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Kim HA, Hwang UJ, Jung SH, Ahn SH, Kim JH, Kwon OY. Comparison of shoulder strength in males with and without myofascial trigger points in the upper trapezius. Clin Biomech (Bristol, Avon) 2017; 49:134-138. [PMID: 28934634 DOI: 10.1016/j.clinbiomech.2017.09.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 08/31/2017] [Accepted: 09/01/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study was conducted in order to compare the strength of scapular elevator and shoulder abductor with and without restricted scapular elevation between male subjects with and without myofascial trigger points in the upper trapezius. METHODS In total, 15 male subjects with myofascial trigger points, and 15age- and weight-matched male subjects without myofascial trigger points in the upper trapezius. Each subject was measured in the strength of maximum isometric scapular elevation and shoulder abduction with and without restricted scapular elevation. Maximum isometric contractions were measured using the Smart KEMA strength measurement system. Independent t-tests were used to compare shoulder strength values between the myofascial trigger points and non- myofascial trigger points groups. FINDING The results showed that shoulder abductor strength in the group with myofascial trigger points (5.64kgf) was significantly lower than in the group without myofascial trigger points (11.96kgf) when scapular elevation was restricted (p<0.05). However, there was no significant difference in the strength of the scapular elevator or shoulder abductor between groups (p>0.05). INTERPRETATION These findings suggest that decreased strength in the shoulder abductor with restricted scapular elevation should be considered in evaluating and treating individuals with myofascial trigger points of the upper trapezius.
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Comparative Study |
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Hwang UJ, Kwon OY, Yi CH, Jeon HS, Weon JH, Ha SM. Predictors of upper trapezius pain with myofascial trigger points in food service workers: The STROBE study. Medicine (Baltimore) 2017; 96:e7252. [PMID: 28658117 PMCID: PMC5500039 DOI: 10.1097/md.0000000000007252] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Shoulder pain occurs commonly in food service workers (FSWs) who repetitively perform motions of the upper limbs. Myofascial trigger points (MTrPs) on the upper trapezius (UT) are among the most common musculoskeletal shoulder pain syndromes. This study determined the psychological, posture, mobility, and strength factors associated with pain severity in FSWs with UT pain due to MTrPs.In this cross-sectional study, we measured 17 variables in 163 FSWs with UT pain due to MTrPs: a visual analog scale (VAS) pain score, age, sex, Borg rating of perceived exertion (BRPE) scale, beck depression inventory, forward head posture angle, rounded shoulder angle (RSA), shoulder slope angle, scapular downward rotation ratio, cervical lateral-bending side difference angle, cervical rotation side difference angle, glenohumeral internal rotation angle, shoulder horizontal adduction angle, serratus anterior (SA) strength, lower trapezius (LT) strength, bicep strength, and glenohumeral external rotator strength, in 163 FSWs with UT pain due to MTrPs.The model for factors influencing UT pain with MTrPs included SA strength, age, BRPE, LT strength, and RSA as predictor variables that accounted for 68.7% of the variance in VAS (P < .001) in multiple regression models with a stepwise selection procedure. The following were independent variables influencing the VAS in the order of standardized coefficients: SA strength (β = -0.380), age (β = 0.287), BRPE (β = 0.239), LT strength (β = -0.195), and RSA (β = 0.125).SA strength, age, BRPE, LT strength, and RSA variables should be considered when evaluating and intervening in UT pain with MTrPs in FSWs.
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Observational Study |
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Jung SH, Hwang UJ, Kim JH, Gwak GT, Kwon OY. Effects of horizontal shoulder abduction and adduction on the activity and strength of the scapular protractors. J Electromyogr Kinesiol 2017; 37:155-159. [PMID: 29102878 DOI: 10.1016/j.jelekin.2017.10.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/20/2017] [Accepted: 10/23/2017] [Indexed: 11/20/2022] Open
Abstract
Increased activity of the serratus anterior (SA) muscle combined with decreased activity of the pectoralis major (PM) muscle during scapular protraction exercise is a widely used method for selective strengthening of the former muscle. However, the role played by the PM during maximal scapular protraction remains unclear. The objective of our study was to investigate the effects of horizontal shoulder abduction (decreasing PM activity) and adduction (increasing activity) on the strength and activity of the scapular protractors (the SA and PM) during maximal protraction. Twenty-nine healthy males performed maximal scapular protraction combined with horizontal shoulder abduction or adduction. The strength and activity of the PM and SA decreased significantly (both p < 0.01) during maximal scapular protraction combined with horizontal shoulder abduction, compared with maximal scapular protraction alone, but increased significantly (both p < 0.01) when maximal scapular protraction was combined with horizontal shoulder adduction. We thus conclude that the PM stabilizes the activated SA during maximal scapular protraction, which effectively increases SA activity and scapular protraction strength in the serratus punch posture.
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Ahn SH, Hwang UJ, Gwak GT, Yoo HI, Kwon OY. Comparison of the Strength and Electromyography of the Evertor Muscles With and Without Toe Flexion in Patients With Chronic Ankle Instability. Foot Ankle Int 2020; 41:479-485. [PMID: 31928074 DOI: 10.1177/1071100719898464] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Weakness of evertor strength is controversial in chronic ankle instability (CAI). Ankle evertor muscles are attached to the toe joints as well as to the metatarsal bone. Therefore, it is necessary to consider toe joint position for the measurement of evertor strength. The purpose of this study was to compare ankle evertor strength and muscle activity during eversion with and without toe flexion (TF) in individuals with CAI and individuals in a healthy group. METHODS Fifteen subjects with CAI and 15 healthy subjects participated in this study. Isometric ankle evertor strength and muscle activity of the peroneus longus (PL), peroneus brevis (PB), and extensor digitorum longus (EDL) were measured during eversion with and without TF. RESULTS The results indicated a significant interaction effect in evertor strength (P = .03) and no significant interaction effect on EMG of the PL (P = .08), PB (P = .12), and EDL (P = .28). However, measurements of muscle activity of the PL and PB between eversion with and without TF revealed a significant difference in the CAI group (P < .01) and no significant difference in the healthy group (PL: P = .07; PB: P = .13). CONCLUSION The results indicated that subjects with CAI had increased EDL compensation and reduced selective activation of the PL and PB during eversion. CLINICAL RELEVANCE Our findings suggest that clinicians should consider the activation of EDL when training the evertor of patients with CAI.
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Comparative Study |
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Hwang UJ, Kwon OY, Jung SH, Ahn SH, Kim HA. Predictors of pain intensity and Oswestry Disability Index in prolonged standing service workers with nonspecific chronic low back pain subclassified as active extension pattern. Musculoskelet Sci Pract 2019; 40:58-64. [PMID: 30710825 DOI: 10.1016/j.msksp.2019.01.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 12/14/2018] [Accepted: 01/25/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Because patients with nonspecific chronic low back pain (NSCLBP) are heterogeneous, subgrouping patients with NSCLBP might clarify the research findings. NSCLBP in the direction of extension movement, namely active extension pattern (AEP), is common during prolonged standing. OBJECTIVE Predictors of pain intensity and dysfunction were determined in prolonged standing service workers (PSSWs) with NSCLBP subclassified as AEP in the motor impairment subgroup. METHODS Variables were measured using questionnaires including a visual analog scale (VAS), the Oswestry Disability Index (ODI), Borg Rating of Perceived Exertion (RPE) Scale, and Korean Occupational Stress Scale (KOSS). Postural assessment was performed by measuring pelvic anterior tilting angle (PATA). The smart KEMA measurement system was used to evaluate hip flexion, hip extension (HE), and knee flexion range of motion (ROM), as well as hip extensor strength, hip abductor strength (HArS), hip external rotator strength (HERrS), hip internal rotator strength, knee extensor strength, and knee flexor strength, and lumbopelvic stability (LS) in 78 PSSWs with NSCLBP subclassified as AEP. RESULTS In prediction models, HArS, LS, PATA, KOSS and HE ROM accounted for 40.1% of the variance in the VAS (p < 0.05); predictors of dysfunction included the HERrS and age, which accounted for 11.9% of the variance in the ODI (p < 0.05) in multiple regression models when using a stepwise selection procedure. CONCLUSIONS The present results indicate that HArS and HERrS, LS, PATA, KOSS, HE ROM and age should be considered for evaluating and predicting NSCLBP subclassified as AEP in PSSWs, and when designing interventions.
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Hwang UJ, Jung SH, Kim HA, Kim JH, Kwon OY. Effect of Abdominal Electrical Muscle Stimulation Training With and Without Superimposed Voluntary Muscular Contraction on Lumbopelvic Control. J Sport Rehabil 2020; 29:1137-1144. [PMID: 31910395 DOI: 10.1123/jsr.2019-0348] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/21/2019] [Accepted: 10/23/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT Electrical muscle stimulation (EMS) was designed for artificial muscle activation or superimposed training. OBJECTIVES To compare the effects of 8 weeks of superimposed technique (ST; application of electrical stimulation during a voluntary muscle action) and EMS on the cross-sectional area of the rectus abdominis, lateral abdominal wall, and on lumbopelvic control. SETTING University research laboratory. DESIGN Randomized controlled trial. PARTICIPANTS Fifty healthy subjects were recruited and randomly assigned to either the ST or EMS group. INTERVENTION The participants engaged with the electrical stimulation techniques (ST or EMS) for 8 weeks. MAIN OUTCOME MEASURES In all participants, the cross-sectional area of the rectus abdominis and lateral abdominal wall was measured by magnetic resonance imaging and lumbopelvic control, quantified using the single-leg and double-leg lowering tests. RESULTS There were no significant differences in the cross-sectional area of the rectus abdominis (right: P = .70, left: P = .99) or lateral abdominal wall (right: P = .07, left: P = .69) between groups. There was a significant difference between groups in the double-leg lowering test (P = .03), but not in the single-leg lowering test (P = .88). There were significant differences between the preintervention and postintervention in the single-leg (P < .001) and double-leg lowering tests (P < .001). CONCLUSIONS ST could improve lumbopelvic control in the context of athletic training and fitness.
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Comparative Study |
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Hwang UJ, Lee MS, Jung SH, Ahn SH, Kwon OY. Pelvic Floor Muscle Parameters Affect Sexual Function After 8 Weeks of Transcutaneous Electrical Stimulation in Women with Stress Urinary Incontinence. Sex Med 2019; 7:505-513. [PMID: 31563553 PMCID: PMC6963109 DOI: 10.1016/j.esxm.2019.08.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/08/2019] [Accepted: 08/27/2019] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Stress urinary incontinence (SUI) is often associated with female sexual dysfunction. We investigated which pelvic floor muscle (PFM) parameters (strength, power, and endurance) are associated with improvement of sexual function after 8 weeks of transcutaneous electrical stimulation (TES) training. AIM This study was performed to determine the effects of TES in the seated position on PFM parameters and female sexual function and to identify correlation between improved PFM parameters and sexual function after 8 weeks of TES training in women with SUI. METHODS The present study was performed between August 2018 and November 2018 in women with SUI who were randomized into a TES group (n = 17) or a control group (n = 17). One subject in each of the TES and control groups ultimately withdrew during the intervention due to a lack of time. Both groups were measured at baseline and after 8 weeks of intervention. MAIN OUTCOME MEASURE As outcome measures, PFM parameters (strength, power, and endurance) and female sexual function were assessed using a perineometer and the Female Sexual Function Index (FSFI), respectively. RESULTS The final study population consisted of 32 women with SUI. There were significant differences in PFM strength, power, and endurance and FSFI domain scores (desire, arousal, orgasm, satisfaction, and total score) in both between-group analyses (TES vs control group) and within-group analyses (pre-TES vs post-TSE). Change in PFM endurance had the highest association with change in total FSFI total score (r = 0.437; P = .006), and change in PFM power had the highest association with change in FSFI satisfaction (r = 0.420; P = .008). CONCLUSION TES in a seated position showed a beneficial effect on sexual function in females with SUI. Consideration of PFM parameters associated with FSFI domain scores may be important when developing intervention guidelines to improve female sexual function. Hwang UJ, Lee MS, Jung SH, et al. Pelvic Floor Muscle Parameters Affect Sexual Function After 8 Weeks of Transcutaneous Electrical Stimulation in Women with Stress Urinary Incontinence. Sex Med 2019;7:505-513.
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Journal Article |
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Ahn SH, Hwang UJ, Jung SH, Kim HA, Kim JH, Kwon OY. Hip External Rotator Strength and Compensatory Movement in Three Different Positions. Health (London) 2018. [DOI: 10.4236/health.2018.101011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hwang UJ, Lee MS, Jung SH, Ahn SH, Kwon OY. Which pelvic floor muscle functions are associated with improved subjective and objective symptoms after 8 weeks of surface electrical stimulation in women with stress urinary incontinence? Eur J Obstet Gynecol Reprod Biol 2020; 247:16-21. [PMID: 32058185 DOI: 10.1016/j.ejogrb.2020.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 02/04/2020] [Accepted: 02/04/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Stress urinary incontinence (SUI) is defined as involuntary urine loss during effort, sneezing, or coughing. We investigated which pelvic floor muscle (PFM) functions (muscle strength, power, and endurance) are associated with improvement in subjective and objective symptoms after 8 weeks of surface electrical stimulation (SES) training. This study was performed to determine the effects of SES in the seated position on PFM functions and subjective and objective symptoms, and to identify predictors of improved subjective and objective symptoms after 8 weeks of SES training via secondary analysis of females with SUI. STUDY DESIGN The study was performed between August 2018 and December 2018. Patients with SUI were randomized into an SES group (n = 17) and a control group (n = 17). Both groups were assessed pre-intervention and after 8 weeks of intervention. The outcome measures were PFM functions (strength, power, and endurance) as measured via perineometry, the score on the urogenital distress inventory-6 (UDI-6), and the ultra-short perineal pad test result. RESULTS Significant differences in all PFM functions, the UDI-6 score, and the pad weight were evident both between the groups (SES vs. control group) and within the groups (pre-SES vs. post-SES). On regression of factors predicting relative changes in subjective and objective symptoms, the relative change in PFM power accounted for 15 and 13 % of the variance in the UDI-6 score (P < 0.05) and pad weight (P < 0.05), respectively. CONCLUSIONS SES in a seated position improved both subjective and objective symptoms in females with SUI. PFM power, the UDI-6 score, and the pad weight test result should be considered when developing intervention guidelines to improve the subjective and objective symptoms of females with SUI.
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Randomized Controlled Trial |
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Kim SH, Kwon OY, Park KN, Hwang UJ. Leg lateral reach test: The reliability and correlation with thoraco-lumbo-pelvic rotation range. J Sci Med Sport 2016; 20:2-5. [PMID: 27210501 DOI: 10.1016/j.jsams.2016.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 04/12/2016] [Accepted: 04/14/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of the present study was to examine the intra- and inter-rater reliabilities of the leg lateral reach test as a screening tool for thoraco-lumbo-pelvic rotation and to assess the relationship between leg lateral reach distance and thoraco-lumbo-pelvic rotation range in a supine position. DESIGN Controlled laboratory study. METHODS Thirty-six physically active participants were recruited. The leg lateral reach test was performed over 2 days. In the first session, two testers measured the distance of the leg lateral reach to determine the within-day inter-rater reliability, and one tester repeated the measurement on day 2 to determine the intra-rater reliability between days. The leg lateral reach test was performed three times per leg, and the mean value was used for data analysis. Reliability was determined using the intraclass correlation coefficient, standard error of measurement, and minimal detectable change. The correlation between leg lateral reach distance and thoraco-lumbo-pelvic rotation range was determined using Pearson correlation. RESULTS Almost perfect intra- and inter-rater reliabilities were shown for the test [intraclass correlation coefficient2,3=0.97 (95% confidence interval=0.914-0.984) and 0.99 (0.974-0.996), respectively]. The within-day inter-rater standard error of measurement was 1.40cm, and the minimal detectable change was 3.87cm. The between-day intra-rater standard error of measurement was 2.66cm, and the minimal detectable change was 7.37cm. The Pearson correlation showed a moderate to good correlation between the leg lateral reach distance and the thoraco-lumbo-pelvic rotation range (r=0.73). CONCLUSIONS The leg lateral reach screening test is reliable for measuring thoraco-lumbo-pelvic rotation range and allows for practical measurement of the thoraco-lumbo-pelvic rotation range in a supine position.
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Kim JH, Kwon OY, Hwang UJ, Jung SH, Ahn SH, Kim HA. Comparison of the Shoulder External Rotator Strength and Asymmetry Ratio Between Workers With and Without Shoulder Impingement Syndrome. J Strength Cond Res 2021; 35:3364-3369. [PMID: 31567841 DOI: 10.1519/jsc.0000000000003343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Kim, J-H, Kwon, O-Y, Hwang, U-J, Jung, S-H, Ahn, S-H, and Kim, H-A. Comparison of shoulder external rotator strength and the asymmetry ratio between workers with and without shoulder impingement syndrome. J Strength Cond Res 35(12): 3364-3369, 2021-Shoulder impingement syndrome (SIS) is the most common shoulder problem causing shoulder pain. Several studies have indicated that shoulder external rotator muscles provide dynamic stability to the shoulder joint. However, the relationship of SIS to changes in shoulder external rotator muscle strength remains controversial. The purpose of the study was to compare the shoulder external rotator strength and asymmetry ratio between workers with SIS and the normal group in a side-lying position. Twelve male industrial workers with SIS and the normal group of 12 workers participated in this study. A pulling sensor measured shoulder external rotator muscle strength in a side-lying position with the shoulder at 0° and 90° of flexion. The asymmetry ratio was calculated by a specific formula using the shoulder external rotator muscle strength of the dominant side and the unaffected side. Two-way analysis of variance was used to determine between-group differences in shoulder external rotator muscle strength and the asymmetry ratio among the 2 positions. Subjects with SIS did not exhibit significant differences in shoulder external rotator muscle strength in the side-lying position with the shoulder at 0° and 90° of flexion relative to the normal group. However, subjects with SIS had a significantly increased asymmetry ratio of shoulder external rotation strength in the side-lying position with the shoulder at 90° of flexion compared with the normal group. In conclusion, workers with SIS had an asymmetry of shoulder external rotator strength in side-lying with the shoulder at 90° of flexion.
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Hwang UJ, Lee MS. Relationship between female sexual function, vaginal volume, vaginal resting tone, and pelvic floor muscle strength in women with stress urinary incontinence. Obstet Gynecol Sci 2023:ogs.23057. [PMID: 37078134 PMCID: PMC10375215 DOI: 10.5468/ogs.23057] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/15/2023] [Indexed: 04/21/2023] Open
Abstract
Objective Vaginal morphology and pelvic floor muscle (PFM) strength may influence sexual stimulation, sensation, and orgasmic response. This study aimed to determine the relationship between female sexual function and PFM strength and vaginal morphology (represented by vaginal resting tone and vaginal volume) in women with stress urinary incontinence (SUI). Methods Forty-two subjects with SUI were recruited for the study. Female sexual function was measured using the female sexual function index (FSFI) questionnaire. PFM strength was measured by digital palpation. Vaginal resting tone (mmHg) and vaginal volume (mL) were measured using a perineometer. The significance of the correlations between female sexual function and PFM function and hip muscle strength was assessed using Pearson's correlation coefficients. If a significant correlation between vaginal morphology and FSFI score was confirmed using Pearson's correlation, the cutoff value was confirmed through a decision tree. Results PFM strength was significantly correlated with desire (r=0.397), arousal (r=0.388), satisfaction (r=0.326), and total (r=0.315) FSFI scores. Vaginal resting tone (r=-0.432) and vaginal volume (r=0.332) were significantly correlated with the FSFI pain score. The cutoff point of vaginal resting tone for the presence of pain-related sexual dysfunction was >15.2 mmHg. Conclusion PFM strength training should be the first strategy to improve female sexual function. Additionally, because of the relationship between vaginal morphology and pain-related sexual dysfunction, surgical procedures to achieve vaginal rejuvenation should be carefully considered.
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Hwang UJ, Kwon OY, Jung SH, Kim HA, Gwak GT. Effect of neuromuscular electrical stimulation training for abdominal muscles on change of muscle size, strength, endurance and lumbopelvic stability. J Sports Med Phys Fitness 2020; 60:206-213. [PMID: 32125124 DOI: 10.23736/s0022-4707.19.09998-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Neuromuscular electrical stimulation (NMES) devices for abdominal muscles are being marketed to the general public to improve physical appearance. Abdominal muscles play an important role in lumbopelvic stability for optimizing performance. We investigated the effects of NMES training of abdominal muscles on muscle size, muscle strength, endurance, and lumbopelvic stability. METHODS Twenty-three subjects (12 females, 11 males) performed abdominal muscle NMES training for 8 weeks. Before and after NMES training, we measured muscle size (cross-sectional area [CSA] of the rectus abdominals [RA] and lateral abdominal wall [LAW]) by magnetic resonance imaging, muscle strength (trunk flexor and side bridge strength), endurance (trunk flexor and side bridge endurance time), and lumbopelvic stability (one-leg loading test). RESULTS There were significant increases between pre- and post-NMES training differences in the size (CSA of RA 21.7-25.4%, P<0.001; CSA of LAW 9.00-9.71%, P<0.001), strength (trunk flexor 14.9%, P<0.05; side bridge 33.7-53.6%, P<0.05), and endurance (trunk flexor 29.1%, P<0.05; side bridge 24.6-28.9%, P<0.05) of abdominal muscles and lumbopelvic stability (37.2-37.4%, P<0.05). CONCLUSIONS NMES training could be applied to increase muscle size and muscle performances of abdominal muscles in sports and fitness fields.
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Joung HN, Yi CH, Jeon HS, Hwang UJ, Kwon OY. Effects of 4-week self-cross body stretching with scapular stabilization on shoulder motions and horizontal adductor strength in subjects with limited shoulder horizontal adduction: cross body stretching with stabilization. J Sports Med Phys Fitness 2018; 59:456-461. [PMID: 29845835 DOI: 10.23736/s0022-4707.18.08454-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Posterior shoulder tightness is related to shoulder conditions such as shoulder impingement and limited shoulder horizontal adduction (SHA). The purpose of this study was to compare the effects of self-cross body stretching (CBS) with and without scapular stabilization (SS) on SHA and shoulder internal rotation (SIR) range of motion (ROM) and shoulder horizontal adductor strength (SHAS) in subjects with limited SHA. METHODS Twenty-six subjects (14 males, 12 females) with limited SHA was participated in this study. The SS group and without stabilization (WS) group were assigned randomly. The SS group performed self-CBS with SS by applying belt just under the subject's axilla. The subjects were asked to perform self-CBS 4 times a week for 4 weeks. SHA and SIR RM were measured by Clinometer smartphone application, and SHAS by hand-held dynamometer before and after 4-week self-CBS. RESULTS 2 × 2 mixed analysis of variance (ANOVA) was used to identify the significance. If there was an interaction effect, t-test was used to confirm the simple effect. There was a significant interaction in SHA ROM and SHAS. The post-test value of SHA ROM was significantly greater in SS group than WS group (P<0.0125). In SHAS, there was no significant difference between groups (P>0.0125). CONCLUSIONS SS during self-CBS could enhance to improve SHA, SIR ROM, and SHAS in individuals with limited SHA.
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Yoo HI, Hwang UJ, Ahn SH, Gwak GT, Kwon OY. Comparison of pelvic rotation angle in the transverse plane in the supine position and during active straight leg raise between people with and without nonspecific low back pain. Clin Biomech (Bristol, Avon) 2021; 83:105310. [PMID: 33721727 DOI: 10.1016/j.clinbiomech.2021.105310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Faults in postural alignment and movement of the pelvis are associated with non-specific low back pain. However, limited studies have investigated the differences in pelvic rotation angle in the transverse plane in the supine position and during active straight leg raise between subjects with and without non-specific low back pain. METHODS Thirty-one subjects with non-specific low back pain and 31 subjects without non-specific low back pain were examined. Angular measures of the pelvic rotation angle in the transverse plane were obtained in the supine position and during active straight leg raise using a Smart KEMA measurement system. FINDING The pelvic rotation angle in the transverse plane during active straight leg raise was significantly greater in subjects with non-specific low back pain than in healthy subjects (p < 0.05). However, the pelvic rotation angle in the transverse plane in the supine position and asymmetry index of the pelvic rotation angle during active straight leg raise were not significantly different between subjects with and those without non-specific low back pain. INTERPRETATION This indicates that a greater pelvic rotation angle in the transverse plane during active straight leg raise could be contributing factors to the development of a non-specific low back pain related to lumbopelvic instability.
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Ahn SH, Kwon OY, Hwang UJ, Jung SH, Kim HA, Kim JH. The association between genu recurvatum angle and the strength of the hip and knee muscles in standing workers. Work 2020; 66:173-181. [PMID: 32417824 DOI: 10.3233/wor-203161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Increased genu recurvatum (GR) angle is a risk factor for knee injury. Identification of factors causing GR is important for the prevention and rehabilitation of GR. Few studies have investigated the association between muscle strength and GR. OBJECTIVE To examine the association between GR angle and hip and knee muscle strength in standing workersMETHODS:The participants in this study were 110 healthy volunteers (59 male, 51 female) who performed standing work in a theme park. The GR angle, muscle strength, and strength ratio of the lower extremities were measured to determine their associations with GR. The GR angle was measured using a Smart KEMA motion sensor, and muscle strength was assessed using a Smart KEMA strength sensor. Stepwise multiple regression models were used to investigate which muscles contributed most to the extent of the GR angle. RESULTS Stepwise multiple regression analysis showed that the decreased hip external rotator to hip internal rotator ratio, increased knee extensor to knee flexor ratio, and young age were associated with an increased GR angle. CONCLUSIONS Many factors are known to increase the GR angle. However, this study investigated the roles of only hip and knee muscle strength. The results suggest that muscle strength ratios are more important than the weakness of any muscle.
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Park HY, Hwang UJ, Kwon OY. Correlation between trunk rotation and lateral flexion range of motion, peak cough flow, and chest expansion in stroke patients. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2023; 28:e1970. [PMID: 35962597 DOI: 10.1002/pri.1970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/28/2022] [Accepted: 07/21/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Stroke patients have problems with voluntary movement and trunk control. Moreover, the respiratory function in stroke patients is affected by neurological impairment, which increases the incidence of respiratory complications. OBJECTIVES To determine the correlation between trunk rotation range of motion (TRROM) and trunk lateral flexion range of motion (TLFROM), peak cough flow (PCF), and chest expansion in stroke patients. METHODS This was an observational study involving 21 patients with a clinical diagnosis of stroke from October 2021 to January 2022. TRROM and TLFROM were assessed using smartphone applications (Compass and Clinometer), respectively, PCF was assessed using a peak flow meter, and chest expansion was assessed using a tape measure. Pearson's correlation was used to analyze the relationships between the variables. RESULTS Statistically significant correlations were found between TRROM and TLFROM (r = 0.91, p < 0.01) and between upper chest expansion and PCF (r = 0.59, p < 0.01). There were significant correlations between lower chest expansion and TRROM (r = 0.50, p < 0.05) and between lower chest expansion and TLFROM (r = 0.51, p < 0.05). CONCLUSION This study demonstrates the relationship between upper chest expansion and PCF. Upper chest expansion exercises should be considered to improve the PCF in stroke patients. In addition, a very strong positive correlation between TRROM and TLFROM was demonstrated. TRROM and TLFROM exercises should be considered to improve the lower chest expansion in stroke patients.
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Hwang UJ, Kwon OY. Influencing factors of pressure pain hypersensitivity of the upper trapezius in food service workers with nonspecific neck/shoulder myofascial pain: A cross-sectional study. Medicine (Baltimore) 2022; 101:e29696. [PMID: 35945777 PMCID: PMC9351888 DOI: 10.1097/md.0000000000029696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
It is unclear which factors contribute to the developing pressure pain hypersensitivity of the upper trapezius, a type of neurophysiological hyperexcitability. The present study investigated the relationship between physical and psychological factors and pressure pain hypersensitivity of the upper trapezius for each sex. In total, 154 individuals with neck/shoulder myofascial pain participated, among 372 food service workers. Participants completed a questionnaire (Beck Depression Inventory, and Borg Rating of Perceived Exertion scale) and were photographed to measure posture. Pressure pain sensitivity, 2 range of motions (cervical lateral bending and rotation), and 4 muscle strengths (serratus anterior, lower trapezius [LT], biceps, and glenohumeral external rotator) were measured by a pressure algometer, iPhone application, and handheld dynamometer, respectively. For each sex, forward multivariate logistic regression was used to test our a priori hypothesis among selected variables that a combination of psychosocial and physical factors contributed to the risk for pressure pain hypersensitivity. In multivariate analyses, LT strength (odds ratio = 0.94, 95% confidence interval = 0.91-0.97, P = .001) was the only significant influencing factor for pressure pain hypersensitivity in men. Dominant painful ipsilateral cervical rotation range of motion (odds ratio = 0.96, 95% confidence interval = 0.92-0.99, P = .037) was the only influencing factor for pressure pain hypersensitivity in women. LT strength and dominant painful ipsilateral cervical rotation range of motion could serve as guidelines for preventing and managing pressure pain hypersensitivity of the upper trapezius in food service workers with nonspecific neck/shoulder myofascial pain.
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research-article |
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Hwang UJ, Lee MS, Jung SH, Ahn SH, Kwon OY. Relationship Between Sexual Function and Pelvic Floor and Hip Muscle Strength in Women With Stress Urinary Incontinence. Sex Med 2021; 9:100325. [PMID: 33662705 PMCID: PMC8072144 DOI: 10.1016/j.esxm.2021.100325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/06/2021] [Accepted: 01/12/2021] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION The pelvic floor muscle (PFM) could affect female sexual functions. The hip muscles are morphologically and functionally linked to PFM and are important elements of female sexual attraction. AIM To determine the relationship between female sexual function and hip muscle strength and PFM functions in women with stress urinary incontinence (SUI). METHODS A total of 42 women with SUI were recruited in this study. Female sexual function was measured using the pelvic organ prolapse urinary incontinence sexual function questionnaire (PISQ). PFM functions were measured using a perineometer. Hip muscle strength was measured using a Smart KEMA tension sensor. The relationship between female sexual function and PFM function and hip muscle strength was assessed using Pearson correlation coefficients and multiple regression analyses with forward selection. MAIN OUTCOME MEASURES PISQ score, PFM functions (strength and endurance), and strength of hip extensor, abductor, and adductor were the main outcome measures. RESULTS For the behavioral/emotive domain in the PISQ, hip extensor strength (r = 0.452), PFM strength (r = 0.441), PFM endurance (r = 0.362), and hip adductor strength (r = 0.324) were significantly correlated and hip extensor strength emerged in multiple regression. For the physical domain in the PISQ, hip abductor strength (r = 0.417), PFM endurance (r = 0.356), hip adductor strength (r = 0.332), and PFM strength (r = 0.322) were significantly correlated and hip abductor strength entered in multiple regression. For partner-related domain in the PISQ, hip adductor (r = 0.386) and abductor strength (r = 0.314) were significantly correlated and hip adductor strength appeared in multiple regression. For the PISQ total score, hip extensor strength (r = 0.484), PFM endurance (r = 0.470), hip adductor strength (r = 0.424), hip abductor strength (r = 0.393), and PFM strength (r = 0.387) were significantly correlated and hip extensor strength and PFM endurance emerged in multiple regression. CONCLUSION The female sexual function could be related to not only PFM functions but also hip muscle strength in women with SUI. Hwang UJ, Lee MS, Jung SH, Ahn SH, Kwon OY. Relationship Between Sexual Function and Pelvic Floor and Hip Muscle Strength in Women With Stress Urinary Incontinence. Sex Med 2021;9:100325.
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Gwak GT, Hwang UJ, Jung SH, Kim JH, Kim MH, Kwon OY. Comparison of maximal isometric forearm supination torque in two elbow positions between subjects with and without limited forearm supination range of motion. Physiother Theory Pract 2019; 37:99-105. [PMID: 31088319 DOI: 10.1080/09593985.2019.1616342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Study Design: Cross-sectional comparison. Introduction: Forearm supination range of motion is often limited by short or stiff pronators. Many studies have examined maximal isometric forearm supination torque (MIFST). However, there is little research comparing MIFST in two elbow positions between subjects with and without limited forearm supination range of motion (LSR). Purpose of the Study: The purpose of this study was to compare MIFST in two elbow positions (90º flexed elbow, extended elbow) between subjects with and without LSR. Methods: Thirteen right-handed subjects (seven men, six women) with LSR and 13 age- and gender-matched healthy controls participated in this study. The forearm supination range of motion and MIFST were measured using a Smart KEMA system. Two-way repeated-measures analysis of variance was used to compare MIFST in two elbow positions between subjects with and without LSR. Results: No significant difference between groups (p > .05) was found. However, there was an interaction effect between elbow position and group on MIFST (p < .05). Independent t-tests were used to confirm the simple effects. In the LSR group, the value of MIFST was significantly lower in the elbow-extended position than in the group without LSR (p < .05). Conclusions: These findings indicate that elbow position should be considered when assessing the strength or increasing the strength of the supinator muscle, especially in patients with LSR.
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Journal Article |
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Hwang UJ, Kwon OY, Jeon IC, Jung SH, Kim MH. Effect of applying consistent pressure to the stationary and the moving arm on measurement reliability of glenohumeral internal rotation range of motion. Physiother Theory Pract 2018; 35:586-595. [PMID: 29578820 DOI: 10.1080/09593985.2018.1455121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES The aim of this study was to determine the inter-rater reliability of glenohumeral internal rotation (GIR) range of motion (ROM) and pressure measurements among four measurement methods: (1) Manual stabilization of the humeral head and coracoid process (MSHC) without applying consistent pressure (ACP) to both the stationary and the moving arms (BSaMA); (2) MSHC with ACP to the moving arm; (3) MSHC with ACP to the stationary arm; and (4) MSHC with ACP to BSaMA. DESIGN Test-retest analyses. PARTICIPANTS 39 subjects with GIR deficit. MAIN OUTCOME MEASURES GIR ROM and pressure were measured on the stationary or moving arm by four examiners using the Clinometer application and a pressure biofeedback unit. RESULTS GIR ROM measurement with MSHC and ACP to the moving arm resulted in the lowest intra-class correlation coefficient (ICC = .43); the ICC for MSHC without ACP to BSaMA was .54; that for MSHC with ACP to the stationary arm was .77; and that for MSHC with ACP to BSaMA was highest, at .81. CONCLUSION MSHC with ACP to both arms leads to reliable GIR ROM measurement in a clinical setting.
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Comparative Study |
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Kim JH, Hwang UJ, Jung SH, Gwak GT, Kwon OY. Immediate improvements of supination range of motion and strength following pronator teres muscle friction massage: a clinical trial comparing people with and without supination limited motion. J Man Manip Ther 2019; 27:109-114. [PMID: 30935339 DOI: 10.1080/10669817.2018.1542559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES To investigate the effects of friction massage techniques on the pronator teres muscle on supination range of motion (ROM) and supinator strength in individuals with and without limited supination ROM. METHODS In total, 26 subjects (13 with limited supination ROM and 13 healthy subjects) volunteered to participate in this study. We used a customized wrist cuff. Supination ROM and supinator strength were measured with a 9-axis inertial motion sensor and load cell. The friction massage protocol was executed with the pronator teres muscle in a relaxed position. Then supination ROM and supinator strength were measured again. RESULTS There was no significant interaction effect on supination ROM, which was significantly greater in the limited supination and control groups. A post hoc t-test revealed that the limited supination group achieved a significantly increased post-test supination ROM (51.7 ± 7.8°) compared to the pre-test value (43.6 ± 5.2°). In addition, the control group achieved a significant increase in post-test supination ROM (67.7 ± 10.0°) compared to the pre-test value (61.4 ± 7.7°). There was no significant interaction effect on supinator strength. Supinator strength was significantly greater in the limited supination and control groups. A post hoc t-test revealed a significant difference in supinator strength between the pre- and post-test values in the limited supination group. DISCUSSION Friction massage helps restore a limited ROM of the forearm supination motion and immediately increases supinator muscle strength. This technique can be used as an intervention method to improve muscle strength in patients with limited supination ROM.
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Clinical Trial |
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Kim JH, Kwon OY, Hwang UJ, Jung SH, Gwak GT. Prediction model of subacromial pain syndrome in assembly workers using shoulder range of motion and muscle strength based on support vector machine. ERGONOMICS 2024; 67:1237-1246. [PMID: 38039103 DOI: 10.1080/00140139.2023.2290983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/29/2023] [Indexed: 12/03/2023]
Abstract
Subacromial pain syndrome (SAPS) is the most common upper-extremity musculoskeletal problem among workers. In this study, a machine learning model was built to predict and classify the presence or absence of SAPS in assembly workers with shoulder joint range of motion (ROM) and muscle strength data using support vector machine (SVM). Permutation importance was used to determine important variables for predicting workers with or without SAPS. The accuracy of the support vector classifier (SVC) polynomial model for classifying workers with SAPS was 82.4%. The important variables in model construction were internal rotation and abduction of shoulder ROM and internal rotation of shoulder muscle strength. It is possible to accurately perform SAPS classification of workers with relatively easy-to-obtain shoulder ROM and muscle strength data using this model. In addition, preventing SAPS in workers is possible by adjusting the factors affecting model building using exercise or rehabilitation programs.Practitioner summary: This study aimed to create a machine learning model that can predict and classify SAPS using shoulder ROM and muscle strength and identify the variables that are of high importance in model construction. This model could be used to predict or classify workers' SAPS and manage or prevent SAPS.
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Gwak GT, Kim JH, Hwang UJ, Jung SH. Ensemble approach for predicting the diagnosis of osteoarthritis using physical activity factors. J Eval Clin Pract 2024. [PMID: 39440954 DOI: 10.1111/jep.14195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 08/28/2024] [Accepted: 09/30/2024] [Indexed: 10/25/2024]
Abstract
BACKGROUND Osteoarthritis (OA) is a common degenerative disease of the joints. Risk factors for OA include non-modifiable factors such as age and sex, as well as modifiable factors like physical activity. OBJECTIVES this study aimed to construct a soft voting ensemble model to predict OA diagnosis using variables related to individual characteristics and physical activity and identify important variables in constructing the model through permutation importance. METHODS By using the recursive feature elimination, cross-validated technique, the variables with the best predictive performance were selected among variables, and an ensemble model combining RandomForest, XGBoost, and LightGBM algorithms was constructed. The predictive performance and permutation importance of each variable were evaluated. RESULTS The variables selected to construct the model were age, sex, grip strength, and quality of life, and the accuracy of the ensemble model was 0.828. The most important variable in constructing the model was age (0.199), followed by grip strength (0.053), quality of life (0.043), and sex (0.034). CONCLUSION The performance of the model for predicting OA was relatively good. If this model is continuously used and updated, it could be used to predict OA diagnosis, and the predictive performance of the OA model may be further improved.
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Kim JH, Kwon OY, Hwang UJ, Jung SH, Ahn SH, Gwak GT. Comparison of scapular upward rotator muscle activities and activity ratios during three scapular upward rotator strengthening exercises. ISOKINET EXERC SCI 2021. [DOI: 10.3233/ies-210181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The focus of exercises for restoring the imbalance between scapular upward rotator muscles – upper trapezius (UT), serratus anterior (SA), and lower trapezius (LT) – commonly aims to increase SA and LT activities while not increasing UT activity. OBJECTIVES: The purpose of this study was to compare the activity of the UT, SA, and LT muscles during scapation and protraction exercises, which are two traditional exercises, and during a newly designed scapular upward rotation (SUR) exercise. METHODS: A total of 29 healthy young adult men performed all three exercises with maximum isometric contraction. The electromyographic activities of the UT, SA, and LT were recorded. RESULTS: UT demonstrated the highest activity during scapation. SA activity was the lowest during protraction. However, no difference was found in SA activity during the performance of scapation and SUR. The SA/UT ratio was the highest during scapation. CONCLUSIONS: SUR is a new exercise that can be performed at moderate intensity for shoulder rehabilitation to restore scapular upward rotator muscle imbalance.
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