• 대한정형도수물리치료학회지
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• 제12권1호
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• pp.57-67
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• 2006

Musculoskeletal neck dysfunction syndromes are common in outpatient musculoskeletal pain practice. The underlying musculoskeletal and neurologic causes of pain are variable. In the management of these patients, it is important to accurately identify and treat these pain generators to optimize patient outcome. It is the purpose of this review to discuss three main categories of functional anatomy, the role of superficial/deep muscular system and the scientific evidence for optimal physical therapy intervention for cervical dysfunction. Specifically there is evidence of lowered microcirculation in the upper trapezius muscle, morphological signs of disturbed mitochondrial function which appears to be limited to type I fibers and an increased cross-sectional area of type I muscle fibers despite a lower capillary to fiber area ratio. In acute neck pain syndrome, changes in muscle activity of painful muscles may result from segmental and supraspinal inhibitory effects. Muscle activation is closely related to the control of joint movements and postures and it is difficult to separate the influence of the two components. Both the altered muscle recruitment patterns and altered kinematics appear to be a poor adaptation for pain of the head - neck region, as they are likely to result in increased compressive loading in the cervical spine, affecting muscles, articular structures such as zygapophyseal joints, connective tissues and neural tissues which are all peripheral generators of referred pain. The rectus capitus posterior minor muscle shows that it is one of the most important muscles of the suboccipital region. In this article, i reviewed the anatomy, neurophysiology, function and dysfunction as well as the treatment of cervical dysfunction.

• PNF and Movement
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• 제16권1호
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• pp.151-159
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• 2018

Purpose: The aim of this study was to examine the activation of the contralateral upper and lower extremities and trunk muscle during ipsilateral upper extremity diagonal isokinetic exercise. Methods: Twenty-one healthy male subjects with no history of shoulder injury undertook ipsilateral diagonal isokinetic exercise at 60, 120, and $180^{\circ}/sec$, utilizing a standard Biodex protocol. Muscle activation amplitudes were measured in the upper trapezius, pectoralis major, biceps brachii, rectus abdominis, external oblique, rectus femoris, adductor longus, and biceps femoris muscles using electromyography. A one-way analysis of variance and paired t-tests were conducted, and the data were analyzed using SPSS, version 21.0. Results: The results revealed no statistically significant interaction between motion and angular velocity and no statistically significant contralateral muscle activation according to angular velocity (p>0.05). However, they revealed statistically significant contralateral muscle activation according to motion (p<0.05). Conclusion: These results suggest that the movements involved in contralateral upper extremity diagonal isokinetic exercise can enhance muscle strength in patients affected by stroke, fracture, burns, or arthritis.

• 대한물리의학회지
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• 제11권4호
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• pp.65-70
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• 2016

PURPOSE: This study aimed to compare the electromyography (EMG) activity for the middle deltoid (MD) and upper trapezius (UT) muscles in various shoulder abduction angles in patients with adhesive capsulitis (AC). METHODS: A total of 15 subjects participated in the study: 6 without AC (control group) and 9 with AC (AC group). The muscle activities of the UT and MD were measured using EMG during maximal static shoulder abductions in both groups. Each subject performed three repetitions of horizontal abduction at $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, and $90^{\circ}$ of the shoulder abduction angle in a sitting position. The measurement data from the middle 3-seconds of the 5-second periods were used. The mean value of three separate sets of measurements was used in the data analysis. For each muscle, independent t-tests were performed to determine group differences. A measured repeated-measures ANOVA was performed using Bonferroni's post-hoc test. RESULTS: The muscle activity of the UT was significantly greater in the AC group; than in the control group (p<.05). The muscle activity of the MD was significantly lower in the AC group; than in the control group (p<.05). The greatest level of muscle activity for both the MD and UT was demonstrated at the $0-60^{\circ}$ and $0-90^{\circ}$ of shoulder abduction angles in the AC group. CONCLUSION: These findings showed that low muscle activation of the MD may contribute to hyperactivity of the UT during shoulder abduction in AC patients.

• 대한물리의학회지
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• 제10권4호
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• pp.113-121
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• 2015

PURPOSE: The purpose of this study was to determine the effect of shoulder external rotation on muscle activities of the scapular upward rotators during arm elevation. METHODS: Nineteen healthy subjects with no medical history of shoulder pain or upper extremity disorders were recruited for this study. Electromyography (EMG) was used to measure the muscle activities of the serratus anterior (SA), upper trapezius (UP), lower trapezius (LT) and infraspinatus (IS) muscles during arm elevation. The EMG activities were recorded while the subjects performed $90^{\circ}$ arm elevation with three different arm positions; palm down (PD), neutral position (NP), and palm up (PU). While seated in a chair, the subject was asked to raise the upper extremity in the sagittal plane in random order. Subjects performed $90^{\circ}$ arm elevations in three trials at each arm position. The mean EMG activity normalized by the maximal voluntary isometric contraction was analyzed across three arm positions. Repeated measures one-way ANOVA and the post hoc Bonferroni tests were used to determine the differences in muscle activities among the three arm positions. RESULTS: The EMG activities of the SA and IS were significantly greater in the PU condition than in the other conditions during arm elevation. No significant difference was noted between the NP and PD conditions during arm elevation. CONCLUSION: These results suggest that shoulder external rotation (palm up position) can be used to activate the SA. Therefore, we recommend a scapular protraction exercise in the palm up position for strengthening the SA.

• 한국전문물리치료학회지
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• 제22권4호
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• pp.17-26
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• 2015

The purpose of this study was to investigate the effects of visual electromyography (EMG) biofeedback on the EMG activity of the lower trapezius (LT), serratus anterior (SA), and upper trapezius (UT) muscles, the LT/UT and SA/UT EMG activity ratios, and the scapular upward rotation angle during scapular posterior tilting exercise (SPTE). Twenty-four subjects with round-shoulder posture participated in this study. The EMG activities of the LT, SA, and UT were collected during SPTE both without and with visual EMG biofeedback. The scapular upward rotation angle was measured at the baseline, after SPTE without visual EMG biofeedback, and after SPTE with visual EMG biofeedback. The LT, SA, and UT EMG activities, and the LT/UT and SA/UT EMG activity ratios were analyzed by paired t-test. The scapular upward rotation angle was statistically analyzed using one-way repeated analysis of variance. If a significant difference was found, a Bonferroni correction was performed (p=.05/3=.017). The EMG activities of LT and SA significantly increased, and the EMG activity of UT significantly decreased during SPTE with visual EMG biofeedback compared to SPTE without visual EMG biofeedback (p<.05). In addition, the LT/UT and SA/UT EMG activity ratios significantly increased during SPTE with visual EMG biofeedback compared to SPTE without visual EMG biofeedback (p<.05). Significant increases were found in the scapular upward rotation angle after SPTE without and with visual EMG biofeedback compared to baseline (p<.017), and no significant differences were observed in the scapular upward rotation angle between SPTE without and with visual EMG biofeedback. In conclusion, SPTE using visual EMG biofeedback may be an effective method for increasing LT and SA activities while reducing UT activity.

• 전기학회논문지
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• 제67권7호
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• pp.910-916
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• 2018

In this paper, we developed a shoulder rehabilitation exercise device and monitoring system to remotely provide rehabilitation system for the ones who need shoulder exercises including the patients with rotator cuff rupture. In order to evaluate the severity of shoulder muscle injury, a total of 4 shoulder rehabilitation exercises ((3) shoulder abduction, (2) shoulder flexion, (3) shoulder abduction with elbow flexion, (4) shoulder extension with elbow flexion) were selected and instructed to be performed with a 3 kg dumbbell for 5 times. For EMG (electromyogram) signal analysis, each subject's maximum voluntary contraction (MVC) was measured. EMG signals reflect the activation level of contracting muscles during dynamic exercises. Six participants' muscle activation levels in posterior deltoid, middle deltoid, upper trapezius, and infraspinatus were measured and compared. The mean power spectrum values in the time and frequency domains were compared between two age-matched groups (20s and 50s). The results showed lower muscle activation in the elderly subjects (n=3) compared to that of the ones in their twenties (n=3).

• 한국운동역학회지
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• 제28권3호
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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.

• 한국융합학회논문지
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• 제9권2호
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• pp.341-347
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• 2018

본 연구의 목적은 4가지 자세의 푸시업 플러스(PUP) 운동 시 5번째와 7번째의 앞톱니근(SA), 위등세모근(UT), 중간등세모근(MT), 아래등세모근(LT), 큰가슴근(PM)의 근활성도를 알아보는 것이다. 25명의 대상자가 다양한 자세의 PUP 융합 운동 (일반자세, $90^{\circ}$, $120^{\circ}$, BOSU)을 실시하였다. 각 근육의 근활성도를 비교하기 위하여 반복 측정된 분산분석을 적용하였다. 다양한 PUP 융합 운동동안 SA7, PM, UT, MT에서 유의한 차이가 있었다(p <.05). SA7은 PUP 와 $90^{\circ}PUP$, BOSUPUP에서 각각 유의한 차이가 나타났다(p <.05). PM은 $90^{\circ}PUP$와 PUP, BOSUPUP에서 각각 유의한 차이가 나타났다(p <.05). UT은 $90^{\circ}PUP$와 PUP, BOSUPUP에서 각각 유의한 차이가 나타났다 (p <.05). MT는 $90^{\circ}PUP$와 PUP, $120^{\circ}PUP$, 그리고 PUP와 $120^{\circ}PUP$에서 유의한 차이가 있었다(p <.05). 본 연구 결과, 어깨의 기능부전이 없는 대상자가 어깨 안정근을 훈련할 때 일반적인 PUP가 효과적일 것이다.

• 한국전문물리치료학회지
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• 제19권4호
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• pp.38-45
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• 2012

The aim of this study is to compare the effect of abdominal drawing-in maneuver (ADIM) on lower trapezius (LT), serratus anterior (SA), and erector spinae (ES) muscle activity during arm lifts in prone and standing positions. Twenty healthy subjects were recruited, and NoraxonTeleMyo 2400T was used to collect electromyographic signals from the LT, SA, and ES muscles. A two-way repeated analysis of variance (ANOVA) used a significance level of .05. If a significant interaction was found, pairwise comparisons were performed with a Bonferroni adjustment (.05/4=.013). The results of the study were as follows: 1) In LT, no significant ADIM by position interaction was found ($F_{1,19}$=.356, p=.558). There was a significant main effect for ADIM. LT muscle activity with ADIM was significantly greater compared with muscle activity without ADIM ($F_{1,19}$=82.863, p<.001). There was also a significant main effect for position. LT muscle activity in the prone position was greater compared with muscle activity in the standing position ($F_{1,19}$=116.401, p<.001). 2) In SA, significant ADIM by position interaction was found ($F_{1,19}$=8.687, p=.008). There were significant differences in all pairwise comparisons. The greatest SA muscle activity was observed in the standing position with ADIM. 3) In ES, significant ADIM by position interaction was found ($F_{1,19}$=122.473, p<.001). The lowest ES muscle activity was elicited in the standing position with ADIM. Based on these results, ADIM is advocated in the prone position to increase LT muscle activity. In addition, it is concluded that arm lifts in the standing position with ADIM offer the most favorable combination for reducing ES muscle activity and increasing SA muscle activity.

• Journal of Oral Medicine and Pain
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• 제21권2호
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• pp.393-405
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• 1996

This study was performed to investigate the effects of changes of head posture and cervical spine shape on the mandibular resting or clenching electromyographic(EMG) activity in anterior temporalis(TA), masseter(MM), sternocleidomastoid muscle(SCM) and trapezius insertion(TI). 30 patients with Temporomandibular Disorders(TMDs) participated in this study. EMG activity($\mu$V) at rest and clenching was observed in four head postures, namely natural head posture(NHP), forward head posture(FHP), upward head posture(UHP), and downward head posture(DHP). For taking in upward or downward head posture head was inclined 10$^{\circ}$ upward or downward and CROM$^\textregistered$(cervical-range-of motion, Performance attainment Inc., USA) was used to maintain same posture during the procedure, and BioEMG$^\textregistered$ (Bioelectromyograph, Bioresearch Inc., USA) was used to record EMG activity in the above four muscles at eight locations on both sides. The recorded EMG activity($\mu\textrm{V}$) were compared and analyzed by cervical spine shape such as the head position from plum line, cervical curvature, and cervical inclination. Head position from plum line was measured in vertical plate calibrated with cm scale, comical curvature by radius was measured with adjustable curved ruler, and cervical inclination by cervical vertebrae tangent(CVT)was measured in lateral cephalograph. The results obtained were as follows : 1. Mean value of head position from plum line, cervical curvature, and cervical inclination were 4.8cm, 26.7cm, and 86.6$^{\circ}$, respectively, And There were no correlationship among these items. 2. For resting EMG activity by head posture, the value in anterior temporalis was higher at FHP than at DHP, the value in masseter was higher at FHP than at NHP, and DHP, the value in sternocleidomastoid muscle was higher at UHP than at NHP, and the value in trapezius insertion was higher at FHP and DHP than, NHP and UHP. The clenching EMG activity, however, did not show any difference by head posture. 3. Comparison of resting and clenching EMG activity between higher and lower groups by head position from plum line, cervical curvature, and cervical inclination did not show any significant difference. From this result, the author concluded that the cervical spine shape had not significantly affected to EMG activity in usual patients with TMDs.