• Journal of The Korean Society of Integrative Medicine
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• v.3 no.3
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• pp.1-8
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• 2015

Purpose : The purpose of this study was to find out the effect of shoulder exercise program for improving forward head posture. Method : Subjects were divided into two groups. The experimental group(15 people) participated in strength exercise and stretching exercise, three times every week, during 4 weeks. And the control group(the other 15 people) didn't participate in exercises. Exercise program was composed of strength exercise of middle and lower trapezius and stretching exercise of levator scapulae and upper trapezius. And then we measured cervical alignment with GPS and muscular activity by EMG. Result : The results of this study were as follows; 1. After the intervention, experimental group was significantly decreased in cervical alignment than control group(p<.05). 2. After the intervention, experimental group was significantly increased in middle lower trapezius musclar activity than control group(p<.05). Conclusion : Strength exercise of middle and lower trapezius and stretching exercise of levator scapulae and upper trapezius were considered a efficient for improving forward head posture.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.3
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• pp.1840-1848
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• 2019

Background : There is lack of studies on the effects of the bag-carrying style on the shoulder muscles and body alignment in adults with rounded shoulder posture (RSP). Objective: The purpose of this study was to investigate the effects of various bag-carrying styles on muscle tone, muscle stiffness and spinal alignment in 20 adults with RSP as they were walking on a treadmill. Design : Crossover Study Design. Methods: A subject performed treadmill walking for 15 minutes at a speed of 4 ㎞/ｈ while carrying three different types of bags: a backpack, a cross bag, and a shoulder bag. Results : The results showed that the main effect of timing was observed in the muscle tone for all the variables and in muscle stiffness only for the upper and lower trapezius muscles. As for the main effect of timing, the muscle tone of the upper trapezius and the pectoralis major significantly increased in all conditions, while the muscle tone of the lower trapezius significantly decreased in all conditions. The muscle stiffness of the upper trapezius significantly increased in all conditions, while the muscle stiffness of the lower trapezius significantly decreased in all conditions. As for the spinal alignment, the dimple distance data values significantly decreased for the cross-bag style. Conclusions : This study demonstrated that walking with a heavy bag, regardless of the bag-carrying style, increased muscle stiffness around the shoulders in adults with rounded shoulder posture, and walking with a cross-bag also induced changes in spinal alignment.

• PNF and Movement
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• v.22 no.2
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• pp.315-324
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• 2024

Purpose: The aim of this study was to compare the activation of shoulder stabilizer muscles to variations of manual resistance during three-dimensional shoulder rehabilitation exercises. Methods: A total of 13 participants were included in this study. To normalize each muscle's activity, a maximal isometric voluntary contraction was performed by all participants. After receiving 30 minutes of training in three-dimensional shoulder rehabilitation exercises, participants randomly performed PNF arm and scapular patterns according to the intensities of manual resistance. The activities of the upper trapezius, lower trapezius, and serratus anterior were measured during these patterns. All exercises were performed for five seconds, and the average of three seconds, excluding the first and last seconds, was used for data analysis. Results: Lower trapezius activity was significant among manual resistance intensities. In both the PNF arm and scapular patterns, using 80% manual resistance of maximum resistance showed higher activity of the lower trapezius muscle compared to 20% of the maximum resistance. Conclusion: It is expected that PNF arm and scapular patterns, with varying intensities of manual resistance, can be used for early rehabilitation of patients with shoulder impingement syndrome.

• The Journal of Korean Physical Therapy
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• v.32 no.3
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• pp.157-162
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• 2020

Purpose: This study was to evaluate several tasks performed at a high intensity in terms of their ability to elicit EMG activity in the serratus anterior by comparing the EMG activities of the serratus anterior, upper trapezius, and lower trapezius muscles during six tasks combined shoulder flexion with rotation. Methods: Fifteen healthy males were recruited to this study. Each subject was instructed to assume a sitting position without back support and asked to flex (90° or 120°) the right shoulder and protract the scapula in the sagittal plane with maximal external rotation; to assume a neutral position; or to internally rotate the glenohumeral joint. The EMG data were collected from the serratus anterior (SA), upper trapezius (UT), and lower trapezius (LT) muscles were normalized to maximum voluntary isometric contraction. The UT/LT and UT/SA muscle activity ratios in each task were assessed by calculating the surface EMG. Data were analyzed by two-way repeated-measures analysis of variance, with the level of significance set at p<0.05. Results: The results of this study, shoulder flexion with external rotation resulted in low upper trapezius/serratus anterior and upper trapezius/lower trapezius ratios and a relatively high level of serratus anterior activation. Conclusion: Shoulder flexion with external rotation used herein may be considered as important for clinical interventions aimed at selectively increasing SA strengthen and clinical selection of exercises for improving glenohumeral joint and scapulothoracic control.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.1
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• pp.1975-1980
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• 2020

Background: It has been argued that changes in muscle activity in the upper trapezius and serratus anterior may or may not cause shoulder joint pain and dysfunction. Objective: To investigate the effects of active vibration exercise on muscle activity regarding scapular stabilization using a flexi-bar. Design: A randomized controlled trial. Methods: A total of 24 subjects were randomly assigned to a flexi-bar group with active vibration and general stick group with non-active vibration. Both groups performed the same four action programs for 6 weeks, three times a week for 30 minutes at a time. The upper trapezius muscle, middle trapezius muscle, lower trapezius muscle and serratus anterior muscle of the dominant side was measured by electromyography before and after the 6 weeks of exercise. The independent t-test and paired t-test were used to analyze data. Results: There was a significant difference between groups in upper trapezius muscle and serratus anterior muscle activity after exercise (P<.05). Also, there was a significant difference in upper trapezius muscle and serratus anterior muscle activity before and after exercise in the flexi-bar group (P<.05). Conclusion: This study demonstrates that active vibration exercise using a flexi-Bar contribute to reduce the activity of the upper trapezius muscle and promote the activity of the serratus anterior muscle.

• Physical Therapy Rehabilitation Science
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• v.5 no.2
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• pp.95-100
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• 2016

Objective: The purpose of this study was to investigate effects of hand grip strength on the muscle activation of shoulder joint in breast cancer patients. Design: Cross-sectional study. Methods: Ten breast cancer patients who agreed to active participation were included. These patients were operated with either conservative surgery or segmental mastectomy, and then were treated with radiation therapy and chemotherapy. The activity of the upper trapezius, lower trapezius, supraspinatus and serratus anterior muscle were measured using surface electrodes during 4 hand gripping tasks (lowered their arms in standing position, 0%, 30%, and 50% of maximum voluntary contraction) in the scapular abduction plane. Results: The results were analyzed using a one-way repeated measures ANOVA. There was a significant difference in the lower trapezius and supraspinatus muscles according to grip strength, lower trapezius and supraspinatus muscles showed significantly difference according to grip strength (p<0.05). The result of the muscle activation according to hand strength (0%, 30%, and 50%) it showed a significant difference between the upper trapezius and supraspinatus in 0% grip strength (p<0.05). In addition, it did not show a significant difference between muscles in 30%, 50% hand strength. Conclusions: This study showed an increase in shoulder muscle activation with increasing hand grip strength with the upper trapezius muscle being more activated than other muscles in 0% grip strength. The finding of this study suggests usefulness for development of preventative measures and rehabilitation strategies for increasing shoulder motor function in patients with breast cancer.

• 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.11 no.1
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• pp.45-52
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• 2004

Altered scapular kinematics in the scapular joint is commonly believed to be a factor contributing to trunk posture. The purpose of this study was to analyze the muscle activity with several changes of the shoulder angle. Tests were performed on 10 male subjects by repeated measures. Each subject was measured while sitting in both erect and slouched trunk positions. In each sitting posture, a three-dimensional motion analysis measurement was used to measure thoracic angle and shoulder abduction angle. Measurements were taken with the shoulder abdcution angle at $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, $90^{\circ}$, $120^{\circ}$, and $150^{\circ}$. By using surface Electromyography (EMG) electrodes, we recorded the activity of the upper trapezius, middle trapezius, lower trapezius, middle deltoid, and serratus anterior muscle while the subject held a 4 kg weight at each angle. The mean of root mean square (RMS) of EMG activity was calculated. The middle trapezius, lower trapezius, and middle deltoid muscle activity showed significantly higher results but serratus anterior muscle activity showed significantly lower results (p<.05). With the shoulder angle increased, the muscle activity was also significantly increased (p<.05). In conclusion, the thoracic spine posture significantly affects the scapular muscle during scapular plane abduction, and the slouched posture is associated with increased trapezius muscle activity and with decreased serratus anterior muscle activity.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.199-207
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• 2022

Purpose : The purpose of this study is to investigate the effect of shoulder stabilization exercise accompanied by application of a pelvic compression belt on the muscle activity, pain and function of the muscles around the shoulder in subjects with round shoulders. Methods : For the study method, 28 students who were enrolled in K University with a distance of 1 cm or more between the clavicle of the peak and the outer ear path were selected through GPS 400 global postural analysis system measurement. The subjects were randomly assigned to 14 participants in the group wearing a pelvic compression belt and 14 patients in the group not wearing a pelvic compression belt. In all subjects, the muscle activities of the middle trapezius, lower trapezius, and serratus anterior muscles and the shoulder pain disorder index (SPADI) were measured. The intervention was performed 3 times a week for 4 weeks, and the applied intervention was push-up plus and modified prone cobra exercise. The muscle activities of the middle trapezius, lower trapezius, and serratus anterior muscles and SPADI score were compared using dependent t test before and after intervention. Results : In this study, both groups showed that the muscle activity of the middle trapezius, lower trapezius, and serratus anterior significantly increased after the intervention compared to before the intervention. On the other hand, SPADI showed no significant difference. Conclusion : The results of this study showed that muscle activity in the peri-shoulder joint was increased after push-up plus and modified prone cobra exercise in both groups, regardless of whether pelvic compression was applied or not. Therefore, it was found that shoulder stabilization exercise using the pelvic compression belt also contributed to the enhancement of muscle activity in the joints around the shoulder.

• Journal of International Academy of Physical Therapy Research
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• v.12 no.2
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• pp.2308-2313
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• 2021

Background: Although the scapular posterior tilt movement could facilitate the lower trapezius (LT) muscle activity, no study identified the effects of the scapular posterior tilt movement on the selective activation of the LT muscle during prone shoulder extension. Objectives: To examine the influences of additional scapular posterior tilt on electromyography (EMG) of the upper trapezius (UT) and the LT muscles during prone shoulder extension. Design: Cross-sectional study. Methods: There were 15 asymptomatic male participants in this study who performed prone shoulder extension with and without scapular posterior tilt movements. For the scapular posterior tilt movements, participants performed visual biofeedback training for scapular movement using motion sensor. During the exercises, the EMG activity of the UT and LT was recorded using surface EMG system. Results: The EMG activity of the LT significantly increased during prone shoulder extension with scapular posterior tilt compared to that of general prone shoulder extension, whereas that of the UT was not significantly different between the two exercises. Moreover, scapular posterior tilt application significantly decreased UT/LT muscle activity ratio. Conclusion: Scapular posterior tilt movement may be emphasized during exercise when facilitating LT muscle activation.