• Title/Summary/Keyword: 관절 운동 범위

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Effects of Pectoralis Minor Stretching and Lower Trapezius Strengthening Exercise using PNF on Posture Change, Shoulder Range of Motion, and Pain in Rotator Cuff Repair Patients with Rounded Shoulder Posture (PNF를 이용한 작은가슴근 신장과 아래등세모근 강화 운동이 둥근 어깨 자세를 가진 돌림근띠 복원술 환자의 자세변화와 어깨 관절가동범위 및 통증에 미치는 영향)

  • Beom-Ryong Kim;Tae-Woo Kang
    • PNF and Movement
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    • v.21 no.1
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    • pp.75-86
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    • 2023
  • Purpose: This study aims to determine the effect of proprioceptive neuromuscular facilitation (PNF) pectoralis minor stretching and lower trapezius strengthening exercise on posture change, shoulder range of motion (ROM), and pain in rotator cuff repair patients with a rounded shoulder posture (RSP). Methods: Following baseline measurements, the subjects (n = 25) with rotator cuff repair were randomized into two groups: the PNF group (n = 13), which engaged in PNF pectoralis minor stretching and lower trapezius strengthening exercise, and the control group (n = 12), which received traditional physical therapy. Each group participated in the intervention five times per week for two weeks. The RSP values for the postural changes, flexion and abduction ROM, and visual analogue scales (VASs) of both groups were recorded at both pre- and post-intervention. In addition, before and after the intervention, a paired t-test was conducted to compare the within-group changes and an independent t-test to compare the between-group differences. Results: After the two-week intervention, both groups experienced significantly decreased RSP and VAS values (p < 0.05) and a significantly increased ROM (p < 0.05). Meanwhile, the PNF group showed greater improvements in RSP, ROM, and VAS than the control group (p < 0.05). Conclusion: These results suggest that PNF pectoralis minor stretching and lower trapezius strengthening exercise reduce posture and shoulder pain and enhance ROM in rotator cuff repair patients with RSP.

Effects of Suboccipital Muscle Inhibition and Neck Muscle Stabilization Exercise on Pain and Range of Motion in Patients with Chronic Non-Specific Neck Pain (뒤통수밑근 억제기법과 목 안정화 운동이 만성 비특이적 목 통증 환자의 통증과 관절가동범위에 미치는 영향)

  • Chool-Hyeong Rhee;Eun-Jin Lim
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.1
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    • pp.125-138
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    • 2024
  • Purpose: The aim of this study was to apply suboccipital muscle inhibition combined with neck muscle stabilization exercise to 20~30s IT industry employees who suffer from chronic non-specific neck pain. Methods: This study was designed as single-blind and randomized controlled trial. The study participants were 20~30s IT industry employees with chonic non-specific neck pain (VAS 3/10) who were divided into an experimental group (n= 20) subjected to suboccipital muscle inhibition with neck muscle stabilization exercise, and control group (n= 20); suboccipital muscle inhibition only. The intervention was applied three times per week for eight weeks. The neck pain·pressure pain threshold·range of motion, and disability index were measured at the 1st, 8th, and 10th week at follow up, then analyzed with an analysis of variance(ANOVA) using the SPSS program. Results: The total number of study participants was 37 (experimental group 19, mean age 34.6±5.3, control group 18, mean age 35.7±4.9). The comparison and analysis of change in VAS, the pressure pain threshold, and the range of motion except the extension (p>.05) revealed a statistically significant decrease between groups over eight weeks and follow up measurement (p<.01). Regarding the within the group differences, the right side of the neck pressure pain threshold showed a statistically significant decrease over eight weeks in the control group (p<.01). The right and left lateral flexion, and the right and left rotation were statistically significant for the experimental group over eight weeks and follow up measurement, but only the left lateral flexion (p<.05) for the control group over eight weeks. The neck disability index showed a slight decrease but this was not satistically significant for the between-grop or the within-group differences (p>.05). Conclusion: The intervention of suboccipital muscle inhibition and a neck muscle stabilization exercise are more beneficial for neck pain and the range of motion than the application of suboccipital muscle inhibition alone.

Hook Plate Fixation for Unstable Distal Clavicle Fractures: A Prospective Study (불안정 원위 쇄골 골절의 치료에서 Hook 금속판을 이용한 전향적 연구)

  • Kim, Kyung-Cheon;Shin, Hyun-Dae;Cha, Soo-Min;Jeon, Yoo-Sun
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.6-12
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    • 2011
  • Purpose: We wanted to analyze and report on the radiologic and clinical results of prospective Hook plate fixation for unstable distal clavicle fractures after a minimum of 2 years follow up. Materials and Methods: We followed up 17 out of 20 cases that underwent prospective Hook plate fixation from 2008 to 2009. We performed radiologic follow up at 2 weeks, 6 weeks, 3 months, 6 months, 18 months and 24 months postoperatively. The clinical results were evaluated at 12 months and 24 months postoperatively. Results: The mean period for bony fusion was 14.5 weeks and the plate was removed after an average of 20.2 weeks. The VAS pain scores were 0.7 and 0.8, the UCLA scores were 33.5 and 33.3, the ASES scores were 92.8 and 92.5, the Constant-Murley scores were 81.5 and 77.0, the KSS scores were 92.5 and 94.3 and the ranges of motion were $173.3^{\circ}$ and $173.7^{\circ}$ of flexion, $56.0^{\circ}$ and $54.5^{\circ}$ of external rotation, $62.3^{\circ}$ and $63.5^{\circ}$ of the internal rotation, $172.0^{\circ}$ and $172.6^{\circ}$ of abduction and $43.3^{\circ}$, and $42.9^{\circ}$ of extension at 1 and 2 years follow-up, respectively. There was no statistically significant difference of clinical outcomes and the range of motion at 1 year and 2 year postoperatively (p>0.05). There was no other complication except 1 case of delayed union. Conclusion: For Hook plate fixation at 2 years postoperatively, the complications will be decreased and excellent clinical results should occur.

Correlation of Clinical Outcome and Cuff Integrity after Open Repair in Large and Massive Rotator Cuff Tears (대형 및 광범위 회전근 개 파열의 개방적 봉합술 후 임상적 결과와 회전근 개 연속성(integrity)의 상관 관계)

  • Noh, Haeng-Kee;Wang, Joon-Ho;Kim, Dong-Hwee;Park, Jong-Woong;Kim, Jae-Gyoon;Park, Jung-Ho
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.65-72
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    • 2007
  • Purpose: To evaluate the relationship between the clinical outcome and the cuff integrity following open repair in large and massive rotator cuff tears using ultrasonography as an imaging modality. Material and Methods: From November 2001 to April 2005, 17 cases(16 patients) who had open repair of tear measuring more than 3cm were assessed with minimal follow-up of 12 months in this study. 6 cases had a large tear and 11 cases a massive tear. There were 6 men and 11 women with a mean age of 52 years at surgery (range, 33 to 72 years). The evaluation consisted of the preoperative and postoperative shoulder scores according to UCLA shoulder scoring system and Visual analogue scale (VAS). Ultrasonography was performed by a experienced musculoskeletal physician at a minimum of 12 months postoperatively to evaluate the postoperative cuff integrity. Results: Retear were detected in four of seventeen cases. Regardless of the presence of recurrent tear, 14 cases had UCLA score of more than 29 points (good grade). All 17 had an improvement in the functional score, which increased from an average of 15.1 to 31.2 points. All cases showed pain relief and five cases had no pain. Sixteen cases except one had the range of motion of forward elevation above $90^{\circ}$. Conclusion: Open rotator cuff repair in large and massive tears showed low retear rate. At a minimum of twelve months follow-up, all cases had improvement on UCLA score, pain relief, increased range of motion of the shoulder regardless of retear. And the correlation between recurrent tear and function score was not statistically significant.

Result of a Long-Term Follow-Up of Arthroscopic Partial Repair for Massive Irreparable Rotator Cuff Tears Using a Biceps Long Head Auto Graft (봉합 불가능한 광범위 회전근 개 파열에서 상완 이두근 건 장두를 이용한 관절경하 부분 봉합술의 장기 추적 관찰 결과)

  • Ko, Sang-Hun;Park, Ki-Bong;Park, Gil-Young;Kwon, Sun-Hwan;Kim, Myung-Seo;Park, Sun-Jae
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.135-142
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    • 2020
  • Purpose: This paper presents the long term follow-up results of arthroscopic partial repair for massive irreparable rotator cuff tears using a biceps long head auto graft. Materials and Methods: Forty-one patients with massive irreparable rotator cuff tear, who underwent arthroscopic repair, were reviewed retrospectively. Patients who underwent arthroscopic partial repair using a biceps long head auto graft were assigned to group 1, and patients in group 2 underwent arthroscopic partial repair alone. Patients with a less than 50% partial tear of the long head biceps tendon were included in this study. The clinical scores were measured using a visual analogue pain scale (VAS) for pain, range of motion (ROM), The University of California, Los Angeles shoulder score (UCLA), American Shoulder and Elbow Surgeons Shoulder Score (ASES), and Korean Shoulder Scoring System (KSS) scores preoperatively and at the final follow-up. The acromiohumeral interval (AHI) was measured using plain radiographs taken preoperatively and at the final follow-up, and re-tear was evaluated using postoperative ultrasound or magnetic resonance imaging at the last follow-up. Results: The mean age of the patients was 62.1±12.7 years, and the mean follow-up period was 90.3±16.8 months. No significant differences in the VAS and ROM (forward flexion, external rotation, internal rotation) were found between the two groups (p=0.179, p=0.129, p=0.098, p=0.155, respectively). The UCLA (p=0.041), ASES (p=0.023), and KSS (p=0.019) scores showed functional improvements in group 1 compared to group 2. At the last follow-up, the measured AHI values were 9.46±0.41 mm and 6.86±0.64 mm in group 1 and 2, respectively (p=0.032). Re-tear was observed in six out of 21 cases (28.6%) in group 1 and nine out of 20 cases (45.0%) in group 2; the retear rate was significantly lower in group 1 than in group 2 (p=0.011). Conclusion: Arthroscopic partial repair for a massive irreparable rotator cuff tear using a biceps long head auto graft has significant clinical usefulness in functional recovery and decreases the re-tear rates after surgery than arthroscopic partial repair alone, showing favorable results after a long-term follow-up.

Treatment of Tibial Fractures by Interlocking Intramedullary Nailing (Interlocking Intramedullary Nail을 이용한 경골 골절의 치료)

  • Jung, Kwang-Yeoung;Lee, Dong-Chul;Suh, Jae-Sung;Kim, Se-Dong
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.388-399
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    • 1993
  • The adequate treatment of tibia fracture is one of the most difficult due to severe commiuntion, open wound, delayed union, angulation deformity and infection. We treated 38 fractures of the tibia by Interlocking intramedullary nail from Feb. 1983 to Mar. 1993, 35 cases of the tibia fracture were fresh, 13 cases of fracture were open. The other 3 cases were delayed union and nonunion. The Mean follow-up was 14.0 months. The results were as followings. 1. Of the 38 fractures, 37 fractures united and the mean union time was 18.7 weeks. 2. Interlocking intramedullary nail could be used to the majority of fractures of the proximal & distal tibia shaft fractures. 3. The Interlocking nail had rigid rotational stability and was appropriate for the treatment in severe unstable fractures, commninution and open with bone loss. 4. Delayed union or nonunion was a good indication for intramedullary nailling. 5. The major complication were valgus deformity of 2 cases, varus deformity of 1 case, 1 case deep infection. 6. Interlocking intramedullary nailing provided rigid fixation of fracture and then made early joint motion exercise and ambulation.

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Osteosarcoma in an 8 Month-Old Infant treated with Limb Sparing Operation (8개월된 유아 골육종 환자에서의 사지 보존술)

  • Kim, Jae-Do;Kwon, Young-Ho;Kang, Myung-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.100-104
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    • 2005
  • Osteosarcoma is the most common tumor in malignant bone tumors. The peak age incidence in osteosarcoma is between 10 to 14 years of age. This tumor rarely develops under 6 years of age and the youngest patient in the previous literature was a 13 months old girl who had an osteosarcoma involving the second metacarpal bone. We report a case of an 8 month old male infant, who had an osteosarcoma involving the right proximal tibia. This patient was treated by wide excision with transepiphyseal resection and reconstruction with allograft. At 20 months after operation, the varus deformity was developed at the proximal junctional site of allograft. Thereafter, the revision was performed with correction of deformity and augmentation with the proximal fibula transfer. At 51 months after operation, he has been remained as free of disease, and he has recovered the knee motion ranged from 15 degree to 75 degree. The osteosarcoma in infant is very rare but it should be considered the osteosarcoma in the differential diagnosis of any bone lesion. Instead of amputation, the limb sparing operation and the solutions for limb length inequility in growing period should be carefully considered in the infantile osteosarcoma.

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Benign Tumors of the Talar Body (거골 체부에 발생한 양성 종양)

  • Suh, Sung-Wook;Lee, Sang-Hoon;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.3
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    • pp.76-82
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    • 2002
  • Purpose: Benign bone tumor of the talar body have rarely been evaluated according to the therapeutic methods because of the scarcity of their incidence. Here, we report our experience of 8 cases who were treated by using of posterior approach and curettage through the posterior process of the talus. Materials and Methods: Between February 1986 and October 2001, we experienced 8 cases of benign bone tumor occurring in the talar body. They included two osteoid osteomas, two giant cell tumors, one capillary hemangioma, one chondroblastoma, one simple bone cyst, and one osteochondroma. Their mean age was 22.1 years (ranging from 10 to 41 years). Mean follow-up period was 7.7 years (ranging from 1 to 16 years). All patients were treated by using of posterior approach. Two osteoid osteomas and one osteochondroma were treated by excision of tumors. Other cases were treated with curettage through the cortical window on the posterior process of the talus. Results: There was no recurrence during the follow-up period. one infection occurred. Except this case, all patients had no pain in weight-bearing, and complete range of movement at the ankle joint was reserved in each case. Conclusion: In this study, we suppose that posterior approach to the talar body may be a safe method with minimal damage of normal tissues and sufficient of curettage is capable through the cortical window on the posterior process of the talus.

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The Effects of Thoracic Spine Self-mobilization Exercise Using a Tool on Pain, Range of Motion, and Dysfunction of Chronic Neck Pain Patients (소도구를 이용한 등뼈 자가 관절 가동성 운동이 만성 목통증 환자의 통증, 관절가동범위, 기능장애에 미치는 영향)

  • Kim, Su-jin;Kim, Suhn-yeop;Lee, Min-ji
    • Physical Therapy Korea
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    • v.27 no.1
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    • pp.1-10
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    • 2020
  • Background: Thoracic spine self-mobilization exercise is commonly used to manage patients with neck pain. However, no previous studies have investigated the effects of thoracic spine self-mobilization exercise alone in patients with chronic neck pain. Objects: The purpose of this study was to investigate the effects of thoracic self-mobilization using a tool on cervical range of motion (ROM), disability level, upper body posture, pain and fear-avoidance beliefs questionnaire (FABQ) in patients with chronic neck pain. Methods: The subjects were 49 patients (21 males, 28 females) with chronic neck pain. The subjects were randomly divided into an experimental group (EG, n = 23) and control group (CG, n = 26). For the EG, thoracic self-mobilization was applied. We placed a tool (made with 2 tennis balls) under 3 different vertebral levels (T1-4, T5-8, T9-12) of the thoracic spine and the subjects performed crunches, which included thoracic flexion and extension in supine position. Five times × 3 sets for each levels, twice a week, for 4 weeks. Cervical pain, disability, upper body posture, FABQ results, and ROM were evaluated at baseline, after 4 weeks of intervention, and at 8 weeks of follow-up. Assessments included the quadruple visual analogue scale (QVAS); Northwick Park neck pain questionnaire (NPQ); craniovertebral angles (CVA), forward shoulder angle (FSA) and kyphosis angle (KA) measurements for upper body posture; FABQ and cervical ROM testing. Results: The EG showed a statistically significant improvement after intervention in the QVAS (-51.16%); NPQ (-53.46%); flexion (20.95%), extension (25.32%), left rotation (14.04%), and right rotation (25.32%) in the ROM of the cervical joint; KA (-7.14%); CVA (9.82%); and FSA (-4.12%). Conclusion: These results suggest that, for patients with chronic neck pain, thoracic self-mobilization exercise using a tool (tennis balls) is effective to improve neck pain, disability level, the ROM, and upper body posture.

Elastofibroma Scapulae (견갑부 탄성섬유종)

  • Kang, Hyun-Guy;Cho, Hwan-Seong;Park, Weon-Seo;Lee, Joo-Hyuk;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.2
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    • pp.118-125
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    • 2006
  • Purpose: We report elastofibroma which is a rare fibrous lesion that most commonly occurs in the between subscapularis and thoracic cage. Materials and Methods: Four patients include one man and three women, the average age was 70 years and the average follow up period was six months. Two patients had on left side, two patients had on both sides. Main symptom was palpable mass. One patient complained mild pain, two complained scapular snapping. Results: All four masses removed with marginal or wide margin. Average mass size was 9.7${\times}$7.2${\times}$3.8 cm. Preoperative symptoms disappeared after surgery. All of the patients have returned to their daily living and showed no recurrence. There was no serious complication such as limitation of shoulder motion and winged scapula. Conclusion: Elastofibroma scapulae can be diagnosed through patient's age, tumor location and radiological finding without preoperative biopsy. When patient is symptomless, observation is enough without surgical operation. Surgical operation considered for relieve of symptoms of pain and snapping.

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