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관절가동술과 스트레칭이 어깨후방뻣뻣함을 가진 충돌증후군의 어깨관절 근활성도와 안쪽돌림에 미치는 영향

The Effects of Joint Mobilization and Stretching on the Muscle Activity and Internal Rotation of Shoulder Joint in Patients With Impingement Syndrome With Posterior Shoulder Tightness

한국전문물리치료학회지 2020년 27권 1호 p.38 ~ 44
문귀도 ( Moon Gui-Do ) - 대구대학교 대학원 재활과학과

임진용 ( Lim Jin-Yong ) - 대구대학교 대학원 재활과학과
김태호 ( Kim Tae-Ho ) - 대구대학교 재활과학대학 물리치료학과
이동우 ( Lee Dong-Woo ) - 대구대학교 대학원 재활과학과

Abstract


Background: Posterior shoulder tightness, which is a problem mainly seen in patients with shoulder impingement syndrome, disrupts the scapulohumeral rhythm between the humerus and scapulae.

Objects: The aim of this study was to compare the effects of joint mobilization and stretch-ing on shoulder muscle activity and internal rotation range of motion (ROM) of the glenohu-meral joint in patients with impingement syndrome with posterior shoulder tightness.

Methods: The research subjects included 22 in-patients with impingement syndrome with posterior shoulder tightness. They were randomly divided into two groups: one group (12 patients) was treated with joint mobilization and the other group (10 patients) was treated with stretching for the posterior shoulder tightness. Each treatment was performed five times a week for two weeks, and there were 15 sessions for each treatment. The ROM of the internal rotation and muscle activities of shoulder joint were evaluated pretest and posttest in each group. Electromyography data were collected from the upper, middle, and lower trapezius and serratus anterior during shoulder abduction of 90°, 120°, and 150°.

Results: Both the joint mobilization and stretching groups showed significant decreases in muscle activity in the upper, middle, and lower trapezius on the posttest (p < 0.05). There was a significant difference in serratus anterior at 150° (p < 0.05), but there was no signifi-cant difference between group in post-hoc analysis (p > 0.025). The internal rotation ROM was significantly increased in the stretching group compared to that in the joint mobilization group (p < 0.025).

Conclusion: This study found that both joint mobilization and stretching for posterior shoul-der tightness were effective in muscle activity during arm abduction, also in order to increase internal rotation ROM of shoulder joint, stretching was effective in patients with impingement syndrome with posterior tightness.

키워드

Exercise; Joint; Musculoskeletal manipulations; Shoulder impingement
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