• 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 $120^{\circ}$.

• Journal of The Korean Society of Integrative Medicine
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• v.4 no.1
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• pp.13-20
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• 2016

Purpose : The purpose of this study was to compare the effect of exercise on the neck muscles activities between scapular stability and McKenzie stretch exercise in the forward head posture subjects. Method : After measuring cervical alignment using the Global Posture System, 20 volunteers with forward head posture posture were selected and divided into two groups. The experimental group A(n=15) and Experimental group B(n=15) participated in respectively and McKenzie neck stretching exercise, three times per week for 4 weeks. The scapular stabilization exercise program was comprised middle and lower trapezius strength exercises and the stretching exercise program was comprised levator scapulae and upper trapezius stretching exercise. The activities of the muscles of the posterior neck was then measured using electromyography. Result : After the intervention, there was significant difference of a electromyography activity changes between the pre-test and post-test in the experimental group. Conclusion : This study showed that both scapular stabilization and McKenzie neck stretching exercises are more effective for reducing neck muscles activities.

• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.400-408
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• 2022

Objective: The purpose of this study is to compare EMG activity during horticulture motion and upper limb rehabilitation motion, to confirm whether horticulture motion is suitable for upper extremity rehabilitation of hemiparesis. Design: Three-group cross-sectional design. Methods: The 45 subjects were divided into three groups: hemiparesis (n=15), elderly (n=15) and healthy (n=15). We have recorded EMG signals of six upper limb muscles Upper trapezius (UT), Middle deltoid (MD), Anterior deltoid (AD), Biceps brachii (BB), Triceps brachii (TB), Brachioradialis (BR) during horticultural motions and three upper limb rehabilitative motions. The dependent variables were peak EMG, integral EMG, co-contraction ratio. A two-way repeated measures ANOVA was used to compare the horticultural motion and rehabilitation motion of the three groups. Results: The peak EMG was significantly different in MD, AD, BB, TB according to the motion(p<0.05), and the UT, BB were significant differences according to the group(p<0.05). The integral EMG was significantly different in MD, AD, BB, TB, BR according to the motion(p<0.05), and the BB were significant differences according to the group(p<0.05). The co-contraction ratio was significantly different in TB/BB according of the motion, and there was no difference between the groups. Conclusions: As a result of this study, horticultural motion alone was insufficient for upper arm rehabilitation, and horticultural motion alone was insufficient to induce continuous activity of the forearm.

• The Journal of the Korea Contents Association
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• v.12 no.12
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• pp.356-362
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• 2012

This study examined the effects of vocalization on upper extremity muscle activity during reaching task in patients with hemiplegia. Thirteen persons with right brain stroke performed reaching to a cup under four concurrent speech conditions of vocalizing the word "Ah" with hemiplegic side. These four conditions are self-vocalization, external vocalization, imaginary vocalization, and no vocalization. The muscle activity(Biceps brachii, Triceps brachii, Middle deltoid, and Upper trapezius) were measured using MP150. Muscle activity was significantly higher under self-vocalization and external vocalization conditions compared to the muscle activity under imaginary vocalization and no vocalization conditions on triceps brachii muscle.(p<0.05). Triceps brachii muscle was highly correlated with biceps brachii muscle(r=0.777, p<0.05). The results suggest that self-vocalization and external vocalization can be used in facilitating upper extremity movements in patients with stroke. When working with patients with right hemispheric stroke, therapists might explore possibilities of using patient's self-speech to enhance the quality of upper extremity movement performance.

• The Journal of Korean Physical Therapy
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• v.34 no.5
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• pp.278-281
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• 2022

Purpose: This study sought to compare the muscle activity of the deltoid muscle according to the range of motion during the proprioceptive neuromuscular facilitation (PNF) upper extremity D2 pattern exercise performed with an isokinetic exercise device. The aim was to provide basic data for selecting an exercise for the relevant segment of the range of motion to enhance function in clinical practice. Methods: In this study, the relevant measurements of the anterior and middle trapezius of 25 healthy adults were taken using a surface electromyography system. The upper extremity pattern exercise was performed in three ranges (0% to 50%, 50% to 100%, and 25% to 75%) using the upper extremity isokinetic device. Results: There was a statistically significant difference in the muscle activity ratios of the anterior and middle deltoid muscles according to the measurement conditions (p<0.05). There was a statistically significant difference in the activity ratio of the middle deltoid muscle according to the measurement conditions in the ratio from the start range to the end range (p<0.05). There was no significant difference in the muscle onset time difference according to the measurement conditions (p>0.05). Conclusion: The muscle activity of the anterior and middle deltoid muscles was analyzed according to the range of motion during the PNF upper extremity pattern exercise performed with an isokinetic device. The results could be used as a basis for selecting exercises for the relevant segment of the range of motion according to the function to be emphasized.

• Korean Journal of Applied Biomechanics
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• v.28 no.3
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• pp.187-191
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• 2018

Objective: The purpose of the present study is to investigate the effect of a muscle activity by applying the complex exercise method of sling in accordance with the provision of various vibration intensities for paraplegia-spinal cord injury. Method: The subjects of the study were 15 men in their 40s and 50s with lower limb disabilities and low potential risk, who were randomly divided into a sling exercise group (SG n=4), a sling with low frequency vibration group (SLVG n=4), a sling with mid-frequency vibration group (SMVG n=4), and a sling with high frequency group (SHVG n=4) in accordance with the provision of slings and vibration stimuli. The vibratory intensity provided was divided into low frequency (30 Hz), mid-frequency (50 Hz), and high frequency (70 Hz). The anterior deltoid (AD), the posterior deltoid (PD), the pectoralis major (PM), the upper trapezius (UT), the latissimus dorsi (LD), and the multifidus (MF) were measured to compare and analyze muscle activity. Results: The closed kinetic chain (CKC) exercise to the shoulder joint showed higher muscle activity in most muscles for the SMVG, and statistically significant differences in the anterior deltoid (AD), the pectoralis major (PM), and the multifidus (MF) in particular. Conclusion: The intermediate frequency (50 Hz) string vibration was the effective vibration stimuli for Closed kinetic chain (CKC) exercises.

• Physical Therapy Korea
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• v.14 no.2
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• pp.44-52
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• 2007

This study was carried out to compare the muscle activities of the shoulder stabilizers between persons with and without winging scapular during push-up plus exercise (adds the scapular protraction to the general push-up exercise). For this study, eleven males with winging scapular and eleven healthy males were recruited. Surface electromyographic (EMG) activity was recorded from the serratus anterior, upper trapezius, lower trapezius, infraspinatus, and pectoralis major while the subjects performed the push-up plus. Each push-up plus was subdivided into three phases according to the elbow position which was measured using the 3-D motion analysis system: elbow flexion (EF), elbow extension (EE), and shoulder protraction phases (SP). Two-way repeated measure ANOVA (phase ${\times}$ group) were used for statistical analysis. There was significant phase by group interaction only on the EMG composition ratio of the serratus anterior (p>.05). The EMG composition ratio of the serratus anterior was significantly higher in SP than in either EF or EE however, it was not different between winging scapular and normal groups. For both groups, the EMG composition ratio of upper trapezius, lower trapezius, and pectoralis major was significantly different across the phases of push-up plus, but the infraspinatus EMG composition ratio was not. For both groups, in EF and EE phases, the EMG composition ratio of both pectoralis major and serratus anterior were relatively higher than that of other muscles. However, in both groups, the EMG composition ratio of the serratus anterior became much more predominant than that of the pectoralis major. In addition, infraspinatus activated greater than pectoralis major. These results showed that the push-up plus exercise is effective to selectively strengthen the serratus anterior for both individuals with and without winging scapular, but not equally effective for other shoulder stabilizers.

• Physical Therapy Korea
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• v.29 no.2
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• pp.165-170
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• 2022

Background: The serratus anterior (SA) muscle prevents scapular winging (SW) by stabilizing the medial border of the scapula during arm movement. The upper trapezius (UT) and lower trapezius (LT) muscles may compensate for the weak SA muscle in individuals with SW during shoulder flexion. However, there is no study to examine whether compensation by UT and LT occurs in individuals with SW. Objects: This study compared the muscle activities of UT, LT, and SA as well as the SA/UT activity ratio between individuals with and without SW during shoulder flexion with load. Methods: This study recruited 27 participants with SW (n = 14) and without SW (n = 13). Electromyography data of the SA, UT, and LT muscles and SA/UT activity ratio were recorded and analyzed during shoulder flexion with 25% load of the maximal shoulder flexion force. Independent t-test was used to compare the UT, LT, and SA muscle activities and SA/UT ratio between the groups with and without SW; statistical significance was set at α of 0.05. Results: SA activity was significantly lesser in the group with SW than in the group without SW. However, there were no significant differences in the UT and LT activities and SA/UT activity ratio between the two groups. Conclusion: The SA activity was lesser in the group with SW than in the group without SW with 25% load of the maximal shoulder flexion force, but there was no compensatory muscle activity of the UT and LT observed. Therefore, further studies are warranted to clarify the compensatory strategy of scapular stabilization in individuals with SW during shoulder flexion under other heavy load conditions.

• Journal of The Korean Society of Integrative Medicine
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• v.3 no.1
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• pp.81-90
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• 2015

Purpose: The purpose of this study was to investigate any visible difference in shoulder stability muscle activity along the bending angle($70^{\circ}$, $90^{\circ}$, $110^{\circ}$) to perform the open kinetic chain(OKC) and closed kinetic chain(CKC) exercise. Method: This study was performed on normal 20 males subjects. Exercise was carried out in two ways OKC and CKC. Shoulder stability muscles are examined activity in the bending angles. In the OKC and CKC exercise to subjects with stretched out waist straightened, and than push forward the shoulder. Muscular activation was examined using the WEMG-8. Result: The results of this study were as follows. 1. Only in the trapezius muscle, it showed specific interaction between exercise methods and angles. When it comes to muscle activity, there was no significant difference in all muscles except for the anterior fibers of the deltoid muscle during both CKC and OKC exercise. 2. The average value of maximum muscle activity was significantly increased with increasing order of angles. But in CKC exercise, the muscle activity of infraspinatus tended to decrease with increasing angles. Conclusion: To summarize the research results, the muscle activity in upper fibers of the trapezius, anterior fibers of the deltoid, and serratus anterior was significantly different depending on the angle of the shoulder in both CKC and OKC exercise.

• 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.