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.

The purpose of this study is to evaluate the differences of body compensation image on variations in the shoulder height and width of power shoulder raglan sleeve jacket. Nine samples were examined: 3 variations of the shoulder height and 3 variations of the shoulder width. The data was evaluated by 123 fashion design majors. The results were as follows; as a result of analyzing the body compensation image according to changes in the shoulder height and width of power shoulder raglan sleeve jacket, five factors were selected; the shoulder compensation factor, the bust compensation factor, the waist compensation factor, the arm compensation factor and the neck compensation factor. Among these factors, the shoulder compensation factor is the most important factor. Examining the major effect of the body compensation image based on changes in the shoulder height and width of power shoulder raglan sleeve jacket, it had an independent influence on factors about waist, neck, shoulder and arm compensation except a factor about bust compensation, had an influence on interacting effect of factors about shoulder, bust, waist, arm compensation, and it had no influence on interacting effect of a factor about neck compensation. This shows that the shoulder height has larger effect on neck compensation image than the shoulder width in power shoulder raglan sleeve jacket.

This study aimed to compare the characteristics of breast cancer surgery and shoulder surgery patients on the shoulder range of motion (ROM), degree of pain and dysfunction, and scapular position. This study was carried out with a total of 90 women: a breast cancer surgery group (BS, n1=30), a shoulder surgery group (SS, n2=30) and a control group (n3=30). Shoulder ROM, the Quadruple Visual Analogue Scale (QVAS), the Shoulder Pain and Disability Index (SPADI), and the Scapular Index (SI) were used to assess shoulder function. Statistical analyses were performed using a one-way analysis of variance, crosstab test, and independent sample t-test. Post-hoc testing was carried out with Bonferroni test. There were significant differences in shoulder ROM when the BS and the SS were compared with the control group. However, there was no significant difference in ROM between the BS and SS. Furthermore, there was a significant difference in shoulder pain between both surgery groups, and there was greater shoulder dysfunction in the SS than in the BS. There was also a significant difference in upper extremity posture when the BS and the SS were compared to the control group. Finally, there was no significant difference in upper extremity posture between the BS and the SS. This study compared shoulder ROM, pain, dysfunction, and upper extremity postures between the BS and SS. While there were no significant differences in shoulder ROM, pain, and upper extremity posture between both surgery groups, the level of dysfunction was found to be significantly different. Therefore, health professionals managing for breast cancer surgery or shoulder surgery patients should consider these outcomes.

PURPOSES: The purpose of this study is to verify the causes of surface scaling at L-shoulder concrete structure. METHODS : From the literature reviews, mechanisms of frost damage were studied and material properties including strength, air void, spacing factor and scaling resistance of L-shoulder concrete structure were analyzed using core specimens taken by real fields. RESULTS : The spacing factor of air void has relatively high correlation of surface conditions : lower spacing factor at good surfacing condition and vice versa. If the compressive strength is high, even thought spacing factor does not reach the threshold value of reasonable durability, the surface scaling resistance shows higher value. Based on these test results, the compressive strength also provide positive effect on the surface scaling resistance. CONCLUSIONS: The main causes of surface scaling of L-shoulder could be summarized as unsuitable aid void amount and poor quality of air void structure. Secondly, although the compressive strength is not the governing factor of durability, but it shows the positive effect on the surface scaling resistance.

The aim of this study was to compare the activity of the upper trapezius (UT) and serratus anterior (SA) and ratio of UT to SA during shoulder elevations. Ten subjects with UT pain (UTP) and 13 subjects without UTP participated in this study. Subjects with a UTP of over five in a pain intensity visual analogue scale (0-10 ㎝) for more than 2 months and latent myofascial trigger points (MTrPs) in the UT muscle were included in the UTP group. Electromyography (EMG) data of UT and SA at 1st and 10th elevations were analyzed. Two-way repeated analyses of variance were used to compare the EMG activity of UT and SA and the ratio of UT to SA during shoulder elevations between groups with and without UTP. There was a significant increase in UT/SA ratio in the group with UTP compared to the group without UTP (p=.01). The activity of UT and SA measured at the 10th elevation was significantly greater than that in the first elevation (p<.05). The activity of SA was significantly greater in the group without UTP than the group with UTP (p=.03). However, there was no significant difference between groups with and without UTP in terms of UT activity (p=.28). These results indicate that UTP may have relevance to the increased muscle activity ratio of UT to SA during shoulder elevations.

The purpose of this study were to determine the intra-rater and inter-rater reliability of shoulder passive range of motion measurement using the “Clinometer + bubble level”, a smartphone application and to compare with the intra-rater and inter-rater reliability of measurement using a goniometer. Twenty six patients with stroke were recruited for this study. Two raters measured the passive range of motion of four types of shoulder movements (forward flexion; FF, abduction; ABD, external rotation at 90° abduction; ER90 and internal rotation at 90° abduction; IR90) using a goniometer and a smartphone to determine within-day inter-rater reliability. A retest session was performed thirty minutes later to determine within-day intra-rater reliability. The reliability was assessed using intraclass correlation coefficients (ICC) and the standard error of measurement (SEM). The ICC (2,1) for the inter-rater reliabilities of the goniometer and smartphone were good in FF and ABD [ICC (2,1)=.75∼.87] and excellent in ER90 [ICC (2,1)=.90∼.95]. The intra-rater reliabilities for the goniometer and smartphone were good or more than good, with an ICC (3,1) value >.75, the exception was IR90 measured by rater 2 on the smartphone. These results suggest that smartphone could be used as an alternative method tool for measurement of passive shoulder range of motion in patients with stroke.

The smart-phone has become a necessity for most people. In this study, we determined that using a smart-phone for 20 minutes can cause increased neck and shoulder muscle activities and fatigue. Seventeen healthy male smart-phone users who attended Yonsei University played a smart-phone game for 20 minutes and changes in their bilateral cervical erector spinae and upper trapezius muscle activities and fatigue were measured. To assess muscle activities and fatigue, we used the following variables: the median frequency, the 50th percentile Amplitude probability distribution function (APDF) value (median load), and the discrepancy in the 90th percentile APDF value and the 10th percentile APDF value (APDF range). A paired t-test was used to compare pre-smart-phone-use status with post-smart-phone-usestatus. The median frequency of the bilateral cervical erector spinae and the upper trapezius decreased significantly after 20 minutes of smart-phone use (p<.05). In addition, the 50th percentile APDF value of the bilateral cervical erector spinae and the right upper trapezius increased significantly (p<.05). The APDF range of the bilateral cervical erector spinae and the upper trapezius also increased significantly (p<.05). However, the 50th percentile APDF range of the left upper trapezius was not significantly different (p>.05). These findings suggest that using smart-phones for 20 minutes can induce muscle fatigue and increased neck and shoulder muscle activities.

The purpose of this study was to examine the influences of chronic shoulder pain on the muscle tone in trunk muscles. The study's subjects were 40 men and women in their 30 to 50s, which were divided into two groups. A chronic shoulder pain group consisted of 20 subjects who had been diagnosed with chronic shoulder pain by doctors, and a painless group consisted of 20 subjects who had experienced no such pain. An analysis was performed using electromyography on the muscle tone in the rectus abdominalis, external oblique, internal oblique, and erector spinae muscles under the same conditions between the two groups. The analysis results were as follows. The chronic shoulder pain group exhibited an overall high level of trunk muscle tone than the painless group, along with a statistically significant difference in the rectus abdominalis(p<.05). Moreover, the chronic shoulder pain group showed differences in the trunk muscle tone depending on the affected side. The chronic left shoulder pain group yielded higher levels of muscle tone in the right-side trunk muscles. In particular, the group revealed statistically significant differences in the rectus abdominalis and internal oblique(p<.05). The chronic right shoulder pain group exhibited higher levels of muscle tone in the left-side trunk muscles with a statistically significant difference in the internal oblique(p<.05). The above results suggested that chronic shoulder pain influences increases in the muscle tone in the trunk muscles on the opposite side to the affected shoulder.

This study was conducted in order to examine whether abdominal draw-in maneuver (ADIM) with isometric shoulder flexion, extension, adduction, and abduction selectively contracted deep abdominal muscles. This study's subjects were 13 males 17 females. In order to evaluate the comparison of effects of ADIM and ADIM with isometric shoulder flexion, extension, adduction and abduction, measurements were made on transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) using a real-time ultrasonic diagnostic imaging system. Each position was repetitively measured three times with a real-time ultrasonic diagnostic imaging system and their mean values were used for analysis. The ADIM with isometric shoulder flexion, extension, adduction and abduction significantly increased the thickness of TrA relative to the ADIM only (p<.05). The ADIM with isometric shoulder abduction significantly increased the thickness of IO compared to the ADIM only (p<.05). The ADIM with isometric shoulder extension and abduction significantly decreased the thickness of EO compared to the ADIM only and the ADIM with isometric shoulder extension significantly decreased the thickness of EO relative to the ADIM with isometric shoulder adduction (p<.05). ADIM with isometric shoulder abduction is an effective method to selectively strengthen deep abdominal muscles and therefore may be employed as an intervention for trunk stabilization.

This study examined the effects of a physical therapy program on quality of life (QOL), and neck and shoulder disability in head and neck cancer patients. The program included neck and shoulder range of motion (ROM) exercises, massage, progressive strengthening exercises, and stretching exercises. Sixteen patients who were assigned to an experimental group performed physical therapy for 40 minutes three times a week for eight weeks. Fifteen other patients were assigned to a control group who did not performed the physical therapy program. The European organization for research and treatment of cancer (EORTC QLQ-C30) and head and neck (EORTC QLQ-H&N) instruments, and the Neck Disability Index (NDI) were assessed before and after the rehabilitation program. The 40-minute program consisted of a 10-minute ROM exercise for the neck and shoulder, a 10-minute massage and 15-minute of progressive resistance exercises, followed by a five-minute stretching exercises. Statistically significant differences were noted for changes in global health, physical function in the EORTC QLQ-C30 and cancer related symptoms in the EORTC QLQ-H&N35 (p<.05). The NDI also showed significant differences (p<.05). Physical therapy may therefore benefit the physical aspects and QOL and improve neck and shoulder disability in patients with head and neck cancer.

Posterior shoulder muscle tightness is frequently observed in shoulder impingement syndrome because tightness in the posterior portion of the shoulder muscles can cause anterior and superior translation of the humeral head in relation to the glenoid fossa. The purpose of this study was to determine the immediate effects of soft tissue massage on acromiohumeral distance (AHD), anterior translation of the humeral head, and glenohumeral (GH) range of motion (ROM) in subjects with posterior shoulder muscle tightness. Twenty-seven subjects with greater than difference in the range of GH horizontal adduction between right and left sides were recruited. The range of GH horizontal adduction and internal rotation were measured by a digital inclinometer. The AHD and anterior translation of the humeral head were measured using ultrasonography. A paired t-test was used to compare AHD, anterior translation of the humeral head, and the range of GH horizontal adduction and internal rotation before and after soft tissue massage. The results showed that AHD increased significantly (p<.05) and the anterior translation of humeral head decreased slightly, but not significantly (p=.40) after the soft tissue massage. Furthermore, the ROM of horizontal adduction and internal rotation in the GH joint increased significantly after the soft tissue massage (p<.05). These findings indicate that soft tissue massage on posterior shoulder muscle tightness is an effective method to increase AHD and ROM in the horizontal adduction and internal rotation of the GH joint.

The purpose of this study was to comparatively analyze the active stability of shoulder joints according to the frequency of overhead motions, such as serving and spiking, engaged in by female professional volleyball athletes who play different positions, and to provide the results as the basic data for developing exercise programs to prevent shoulder joint injuries. The subjects of this study were 50 Korean female professional volleyball players and positions were as follows: left and right attackers, centers, setters, and liberos. The external rotation and internal rotation muscle strength and muscle strength ratios of the dominant and non-dominant arms of all subjects were measured using Biodex. The results of this study are as follows: Frist, no significant differences were found in the internal and external rotation muscle strength of the dominant and non-dominant arms between positions. Second, for the shoulder joint muscle strength ratio of the dominant arm, by position, the setter showed significantly greater stability compared to the other positions. Third, for the shoulder joint muscle strength ratio of the non-dominant arm, by position, no significant difference in stability between positions was found. Fourth, it was found that the dominant arm had significantly greater instability of the shoulder joint than the non-dominant arm for attackers and centers, but no significant difference was found for setters and liberos. This study comparatively analyzed the muscle strength ratios of the external/internal rotations and dominant/non-dominant arms, which can determine the stability of the shoulder joints between female professional volleyball playing positions that engage in jumps and spikes using only the dominant hand and positions that do not.

The purpose of this study was to compare electromyography (EMG) activity for the middle and lower trapezius muscle according to various shoulder abduction angles. Thirty healthy male subjects were recruited for this study. Each subject performed three repetitions of horizontal abduction at 75˚, 90˚, 125˚, 160˚, and 180˚ of shoulder abduction angle in a prone position. Surface EMG activity was recorded from the middle and lower trapezius while the subjects held for five seconds at a predetermined position. The EMG activity was normalized using the maximal voluntary isometric contraction (MVIC) elicited using a manual muscle testing technique. A repeatedly measured ANOVA was performed by Bonferroni's post hoc test. The EMG activity of the middle and lower trapezius was significantly different among shoulder abduction angles (p<.05). The greatest level of muscle activity for the middle and lower trapezius were demonstrated at and of shoulder abduction angle, respectively. These results suggest that middle and lower trapezius strengthening exercise and manual muscle testing should be performed at different shoulder abduction angles.

Stiffness of the posterior deltoid is as a causative factor in the limited range of glenohumeral horizontal adduction and various other shoulder pathologies including shoulder impingement syndrome, frozen shoulder, and humerus anterior glide syndrome. The purpose of this study was to compare the effects of two techniques (soft tissue massage and cross-body stretch) on increasing the range of horizontal adduction. Thirty-two subjects with a or greater difference between the right and left sides in horizontal adduction were selected. Sixteen subjects from each group were allocated randomly. Interventions were applied on six occasions for 2 weeks, and the range of horizontal adduction was measured using an inclinometer at pre-and post-intervention. A analysis of variance (interventiontime) was used to compare the effects of the two techniques. In the soft tissue massage group, the angle of horizontal adduction significantly increased compared with the cross-body stretch group. These findings indicate that the soft tissue massage of the posterior deltoid muscle is a more effective method to increase the flexibility of the glenohumeral horizontal adduction.

The purpose of this study was to investigate the variations in gait parameters in terms of the type of arm sling used in hemiplegic patients. Ten patients with hemiplegia and ten healthy adults participated in this study and walked at self-selected speeds on a GAITRite-instrumented carpet. The activities of the opposite shoulder girdle muscle including the latissimus dorsi, anterior deltoid, and posterior deltoid were simultaneously recorded using surface EMG during gait. They were randomly assigned a condition: without an arm sling, a single strap arm sling, a Harris hemi arm sling, a Rolyan humeral cuff arm sling, and a Bobath roll arm sling. The following gait variables were analyzed: the temporo-spatial parameters of velocity, step length, stride length, swing phase, stance phase, single support, step time and toe in/toe out. The statistical analysis was one-way ANOVA with repeated measures to compare the variation of each variable. In comparison of parameters in each trial in the hemiplegia group, the non-affected side stride length, single support, and toe in/toe out resulted in statistically significantly changes (p<.05). But without an arm sling group did not show any gait parameter differences with arm slings. This study found that several arm slings varied gait patterns in patients with hemiplegia and in healthy adults. In the EMG analysis, the Rolyan humeral cuff arm sling and the Bobath roll arm sling were higher muscle activity for the latissimus dorsi muscle than did the single strap ann sling. Further study should examine the problems that appeared in patients who worn arm slings by focusing on a larger number of subjects and by studying the variety of responses in more detail using an assessment tool that measures variation.

The purpose of this study was to measure intra-rater and inter-rater reliability and range of motion for measurement of passive shoulder internal rotation range of motion and to compare anterior glide distance of humeral head in three methods. Fifty healthy subjects and fifty patients with shoulder musculoskeletal pain were recruited for this study. The subjects' passive shoulder internal rotation range of motion was measured by visual estimation, manual stabilization, and pressure biofeedback unit methods. In two trials, measurements were performed on each subject by two examiners. Intraclass correlation coefficient (ICC(3,1)) was used to determine the reliability of each measurement. The intra-rater reliability of the three methods was excellent (ICC=.77~.93) in both groups. The inter-rater reliability of the visual estimation method was poor (ICC=.20, .29), the manual scapular stabilization method was poor and fair (ICC=.09, .50), and the pressure biofeedback unit method was excellent (ICC .86, .75) in the experimental and control groups. In the experimental group, the difference of examined range of motion by each examiner was significant in the visual estimation method and manual scapular stabilization method, but there was an insignificant difference between the groups is the pressure biofeedback unit method. This result suggests that the intra-rater and inter-rater reliability of a pressure biofeedback unit was better than the other methods. The difference in distance of the anterior glide of humeral head was insignificant among all the methods. The pressure biofeedback unit method was the most reliable method, so it is proposed to be a new and reliable method to measure internal rotation range of motion.

The purpose of this study was to investigate the most effective and comprehensible method for the assessment of resting scapular position (RSP) and pain level (PL) in unilateral shoulder pain (USP). Fifty volunteers with USP were involved in the study. Resting scapular assessments of the patients' pain sides (PS) and non-pain sides (NPS) were evaluated. The assessment tools for RSP are: 1) sternal notch (SN) to coracoid process (CP) distance 2) 3rd thoracic spinous process (T3S) to posterolateral angle of acromion (PLA) distance 3) scapular index 4) 8th thoracic spinous process (T8S) to inferior angle of scapular (IAS) distance 5) supine measurement of pectoralis minor (PM) distance 6) standing PM distance 7) PM index (PMI) and 8) PM pain. The paired t-test was used to compare PS and NPS in RSP. Pearson correlation analysis was used to confer a relationship between the PL and RSP. The results of this study indicated that: 1) all the variables between the PS and NPS for RSP were statistically significant(p<.05) and 2) the PMI showed the strongest relationship in the correlation analysis between RSP and PL(p<.05, r=.37). Therefore, it can be concluded that there is a relationship between PMI and PL and it is suggested that an assessment tool using PMI to diagnose shoulder pain would be clinically effective.

The purpose of this study was to compare EMG activity for pectoralis major muscle during shoulder movement with various abduction angle and rotation position in supine position. Fifteen healthy subjects were recruited for this study. All subjects performed shoulder horizontal adduction holding a 2 kg dumbbell in shoulder abduction 40˚, 70˚, 90˚, 130˚, 160˚ with shoulder neutral, internal rotation (IR), and external rotation (ER). Surface EMG activity was recorded from pectoralis major clavicle part and pectoralis major sternum part for 5 seconds and EMG activity was normalized to the value of maximal voluntary isometric contraction (%MVIC). Dependent variables were examined with 3 (Neutral, IR, ER) 5 (40˚, 70˚, 90˚, 130˚, 160˚) analysis of variance with repeated measures. The EMG activity of pectoralis major muscle was significantly different between shoulder abduction angles and between shoulder rotation positions (p<.05). The highest value of EMG activity of pectoralis major clavicle part among shoulder abduction angles was in 70˚ and, 90˚ in that order. The highest value of EMG activity of pectoralis major sternum part among shoulder abduction angles was in and 130˚, 90˚ in that order. According to the rotation degree, shoulder ER showed the highest value and IR showed the lowest value in both muscle parts. These results suggest that shoulder abduction 70˚, 90˚, 130˚ will be effective during manual muscle testing (MMT) and strengthening exercise for pectoralis major muscle. It is also supposed that shoulder ER is the efficient posture for strengthening of pectoralis major muscle.