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Phys. Ther. Korea 2019; 26(3): 1-10

Published online August 31, 2019

https://doi.org/10.12674/ptk.2019.26.3.001

© Korean Research Society of Physical Therapy

날개 어깨뼈 대상자들에게 어깨 내밈 운동시 벌림 각도와 외부 무게에 따른 앞톱니근, 큰가슴근, 위 등세모근의 활성도 및 비율에 미치는 영향

야담바담허럴1, 김태호2, 박한규3

1대구대학교 대학원 물리치료학과,
2대구대학교 재활과학대학 물리치료학과,
3동주대학교 물리치료과

Effect on the Activity and Ratio of the Serratus Anterior, Pectoralis Major, and Upper Trapezius according to the Angle of Abduction and External Weight During Shoulder Protraction Exercise for Winged Scapular Subjects

Yadam BadamKhorl1, Tae-ho Kim2, and Han-kyu Park3

1Dept. of Physical Therapy, The Graduate School, Daegu University,
2Dept. of Physical Therapy, College of Rehabilitation Science, Daegu University,
3Dept. of Physical Therapy, Dong-ju College

Correspondence to: Han-kyu Park hanqy@naver.com

Received: June 19, 2019; Revised: June 19, 2019; Accepted: August 6, 2019

Abstract

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Background:

Winged scapular (WS) causes muscle imbalance with abnormal patterns when moving the arm. In particular, the over-activation of the upper trapezius (UT) and decrease in activity of the lower trapezius (LT) and serratus anterior (SA) produce abnormal scapulohumeral rhythm. Therefore, the SA requires special attention in all shoulder rehabilitation programs. In fact, many previous studies have been devoted to the SA muscle strength training needed for WS correction.

Objects:

The purpose of this study was to investigate the effect of shoulder girdle muscle and ratio according to the angle of shoulder abduction and external weight in supine position.

Methods:

Twenty three WS patients participated in this experiment. They performed scapular protraction exercise in supine position with the weights of 0 ㎏, 1 ㎏, 1.5 ㎏, and 2 ㎏ at shoulder abduction angles of 0°, 30°, 60°, and 90°. The angle and weight applications were randomized. Surface electromyography (EMG) was used to collect the EMG data of the SA, pectoralis major (PM), and UT during the exercise. The ratio of PM/SA and UT/SA was confirmed. Two-way repeated analyses of variance were used to determine the statistical significance of SA, PM, and UT and the ratios of PM/SA and UT/SA.

Results:

There was a significant difference in SA according to angle (p<.05). Significant differences were also identified depending on the angle and weight (p<.05). The angle of abduction at 0°, 30° and weight of 2 ㎏ showed the highest SA activity. However, there was no significant difference between PM and UT (p>.05). There was a significant difference between PM/SA and UT/SA in ratio of muscle activity according to angle (p<.05). Significant differences were found at PM/SA angles of 30°, 60° and 90° (p<.05). For UT/SA, significant difference was only observed at 90° (p<.05).

Conclusion:

Based on the results of this study, in order to strengthen the SA, it was found to be most effective to use 1 and 1.5 ㎏ weights with abduction angles of 0° and 30° at shoulder protraction in supine position.

Keywords: Pectoralis major, Serratus anterior, Shoulder protraction, Upper trapezius, Winged scapular

Article

ARTICLE

Phys. Ther. Korea 2019; 26(3): 1-10

Published online August 31, 2019 https://doi.org/10.12674/ptk.2019.26.3.001

Copyright © Korean Research Society of Physical Therapy.

날개 어깨뼈 대상자들에게 어깨 내밈 운동시 벌림 각도와 외부 무게에 따른 앞톱니근, 큰가슴근, 위 등세모근의 활성도 및 비율에 미치는 영향

야담바담허럴1, 김태호2, 박한규3

1대구대학교 대학원 물리치료학과,
2대구대학교 재활과학대학 물리치료학과,
3동주대학교 물리치료과

Received: June 19, 2019; Revised: June 19, 2019; Accepted: August 6, 2019

Effect on the Activity and Ratio of the Serratus Anterior, Pectoralis Major, and Upper Trapezius according to the Angle of Abduction and External Weight During Shoulder Protraction Exercise for Winged Scapular Subjects

Yadam BadamKhorl1, Tae-ho Kim2, and Han-kyu Park3

1Dept. of Physical Therapy, The Graduate School, Daegu University,
2Dept. of Physical Therapy, College of Rehabilitation Science, Daegu University,
3Dept. of Physical Therapy, Dong-ju College

Correspondence to:Han-kyu Park hanqy@naver.com

Received: June 19, 2019; Revised: June 19, 2019; Accepted: August 6, 2019

Abstract

Background:

Winged scapular (WS) causes muscle imbalance with abnormal patterns when moving the arm. In particular, the over-activation of the upper trapezius (UT) and decrease in activity of the lower trapezius (LT) and serratus anterior (SA) produce abnormal scapulohumeral rhythm. Therefore, the SA requires special attention in all shoulder rehabilitation programs. In fact, many previous studies have been devoted to the SA muscle strength training needed for WS correction.

Objects:

The purpose of this study was to investigate the effect of shoulder girdle muscle and ratio according to the angle of shoulder abduction and external weight in supine position.

Methods:

Twenty three WS patients participated in this experiment. They performed scapular protraction exercise in supine position with the weights of 0 ㎏, 1 ㎏, 1.5 ㎏, and 2 ㎏ at shoulder abduction angles of 0°, 30°, 60°, and 90°. The angle and weight applications were randomized. Surface electromyography (EMG) was used to collect the EMG data of the SA, pectoralis major (PM), and UT during the exercise. The ratio of PM/SA and UT/SA was confirmed. Two-way repeated analyses of variance were used to determine the statistical significance of SA, PM, and UT and the ratios of PM/SA and UT/SA.

Results:

There was a significant difference in SA according to angle (p<.05). Significant differences were also identified depending on the angle and weight (p<.05). The angle of abduction at 0°, 30° and weight of 2 ㎏ showed the highest SA activity. However, there was no significant difference between PM and UT (p>.05). There was a significant difference between PM/SA and UT/SA in ratio of muscle activity according to angle (p<.05). Significant differences were found at PM/SA angles of 30°, 60° and 90° (p<.05). For UT/SA, significant difference was only observed at 90° (p<.05).

Conclusion:

Based on the results of this study, in order to strengthen the SA, it was found to be most effective to use 1 and 1.5 ㎏ weights with abduction angles of 0° and 30° at shoulder protraction in supine position.

Keywords: Pectoralis major, Serratus anterior, Shoulder protraction, Upper trapezius, Winged scapular

Fig 1.

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Figure 1.

Protraction exercise according to four abduction angle and weight (2 ㎏) (A: Shoulder abduction 0˚, B: Shoulder abduction 30˚, C: Shoulder abduction 60˚, D: Shoulder abduction 90˚).

Physical Therapy Korea 2019; 26: 1-10https://doi.org/10.12674/ptk.2019.26.3.001

Fig 2.

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Figure 2.

Comparison of serratus anterior activity by weight and angle of abduction (*p<.05).

Physical Therapy Korea 2019; 26: 1-10https://doi.org/10.12674/ptk.2019.26.3.001

Fig 3.

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Figure 3.

Comparison of ratio by weight and angle of abduction (A: PM/SA ratio, B: UT/SA ratio, PM: pectoralis major, SA: serratus anterior, UT: upper trapezius, *p<.05).

Physical Therapy Korea 2019; 26: 1-10https://doi.org/10.12674/ptk.2019.26.3.001

Table 1 . General characteristics of subject (N=23).


Table 2 . Muscle activities according to weight and angle of shoulder abduction of each muscle.


Table 3 . Ratio of muscle activities according to weight and angle of shoulder abduction of PM/SA and UT/SA.