• The Journal of Pediatrics of Korean Medicine
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• v.15 no.1
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• pp.219-227
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• 2001

중국 낙양의 평악곽씨(平樂郭氏) 정골법은 중국의학의 골상과(骨傷科) 중에서 중요한 학술유파로 널리 알려져 있다. 그 치료법에 있어서 독특하고 체계적인 시술법을 갖추고 있는데, 교정 수기법, 고정방법, 기능훈련, 약물치료 등의 내용을 포함하고 있다. 창상(創傷)에 대한 약물요법에서 "파(破) 화(和) 보(補)" 3단계로 분류된 약물사용 원칙을 제시하였는데, 즉 골정손상의 초기에는 기혈어체(氣血瘀滯)의 병리기전에 입각하여 약물은 활혈화어제(活血化瘀劑)를 주로 사용하고, 중반에는 기혈부화(氣血不和) 경락부통(經絡不通)의 기전으로 파악하고 주로 활혈통락(活血通絡)시키는 약물을 사용하며, 말기에는 구병(久病)으로 기형(氣血)이 휴손(虧損)되므로 보기혈(補氣血) 및 장근골(壯筋骨)의 약물을 주로 사용한다. 이와 같은 평악곽씨(平樂郭氏)의 正骨(정골)에 관한 약물사용 원칙을 토대로 선조의 처방과 경험방 및 후세의 통용방(協定方)을 근간으로 심은 평악곽씨(平樂郭氏)의 正骨(정골)에 대한 전통약물시리즈가 형성되었다. 이러한 처방들은 장기간의 임상활용에서 그 효과가 뛰어나고 안전성이 확보된 것으로 입증되었다. 근골통소환(筋骨痛消丸)은 활혈행기(活血行氣), 온경통락(溫經通絡), 소종지통(消腫止痛)의 효능이 있어 근골의 퇴행성 질환이나 만성 노손(勞損)으로 일어나는 종창(腫脹), 통증, 관절활동의 제한, 목 어깨 허리 다리 등의 통증, 발꿈치 통증, 골절 후 지체(肢體)의 종통(腫痛), 어혈 등에 활용한다. 활혈접골지통고(活血接骨止痛膏)는 접골속근(接骨續筋), 통락지통(通絡止痛)의 효능이 있어 골상(骨傷)을 입은 후 지체(肢體)의 종창(腫脹)이나 통증 또는 골절 등에 사용한다. 이 약은 크림제와 고약제 두가지가 있다. 평악내복접골교양(平樂內服接骨膠襄)은 활혈소종(活血消腫), 접골속근(接骨續筋)의 효능이 있어 각종 근육의 손상이나 골정상에 활용된다. 평낙전근단(平樂展筋丹)은 활혈화어(活血化瘀), 서근지통(舒筋止痛), 통리관절(通利關節), 등의 효능이 있어 타박상으로 인한 지체(肢體)의 종통(腫痛), 관절강직, 활동제한 및 골관절 질환과 풍습비통(風濕痺痛) 등을 치료한다. 전통적으로 외용(外用)에 사용되는 산제(散劑)는 마사지에 주로 활용된다. 임상에서 다양한 제형(劑型)으로 개발되어 분무형태로 쓰이는 근상정(筋傷酊)과 마사지 크림으로 사용되는 평악낙전근접마유제(平樂展筋接摩乳劑)가 있다. 소종활혈(消腫活血) 대포제(袋泡劑)는 산제(散劑)를 티팩 형식으로 사용하는 외용제형(外用劑型)이며, 서근활혈(舒筋活血), 소종지통(消腫止痛)의 효능이 있어 타박상 말기에 근육이 굳어지고, 어반이 형성되면서 통증이 나타나며, 종창(腫脹) 등이 생길 때 사용한다. 사용방법은 따뜻한 물에 담가 우려낸 다음 상처부위를 씨어주면 된다. 특별히 제작된 접골환(接骨丸)은 배보간신(培補肝腎), 익기건비(益氣健脾), 활혈통락(活血通絡), 강근건골(强筋健骨) 등의 작용이 있어 파박상이나 골절이 잘 치유되지 않고 오래 지속되는 경우에 사용된다. 이와 같은 다양한 평악곽씨(平樂郭氏)의 전통적인 정골(正骨)에 관한 약물들은 약리학적 실험을 거쳐 그 독성반응이나 부작용 및 임상효과를 관찰한 결과 통제학적으로 p<0.05-0.01로 나타나 98%의 치료효과를 보였으며, 독성 및 부작용이 없어 안정성이 인정되었으므로 긍정적인 치료효과를 확인할 수 있었다.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.1
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• pp.85-94
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• 2020

PURPOSE: This study examined the effects of the meridian muscle release technique on the pain and functional movement of patients with myofascial pain syndrome (MPS) of the shoulder joint. METHODS: The subjects of this study included 45 patients with MPS of the shoulder joint. The subjects were divided randomly into the following groups; the meridian muscle release technique group (n=15), the Graston technique group (n=15), and the control group (n=15). Both the meridian muscle release group and the Graston technique group received conventional therapy for 35 minutes initially and were then treated using the meridian muscle releases technique and Graston technique for 10 minutes, respectively. The control group received only conventional therapy for 35 minutes. All three groups underwent treatments three times a week for four weeks. Each subject was evaluated randomly using the VAS, PPT, SPADI and ROM both before and after treatment. RESULTS: The Graston technique group showed a significantly more substantial increase in functional movement (p<.05) than the meridian muscle release technique and control groups. The meridian muscle release technique group had significantly less pain (p<.05) compared to the Graston technique and control groups. CONCLUSION: These findings suggest that the meridian muscle release technique can be useful for decreasing pain and increasing the functional movement of patients with MPS of the shoulder joint.

• Journal of The Korean Society of Integrative Medicine
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• v.4 no.3
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• pp.1-15
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• 2016

Purpose : The purpose of this study was to evaluate the difference of early muscle strengthening exercise(starting at 1 week) on pain, function and sleep quality for rotator cuff partial tear patients. Method : Experimental group 15 people, control group 15 people, was a total of 30 people. Group-specific arbitration method, was applied to early muscle strengthening exercise (experimental group) and general movement treatment(Starting at 6 week) (control group). Both groups were subjected to 40 minutes of basic physical therapy interventions four times a week over an six-week intervention period. In this study, Pain, function and sleep quality measured by VAS, PPT and ROM, CMS, SST and PSQI. Result : 1. The VAS and PPT in the experimental group and control group before and after treatment were significant difference(p<.01). Comparison between the two groups in the change in motion before and after treatment also showed a statistically significant(p<.01). 2. Comparison functional Assessment of the shoulder ROM, CMS and SST in the experimental group and control group before and after treatment were significant difference(p<.01). ROM was not significant differences between the groups but CMS and SST were significant differences between the groups. 3. PSQI in the experimental group and control group before and after treatment were significant difference(p<.01). Comparison between the two groups in the change in motion before and after treatment also showed a statistically significant(p<.01). Conclusion : Therefore, early muscle strengthening exercise is useful to improve the shoulder function and pain for rotator cuff tear patients.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.1
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• pp.101-111
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• 2020

Purpose : The purpose of this study was to identify the comparison of the effects of manual therapy combined with exercise on range of motion (ROM), muscle strength, and functional performance in adolescent baseball players with internal impingement syndrome of the shoulder. Methods : The subjects were 30 patients diagnosed with impingement syndrome of the shoulder. Thirty subjects are randomly assigned to each 3 different groups; Group 1. (exercise group), Group 2. (exercise+mobilization; EMOB group), Group 3. (exercise+mobilization with movement; EMWM group). The interventions were performed three times a week for 4 weeks. The main outcome measures were goniometer, Biodex dynamometer, and Korean Kerlan Jobe shoulder-elbow (K-KJOC) scores. The ROM (external and internal rotation), muscle strength (external and internal rotation: 60 °/sec., 180 °/sec.), and functional performance were compared among the groups. Results : No significant difference was observed among the groups in the range of external rotation of the shoulder before and after the intervention, but the range of internal and total rotation was significantly increased in Group 2, 3 compared to Groups 1. Muscle strength of external and internal rotation (60 °/sec., 180 °/sec.) was not significantly different among Group 1, 2, 3, and functional performance was significantly increased in Group 2, 3 compared to Group 1. However, there was no significant difference between Group 2 and Group 3 in all measurements. Conclusion : An intervention with manual therapy such as EMOB and EMWM was more effective than exercise alone for rapid recovery from shoulder injury and improvement in functional performance. However, further efforts are needed to identify effects of specific interventions with manual therapy.

• PNF and Movement
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• v.17 no.2
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• pp.167-175
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• 2019

Purpose: This study aims to determine the effect of Jeonbuk tri-pull taping and proprioceptive neuromuscular facilitation (PNF) exercise on the shoulder's active range of motion, pain, subluxation, upper extremity function, and activities of daily living in patients with stroke. Methods: In this study, Jeonbuk tri-pull taping and PNF exercise were applied to three patients with stroke and subluxation. The tape was removed and new tape applied for two days every Monday, Wednesday, and Friday over six consecutive weeks. PNF exercise was applied five times a week for six weeks. To measure the range of motion, a smart phone clinometer application was used, and the degree of pain was measured using a visual analogue scale (VAS). A jig measuring method was employed to measure the distance of subluxation. The Fugl-Meyer Assessment (FMA) was used to evaluate arm function, and the modified Barthel Index (MBI) was employed to evaluate the activities of daily living. Results: The shoulder's active range of motion was improved in the patients compared to the range of pre-tests, and the pain and subluxation distance were reduced compared to those of pre-tests. Arm function and activities of daily living were increased compared to those of pre-tests. Conclusion: The study results verified that Jeonbuk tri-pull taping and PNF exercise are useful when applied to patients with subluxation and stroke.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.2
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• pp.66-74
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• 2012

Purpose: To compare the outcome of two methods of chronic calcific tendinitis (CCT) treatment, Multiple drilling alone versus combined drilling and extracorporeal shock-wave therapy (ESWT). Furthermore, to analyze the clinical and radiologic results of different energy level configurations of ESWT. Materials and Methods: Among the patients complaining shoulder pain who visited the clinic from June 2010 to August 2011, 98 were diagnosed with CCT of the supraspinatus and were divided into the following three groups. Multiple drilling alone (n=31), Multiple drilling followed by high-energy ESWT (n=31), Multiple drilling followed by low-energy ESWT (n=36). The study was conducted only with patients with chronic pain persisting longer than six months despite prolonged conservative therapy. Clinical evaluation was done before and after 12 weeks from treatment, in clinical terms using the ASES, KSS, CSS system reflecting performance and symptom improvement, and in radiologic terms by studying the change in size of the calcific nodules. Results: All of three groups showed effects for improvement of clinical function and decrease of calcification and clinical improvement was significantly high in comparison between the group fulfilled by only multiple needling (the third group) and the group fulfilled by additional ESWT (the first and second groups) and in the radiological evaluation, calcification size and the rate of calcification decrease showed significant improvement statistically. For the comparison among the groups, degree of clinical function improvement and rate of calcification decrease showed significant difference between high energy group (the first group) and multiple needling group (the third group) as well as low energy group (the second group) and multiple needling group (the third group). But, in comparison between high energy group (the first group) and low energy group (the second group), there was no significant difference for the degree of clinical function improvement and rate of calcification decrease. Conclusion: For the treatment of chronic calcific tendinitis, additional ESWT showed more superior effects on clinical function improvement and radiological improvement regardless of the energy standard rather than the exclusive fulfillment of needling. But, as the result of ESWT by the energy standard, there was no significant difference for the decrease of calcification and degree of clinical function improvement.

• PNF and Movement
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• v.16 no.2
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• pp.275-286
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• 2018

Purpose: This study aimed to investigate the effect of an intensive rehabilitation program on the pain, range of motion (ROM), muscle strength, function, quality of life (QoL), and depression of patients with traumatic rotator cuff injury caused by an industrial accident. Methods: Seventeen patients with traumatic rotator cuff injury caused by an industrial accident participated in this study. The 12-week treatment included 30 min of manual therapy and 30 min of exercise therapy twice a day, five times a week. The outcomes were measured for evaluating the pain, ROM, muscle strength, function, QoL, and depression before the commencement of the program and after 4, 8, and 12 weeks. Results: According to the time of applying the intensive rehabilitation program, the pain (p<0.01), ROM (p<0.01), muscle strength (p<0.01), function (p<0.01), and depression (p<0.05) significantly improved with time. However, QoL was not statistically significant. Conclusion: This study confirmed the excellent effect of an intensive rehabilitation program on the pain, ROM, muscle strength, function, and depression of patients with traumatic rotator cuff injury caused by an industrial accident. However, this study was limited by the absence of a control group. This pilot study highlights the need for more extensive research with a larger sample.

• Journal of Korean Public Health Nursing
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• v.13 no.2
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• pp.101-114
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• 1999

This study was designed to investigate the effects of an aquatic exercise program on the shoulder joint function. physical symptom. quality of life and stress among the patients who received modified radical mastectomy between 6 to 12 months prior to their visits. The subjects were 31 women aged between 40 and 60 who visited the out-patient department at Kang Nam St. Mary's Hospital for follow-up care. and were not under the treatment of intravenous cancer chemotherapy or radiation therapy. and had no complications. Twelve of them were assigned to the control group. while nineteen subjects to the experimental group. The aquatic exercise program was developed by the author with the assistance of exercise specialists. The program includes warming uP. aerobic and cooling down exercises in water. The aquatic exercise program for the experimental group was carried out 3 times a week with 60 minutes in each time for 8 weeks from September 20th to November 15th. 1995 in a regular swimming pool in Seoul. Changes in the range of motion of the shoulder joint. muscle strength. physical symptom. quality of life. and stress were examined after the completion of treatment. The data were collected through isokinetic muscle strength evaluation and questionnaire survey before and after the treatment. Paired and unpaired t-test were adopted to analyze the data. The results were as follows ; 1. The increment in the range of motion of the shoulder joint in the experimental group after the exercise was significantly greater than those in the control group. 2. The peak torque of shoulder girdle muscles increased significantly after the exercise in the experimental group only. 3. The physical symptom score decreased significantly after the exercise in the experimental group only. 4. The experimental group revealed significantly higher level of quality of life and lower level of stress after the exercise compared with those before the exercise. whereas the control group showed no significant changes in those levels. These findings may indicate that the aquatic exercise program is effective in increasing the range of motion of the shoulder joint and muscle strength and quality of life. and also effective in decreasing physical symptoms. and the level of stress in postmastectomy patients. Accordingly. the acquatic exercise program' can be adopted as an effective nursing intervention for postmastectomy rehabilitation.

• Journal of Hospice and Palliative Care
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• v.21 no.4
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• pp.158-162
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• 2018

Breast cancer related lymphedema (BCRL) is one of the most intractable complications after surgery. Patients suffer from physical impairment, as well as psychological depression. Moreover, a recent study revealed that cellulitis significantly increased the risk of BCRL, and cellulitis has been suggested as a risk factor of BCRL development. We describe a patient treated with stellate ganglion blocks (SGBs) without steroid for relief of symptoms and reduction of the arm circumference of breast cancer-related infectious lymphedema in a month. We measured the arm circumference at four locations; 10 cm and 5 cm above and below the elbow crease, numeric rating scale (NRS) score, lymphedema and breast cancer questionnaire (LBCQ) score on every visit to the pain clinic. A serial decrease of the arm circumference and pain score were observed after second injection. In the middle of the process, cellulitis recurred, we performed successive SGBs to treat infectious lymphedema. The patient was satisfied with the relieved pain and swelling, especially with improved shoulder range of motion as it contributes to better quality of life. This case describes the effects of SGB for infectious BCRL patients. SGB could be an alternative or ancillary treatment for infectious BCRL patients.

• Physical Therapy Korea
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• v.26 no.3
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• pp.11-22
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• 2019

Background: Sling exercises are frequently used for the rehabilitation process of patients with shoulder joint injuries, but research on the significant frequency intensity and appropriate treatment duration for sling exercises with local vibration stimulation is lacking. Objects: The aim of this study was to investigate the effects of sling exercise with vibration on shoulder range of motion (ROM), muscle strength, pain, and dysfunction in patients with a medical diagnosis of shoulder joint injury. Methods: Twenty-two patients were randomly assigned to the experiment and control groups. Six sling exercises with and without 50 Hz vibrations were applied in the experiment and control groups, respectively. Each exercise consisted of 3 sets of 5 repetitions performed for 6 weeks. The assessment tools used included shoulder joint range of motion, muscle strength, pain level, and shoulder pain and disability index for functional disability. We conducted re-evaluations before and 3 and 6 weeks after intervention. The changes in the measurement variables were analyzed and compared between the two groups. Results: The ROM of the external rotation of the shoulder joint had a significant interaction between the group and the measurement point (F=3.652, p<.05). In both groups, we found a significant increase in external rotation angle between the measurement points (p<.05). The flexor strength of the shoulder joint significant interaction between the group and the measurement point (F=4.247, p<.05). Both the experiment (p<.01) and control groups (p<.05) showed a significant increase in shoulder flexor strength at the measurement points. After 6 weeks of the interventions, both the groups showed significantly improved VAS (p<.01), SPADI (p<.01), and orthopedic tests (p<.01). However, there was no significant difference between the group and the measurement point in terms of the clinical outcomes observed. Conclusion: The sling exercise with local vibration of 50 Hz affected the external rotation of the shoulder range of motion and improved shoulder flexor strength in the patients with shoulder injuries. Therefore, we propose the use of the sling exercise intervention with vibration in the exercise rehabilitation of patients with shoulder joint injuries.