• Journal of Korean Physical Therapy Science
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• v.9 no.3
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• pp.77-87
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• 2002

The purpose of this study was to compare the changes of muscle activities in deltoid with those in supraspinatus using electromyography(EMG) while subjects abducted their shoulder to different angles with different resistance. Methods : 20 volunteers who were comprised of 10 males(mean age: $21.2{\pm}2.0$) and 10 females(mean age: $20.2{\pm}1.6$) were collected. Surface electrodes were attached on deltoid and supraspinatus muscle for recording. Each reference electrode was located 3 cm to the each recording electrode. Muscle action potentials were recorded with changing the angle of shoulder abduction, $30^{\circ}$, $60^{\circ}$, $90^{\circ}$. This procedure was repeated with different resistance 0 pound, 2 pounds, 4.5pounds. The angle of shoulder abduction was determined by clinical goniometer. SPSS(Statistical Program for Social Science)/WIN 10.0 was used for statistics. Analysis included ANOVA, T-test. Results : The following results were obtained in this study. 1. There was significant differences during isometric shoulder abduction $30^{\circ}$, $60^{\circ}$, $90^{\circ}$ comparing muscle activity in deltoid and supraspinatus muscles at 0 pound, 2pound, 4.5pound resistance(p<0.05). 2. There was no useful significant in the deltoid and supraspinatus muscles activity EMG compared by physical condition. 3. Their was significant in the deltoid EMG compared by gender t=-5.41, P<0.01, but no difference in the supraspinatus EMG(P=0.333 >a=0.05). Conclusions: There are many previous studies on influence of shoulder angles and speeds of muscle activity. However most of them placed the focus on isotonic or isokinetic exercise, or shoulder function. But this study was done during isometric exercise, which is better for early assessment and treatment for injured patients. There is strong relationship between the shoulder angle with resistance in deltoid supraspinatus muscle activity. We conclude that it is important to apply isometric shoulder abduction exercise with correct angle and resistance especially in early stage.

• Clinics in Shoulder and Elbow
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• v.21 no.4
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• pp.200-206
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• 2018

Background: The purpose of this study was to assess the relevance of preoperative magnetic resonance imaging (MRI) evaluation by occupation ratio (OR) at maximum diameter of supraspinatus muscle. Methods: Patients from the Inje University Sanggye Paik Hospital who received rotator cuff repair and underwent pre- and postoperative MRI were selected as subjects of this study. On T1-weighted MRIs, OR of fat and muscle at Y-shaped view, OR at a location on supraspinatus muscle where its diameter was maximum on coronal view, and pre- and postoperative Goutallier Classification and changes in the tangent sign were measured. Statistical significance of postoperative OR was assessed regarding time from symptom onset to surgery, size of rotator cuff tear, preoperative OR, and the difference between ORs measured at maximum diameter of supraspinatus muscle and Y-shaped view. Results: Preoperative OR at Y-shaped view was $52.28{\pm}8.57$ (32.5-65.3). Preoperative OR difference between maximum diameter and Y-shaped view was $13.76{\pm}10.51$ (2.38-42.04), and Pearson correlation coefficient was 0.604 (p=0.001). Postoperative OR at Y-shaped view was $63.77{\pm}9.35$ (37.3-76.1). Pearson correlation coefficient of pre- and postoperative Goutallier Classification was -0.579 (p=0.002) and Pearson correlation coefficient of the postoperative difference between ORs measured at maximum diameter of supraspinatus muscle and Y-shaped view was -0.386 (p=0.047). Conclusions: Fatty degeneration of supraspinatus muscle in rotator cuff tear patients should be evaluated not only in the conventional Y-shaped view, but also at location of maximum diameter of supraspinatus muscle to establish patients' therapeutic plan.

• PNF and Movement
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• v.21 no.1
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• pp.139-146
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• 2023

Purpose: The aim of this study is to provide basic information to create an efficient training program to improve shoulder stability and function in patients with injuries and in patients having undergone surgery of the supraspinatus and infraspinatus muscles, which have a relatively high incidence of injury in shoulder joint disease. Further, independent activities of the supraspinatus and infraspinatus muscles were investigated according to forearm rotation and the neutral and lateral rotation postures. Methods: The activities of the supraspinatus and infraspinatus muscles were measured using surface electromyography in 22 healthy adults in Busan, and isokinetic muscle strength measurement equipment was used to measure muscle strength during shoulder lateral rotation. The subjects performed lateral rotation of the shoulder in three different forearm postures (neutral, supine, prone) to measure shoulder muscle activity and lateral rotation strength. Results: The independent activity ratio (% Isolation) of the supraspinatus and infraspinatus muscles during lateral rotation of the shoulder joint demonstrated a significant difference (p<0.05) according to the change in forearm posture. Conclusion: The supraspinatus muscle showed independent activity ranging from highest to lowest in the order of pronation, neutral, and supination of the forearm, while the independent activity of the infraspinatus muscle ranged from highest to lowest in the order of neutral, supination, and pronation of the forearm. Therefore, the most active forearm positions for the supraspinatus and infraspinatus muscles are pronation and neutral, respectively.

• Journal of Haehwa Medicine
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• v.25 no.1
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• pp.27-36
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• 2016

Objectives : The purpose of this report is to prove the effect of The Daoyin exercise program combined with Korean medicine treatment on supraspinatus tendon tear. Methods : Two patients, diagnosed with Supraspinatus tendon tear by shoulder MRI, were treated with The Daoyin exercise program and Korean medicine treatment. VAS(Visual analog scale), ROM(Range of motion) and Physical examination were used to evaluate patients. Results of application : The Daoyin exercise program combined with Korean medicine treatment reduced shoulder pain and improved shoulder ROM of the two patients significantly. Conclusions : The Daoyin exercise program combined with Korean medicine treatment is proved to be effective treatment for reducing pain and improving shoulder ROM of supraspinatus tendon tear patients.

• Journal of Acupuncture Research
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• v.31 no.1
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• pp.167-176
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• 2014

Objectives : The purpose of this study is to report the improvement of acupotomy in patients with partial tear of supraspinatus tendon. Methods : We treated 4 patients having shoulder pain due to partial tear of supraspinatus tendon with acupotomy combined with oriental medical treatments. We checked visual analog scale(VAS) and range of movement(ROM). Results : There are remarkable improvement in VAS and ROM. Conclusions : This report shows acupotomy has a effectiveness on partial tear of supraspinatus tendon. Follow-up study is needed.

• Clinics in Shoulder and Elbow
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• v.25 no.4
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• pp.328-333
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• 2022

Irreparable rotator cuffs with retracted torn ends remain a significant challenge for most shoulder surgeons. Since repairs are preferable to reconstruction or replacement whenever possible, studies for anatomical reductions with minimal tension and secure fixation are important. In this study, the authors introduce an arthroscopic supraspinatus advancement (ASSA) procedure for retracted rotator cuff tears that could not be adequately reduced to the original footprint. Using modified long, narrow, curved Cobb elevators, procedures can be performed through lateral portals without any additional skin incision. Following meticulous stepwise three-compartment elevation procedures based on the supraspinatus insertion anatomy, the supraspinatus muscle could be safely elevated from the fossa and sufficiently advanced laterally. The authors suggest that ASSA could be a useful procedure for management of challenging retracted rotator cuff tears by maximizing lateral excursions that could convert irreparable tears to reparable tears in select patients.

• Clinics in Shoulder and Elbow
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• v.4 no.1
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• pp.13-16
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• 2001

Object: To determine the sensitivity, specificity, and positive and negative predictive values of an empty can test for diagnosing supraspinatus tendon tear. Methods: We reviewed 146 patients who have shoulder pain with limited active range of motion. We evaluated patients according to empty can test. Sensitivity, specificity, and positive and negative predictive values for supraspinatus test was estimated using arthroscopic evaluation. Results: A hundred and twenty-four of 127 cases with positive empty can test had supraspinatus tendon tear. Of 19 samples with negative empty can test, 15 had no supraspinatus tear. Sensitivity, specificity, and positive and negative predictive values for the empty can test were 97.6%, 83.3%, 97.6%, and 78.9%, respectively. Conclusions: Empty can test was found to have a high sensitivity and good positive predictive value in identifying the tear of rotator cuff tendon. We concluded that empty can test of the shoulder is a reliable diagnostic method which could be used for the diagnosis of rotator cuff tear.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.14 no.1
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• pp.24-30
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• 2008

Purpose : The patients who have Supraspinatus tendinitis, Lateral epicondylitis, Achilles tendinitis are our targets, so we want to know their opinions in order to take Sono-graphic tests and to study utility value of Sono-graphic. Object and Methods : The case of 30 patients with Tendinitis results, we classified with three categories, Supraspinatus tendinitis, Lateral epicondylitis and Achilles tendinitis. Case by case, before medical treatment, we executed the inspections which are Sound side and Affected side. After 4 weeks of medical treatment, we executed the inspection which is Sono-graphic. Objectively comparing with Sono-graphic, we measured VAS(Visual Analog Scale) before and after physical therapy. Results : We could learn that VAS (Visual Analog Scale) and Sono-graphic wore decreased about changing the lesion area of each disease. For example, Supraspinatus tendinitis is from case 1 and case 2, Lateral epicondylitis is from case 8, case 9 and case 10, Achilles tendinitis is from case 16, case 17 and case 18. Conclusion : About organization of complicated anatomy, we could learn general ideas about Supraspinatus tendinitis, Lateral epicondylitis, Achilles tendinitis. And finally the results which appeared between the decrements of VAS and Sono-graphic are similar.

• Physical Therapy Korea
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• v.23 no.2
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• pp.84-92
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• 2016

Background: Strengthening the supraspinatus is an important aspect of a rehabilitation program for subacromial impingement and tendinopathy. Many authors recommended empty-can (EC), full-can (FC), and prone full-can (PFC) exercises to strengthen the supraspinatus. However, no ultrasonography study has yet investigated supraspinatus muscle architecture (muscle thickness; MT, pennation angle; PA, fiber bundle length; FBL) in relation to supraspinatus strengthening exercises. Objects: The purpose of this study was to compare the architecture (MT, PA, and FBL) of the supraspinatus muscle during three different types of exercises (EC, FC, and PFC) using diagnostic ultrasound. Methods: Participants performed three different exercises: (A) EC; the arm was maintained at $60^{\circ}$ abduction with full internal rotation in the sitting position, (B) FC; the arm was maintained at $60^{\circ}$ abduction with full external rotation in the sitting position, and (C) PFC; the arm was maintained at $60^{\circ}$ abduction with full external rotation in the prone position. Ultrasonography was used to measure the MT, PA and FBL of the supraspinatus. One-way repeated analysis of variance with Bonferroni's post-hoc test was used to compare between the three exercises and the initial position of each exercise. Results: Compared with each initial position, the FC exercise showed the greatest mean difference in muscle architecture properties and the PFC exercise showed the least mean difference. Conclusion: The findings suggest that the FC exercise position may have an advantage in increasing the amount of contractile tissue or producing muscle power and the PFC exercise position may be useful in a rehabilitation program because it offers the advantage of maintaining the muscle architecture properties.

• Investigative Magnetic Resonance Imaging
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• v.20 no.4
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• pp.224-230
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• 2016

Purpose: The purpose of this study was to compare the grade of fatty degeneration and atrophy of rotator cuffs on immediate postoperative MRI to those on preoperative MRI in patients with rotator cuff tears. Materials and Methods: Seventy patients were included in this study, who received arthroscopic rotator-cuff repair and underwent both preoperative magnetic resonance imaging (MRI) and immediate postoperative MRI in our institution. Fatty degeneration of rotator cuffs and the atrophy of supraspinatus muscles were evaluated with T1 oblique sagittal images in the Y-shaped view. Fatty degeneration was evaluated using a Goutallier classification system, and the atrophy of supraspinatus muscles was evaluated using a modified tangent sign and a visual occupation ratio. Results: From 70 patients, a total of 100 tendons were repaired: 18, 69, and 13 tendons were treated for subscapularis, supraspinatus, and infraspinatus, respectively. The Goutallier grades (P = 0.012), modified tangent signs (P = 0.000), and visual occupation ratios (P = 0.000) of supraspinatus muscles were significantly decreased in immediate postoperative MRIs when compared to preoperative MRIs. In immediate postoperative MRIs, the Goutallier grades of supraspinatus muscles were decreased by one grade in 18.8% (n = 13) of the patients, and the atrophy of supraspinatus muscles was improved by one grade in 26.1% (n = 18) for modified tangent signs and 21.7% (n = 15) for visual occupation ratios. However, fatty infiltration by the Goutallier grades of subscapularis (P = 1.000) and infraspinatus (P = 0.157) muscles were not significantly changed after arthroscopic surgery. Conclusion: Immediate postoperative MRIs showed a significant improvement of fatty degeneration and muscle atrophy in supraspinatus muscles when compared to preoperative MRIs.