Background: The serratus anterior is one of the most important muscle for maintaining good scapular alignment in the shoulder joint. The pectoralis major and upper trapezius may also compensate for weak serratus anterior muscles. The push-up plus exercise has been identified as the optimal exercise for maximum activation of the serratus anterior. Objects: The purpose of this study was to examine differences in surface electromyography (EMG) activity of upper trapezius, pectoralis major, and serratus anterior muscles during push-up plus exercises on variously angled surfaces in subjects with winged scapula. Methods: Sixteen subjects with winged scapula (male=5, female=11) volunteered for this study. The subjects performed push-up plus exercise on four different tilt angles, namely 0˚, 30˚, 60˚, and 90˚. EMG activities in the serratus anterior, upper trapezius, and pectoralis major muscles during performance of push-up plus exercise were measured in all subjects. Data were processed from repeated measures one-way analysis of variance. Results: There was significant difference in the muscle activity of the serratus anterior on the different surface angles (p＜.05). The results of the post-hoc analysis showed significantly greater serratus anterior muscle activity on a surface at a 0˚ angle than at others tilt angles (p＜.05). There was also significant difference in the ratio of serratus anterior to upper trapezius and serratus anterior to pectoralis major across the four surfaces (p＜.05), and post-hoc analysis showed significantly greater values on the 0˚ surface than on other tilts (p＜.05). Conclusion: This study found that performing push-up plus exercises on a flat surface with 0˚ and 30˚ tilt angle achieves high activation of the serratus anterior muscle for selective strengthening. It can also take into account the sequential application, which is first performed at a 30˚ and at a 0˚ tilt angle for and effective but not excessive muscle activation.

The aim of this study to investigate the effects of craniocervical flexion on muscle activities of scapular upward rotators during push-up plus exercise in subjects with winging scapula. Eighteen males with scapular winging were recruited, and each subject performed knee push-up plus and other exercises, in two conditions (craniocervical flexion vs. natural head positions). A surface electromyography (EMG) was used to measure upper trapezius (UT), serratus anterior (SA), and lower trapezius (LT) muscle activity. A paired t-test was used to determine the statistical significance between the different condition with/without applying of craniocervical flexion. UT EMG activity significantly decreased and SA EMG activity significantly increased during knee push-up plus involving the craniocervical flexion compared to the natural head position. However, no significant differences (p>.05) were found in the activity of the LT muscle. The UT/SA ratios with and without craniocervical flexion showed a significant difference (p<.05). These results showed that the knee push-up plus other exercises performed with craniocervical flexion could strengthen the serratus anterior muscle and minimize the activity of the UT muscle.

The present study examined the effects of functional electrical stimulus( group 1), proprioceptive neuromuscular facilitation(group 2) and combined training of functional electrical stimulus and proprioceptive neuromuscular facilitation(group 3) with scapula adductor muscles on scapula movement, upper limb function and gait in fifteen subjects stroke patients. The training was thirty minutes a day, five times a week for six weeks, obtained result as follow, upper limb function was significant difference in the group 2(p<.05) but no significant difference in other groups. The change of weight bearing were significant difference in all the groups(p<.05), and increase of gait velocity were significant difference in all the group(p<.05). In conclusion, when applied with functional electrical stimulus, proprioceptive neuromuscular facilitation and combined training to the scapular adductor muscles, it was oberved in the course of the experiment that proprioceptive neuromuscular facilitation was the most effective treatment among the three methods applied to the scapula adductors.

This study was conducted to find the effects of scapular taping on muscle activities of the scapular rotators and upper trapezius pain in subjects with upper trapezius pain. Fifteen male subjects were recruited from Yonsei University for this study. Muscle activity of upper trapezius, lower trapezius, and serratus anterior was measured using surface electromyography. Visual analog scale was used for measuring upper trapezius pain. The subjects were asked to maintain shoulder flexion position with holding a 1 kg dumbbell in standing position. Scapular taping was applied over the muscle belly of the upper trapezius and attached parallel with the lower trapezius muscle fibers. For normalization, % maximal voluntary isometric contraction (%MVIC) was conducted. Paired t-test was applied to compare the muscle activities of scapular rotator and upper trapezius pain before and after applying the scapular taping. The muscle activity of the upper trapezius muscle and serratus anterior decreased significantly after tape application (p<.05). However, no significant difference was observed in lower trapezius muscle. The level of pain in the upper trapezius muscle significantly decreased after tape application (p<.05). The results of this study suggest that scapular taping can be used an additional therapy for reducing muscle activity of upper trapezius, serratus anterior and upper trapezius pain during shoulder flexion in patient with upper trapezius pain.

견갑골의 골절 유․무와 외상에 의한 탈구를 진단하는데 있어 견갑골의 정측면상의 영상을 얻는 것이 매우 중요하 다. 본 연구의 목적은 견갑골 측방향 촬영시 한국인 성인을 대상으로 견갑골의 정측면상을 얻는데 가장 적합한 회전 각도를 알아보는데 있다. 견갑골의 촬영을 위해 내원한 환자 20명(여 8명)을 대상으로 하였고 이들의 평균연령은 35.4 세(15세부터 66세)였다. 수동각도기의 거상각도를 30°, 40°, 45°로 하여 전 후방향 촬영하였다. 영상의 평가는 전문가 5명이 내측연과 외측연의 완전겹침이 있는 영상은 4점, 내측연과 외측연이 불완전 겹침이 있는 영상은 3점, 견갑골체 내측연과 외측연이 겹침이 없는 영상은 2점, 내측연과 외측연이 사방향으로 나타난 영상은 1점으로 4단계로 나누어 blind test를 하여 평가하였다. 평가한 각도별 평균점수는 30°가 1.53±0.39점, 40°가 3.83±0.15점, 45°가 2.17±0.43 점으로 나타났다. 또한 가 슴둘레가 100cm이상인 군과 100cm이하인 군 간에는 유의한 차이가(p<0. 05) 없었고, 남자와 여자 간에도 역시 유의 한 차이가 없는 것으로 나타났다. 지금까지 견갑골 정측면상을 얻는데 적합한 환자의 회전각도에 관한 연구가 없었으 나, 본 연구를 통해 검사측을 40° 회전하며 검사측 상완골을 반대쪽으로 들며 촬영하는 것이 한국인 성인에서 견갑골 의 정측면상을 얻는데 가장 적합하다는 결론을 얻었다. 본 연구 결과는 향후 견갑골의 측방향 촬영을 하는데 유용할 것으로 사료된다.