DOI QR코드

DOI QR Code

Effect of Shoulder Protraction Exercise on the Supine position for Selective Activation of the Serratus Anterior according to Weight in Winging Scapula

  • Kim, TaeHo (Department of Physical Therapy, College of Rehabilitation Science, Daegu University) ;
  • Kim, SungYoung (Department of Physical Therapy, Graduate School of Daegu University) ;
  • Park, HanKyu (Department of Physical Therapy, Dong-ju College)
  • Published : 2019.08.31

Abstract

Purpose: This study investigated the effects of shoulder protraction exercise according to weight by examining the surface electromyography (EMG) amplitude in the serratus anterior (SA), upper trapezius (UT), and pectoralis major (PM) as well as the activity ratio of each muscle. Methods: Twenty three winging scapula subjects participated in the study. The subjects performed scapula protraction at shoulder $90^{\circ}$ flexion and $60^{\circ}$ horizontal abduction with up to four (none, 1kg, 1.5kg, and 2kg) dumbbells in the supine position. The EMG data were collected from the dominant side muscles during a shoulder protraction exercise according to weight in the supine position. One way repeated measures analysis of variance (ANOVA) was used to compare the normalized activities of the SA, UT, and PM and the ratios of PM/SA and UT/SA. Results: The results showed that the activities of both the SA and UT were highest for the shoulder protraction exercise at 2kg in the supine position. The UT/SA ratio also was the lowest for exercise at 2kg. On the other hand, the activities of both the UT and PM/SA ratio were similar under all conditions. Conclusion: These results show that there is a need to selectively strengthen the SA muscle in the case of patients with the shoulder dysfunction. In particular, it is necessary to weigh 2kg when performing shoulder protraction exercises in the supine position to activate the SA muscle in patients with a winging scapula.

Keywords

References

  1. Andrews DW. Cross-section regression with common shocks.Econometrica, 2005;73(5):1551-85. https://doi.org/10.1111/j.1468-0262.2005.00629.x
  2. Ludewig PM, Hoff MS, Osowski EE et al. Relative balance of serratus anterior and upper trapezius muscle activity during push-up exercises. Am J Sports Med. 2004;32(2):484-93. https://doi.org/10.1177/0363546503258911
  3. Struyf F, Nijs J, De Coninck K et al. Clinical assessment of scapular positioning in musicians: an intertester reliability study. J Athl Train. 2009;44(5):519-26. https://doi.org/10.4085/1062-6050-44.5.519
  4. Lear LJ, Gross MT. An electromyographical analysis of the scapular stabilizing synergists during a push-up progression. J Orthop Sports Phys Ther. 1998;28(3):146-57. https://doi.org/10.2519/jospt.1998.28.3.146
  5. Mottram SL. Dynamic stability of the scapula. Man Ther. 1997;2(3):123-31. https://doi.org/10.1054/math.1997.0292
  6. Cools AM, Struyf F, De Mey K et al. Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete. Br J Sports Med. 2013:48(8);692-7. https://doi.org/10.1136/bjsports-2013-092148
  7. Smith D, Riel J, Tilles I et al. Intravenous epinephrine in life-threatening asthma. Ann Emerg Med. 2003;41(5):706-11. https://doi.org/10.1067/mem.2003.144
  8. Ekstrom RA, Bifulco KM, Lopau CJ et al. Comparing the function of the upper and lower parts of the serratus anterior muscle using surface electromyography. J Orthop Sports Phys Ther. 2004;34(5):235-43. https://doi.org/10.2519/jospt.2004.34.5.235
  9. Kim ER, Oh JS, Yoo WG. Effect of vibration frequency on serratus anterior muscle activity during performance of the push-up plus with a redcord sling. J Phys Ther Sci. 2014;26(8):1275-6. https://doi.org/10.1589/jpts.26.1275
  10. Cools AM, Dewitte V, Lanszweert F et al. Rehabilitation of scapular muscle balance: which exercises to prescribe?. Am J Sports Med. 2007; 35(10):1744-51. https://doi.org/10.1177/0363546507303560
  11. Weon JH, Oh JS, Cynn HS et al. Influence of forward head posture on scapular upward rotators during isometric shoulder flexion. J Bodyw Mov Ther. 2010;14(4):367-74. https://doi.org/10.1016/j.jbmt.2009.06.006
  12. Koh EK, Weon JH, Jung DY. The comparison of electromyographic ratio of serratus anterior and upper trapezius according to exercise position and shoulder flexion angle during scapular protraction exercises. KJSB. 2012;22(2):193-9.
  13. Ki HS, Kwon OY, Yi CH et al. Effects of the scapular taping on the muscle activity of the scapula rotators and pain in subjects with upper trapezius pain. Phys Ther Korea. 2010;17(1):77-85.
  14. Jo YJ. Analytic comparison of trapezius and serratus anterior activities depending on shoulder complex movement. Korea University. Dissertation of Master's Degree. 2014.
  15. Decker MJ, Hintermeister RA, Faber KJ et al. Serratus anterior muscle activity during selected rehabilitation exercises. Am J Sports Med. 1999;27(6):784-91. https://doi.org/10.1177/03635465990270061601
  16. Moseley JB Jr, Jobe FW, Pink M et al. EMG analysis of the scapular muscles during a shoulder rehabilitation program. Am J Sports Med. 1992;20(2):128-34. https://doi.org/10.1177/036354659202000206
  17. Kim TH, Park HK. The comparison for serratus anterior muscle activity during protraction in open chain and closed chain exercises in healthy adults. J KEMA. 2018;2(1):1-5. https://doi.org/10.29273/jkema.2018.2.1.1
  18. Lim JY. The effects of closed and open kinematic chain exercises for scapular winging. Daegu University. Dissertation of Master's Degree. 2010.
  19. Cram JR, Ksamann GS, Holtz. Cram's introduction to surface electromyography. 2nd ed. Jones and Bartlett, 2010:65-70.
  20. Kendall FP ME, Provance PG. Muslces: testing and function. 4th ed. USA, Williams & Wilkins, 1993:318-332.
  21. Park SK, Park JM, Lee JH. Effects of a push-up plus exercise program on scapular position and muscle activity in individuals with rounder shoulder posture. J Kor Phys Ther. 2010;22(5):1-8. https://doi.org/10.1589/jpts.22.1
  22. Moon SJ, Kim TH, Roh JS. A comparison of the serratus anterior muscle activity according to the shoulder flexion angles in a closed kinetic chain exercise and an open kinetic chain exercise. J Korean Soc Phys Med. 2013;8(3):369-78. https://doi.org/10.13066/kspm.2013.8.3.369
  23. Shim YH, Nam KS, Park JW. Glenohumeral joint rotation on serratus anterior, pectoralis major and upper trapezius EMG activity during push-up plus exercise. J Kor Phys Ther. 2016;28(2):106-11. https://doi.org/10.18857/jkpt.2016.28.2.106
  24. Park KM, Cynn HS, Yi CH et al. Effect of isometric horizontal abduction on pectoralis major and serratus anterior EMG activity during three exercises in subjects with scapular winging. J Electromyogr Kinesiol. 2013;23(2):462-8. https://doi.org/10.1016/j.jelekin.2012.11.013
  25. Yoon JY KT, Oh JS. Effect of hand positions in electromyographic activity in scapulothoracic muscles during push-up plus. J Phys Ther Korea. 2010;17(4):8-15.
  26. Uhl TL, Carver TJ, Mattacola CG et al. Shoulder musculature activation during upper extremity weight-bearing exercise. J Orthop Sports Phys Ther. 2003;33(3):109-17. https://doi.org/10.2519/jospt.2003.33.3.109
  27. Martins J, Tucci HT, Andrade R et al. Electromyographic amplitude ratio of serratus anterior and upper trapezius muscles during modified push-ups and bench press exercises. J Strength Cond Res. 2008;22(2):477-84. https://doi.org/10.1519/JSC.0b013e3181660748
  28. Kim GH, Choe HS, Lee HI et al. The effects of scapular stabilization exercising on dynamic standing balance in stroke patients. J Kor Phys Ther. 2014;26(1):15-20. https://doi.org/10.1589/jpts.26.15

Cited by

  1. Effect of early stabilization exercise focused on the scapulothoracic joint on the recovery of surgical patients due to rotator cuff tear vol.32, pp.1, 2020, https://doi.org/10.18857/jkpt.2020.32.1.14
  2. Effect of Shoulder Position on Scapular Muscle Activity during Scapular Protraction vol.32, pp.3, 2019, https://doi.org/10.18857/jkpt.2020.32.3.157
  3. Quantitative Analysis of Myofascial Pain Syndrome in Trapezius Muscle Using Pressure Algometer and Surface Electromyography vol.33, pp.5, 2019, https://doi.org/10.18857/jkpt.2021.33.5.258