• Physical Therapy Korea
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• v.30 no.2
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• pp.160-168
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• 2023

Background: Individuals with scapular winging have a weak serratus anterior (SA) muscle, and to compensate, the pectoralis major (PM) and upper trapezius (UT) muscles excessively activate, which can cause upper extremity dysfunction. This study aimed to compare the effects of isometric horizontal abduction (IHA) on SA, PM, and UT muscle activity, as well as the SA/PM and SA/UT muscle activity ratios during knee push-up plus (KPP) at 90° and 120° of shoulder flexion. Objects: This study aimed to compare the effects of IHA on SA, PM, and UT muscle activity, as well as the SA/PM and SA/UT muscle activity ratios during KPP at 90° and 120° of shoulder flexion. Methods: This study, conducted at a university research laboratory, included 20 individuals with scapular winging. Participants performed KPP with and without IHA at 90° (KPP90) and 120° (KPP120) of shoulder flexion. SA, PM, and UT muscle activity were measured using surface electromyography. Results: PM activity in KPP90 with IHA was significantly lower than KPP90 and in KPP120 was significantly lower than KPP90. UT activity was significantly greater with IHA than without IHA and at 120° than 90° of shoulder flexion. SA/PM muscle activity ratio was significantly higher in KPP90 with IHA than without IHA and in KPP120 than in KPP90. SA/UT muscle activity ratio was significantly lower with IHA than without IHA. Conclusion: KPP90 with IHA and KPP120 are effective exercises to reduce PM activity and increase SA/PM muscle activity ratio. However, applying IHA in KPP90 also reduces SA/UT muscle activity ratio, implying that it would be preferable to apply KPP120 in individuals overusing their UT muscles.

• Korean Journal of Applied Biomechanics
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• v.26 no.2
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• pp.197-204
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• 2016

Objective: The purpose of this study was to analyze the kinematic factors of motion during air pistol shooting. Method: This study aimed to investigate changes in forces during movement and determine the factors that affect changes in force during the first, middle, and last periods of shooting an air pistol. Two ground reaction force systems (force platform), SCATT (a shooting training system), and EMG (electromyogram) to measure the action potentials in the muscles of the upper body were used in this study. Four university air pistol players (age: 19.75 years, height: 175.50 cm, body mass: $69.55{\pm}11.50kg$, career length: $6.25{\pm}6years$) who are training to progress to a higher rank were enrolled. Results: In terms of the actual shooting results, the mean score in the middle section was $42.48{\pm}1.74$ points, higher than those in the first and the last periods when using SCATT. The gunpoint moved 13.48 mm more vertically than horizontally in the target trajectory. With respect to action potentials of muscles measured using EMG, the highest action potentials during the aiming-shooting segments, in order higher to lower, were seen in the trapezius (intermediate region), trapezius (superior region), deltoid (lateral), and triceps brachii (long head). The action potentials of biceps brachii and brachioradialis turned out to be high during grasping motion, which is a preparatory stage. During the final segment, muscle fatigue appeared in the deltoid (lateral), biceps brachii (long head), brachioradialis, and trapezius (intermediate region). In terms of the ground reaction force, during the first period of shooting, there was a major change in the overall direction (left-right $F_x$, forward-backward $F_y$, vertical $F_z$) of the center of the mass. Conclusion: The development and application of a training program focusing on muscle groups with higher muscle fatigue is required for players to progress to a higher rank. Furthermore, players can improve their records in the first period if they take part in a game after warming up sufficiently before shooting in order to heighten muscle action potentials, and are expected to maintain a consistent shooting motion continuously by restoring psychological stability.

• Physical Therapy Korea
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• v.27 no.2
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• pp.93-101
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• 2020

Background: For performing various movements well, cooperation between the muscles around the scapula and shoulder has been emphasized. Taping has been widely used clinically as a helpful adjunct to other physiotherapy methods for shoulder pathology and dysfunction treatment. Previous studies have evaluated the effect of taping techniques using dynamic tapes on shoulder function and pain. However, no study investigated the electromyographic (EMG) changes in the shoulder muscles. Objects: This study aimed to investigate the effect of the upper limb offload taping technique using a dynamic tape on EMG activities of the upper trapezius (UT), lower trapezius, serratus anterior (SA), and middle deltoid (MD) muscles during scaption plane elevation. Methods: A total of 26 healthy subjects (19.85 ± 6.40 years, male = 20) volunteered to participate in this study. The subjects were instructed to perform scaption elevation with and without dynamic taping on the shoulder. Shoulder elevation strength tests were performed at 100%, 75%, 50%, and 25%, for the maximal isometric contraction force. Results: There were statistically significant interaction effects between the taping application and shoulder scaption elevation force in EMG activities in the UT (p < 0.05) and MD (p < 0.05). EMG activities in the UT showed significant increases in 50%RVC (reference voluntary contraction, p < 0.05) and 25%RVC (p < 0.01). Furthermore, the EMG activity of the SA significantly increased in 50%RVC (p < 0.01) and 25%RVC (p < 0.01) after dynamic taping. For the MD, the EMG activity level significantly decreased in 100%RVC (p < 0.05). Conclusion: These results indicated that upper limb offload dynamic taping application affects the muscle activities of some shoulder muscles depending on different scaption elevation strength levels. Therefore, we suggest that the upper limb offload dynamic taping can be applied to the shoulders when patients need middle deltoid inhibition or upper trapezius facilitation, such as patients with shoulder impingement syndrome.

• 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.22 no.5
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• pp.9-16
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• 2010

Purpose: The purpose of this study was to compare modified sling exercise and general isometric exercise in patients with shoulder impingement syndrome. Methods: Twenty subjects were studied. The control group, n1 = 10, received instructions for doing general isometric (ISO) exercise. An experimental group, n2 = 10, received instructions for doing push-ups from standing and sitting positions and modified scapular exercises using a sling (3 sets, 3 times per week for 6 weeks). To evaluate the effects of exercise, subjects were evaluated using a visual analog scale for pain, a goniometer for range of motion, and electromyography for onset time of muscle contraction. Statistical analysis was done using the Wilcoxon Signed rank and Mann-Whitney U tests. Results: Pain in the sling group was significantly decreased after 6 weeks of treatment (p<0.05) pain in the general ISO exercise group was not significantly decreased (p>0.05). Flexion and external rotation were significantly increased after 6 weeks of treatment in both groups (p<0.05) and the change in the Sling group was greater than in the ISO group (p<0.05) in the flexion test. Time of onset of contractions in the Sling group for the upper trapezius, lower trapezius and serratus muscle were significantly decreased after 6 weeks of treatment (p<0.05), but the onset time for the middle trapezius did not significantly decrease (p>0.05). Conclusion: Scapular stabilizing exercise using a sling increases range of motion and decreases pain, and onset time of muscle contraction in patients with impingement syndrome.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.49-54
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• 2016

PURPOSE: This study was implemented to measure the muscle activity of muscles surrounding shoulder during push-up exercise according to the slope angle. METHODS: This study has research subject consisting of 25 normal male adults without neurologic or musculoskeletal injury in shoulder part. EMG was used as a tool for measuring muscle activity and four muscles including upper trapezius (UT), middle trapezius (MT), Lower Trapezius (LT), and Serratus Anterior (SA) were chosen for measuring the muscle activity of muscles surrounding shoulder. Tilting table slope was set at $0^{\circ}$, $30^{\circ}$, $45^{\circ}$, and $60^{\circ}$ and push-up motion was performed three time for each case to use the average value. The measured value was used after generalization process to create %RVC value where the measured value was standardized by using $0^{\circ}$ as a standard. RESULTS: There was a difference of muscle activity according to the tilting table slope during push-up exercise. In UT, MT, and SA, there was no significant $0^{\circ}$ and $30^{\circ}$, $45^{\circ}$ and $60^{\circ}$. But there was significant $30^{\circ}$ and $45^{\circ}$. LT was significant difference between $45^{\circ}$ and $60^{\circ}$ (p<.05). CONCLUSION: There are cases where push-up exercise should be selectively implemented due to shoulder problems. According to this results between $0^{\circ}$ and $30^{\circ}$, push up will be able to more effectively exercise. Applying proper angle of tilting table for push-up to patients who have difficulties in performing motions along with physical consumption can deliver effective and easy exercise program.

• Physical Therapy Korea
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• v.24 no.4
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• pp.60-67
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• 2017

Background: Scapular downward rotation syndrome (SDRS) is a common scapular alignment impairment that causes insufficient upward rotation and muscle imbalance, shortened levator scapulae (LS) and rhomboid, and lengthened serratus anterior (SA) and trapezius. A modified shrug exercise (MSE), performing a shrug exercise with the shoulders at $150^{\circ}$ abduction, is known as an effective exercise to increase scapular stabilizer muscle activation. Previous studies revealed that scapular exercise are more effective when combined with trunk stabilization exercises in decreasing scapular winging and increasing scapular stabilizer muscle activation. Objects: The purpose of our study was to clarify the effect of MSE with or without trunk stabilization exercises in subjects with SDRS. Methods: Eighteen volunteer subjects (male=10, female=8) with SDRS were recruited for this experiment. All subjects performed MSE under 3 different conditions: (1) MSE, (2) MSE with an abdominal draw-in maneuver (ADIM), and (3) MSE with an abdominal expansion maneuver (AEM). The muscle thickness of the lower trapezius (LT) and the SA were measured using an ultrasonography in each condition. Electromyography (EMG) data were collected from the LT, LS, SA, and upper trapezius (UT) muscle activities. Data were statistically analysed using one-way repeated analysis of variance at a significance level of .05. Results: The muscle thickness of the LT and the SA were the significant different in the MSE, MSE with ADIM (MSE+ADIM) and MSE with AEM (MSE+AEM) conditions (p<.05) In both LT and SA, the order of thick muscle thickness was MSE+AEM, MSE+ADIM, and MSE alone. No significant differences were found in the EMG activities of the SA, UT, LS, and LT in all condition. Conclusion: In conclusion, MSE is more beneficial to people with SDRS when combined with trunk stabilization exercises by increased thickness of scapular stabilizer muscles.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.1
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• pp.71-80
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• 2022

Background: This study investigated the effect of robot-assisted arm training on muscle activity of arm and weight bearing in stroke patients. Methods: The study subjects were selected 20 stroke patients who met the selection criteria. 10 people in the robot-assisted arm training group and 10 people in the task-oriented arm training group were randomly assigned. The experimental group performed robot-assisted arm training, and the control group performed task-oriented arm training for 6 weeks, 5 days a week, 30 minutes a day. The measurement tools included surface electromyography and smart insole system. Data were analyzed using independent sample t-test and the paired sample t-test. Results: Comparing the muscle activity of arm within the group, the experimental group and the control group showed significant differences in muscle activity in the biceps brachii, triceps brachii, anterior deltoid, upper trapezius, middle trapezius, and lower trapezius. Comparing the muscle activity of arms between the groups, the experimental group showed significant difference in all muscle activity of arm compared to the control group. Comparing the weight bearing within the groups, the experimental group showed significant difference in the affected side and non-affected side weight bearings and there were significant differences in anterior and posterior weight bearing. The control group showed significant difference only in the non-affected side weight bearing. Comparing the weight bearings between groups, the experimental group showed significant difference in the affected side and non-affected side weight bearings compared to the control group. Conclusion: This study confirmed that robot-assisted arm training applied to stroke patients for 6 weeks significantly improved muscle activity of arm and weight bearing. Based on these results, it is considered that robot-assisted arm training can be a useful treatment in clinical practice to improve the kinematic variables in chronic stroke patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.11
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• pp.5689-5697
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• 2013

The purpose of this study was to determine the effects of scapular taping on muscle activities of the scapular rotators and anterior deltoid, ROM, shoulder pain, proprioception in subacute stroke patients. Twenty-eight patients were randomly assigned to an experimental and control groups of fourteen patients respectively. Muscle activity of upper and lower trapezius, serratus anterior, anterior deltoid was measured using surface electromyography. Visual analog scale was used for shoulder pain. Electro-Goniometry was used for shoulder elevation ROM. Assessment board was used for shoulder elevation proprioception. The muscle activity of the lower trapezius and serratus anterior increased significantly after scapular tape application (p<0.05). The AROM and PROM in the shoulder elevation significantly increased after scapular tape application (p<0.05). The VAS in the shoulder no significantly decreased after scapular tape application (p>0.05). The proprioception in the shoulder no significantly increased after scapular tape application (p>0.05). The results of this study suggest that scapular taping can be used an additional therapy for increasing muscle activity of lower trapezius and serratus anterior and ROM during shoulder elevation in subacute stroke patients.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.11 no.2
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• pp.71-82
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• 2005

The couple force of the scapular stabilizers for upward rotation that include the upper and lower trapezius, serratus anterior muscles is essential to maintain the stability of shoulder joint. But if there is an imbalance of these muscles, it would occur many problems of shoulder joint. A push-up plus exercise with an unstable support is used in order to increase the muscle activity and stimulate the proprioception of shoulder joint. The purpose of this study was to compare the muscle activity of upper and lower trapezius, serratus anterior muscles and to determine which exercise is more effective when subjects perform push-up plus exercise in the stable support and unstable support. 15 healthy subjects and 15 painful subjects with injury of shoulder joint participated in this study. Surface electromyography data were collected during plus phase of push-up plus exercise. The types of push-up plus exercise were composed of three conditions. Stable type is subjects performed the push-up plus exercise on the fixed support and unstable type 1 is on the sling without shaking and unstable type 2 is on the sling with shaking by tester's manual. The upper and lower trapezius activities of injured group were higher than uninjured group at three measure conditions, but serratus anterior activities were not. The UT/SA ratio of injured group was higher than uninjured group at three measure conditions. The serratus anterior activities were most high at unstable 2 measure in both groups. The UT/SA ratio was most low at unstable 2 measure condition in injured group only. The present result revealed that push-up plus exercise in the unstable support with shaking which took most high serratus anterior activities and most low of UT/SA ratio is optimal cure method that can improve the imbalance of the scapular stabilizer.