle activity was 79.88% maximum voluntary isometric contraction (MVIC), which was significantly higher than its activity during the other 2 exercises. The UT muscle activity was 47.53 %MVIC during the SUR exercise, indicating a significantly higher UT muscle activity than during the other 2 exercises. Conclusion: These findings suggest that the SUR exercise can maximize SA muscle activity to strengthen the SA while keeping UT muscle activity at an appropriate level.

• The Journal of Korean Physical Therapy
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• v.32 no.1
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• pp.58-63
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• 2020

Purpose: This study examined the effects of the right or left knee lift during push up plus in the quadruped position on the serratus anterior (SA) muscle activity. Methods: Twenty-one subjects (male 11, female 10) performed the quadruped position on push up plus. The muscle activities of the lower trapezius (LT), SA, and upper trapezius (UT) were measured by surface electromyography. Repeated measurements of one-way ANOVA were performed for statistical analysis of the data, and the criterion for statistical significance was set to p<0.05 and comparative analysis of the UT and SA ratio using a Paired t-test. Results: The right SA increased the muscle activity of the right knee lift during quadruped position push up plus (p<0.05). In particular, the right SA muscle activity was higher than the left. In addition, comparative analysis of the UT and SA ratio to the right knee lift during quadruped position push up plus was performed (p<0.05). The right was found to be a significant statistic compared to the left, but the left SA increased the muscle activity of the left knee lift during quadruped position push up plus (p<0.05). The left SA muscle activity was higher than right. In addition, comparative analysis of UT and SA ratio to the left knee lift during quadruped position push up plus was performed (p<0.05). The left was found to be a significance statistic than the right. In addition, the interaction effect between the groups showed significant differences (p<0.05). Conclusion: Knee lift during push up plus is recommended for the selective activation of a research exercise protocol of one side of the serratus anterior.

• Journal of Korean Physical Therapy Science
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• v.29 no.3
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• pp.48-55
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• 2022

Background: The purpose of this study is to examine the effect of push-up plus exercise on the changes in the thickness of the trapezius trapezius, serratus anterior and pectoralis major muscles involved in shoulder stability in various support surfaces. Design: Randomized controlled trial. Methods: The thickness change of the shoulder stabilizing muscle was measured using an ultrasound device. Corresponding t-test was performed to confirm the change within the group before the experiment and after 5 weeks. And one-way ANOVA was used to confirm the change between groups after 5 weeks. As a post hoc test, the least significant difference test was performed, and the significance level was set to a=0.05. Results: Changes in the thickness of the trapezius muscle within the group were significantly different between UPEG and SPEG after 5 weeks (p<0.05), and there was a significant difference between groups after 5 weeks (p<0.05). Changes in the thickness of the serratus anterior and pectoralis major muscle within the group were significantly different after 5 weeks in PEG, UPEG and SPEG (p<0.05), and the changes between the groups were significantly different in the serratus anterior muscle after 5 weeks (p<0.05). Conclusion: From the results of this study, it was found that the push-up exercise on an unstable support surface was effective for strengthening the trapezius upper and serratus anterior. This study intends to suggest the possibility of application as basic data for a push-up plus exercise program in clinical practice.

• Journal of International Academy of Physical Therapy Research
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• v.6 no.1
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• pp.815-823
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• 2015

This study aimed to examine the most effective exercise method for shoulder joint rehabilitation by comparatively observing activity of shoulder stabilizer muscles during push up and push up plus exercises under diverse stable conditions. The subjects were 20 healthy adults students who went to M university. While the subjects conducted push up and push up plus exercises under diverse stable conditions(a stable surface, a support of 25cm height, a support of 30 cm height and a balance pad), activities of the upper trapezius muscle, pectoralis major muscle, serratus anterior muscle, and triceps brachii muscle were recorded. During push up and push up plus exercises, activities of the stabilizer muscles were higher when the stable condition was changed rather than on the stable surface. In particular, when the support of 30cm height and balance pads were applied, activity of the shoulder stabilizer was highest. There were significant differences in the upper trapezius muscle and triceps brachii muscle during the push up exercise(p<.05) and in the serratus anterior muscle during the push up plus exercise(p<.05). Activities of the shoulder stabilizers were higher when the upper and lower limbs' surface stable conditions were changed than the stable surface. Therefore, when programs for rehabilitation of shoulder joints are applied, provision of diverse stable conditions according to patients' conditions will be effective methods.

• The Journal of Korean Physical Therapy
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• v.22 no.5
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• pp.1-8
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• 2010

Purpose: This study aimed to provide a scientific basis for effects of the push-up plus exercise program on scapular position and on muscle activity in individuals with rounded shoulder posture (RSP). Methods: The supine method was applied to 46 potential subjects, of which 30 with RSP were selected. Subjects with RSP were divided into two groups: a gender push-up plus group as the experimental group a pectoralis minor self.stretch group as the control group. RSP data after 4 weeks of each intervention were obtained and analyzed to measure the activities of the 3 muscles. Results: The two groups differed significantly with regard to EMG changes in the serratus anterior (p<0.05). The EMG results indicated a significant reduction in the activity of the upper trapezius in the experimental group (p<0.05). EMG results indicated a significant increase in the activity of the serratus anterior after the intervention (p<0.05). EMG results of the subjects in the control group indicated that the activity of the upper trapezius significantly decreased (p<0.05). The RSP values of the subjects in both groups were significantly decreased (p<0.00). Conclusion: An improvement in the strength of the serratus anterior, and in the stretch effectiveness of the pectoralis minor, as well as changes in the scapular position were observed after 4 weeks of push-up plus exercise by the subjects.

• Physical Therapy Korea
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• v.23 no.4
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• pp.55-62
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• 2016

Background: The functioning of the serratus anterior (SA) muscle is essential to normal scapulohumeral rhythm during forward flexion (FF) of the shoulder. Also, SA weakness and overuse of the upper trapezius (UT) is observed in patients with shoulder dysfunction and trapezius myalgia. We designed a combination exercise involving FF and scapular protraction with resistance (CFFSP) to activate the SA muscle and to deactivate the UT muscle. Objects: The purpose of this study was to determine whether or not CFFSP would be more effective in activating the SA muscle than FF alone and FF with scapular protraction (FFP). Methods: Nineteen subjects (12 men and 7 women) participated in this study and performed FF, FFP, and CFFSP at $120^{\circ}$. Surface electromyography was applied to the SA, UT, and pectoralis major (PM) muscles, as was one-way analysis of variance (ANOVA) with repeated measures. Statistical significance was set at .05. Bonferroni adjustment was used to counteract the problem of multiple comparisons, with a statistical level of significance of .017 (.05/3). Results: A statistically significant difference was found in relation to the three positions for the SA muscle (p<.001) and the SA/UT ratio (p=.005) using ANOVA. Significantly different results, depending on the position, were also demonstrated using the Bonferroni post-hoc test for the SA muscle ($FF=28.27{\pm}16.20$, $FFP=45.66{\pm}15.81$, and $CFFSP=62.4{\pm}27.21$) and for the SA/UT ratio ($FF=3.04{\pm}2.14$, $FFP=3.61{\pm}2.38$, and $CFFSP=5.95{\pm}3.01$). Significant differences between the three positions was not found regarding the average amplitude of SA/PM muscle ratio (SA/PM: p=.060). Conclusion: We recommend the use of CFFSP to strengthen the SA muscle at $120^{\circ}$.