Journal of Electromyography and Kinesiology 23 (2013) 462468

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Journal of Electromyography and Kinesiology

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Effect of isometric horizontal abduction on pectoralis major and serratus anterior

EMG activity during three exercises in subjects with scapular winging
Kyung-Mi Park 1, Heon-Seock Cynn , Chung-Hwi Yi 2, Oh-Yun Kwon 3
Department of Physical Therapy, The Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea

a r t i c l e

i n f o

Article history:
Received 2 July 2012
Received in revised form 17 November 2012
Accepted 23 November 2012

Keywords:
Scapular winging
Pectoralis major
Serratus anterior

a b s t r a c t
The aim of this study was to determine the effect of isometric horizontal abduction using Thera-Band
during three exercises (forward exion, scaption, and wall push-up plus) in subjects with scapular winging by investigating the electromyographic (EMG) amplitude of the pectoralis major, serratus anterior
and the pectoralis major/serratus anterior activity ratio. Twenty-four males with scapular winging participated in this study. The subjects performed the forward exion, scaption, and wall push-up plus with
and without isometric horizontal abduction using Thera-Band. Surface EMG was used to collect the EMG
data of the pectoralis major and serratus anterior during the three exercises. Two-way repeated analyses
of variance with two within-subject factors (isometric horizontal abduction condition and exercise type)
were used to determine the statistical signicance of pectoralis major and serratus anterior EMG activity
and the pectoralis major/serratus anterior EMG activity ratio. Pectoralis major EMG activity was signicantly lower during forward exion and wall push-up plus with isometric horizontal abduction, and serratus anterior EMG activity was signicantly greater with isometric horizontal abduction. Additionally,
the pectoralis major/serratus anterior activity ratio was signicantly lower during the forward exion
and wall push-up plus with isometric horizontal abduction. The results of this study suggest that isometric horizontal abduction using Thera-Band can be used as an effective method to facilitate the serratus
anterior activity and to reduce excessive pectoralis major activity during exercises for activating serratus
anterior.
2012 Elsevier Ltd. All rights reserved.

1. Introduction
The serratus anterior is the primary muscle used to stabilize the
medial border and inferior angle of the scapula and to prevent
winging and anterior tilting of the scapula (Escamilla et al., 2009;
Neumann, 2002). Accordingly, weakness, fatigue, and abnormal
muscle ring patterns of the serratus anterior can cause shoulder
dysfunctions that deviate from the normal scapulohumeral rhythm
(Madeleine et al., 2008), as well as glenohumeral and scapulothoracic muscle imbalance (Cools et al., 2004; Hallstrm and
Krrholm, 2006). Especially, scapular winging can result from
weakness of the serratus anterior itself without nerve involvement,
even though the most common cause is injury of the long thoracic
nerves that innervate the serratus anterior (Dvir and Berme, 1978;
Martin and Fish, 2008). Therefore, the serratus anterior is a focus of

Corresponding author. Tel.: +82 33 760 2427; fax: +82 33 760 2496.
E-mail addresses: kyungmi87@hanmail.net (K.-M. Park), cynn@yonsei.ac.kr
(H.-S. Cynn), pteagle@yonsei.ac.kr (C.-H. Yi), kwonoy@yonsei.ac.kr (O.-Y. Kwon).
1
Tel.: +82 33 760 2497; fax: +82 33 760 2496.
2
Tel.: +82 33 760 2429; fax: +82 33 760 2496.
3
Tel.: +82 33 760 2721; fax: +82 33 760 2496.
1050-6411/$ - see front matter 2012 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.jelekin.2012.11.013

therapeutic exercise protocols for the prevention and rehabilitation of scapular winging.
Many previous studies have investigated diverse exercises to
determine the most effective exercise to elicit serratus anterior
activity including open and closed kinetic chain exercises (Cools
et al., 2007; Decker et al., 1999; Hardwick et al., 2006; Ludewig
et al., 2004; Martins et al., 2008; McClure et al., 2004). Of these diverse exercises, forward exion has been routinely included in
shoulder rehabilitation programs (Ellenbecker, 2006; McCann
et al., 1993) and is reported to induce serratus anterior activity
greater than 40% of maximal isometric voluntary contraction
(Wattanaprakornkul et al., 2011). Furthermore, the scaption and
push-up plus were found to consistently elicit serratus anterior
activity greater than 20% of maximal isometric voluntary contraction (Decker et al., 1999). Thus, these exercises have been recommended for increasing serratus anterior activation. Decker et al.
(1999) also reported that the plus phase of push-up plus induces
the highest average serratus anterior activation as compared to a
number of other exercises used in the study. Especially, the wall
push-up plus is commonly advocated because this modied
push-up plus is believed to be a less demanding exercise for clinical use, and it is generally recommended to patients who cannot

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463

perform the standard push-up plus (Ludewig et al., 2004). For this
reason, we decided to include forward exion, scaption (Cools
et al., 2007), and the wall push-up plus (Ludewig et al., 2004) to
be examined in this study.
Previous investigators reported muscle activity of the trapezius
and serratus anterior during a variety of shoulder exercises designed to explore not only the actual activity of the muscle but also
the relative muscle activity ratio among synergist muscles (Cools
et al., 2007; Ludewig et al., 2004; Martins et al., 2008). Specically,
a high ratio of the upper trapezius to serratus anterior was
proposed as a contributing factor in abnormal scapular motion
(Ludewig and Cook, 2000; Sharmann, 2001). Also, other previous
investigators have reported that the pectoralis major can be activated simultaneously with the serratus anterior during active
scapular exercises (Decker et al., 1999; Hiengkaew et al., 2003;
Hintermeister et al., 1998; Kim et al., 2010). Additionally, greater
activation of the pectoralis major compared with the serratus anterior can be observed in subjects with scapular winging during the
plus phase of the push-up plus (Kim et al., 2010). Accordingly, it is
possible that the pectoralis major may compensate for a weak serratus anterior because the pectoralis major may act as a synergist
(Decker et al., 1999; Hiengkaew et al., 2003; Hintermeister et al.,
1998). However, the excessive pectoralis major activation may lead
to glenohumeral and scapulothoracic pathologies such as shoulder
anterior joint translations or decreased compression forces on the
glenoid (Konrad et al., 2006; Labriola et al., 2005; McMahon et al.,
2003).
Reciprocal inhibition can reduce unwanted muscle activation
by contracting the antagonist (Kisner and Colby, 2002). With regard to pectoralis major, it can be inhibited when the shoulder is
abducted and rotated externally. Thus, isometric horizontal abduction of the shoulder can be used to reduce activity of the pectoralis
major during exercises that activate the serratus anterior. However, no previous studies have investigated a strategy to increase
activation of the serratus anterior and decrease activation of the
pectoralis major for subjects with scapular winging. Therefore,
the purpose of this study was to determine the effect of isometric
horizontal abduction using Thera-Band during three exercises (forward exion, scaption, and wall push-up plus) in subjects with
scapular winging by investigating the EMG amplitude in pectoralis
major and serratus anterior and the pectoralis major/serratus anterior activity ratio. We hypothesized that isometric horizontal
abduction using Thera-Band during three exercises will change
the pectoralis major/serratus anterior muscle activity ratio by
reducing pectoralis major EMG activity and/or increasing serratus
anterior EMG activity.

during daily activities, signs and symptoms of cervical pain, adhesive capsulitis, thoracic outlet syndrome, or a current complaint of
numbness or tingling in the upper extremity. Additional exclusion
criteria included a history of shoulder injury or surgery, participation in overhead sports at a competitive level, and upper limb
strength training for more than 5 h per week. Prior to participation,
subjects read and signed an informed consent form. The investigation was approved by Yonsei University Wonju Campus Human
Studies Committee.

2. Methods

2.3. Procedures

2.1. Subjects

Subjects were uniformly instructed by a primary investigator on

standardized position of three exercises and how to perform each
exercise. Subjects were then allowed to familiarize for approximately 20 min until the proper motion and timing were achieved.
For data collection, subjects performed three trials of each exercise
with 1-min rest period between trials. The order of the recording of
three exercises was randomized using the random number generator in Microsoft Excel (Microsoft Corp., Redmond, WA, USA). Trials
during which the subject failed to maintain the standardized position and holding period were excluded from the data analysis
(three trials were discarded because 80% of peak pressure was
not sustained during push-up plus). The mean value of three trials
of each exercise was used for data analysis. Each subject rst performed three exercises without isometric horizontal abduction and
then completed with isometric horizontal abduction. A 10-min rest
period was given between the two conditions to avoid fatigue.

Twenty-four males with scapular winging participated in this

study (age = 24.5 2.4 years, heigh = 174.6 5.5 cm, weight =
70.8 9.3 kg, amount of scapular winging = 22.1 1.9 mm). Scapular winging was conrmed by measuring the distance between the
thoracic wall and the inferior angle of the scapula using a scapulometer. The distance equal to or greater than 2 cm was dened as
scapular winging (Weon et al., 2011). Weon et al. (2011) demonstrated the testretest reliability of the scapulometer for measuring scapular winging. The interclass correlation coefcient was
0.97 (95% condence interval: 0.870.99), and the standard error
of the measurement was 0.1 cm.
The exclusion criteria for study participation were a history or
clinical exam revealing pain or dysfunction that substantially
limited shoulder motion or led to gross instability of the shoulder

2.2. EMG recording and data processing

Surface EMG data were collected using a Noraxon TeleMyo
2400 system (Noraxon, Inc., Scottsdale, AZ, USA) and analyzed
using Noraxon MyoResearch 1.06 XP software. The EMG signals
were amplied, band-pass ltered (10 and 450 Hz), and notch ltered (60 Hz, 120 Hz) before being digitally recorded at 1000 Hz
and processed into the root mean square. Data were collected from
the pectoralis major and serratus anterior on the scapular winging
side. After shaving and scrubbing the skin with alcohol, disposable
Ag/AgCl surface electrodes were placed on each muscle at the standardized sites (Criswell, 2010). The electrodes of the pectoralis major (sternal ber) were located on the chest wall horizontal from
the arising muscle mass (approximately 2 cm out from the axillary
fold). The serratus anterior electrodes were attached just below the
axillary area, at the level of the inferior tip of the scapula, and medial to the latissimus dorsi. Two electrodes were placed approximately 20 mm apart in the direction of the muscle bers, and a
ground electrode was placed over the ipsilateral clavicle.
Reference voluntary contractions (RVCs) were collected to normalize the EMG data of the pectoralis major and the serratus anterior, because the normalization using a maximal voluntary
isometric contraction could increase the risk of injury or pain in
the shoulder joint while applying the maximal manual resistance
to the humerus. To collect RVC data, while wearing a 6.5 kg sandbag on their forearm, subjects exed their shoulder at 90 in the
scapular plane (Park and Yoo, 2011). Subjects maintained this posture for 5 s without moving their center of mass. The middle 3-s of
the 5-s contraction was used for data analysis, and a 1-min rest
was given between trials. The mean value of three trials for each
muscle activity was taken as the RVC. The EMG signals collected
during the three exercises were expressed as a percentage of the
calculated root mean square of RVC (%RVC). To calculate the pectoralis major/serratus anterior ratio, the normalized pectoralis major
amplitude was divided by the normalized serratus anterior
amplitude.

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K.-M. Park et al. / Journal of Electromyography and Kinesiology 23 (2013) 462468

The three exercises with isometric horizontal abduction were

similar to the exercises without isometric horizontal abduction except that Thera-Band was applied around both wrists providing
resistance to shoulder horizontal abduction. The tensile load of
the Thera-Band was determined when the subject was able to perform more than 10 repetitions while maintaining consistent metronome speed (Decker et al., 1999).
2.3.1. Forward exion
Subjects stood with their backs at against a wall, knees slightly
bent and feet positioned shoulder-width apart (Fig. 1). Two target

bars (a base, a vertical pole, and a height-adjustable horizontal bar)

were positioned at the side of the subjects bilaterally to control the
plane of exion and amount of exion. A universal goniometer was
used to measure the level of 130 shoulder exion in each subject
to determine the height of the horizontal bars. Subjects were instructed to lift both arms with their elbows extended and the forearm and wrist in a neutral position by brushing the vertical pole
with the dorsal side of the forearm to maintain the shoulders in
the sagittal plane. Subjects then maintained forward exion posture for 5 s when the radial border of the wrist slightly touched
the horizontal bar which was placed at 130 shoulder exion.

Fig. 1. Ending position of three exercises with and without IHA (A: forward exion, B: scaption, C: wall push-up plus, 1: without IHA, 2: with IHA; IHA: isometric horizontal
abduction).

K.-M. Park et al. / Journal of Electromyography and Kinesiology 23 (2013) 462468

465

2.3.2. Scaption
Subjects stood with their backs at against a wall, knees slightly
bent and feet positioned shoulder-width apart (Fig. 1). Two target
bars (a base, a vertical pole, and a height-adjustable horizontal bar)
were positioned at the plane of the scapula (30 anterior to the
frontal plane) of the subjects bilaterally to control the plane of
the scapula and 130 shoulder exion. A universal goniometer
was used to measure the level of 130 shoulder exion at the plane
of the scapula in each subject to determine the height of the horizontal bars. Subjects were then instructed to lift both arms with
the elbows extended and the forearm and wrist in a neutral position by brushing the vertical pole with the dorsal side of their forearm to maintain the shoulders in the scapular plane. Subjects then
maintained this scaption posture for 5 s when the radial border of
the wrist slightly touched the horizontal bar at 130 shoulder
exion.

icant condition  exercise type interaction was observed

(F2.22 = 11.444, p < .05). The pectoralis major activity was signicantly lower in the forward exion and wall push-up plus exercises
with isometric horizontal abduction compared to without isometric horizontal abduction (forward exion: 30.9 8.4 %RVC with isometric horizontal abduction, 35.4 9.9 %RVC without isometric
horizontal abduction; scaption: 27.2 9.1 %RVC with isometric
horizontal abduction, 29.1 8.6 %RVC without isometric horizontal
abduction; wall push-up plus: 52.1 14.5 %RVC with isometric
horizontal abduction, 97.3 18.4 %RVC without isometric horizontal abduction). The pectoralis major activity was signicantly
greater in the wall push-up plus compared with forward exion
and scaption regardless of the presence or absence of isometric
horizontal abduction.

2.3.3. Wall push-up plus

Subjects stood facing a wall at arms length away with feet positioned parallel and shoulder-width apart on the oor. Subjects
were instructed to maintain shoulders exed at 90, to exend the
elbows and to make a st with neutral wrist in both hands
(Fig. 1). Target bars (a base, a vertical pole, and a height-adjustable
horizontal bar) were positioned in front of the subjects. The height
of the horizontal bar was set at the level of the manubrium of the
sternum for each subject. The end tip of the horizontal bar touched
the manubrium of the sternum and prevented forward movement
of the trunk during the exercise. Before the wall push-up plus, the
peak pressure was measured by pressure biofeedback units placed
at the level of 90 shoulder exion on the wall to control the
amount of pushing force subjects exerted toward the wall during
the exercise. Then, subjects were asked to push the center of pressure biofeedback units with their knuckles to control the protraction of bilateral scapulae without forward movement of the
trunk, sustaining 80% of their maximal pressure. Trials during
which the subject failed to maintain 80% of their maximal pressure
were excluded in the data analysis. Each subject maintained this
posture for 5 s.

The serratus anterior EMG activity during three exercises with

and without isometric horizontal abduction is shown in Fig. 3.
No signicant isometric horizontal abduction condition  exercise
type interaction was found (F2.22 = 1.780, p = .192). A signicant
main effect of isometric horizontal abduction was observed
(F1.23 = 25.843, p < .05), but no signicant main effect of exercise
type was found (F2.22 = 1.653, p = .203). The serratus anterior
activity was signicantly greater with than without isometric horizontal abduction (55.1 6.2 %RVC with isometric horizontal
abduction and 47.4 5.4 %RVC without isometric horizontal
abduction).

2.4. Statistical analysis

Two-way repeated analyses of variance (ANOVA) with two
within-subject factors (isometric horizontal abduction condition:
with and without isometric horizontal abduction; exercise type:
forward exion, scaption, and wall push-up plus) were used to assess the statistical signicance of pectoralis major and serratus
anterior EMG activity and the pectoralis major/serratus anterior
EMG activity ratio. The level of signicance was set at a = 0.05. If
a signicant isometric horizontal abduction condition  exercise
type interaction was not revealed from the two-way repeated
ANOVA, the main effects of isometric horizontal abduction condition and exercise type were determined. If a signicant main effect
of exercise type was observed, the Bonferroni correction was used
(a = 0.05/3 = 0.017). If a signicant isometric horizontal abduction
condition  exercise type interaction was found, a pair-wise comparison with Bonferroni correction was used to determine the simple effect (a = 0.05/6 = 0.008). All statistical analyses were
performed using PASW Statistics 18 (SPSS, Chicago, IL, USA).

3.2. Serratus anterior

3.3. Pectoralis major/serratus anterior activity ratio

The pectoralis major/serratus anterior ratios during the three
exercises with and without isometric horizontal abduction are
shown in Fig. 4. A signicant isometric horizontal abduction condition  exercise type interaction was observed (F2.22 = 10.560,
p < .05), with the pectoralis major/serratus anterior ratio signicantly greater in the forward exion and wall push-up plus with
isometric horizontal abduction compared to without isometric
horizontal abduction. The pectoralis major/serratus anterior ratio
was signicantly greater in the wall push-up plus than in the forward exion and scaption regardless of the presence or absence of
isometric horizontal abduction (forward exion: 0.7 0.3 with isometric horizontal abduction, 1.3 0.5 without isometric horizontal
abduction; scaption: 0.7 0.3 with isometric horizontal abduction,
0.84 0.4 without isometric horizontal abduction; wall push-up

3. Results
3.1. Pectoralis major
The pectoralis major activity during three exercises with and
without isometric horizontal abduction is shown in Fig. 2. A signif-

Fig. 2. Comparison of PM EMG activity during the serratus anterior activation

exercises with and without IHA (PM: pectoralis major, IHA: isometric horizontal
abduction). p < 0.008, signicant simple effect.

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K.-M. Park et al. / Journal of Electromyography and Kinesiology 23 (2013) 462468

Fig. 3. Comparison of SA EMG activity during the SA activation exercises with and
without IHA (SA: serratus anterior, IHA: isometric horizontal abduction). p < 0.05,
signicant difference in main effect for IHA condition.

Fig. 4. Comparison of the PM/SA EMG activity ratio during the SA activation
exercises with and without IHA (PM: pectoralis major, SA: serratus anterior, IHA:
isometric horizontal abduction). p < 0.008. signicant simple effect.

plus: 1.1 0.5 with isometric horizontal abduction, 2.3 0.9 without isometric horizontal abduction).
4. Discussion
The purpose of this study was to investigate whether pectoralis
major and serratus anterior EMG activity and the pectoralis major/
serratus anterior activity ratio could be changed with isometric
horizontal abduction during the three exercises in subjects with
scapular winging. To our knowledge, this is the rst study to investigate this strategy to increase serratus anterior activity and decrease activation of the pectoralis major in subjects with scapular
winging during exercises.
Our results demonstrated signicantly lower pectoralis major
activity during the forward exion and wall push-up plus with isometric horizontal abduction compared to without isometric horizontal abduction. This nding can be explained by the reciprocal
inhibition mechanism. The mechanism of reciprocal inhibition is
due to afferent impulses from agonist muscle spindles stimulating
an inhibitory interneuron in the spinal cord, which causes inhibition of the alpha motor neuron to the antagonist muscle (Leonard,
1997; Stuart, 2007). Thus, isometric horizontal abduction may
have induced contraction of the agonist muscle (horizontal abductors) by providing resistance while simultaneously relaxing and
inhibiting the antagonist muscle (pectoralis major).
In this study, the isometric horizontal abduction had no significant effect on pectoralis major activity during the scaption. This

nding can also be explained by the reciprocal inhibition mechanism (Leonard, 1997; Stuart, 2007). During scaption, the arms were
positioned in the scapular plane (i.e., 30 anterior to the frontal
plane) activating the shoulder horizontal abductor including posterior deltoid, supraspinatus, infraspinatus, and teres minor, and
thus inhibiting pectoralis major activation. Considering the comparable pectoralis major EMG amplitudes between scaption without
isometric horizontal abduction and forward exion with isometric
horizontal abduction, positioning the arms in the scapular plane
may have inherently reduced excessive pectoralis major activity
during the exercise.
Our data indicated that pectoralis major activity during the wall
push-up plus was signicantly greater than that during forward
exion and scaption. This nding may be attributed to the differing
nature of weight bearing on the upper extremity. Forward exion
and scaption are open kinematic chain motions, whereas the wall
push-up plus is classied as a closed kinematic chain exercise, as
the distal segment was xed (Ludewig et al., 2004). Uhl et al.
(2003) also reported that greater demand during weight bearing
exercises increases pectoralis major activation. Thus, pectoralis
major activity is increased during the wall push-up plus compared
with that during forward exion and scaption.
Our study found that serratus anterior activity was signicantly
increased during three exercises with isometric horizontal abduction compared to without isometric horizontal abduction. The increase in serratus anterior EMG activity during the exercises may
be associated with reduced activation of the pectoralis major. Previous studies have suggested that synergistic muscles that work
together can inuence each other through movement (Chance-Larsen et al., 2010; Page et al., 2009), and that surface EMG contents
were changed in the presence of altered afferent information to
maintain force (Farina et al., 2008; Madeleine et al., 2006). Specifically, when the movement is performed in the same range of motion, decreased activity of one muscle can give rise to increased
activity of another muscle to achieve the same range of motion
(Jonkers et al., 2003; Oh et al., 2007). In the present study, because
pectoralis major activity was reduced during the exercises by adding isometric horizontal abduction, it might be assumed that relatively greater serratus anterior activation was required to perform
the same exercises.
The results of this study were supportive of the hypothesis that
the use of isometric horizontal abduction would decrease the pectoralis major/serratus anterior EMG activity ratio during exercises.
A lower pectoralis major/serratus anterior ratio signied that the
serratus anterior activation increased and the pectoralis major
activation decreased. All of three exercises that included isometric
horizontal abduction demonstrated pectoralis major/serratus anterior ratios below 1, except the wall push-up plus. If higher pectoralis major/serratus anterior ratios are of concern when choosing
a particular exercise program for increasing serratus anterior activation, instructing the individuals to perform the exercises with
isometric horizontal abduction might be necessary. For patients
with scapular winging, an exercise that demonstrates low pectoralis major activity would be an important component of rehabilitation to facilitate selective serratus anterior strengthening and
reduction of the risk of the glenohumeral joint instability. Therefore, the wall push-up plus would be least indicated, as pectoralis
major activation was nearly twice that of the serratus anterior despite the use of isometric horizontal abduction.
However, limitations of this study should be noted. Other muscles beyond the pectoralis major and serratus anterior that could
contribute to scapular control were not considered in this investigation. This was because the major interest in this study was the
activity of the pectoralis major and serratus anterior muscles
during three exercises with and without isometric horizontal
abduction. Further studies are warranted to examine the muscle

K.-M. Park et al. / Journal of Electromyography and Kinesiology 23 (2013) 462468

activity of other agonist and antagonist muscles which can affect

scapulothoracic joint would strengthen the results of this study.
Another limitation is that the restricted age range of our subject
population (2129 years of age) affects generalizability outside of
this age group. Third, the EMG data were collected during isometric holding contraction phase in this study. The changes in pectoralis major and serratus anterior activity with isometric
horizontal abduction during dynamic contraction (ascending and
descending phases) of three exercises should be investigated in
further investigation. Fourth, the order of two conditions (with
vs. without isometric horizontal abduction) was not randomized.
Further studies should consider randomizing two conditions in order to observe the effect of isometric horizontal abduction during
exercises more precisely. However, we believe that the lack of randomization did not interfere in our results, as we considered that
performing exercises without isometric horizontal abduction rst
can prevent the results in this study from being affected by potential carry over effect or learning effect.

5. Conclusions
This study examined the effects of isometric horizontal abduction using Thera-Band on the EMG amplitude of the pectoralis major and serratus anterior and the pectoralis major/serratus anterior
EMG activity ratio during forward exion, scaption, and wall pushup plus in subjects with scapular winging. Our results showed that
adding isometric horizontal abduction using Thera-Band signicantly decreased pectoralis major activity during forward exion
and wall push-up plus, signicantly increased serratus anterior
activity, and signicantly decreased the pectoralis major/serratus
anterior EMG activity ratio during forward exion and wall pushup plus. Therefore, isometric horizontal abduction using TheraBand can be implemented as an effective method for inducing
greater serratus anterior activation while preventing excessive
pectoralis major activation during three exercises.
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Kyung-Mi Park received her B.S. degree in Physical

Therapy from Daejeon University in 2010, and M.A.
degree in Physical Therapy from Yonsei University in
2012. She is a member of the Korean Physical Therapy Association. Her research interests are the clinical biomechanics associated with therapeutic options
for enhancing a variety of musculoskeletal problems,
including the scapular winging, patellofemoral pain
syndrome, and pes planus.

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K.-M. Park et al. / Journal of Electromyography and Kinesiology 23 (2013) 462468

Heon-Seock Cynn is an associate professor in the
Department of Physical Therapy at the College of
Health Science of Yonsei University. He received B.S.
degree in Physical Therapy from Yonsei University,
M.A. degree in Physical Therapy from New York
University, and Ph.D. degree in Physical Therapy from
Yonsei University. He was a full time lecturer of Seoul
Health College and an associate professor of Hanseo
University. His research interests are identication of
etiologic factors, classication, and intervention
approaches for movement disorders and musculoskeletal diseases.

Chung-Hwi Yi received his Ph.D. degree in Physical

Therapy from Yonsei University in 1990. He joined
the Department of Rehabilitation Therapy of Yonsei
University in 1993. He was a president of The Korean
Academy of University Trained Physical Therapists.
From 1993 onwards he has been employed as a
professor in the Department of Physical Therapy at
the College of Health Science of Yonsei University.
His research interests include motion, posture analysis, and the development of outcome measures for
evaluating disability.

Oh-Yun Kwon is a professor in the Department of

Physical Therapy at the College of Health Science of
Yonsei University. He received his B.S. degree in
Physical Therapy and M.P.H. degree from Yonsei
University in 1986 and 1992 respectively, and Ph.D.
degree from Keimyung University in 1998. He had
research experience in Program in Physical Therapy
at Washington University in St Louis as a Post Doctoral Fellow. He is a director in Lab of Kinetic Ergocise
based on Movement Analysis (KEMA). He is interested in the mechanisms of movement impairment,
movement analysis, and prevention and management of the work related musculoskeletal pain syndrome.