[Purpose] This study investigated the effects of an end-range mobilization technique on the range of motion of the glenohumeral internal rotation and the skin temperature of the shoulder in individuals with posterior shoulder tightness. [Subjects] Thirteen subjects with posterior shoulder tightness who had glenohumeral internal rotation deficit ≥ 15° participated. [Methods] All subjects underwent glenohumeral joint end-range mobilization intervention. The internal rotation range of motion of the glenohumeral joint was measured by a goniometer and the shoulder skin temperature was measured by a digital infrared thermographic imaging device before and immediately after the intervention. Paired t-tests were used to analyze the differences in these parameter pre and post-intervention. [Results] The glenohumeral internal rotation range of motion and skin temperature of the posterolateral shoulder in increased significantly post-intervention. [Conclusion] The end-range mobilization technique is effective for increasing the glenohumeral internal rotation range of motion and skin temperature of the shoulder in individuals with posterior shoulder tightness.

[Purpose] This study aimed to determine the effect of forward head posture-improving exercises on rounded shoulder posture when employing the self-stretch exercise, the McKenzie exercise, and the Kendall exercise as intervention methods based on previous studies that reported negative effects of unbalanced posture and musculoskeletal problems on forward head posture and rounded shoulder posture. [Subjects and Methods] The selected 28 subjects were randomly assigned into the McKenzie exercise group (n=9), the self-stretch exercise group (n=10), and the Kendall exercise group (n=9). To compare the forward head posture, the craniovertebral angle was used. To measure the rounded shoulder posture, the scapular index was used. [Results] There were significant differences in the craniovertebral angle and scapular index within the groups and no significant differences between the groups. [Conclusion] The result of this study showed that all interventions increased the craniovertebral angle and the scapular index, which revealed that the applied exercises had a positive effect on forward head posture and rounded shoulder posture.

[Purpose] This study performed an effect-size analysis of massage therapy for shoulder pain. [Subjects and Methods] The database search was conducted using PubMed, CINAHL, Embase, PsycINFO, RISS, NDSL, NANET, DBpia, and KoreaMed. The meta-analysis was based on 15 studies, covering a total of 635 participants, and used a random effects model. [Results] The effect size estimate showed that massage therapy had a significant effect on reducing shoulder pain for short-term efficacy (SMD: -1.08, 95% CI: -1.51 to -0.65) and for long-term efficacy (SMD: -0.47, 95% CI: -0.71 to -0.23). [Conclusion] The findings from this review suggest that massage therapy is effective at improving shoulder pain. However, further research is needed, especially a randomized controlled trial design or a large sample size, to provide evidence-based recommendations.

[Purpose] The aim of this study was to estimate the prevalence of abnormal shoulder ultrasonographic findings in a sample of asymptomatic women. [Subjects and Methods] A secondary analysis of a cross-sectional study was performed. We recruited 305 women (aged 18-56 years). All the subjects had a structured interview screening for self-reported symptoms and underwent a shoulder ultrasonographic examination, in which both shoulders were examined. The radiologist was blinded to the clinical history of the participants. All detectable shoulder abnormalities were collected. [Results] Of the subjects, 228 (74.75%) were asymptomatic at both shoulders, and 456 asymptomatic shoulders were analyzed. Lack of uniformity (supraspinatus, infraspinatus, subscapularis, and biceps brachii long head) was found in 28 shoulders (6.14%), 19 (4.17%) on the dominant side and 9 (1.97%) on the non-dominant side. Tendinosis (supraspinatus, infraspinatus, subscapularis, and biceps brachii long head) was found in 19 shoulders (5.32%), 12 (2.63%) on the dominant side and 7 (1.53%) on the non-dominant side. Calcification and other abnormal findings were reported. [Conclusion] The most common abnormalities were calcifications within the rotator-cuff tendons and humeral head geodes; other degenerative findings were less common.

[Purpose] This study investigated the effect of different leg angles during push-up plus exercise on shoulder stabilization muscle activity. [Participants and Methods] Fifteen healthy adult males participated in this study. The smart phone application Clinometer was used to measure leg angles of 70°, 90°, and 110° during push-up plus exercise. The muscle activities of the serratus anterior, upper trapezius fibers, and pectoralis major muscles involved in shoulder stabilization were analyzed using surface electromyogram. [Results] Leg angle significantly affected serratus anterior muscle activity, but it did not affect activities of the upper trapezius fibers or pectoralis major muscles. Post-hoc analysis revealed that serratus anterior muscle activity at the leg angle of 110° was significantly higher than at leg angles of 70° and 90°. [Conclusion] A higher leg angle during push-up plus exercise is a more effective intervention for the serratus anterior muscle activity.

[Purpose] This review article is designed to expose the application of sonography in shoulder pain after stroke. [Methods] A range of databases was searched to identify articles that address sonography examination, with or without ultrasound guided corticosteroid injection for hemiplegic shoulder pain (HSP). The electronic databases of PubMed, CENTRAL, CINAHL, Cochrane Library, Medline were searched. [Results] According to the articles identified in our databases research, sonographic technique has potential to provide objective measurements in patients with HSP. The main sonography finding of HSP included subacromial subdeltoid (SASD) bursal effusion, tendinosis of the supraspinatus and subscapularis tendon, long head of biceps tendon sheath effusion, and shoulder subluxation. Our analysis also revealed significantly decreased pain score (VAS) and increased passive external rotation degree in the steroid injection group than control group. [Conclusion] The sonography examination is useful for HSP assessment and ultrasound guided technique is recommended for HSP injection treatment.

[Purpose] This study measured %isolation and investigated whether it shows a difference between the presence and absence of wrist joint restriction, as well as changes in muscle activity patterns. [Methods] Twenty subjects performed upper extremity functional movement in the Manual Function Test (MFT) with and without wrist restriction, and the muscle activities of the trapezius, middle deltoid, biceps brachii, triceps brachii, extensor carpi radialis, and flexor carpi radialis were recorded. When there were differences in muscle activation, %isolation was implemented and the changes in the muscle activity patterns were noted. [Results] In the grasping and pinching tasks, there was a significant increase in %isolation of the upper trapezius and a significant decrease in %isolation of the extensor carpi radialis. Carrying a cube task, %isolation of the upper trapezius and middle deltoid significantly increased, whereas %isolation of the triceps brachii and extensor carpi radialis significantly decreased. In the pegboard task, the %isolation values of the extensor carpi radialis and flexor carpi radialis significantly decreased. [Conclusion] The data of this study should be useful for therapists, who can employ the information as material for the education and treatment of patients with wrist joint restriction. Therapists may thus look for ways to improve the quality of mobility by predicting the complement mobility depending on the activity performed and then determine whether to facilitate or restrict mobility.

[Purpose] This study was conducted to identify and analyze the degree of effect of massage therapy on the range of motion of the shoulder. [Subjects and Methods] The database search was conducted using PubMed, CINAHL, Embase, PsycINFO, RISS, NDSL, NANET, DBpia, and KoreaMed. The meta-analysis was based on 7 studies, covered a total of 237 participants, and used a random-effects model. [Results] The effect size estimate showed that massage therapy significantly improved the shoulder range of motion, especially the flexion (SMD: 18.21, 95% CI 1.57-34.85) and abduction (SMD: 22.07, 95% CI 5.84-38.30). [Conclusion] The review findings suggest that massage therapy is effective in improving the shoulder flexion and abduction.

[Purpose] The purpose of this study was to analyze shoulder stabilization using resistant vibration stimulus during bodyblade exercise followed by forward head posture improvement. [Subjects and Methods] Craniovertebral angle and cranial rotation angle were measured with 24 patients who were diagnosed with forward head posture. The experimental group conducted bodyblade exercise for 6 weeks and all patients received conventional physical therapy. The craniovertebral angle and cranial rotation angle were measured using a diagnostic imaging device to measure the change in forward head posture. Sternocleidomastoid, upper trapezius and serratus anterior muscle activity were measured using surface electromyography, voluntary contraction was converting into a percentage and mean value was calculated. [Results] The experimental group showed a significant increase in the comparison of the results of both groups before and after the intervention. The comparing group showed no significant difference. The experimental group showed the significant difference in mean value after the intervention in the comparison between the groups. [Conclusion] Resistant vibration stimulus by bodyblade controlled shoulder muscle activity causing scapular stabilization followed by neck position stability improvement. Rehabilitation program that activates whole kinetic chain of proximal and distal muscles such as bodyblade will show more effective improvement when choosing rehabilitation program for neck and shoulder disease clinically.

[Purpose] The purpose of this study was to confirm the correlation between racket velocity during the forehand smash movements with shoulder extensor strength and internal rotator strength in the neutral and abducted positions. [Subjects and Methods] Fourteen collegiate badminton players participated in the study. Measurements were performed shoulder strength, using torque calculated from the upper extremity length and the isometric force, and racket velocity during the forehand smash movements. The shoulder extensor strength and internal rotator strength were measured in the neutral and abducted positions. [Results] The extension torque and internal rotation torque of the shoulder in the neutral position were not significantly correlated with racket velocity. Additionally, correlations between extension torque of the shoulder in the maximum abducted position and racket velocity were insignificant. However, the internal rotation torque of the shoulder in the abducted external rotated position was significantly correlated with racket velocity (r=0.652). [Conclusion] The shoulder internal rotator strength in the abducted external rotated position are suitable measurements for evaluating badminton players.

[Purpose] The aim of the present study was to identify the effects of an unstable support surface (USS) on the activities of trunk and lower extremity muscles during pulley-based shoulder exercise (PBSE). [Subjects] Twenty healthy college students were included in this study. [Methods] Surface EMG was carried out in twenty healthy adult men. The activities of trunk and lower extremity muscles performed during PBSE using a resistance of 14 kg on a stable or unstable support surface were compared. The PBSE included shoulder abduction, adduction, flexion, extension, internal rotation, and external rotation. [Results] On the unstable surface, the rectus abdominis and erector spinae showed significantly less activation during shoulder external rotation, but the extent of activation was not significantly different during other shoulder exercises. The external oblique and rectus femoris showed no significant difference during any shoulder exercises. The tibialis anterior showed significantly greater activation during all shoulder exercises, except flexion and extension. The gastrocnemius showed significantly greater activation during shoulder abduction, extension, and internal rotation. However, during shoulder adduction, flexion, and external rotation, the gastrocnemius showed no significant difference. [Conclusion] The use of USS to increase core stability during PBSE is probably not effective owing to compensatory strategies of the ankle.

[Purpose] The purpose of the present study was to confirm the relationships between shoulder strength (extensor strength and internal rotator strength) of the abducted position and swimming power during arm-only swimming. [Subjects and Methods] Fourteen healthy male collegiate swimmers participated in the study. Main measures were shoulder strength (strength using torque that was calculated from the upper extremity length and the isometric force of the abducted position) and swimming power. [Results] Internal rotation torque of the dominant side in the abducted external rotated position (r=0.85) was significantly correlated with maximum swimming power. The rate of bilateral difference in extension torque in the maximum abducted position (r=-0.728) was significantly correlated with the swimming velocity-to-swimming power ratio. [Conclusion] The results of this study suggest that internal rotator strength measurement in the abducted external rotated position and extensor strength measurement in the maximum abducted position are valid assessment methods for swimmers.

[Purpose] This study investigated the relationship between the amount of scapular anterior tilting and the ratio of internal and external rotation of the shoulder in a supine position. [Participants and Methods] Twenty healthy participants (8 females, 12 males) were enrolled in this study. Internal rotation (IR) and external rotation (ER) of the glenohumeral joint were performed in a supine position, and the IR and ER angles were measured using a universal goniometer. The changing distance of scapular anterior tilting was measured by a three-dimensional motion analysis tracking system while participants performed IR and ER in a supine position. Pearson's correlation coefficient was used to investigate the relationship between the distance of scapular anterior tilting and the ratio of internal and external rotation angle of the shoulder. [Results] The correlation of the degree of scapular anterior tilting with the IR/ER ratio, particularly the IR angle of the shoulder in a supine position, was good to excellent (r=-0.851). [Conclusion] The findings suggest that asymmetry of the IR and ER angles may cause increased scapular anterior tilting in a supine position.

[Purpose] The purpose of this study was to examine the ratio between the upper trapezius and the serratus anterior muscles during diverse shoulder abduction exercises applied with vibrations in order to determine the appropriate exercise methods for recovery of scapular muscle balance. [Subjects and Methods] Twenty-four subjects voluntarily participated in this study. The subjects performed shoulder abduction at various shoulder joint abduction angles (90°, 120°, 150°, 180°) with oscillation movements. [Results] At 120°, all the subjects showed significant increases in the muscle activity of the serratus anterior muscle in comparison with the upper trapezius muscle. However, no significant difference was found at angles other than 120°. [Conclusion] To selectively strengthen the serratus anterior, applying vibration stimuli at the 120° shoulder abduction position is considered to be appropriate.

[Purpose] The characteristics of neck and shoulder pain (NSP) in different age populations have not been sufficiently examined. Therefore, the purpose of this study was to compare and verify the cervicothoracic spinal alignment and neck flexor muscle endurance of young and older adult females with and without NSP. [Participants and Methods] We assessed 72 female participants (39 young participants, 33 elderly participants, 43 NSP, 29 non-NSP) aged 18-82 years who were recruited for this study. Cervicothoracic spinal alignment measurements were obtained with forward head alignment (FHA) along with the upper thoracic angle. The neck flexor endurance test was performed. [Results] There were no significant age-by-group interactions for any of the assessment variables. However, the upper thoracic angle and neck flexor muscle endurance showed significant effects in the groups. Age also had significant effects on FHA and upper thoracic angle. [Conclusion] These results suggested that the neck flexor muscle endurance was more appropriate as an evaluation tool for older adult females with NSP. It was also suggested that the cervical flexor muscle endurance and upper thoracic angle were more appropriate as evaluation tools for young adult females with NSP.

[Purpose] The aims of this study was to investigate mean velocity and angle of shoulder joint, activation of tibialis anterior and gastrocnemius according to both eyes, dominant eye and non-dominant eye condition during reaching task in normal adults. [Subjects and Methods] Our research recruited 24 participants (male 11, female 13) in Silla University. Participants were performed reaching out movement by conditions of both eye, dominants eye, non-dominants eye. The target was placed at 45 degree diagonal direction and distance far away 130% of their arm length. Kinetic analysis of the upper extremities was investigated by QUALISYS 3-dimensional motion analysis system. Muscle activation were measured by EMG during reaching tasks. The collected data were statistically processed using the SPSS for win version 20.0. [Results] There was a significant difference of shoulder joint velocity of flexion, abduction and internal rotation according to visual field condition during reaching tasks. There was no significant difference of shoulder joint angle and muscle activation according to visual field conditions during reaching tasks. [Conclusion] In conclusion, visual field has an influence on shoulder joint velocity. Therefore, the visual field may be to play an important role in reach performance.

[Purpose] We investigated the effects of unstable conditions on the electromyographic (EMG) activity of the rectus abdominis (RA) and the transverse abdominis-internal oblique (TrA-IO) muscles, and lumbar kinematics during unilateral upper-limb resistance exercises using elastic tubing bands. [Subjects] Twelve healthy males were recruited. [Methods] The subjects performed isometric left shoulder abduction using an elastic tubing band in a sitting position on a chair, and on a Swiss ball. During this exercise, EMG activities of the RA and TrA-IO were recorded using a wireless EMG system, and a three-dimensional motion analysis system monitored lumbar kinematics. Differences in EMG activities of the RA and TrA-IO, the ratio of TrA-IO to RA activity, and lumbar kinematics were compared between the stable and unstable conditions using the paired t-test. [Results] Under the unstable condition, the EMG activities of both muscles were significantly greater than that under the stable condition; however the ratio of TrA-IO to RA activity did not significantly differ between the conditions. The lumbar angle significantly differed only in the coronal plane. [Conclusions] These findings indicate that trunk posture should be considered when performing exercises under unstable conditions.

[Purpose] To evaluate differences in pectoral muscle tightness according to arm abduction angle and to determine the best arm abduction angle for stretching of pectoral muscle tightness in breast cancer patients. [Subjects and Methods] Horizontal abduction differences of shoulders were measured bilaterally by arm abduction to 45°, 90°, and 135° to determine the best arm abduction angle for measuring pectoral muscle tightness. Thirty-two patients were divided into three pectoral muscle stretching groups (A: 45°, B: 90°, and C: 135°). We measured the shoulder range of motion, scores of the Disabilities of the Arm, Shoulder, and Hand, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and the Breast Module, and pain levels (using a visual analog scale) before and after therapy. [Results] The differences in degree of horizontal abduction between shoulders were significantly larger for arm abduction to 90° and 135° than that to 45°. Groups B and C showed greater improvements in horizontal abduction limitations than group A. [Conclusion] Horizontal abduction differences between shoulders are prominent when arms are abducted to 90° and 135°. The appropriate arm abduction angle for measuring horizontal abduction and effective stretching of pectoral muscle tightness may be >90°.

[Purpose] This study investigated the interaction effects between the levels of smartphone use and hand dominance on handgrip, pinch strengths, and functional hand performance in children. [Participants and Methods] A total of 60 children aged between 9 and 15 were assigned into two groups: Group A (high-frequency smartphone users) and Group B (low-frequency smartphone users). Use levels were determined according to the smartphone addiction scale-short version. A hand dynamometer and pinch gauge were used to measure handgrip and pinch strength respectively. Functions of the upper extremity and hand were scored using the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire. [Results] Group A participants had reduced measurements in hand grip and pinch strength, especially in the dominant hand. However, Quick Disabilities of the Arm, Shoulder, and Hand scores indicated that hand function was decreased in the dominant hand whether the child was a high- or low-frequency smartphone user. [Conclusion] Results indicated that high levels of smartphone use diminished hand and pinch-grip strengths as well as and hand function. That is, hand and pinch-grip strengths were reduced in the dominant hands of high-frequency smartphone users. However, hand functions were affected in the dominant hands among both high and low-level smartphone users.

[Purpose] This study investigated the efficacy of our independently developed method for measuring shoulder joint position sense using oral instructions based on body schema ("schema method") and investigated age-related changes. [Participants and Methods] Forty university students, 19 elderly individuals, and 16 elementary school students were included. Active shoulder abduction was measured in an upright sitting position. Target angles for position sense measurement were 45° of abduction (Target 45) and 90° of abduction (Target 90). The schema method consisted of indicating the target angles through oral instructions alone. The reproduction method and the imitation method were also used to measure angles. Abduction angle, absolute error, and variable error were calculated. [Results] A significant difference in abduction angle at Target 45 was observed between the schema method and the reproduction and imitation methods; no significant differences were observed at Target 90. No significant differences in variable error at Target 90 were observed among the three measurement methods. A significant difference in abduction angle was observed between university students and elderly individuals, and a significant difference in variable error was observed between elementary school students and elderly individuals. [Conclusion] Our body schema-based oral instruction method will be useful for evaluating joint position sense or proprioception.