• Physical Therapy Korea
• /
• v.23 no.1
• /
• pp.65-71
• /
• 2016

Background: The unilateral prone arm lift (UPAL) is commonly used to exercise the lower trapezius muscle. However, overactivation of the upper trapezius can induce pain during UPAL exercises in subjects with upper trapezius tenderness. Objects: The purpose of this study was to investigate the effects of position of ipsilateral neck rotation (INR) on the inhibition of upper trapezius muscle activity and the facilitation of the lower trapezius muscle when performing UPAL exercises. Methods: In total, 19 subjects with upper trapezius tenderness were recruited for the study. Electromyographic (EMG) activity was measured in the upper, middle, and lower trapezius muscles during UPAL with and without INR position. Wilcoxon signed-rank test was used to compare EMG activity in the trapezius muscles and the muscle ratios. Results: EMG activity in the upper trapezius muscles was decreased significantly in the INR condition compared to without the position with INR during UPAL exercises (p<.05). EMG activity in the middle and lower trapezius was not significantly different between the with and without INR conditions (p>.05). However, the ratio of lower to upper trapezius activation showed a significant increase in the INR condition compared to the without INR condition (p<.05), indicating greater lower trapezius activation relative to the upper trapezius in the INR position than in the without INR position. Conclusions: The EMG results obtained in this study suggest that the position with INR reduced overactivation in the upper trapezius and improved muscle imbalance during lower trapezius exercises in individuals with upper trapezius tenderness.

• The Journal of Korean Physical Therapy
• /
• v.31 no.2
• /
• pp.134-139
• /
• 2019

Purpose: This study examined the most effective exercise while performing shoulder abduction below ninety degrees. Methods: Thirty two healthy individuals (17 males, 15 females) participated and performed four exercises, 1) Posterior fly, 2) Prone row, 3) Modified prone cobra, and 4) External rotation in the prone position. Surface electromyography (sEMG) was used to measure the electrical activities for the lower, middle and upper fiber of trapezius and serratus anterior. Results: A significant difference in the muscle activities of the upper/middle/lower trapezius and serratus anterior was observed among the three different positions in terms of the PF (posterior fly), PR (prone row), and MPC (modified prone cobra) (p<0.05). In post-hoc analysis, the activities of the lower and upper trapezius were significantly higher than those of the upper trapezius and serratus anterior (p<0.05). In addition, in ERP (external rotation in prone), there was a significant difference in each activity of the muscles. Post-hoc results indicated that the upper trapezius showed greater EMG activity than the other three muscles. Conclusion: External rotation in the prone position revealed the highest activation of the lower trapezius compared to upper trapezius muscle activity. This may be particularly useful in isolating the lower trapezius in cases where excessive scapular elevation is noted. Therefore, the most effective lower trapezius exercise should be performed below ninety degrees of shoulder abduction.

• Physical Therapy Korea
• /
• v.19 no.3
• /
• pp.31-39
• /
• 2012

The lower trapezius muscle is an important stabilizer and primary mover of the scapula. The potential use of ultrasound imaging to evaluate scapular muscle function warrants investigation. The purpose of this study is to use ultrasound imaging for determining the effectiveness of 4 different isometric exercises for maximally activating the lower trapezius muscles in healthy subjects. Twenty-eight (14 men and 14 women) volunteers were recruited for this study. Thickness measurements of the lower trapezius muscles were recorded during 4 exercises: latissimus pulldown (LP), prone V-raise (PV), prone row (PR), and modified prone cobra (MP). Lower trapezius muscle thickness was measured 3 times by 2 investigators at a point 3 cm lateral to the lateral edge of the T8 spinous process. The order of 4 exercise execution was randomized for each participant. To identify statistical significance, one-way ANOVA with repeated measures was used with the significance level of .05. Intraclass correlation coefficient (ICC) for intra-reliability was .86~.98 and inter-rater reliability .83~.96 for the lower trapezius, respectively (p<.01). Thickness changes in the lower trapezius muscles between the relaxed and contracted states in men were as follows: LP ($7.37{\pm}2.68mm$, 182%), MP ($4.69{\pm}1.74mm$, 167%), PV ($4.52{\pm}1.47mm$, 149%), and PR ($3.84{\pm}1.72mm$, 133%). In women the values were as follows: LP ($4.64{\pm}1.24mm$, 163%), MP ($2.79{\pm}.81mm$, 131%), PV ($2.78{\pm}.85mm$, 129%), and PR ($2.21{\pm}1.26$ mm, 100%). Thickness of the lower trapezius muscles significantly differed between exercises in both the gender (p<.01). The LP was the most effective exercise for increasing the activation of the lower trapezius muscle in both the gender. We recommend performing the LP exercise for strengthening the lower trapezius muscles.

• Journal of The Korean Society of Integrative Medicine
• /
• v.5 no.2
• /
• pp.19-23
• /
• 2017

Purpose: The purpose of this study was to determine the muscle activity ratio according to the shoulder abduction angle by identifying the mean muscle activities and calculating the muscle ratios for use in developing strengthening methods. Methods: The participants were healthy adults in their 20s (n=19). The activity of the deltoid middle, upper trapezius, middle trapezius, and lower trapezius muscles was measured by 8-channel surface electromyography. Muscle activity was measured during 4 conditions of angle of shoulder abduction: $30^{\circ}$, $60^{\circ}$, $90^{\circ}$, and $120^{\circ}$. The data used in the analysis were the root mean square and % total muscle activity values. Results: The root mean square values for the deltoid middle, upper trapezius, middle trapezius, and lower trapezius muscles showed significant differences. No significant differences were detected in the % total muscle activity of the deltoid middle, upper trapezius, middle trapezius, or lower trapezius muscles. Conclusion: Future studies aimed at developing selective shoulder abductor muscle strengthening methods are likely to provide more effective results by using muscle activity ratios.

• Journal of The Korean Society of Integrative Medicine
• /
• v.1 no.3
• /
• pp.51-62
• /
• 2013

PURPOSE : This study of 20 healthy male subjects by applying various scapular stabilization exercise to compared Serratus anterior and lower trapezius is change in ultrasound images. METHOD : Thirty healthy subjects voluntarily participated in this study. Ultrasound imaging was recorded from the increasing the activity of Serratus anterior(SA) and Lower trapezius(LT) muscles using Push-up plus, Wall slide, Scapular plane shoulder elevation with resistance exercise. Thickness changes in the Serratus anterior(SA) and lower trapezius(LT) muscles between the relaxed and contracted states in the each exercises. To identify statistical significance, one-way ANOVA with repeated measures was used with the significance level of .05. RESULT : The results of this study were as follows : 1) There were statistically significant difference in thickness changes in the Serratus anterior(SA) and lower trapezius(LT) muscles between the relaxed and contracted states in the each exercises. 2) The Scapular plane shoulder elevation with resistance is more effective to Strengthening in the scapular stabilization muscles than Push up-plus and Wall slide. CONCLUSION : The Scapular plane shoulder elevation with resistance may be used to effectively that patient with various shoulder pain.

• Journal of The Korean Society of Integrative Medicine
• /
• v.7 no.3
• /
• pp.109-115
• /
• 2019

Purpose : The purpose of this study was to investigate the activity of muscles around the scapulothoracic muscles according to the angle of shoulder joint abduction in the prone position. Methods : The participants included 15 adult males who had not undergone orthopedic surgery and did not have shoulder joint impairments. We measured the muscle activity of the upper trapezius, middle trapezius, lower trapezius, and serratus anterior at $120^{\circ}$, $90^{\circ}$, and $60^{\circ}$ shoulder joint abduction angles. Results : There was a significant difference in the comparison of muscle activity in the upper trapezius, middle trapezius, and serratus anterior muscles according to the shoulder joint abduction angle (p<.05). The results of the post test showed that the upper trapezius was significantly different between $120^{\circ}$ and $60^{\circ}$ (p<.01), and the middle trapezius was significantly different between $90^{\circ}$ and $120^{\circ}$, and between $90^{\circ}$ and $60^{\circ}$ (p<.05). There was a significant difference in the serratus anterior between $120^{\circ}$ and $90^{\circ}$ (p<.01), and $120^{\circ}$ and $60^{\circ}$ (p<.01). Conclusion : The results of this study could be used to determine an effective shoulder joint abduction angle to reduce muscle activity of the upper trapezius and increase muscle activity of the middle trapezius, lower trapezius, and serratus anterior.

• The Journal of Korean Physical Therapy
• /
• v.27 no.4
• /
• pp.246-251
• /
• 2015

Purpose: The purpose of this study was to compare activities of shoulder girdle muscles according to types of closed chain exercise in the sixties. Methods: The subjects consisted of 15 persons in their sixties. Muscle activity of the pectoralis major, deltoid middle, deltoid posterior, upper trapezius, lower trapezius, and serratus anterior were measured using electromyography according to shape of the support base and angle of shoulder flexion. According to types of closed chain exercises, muscles activities were compared by paired t-test. Significance level to verify statistical significance was .05. SPSS win (ver. 22.0) program was used for statistical analysis. Results: Muscle activities of the pectoralis major, middle deltoid, trapezius lower, and serratus anterior showed significant difference according to types of closed chain exercise (p<0.05). Conclusion: According to types of closed chain exercises of the shoulder girdle, muscle activities of the pectoralis major, deltoid middle, posterior and lower trapezius showed change of muscle activities.

• Journal of the Korean Society of Physical Medicine
• /
• v.10 no.4
• /
• pp.81-90
• /
• 2015

PURPOSE: The purpose of this study was to compare the muscle architecture of serratus anterior and lower trapezius using rehabilitative ultrasound imaging (RUSI) in affected and unaffected side of chronic stroke patients. METHODS: The participants were thirty five patients with stroke hemiplegia in this study. RUSI was used to measure the muscle thickness of the serratus anterior and lower trapezius muscles. We compared the muscle thickness according to affected side and sex, determined the reliability of the measurement image. Independent t-test, intra-class correlation coefficient (ICC) and standard error of measurement (SEM) were used for statistical analysis. RESULTS: Significant difference in muscle thickness of serratus anterior was observed between affected and unaffected side (p<.001). Muscle thickness according to gender showed a significant difference in unaffected side of serratus anterior (p<.05). Compare asymmetry ratio of serratus anterior and lower trapezius muscle thickness showed a significant difference (p<.001). ICC for intra-reliability was .944~.962 in serratus anterior and .873~.925 in lower trapezius muscle thickness, respectively. SEM was .001~.004 in serratus anterior and .002~.008 in lower trapezius muscle. CONCLUSION: This study, using RUSI, showed significant difference in muscle thickness of serratus anterior in affected and unaffected side of stroke patients. RUSI is a practical tool for measuring soft-tissue thickness in the scapular region muscle of stroke.

• Physical Therapy Korea
• /
• v.22 no.1
• /
• pp.58-68
• /
• 2015

This study aimed to determine the effect of lower trapezius muscle strengthening exercises on pain, neck disability index (NDI), cervical range of motion (ROM), and lower trapezius muscle strength in patients with unilateral neck pain. Following baseline measurements, the subjects (N=40) with unilateral neck pain were randomized into one of two 5 weeks exercise intervention groups: a experimental group (EG, $n_1=20$) that received strength training of the lower trapezius muscles or a control group (CG, $n_2=20$) that received routine physical therapy program. Each group participated in the intervention for 30 minutes, 3 times a week, for 5 weeks. All participants performed 2 repetitions of each intervention per day. The numeric pain rating scale for pain, NDI, ROM, and lower trapezius strength were recorded both pre- and post-intervention for both groups. Paired t-tests were used to determine significant changes post-intervention compared with pre-intervention and independent t-tests were used to analyze differences in the dependent variables between the 2 groups. After the 5-weeks intervention, both groups experienced significantly decreased pain and disability level (p<.05) and significantly increased cervical flexion, extension, lateral flexion, and rotation ROM (p<.05). The EG that received strength training of the lower trapezius muscles showed greater improvements in pain and functional disability level, cervical rotation, and lower trapezius strength than the CG (p<.05). These results suggest that a lower trapezius strengthening exercises reduce neck pain and neck disability level and enhance cervical ROM and lower trapezius strength level in patients with unilateral neck pain.

• Journal of The Korean Society of Integrative Medicine
• /
• v.11 no.4
• /
• pp.41-50
• /
• 2023

Purpose : The aim of study was to determine the effect of lower trapezius muscle strengthening exercises on the height of rounded shoulder posture and muscle activity in patients with rounded shoulder posture. Methods : Thirty-one subjects with rounded shoulders were selected and assigned, with the use of a random number table, to an experimental group (EG, n=16) that received resistance exercises of the trapezius (lower) muscles or a control group (CG, n=15) that received isometric exercises of the lower trapezius muscles. In the EG, with the subject in a prone position, both arms were abducted at the angles suggested for each posture (145 °, 45 ° abduction), with the hands holding dumbbells to assume a functional posture. The CG performed only isometric exercises without dumbbells in the same conditions. At the start signal, with the thumb raised, the arm was raised to the level of the ear. Both groups were assessed by the height of the rounded shoulder posture (RSP) and muscle activity (EMG). The intervention was performed three times a week. Results : The RSP significantly decreased during the intervention period in both the EG and CG (p<.05), and a significant difference was determined between the RSP of the two groups (p<.05). In the EG, the EMG significantly increased during the intervention period (p<.05), but the CG did not show any significant increase (p>.05). The final EMG was significantly higher in the EG than in the CG (p<.05). Conclusion : Both the EG and CG showed positive improvement in rounded shoulder posture during the intervention period. In particular, lower trapezius resistance exercise appears to reduce shoulder height and positively affects the activity of muscles around the shoulder.