• 대한정형외과학회지
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• 제56권1호
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• pp.68-75
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• 2021

목적: 견관절의 운동 기능에 대한 평가는 견관절 질환의 진단 및 경과를 파악하는 데 있어 중요하다. 본 연구는 정상군 및 견관절질환을 가진 환자군에 대해 깊이 센서 기반 동작 분석 시스템을 통한 관절 운동을 동적으로 분석하여 문헌 고찰과 함께 보고하는 바이다. 대상 및 방법: 70명의 피험자가 연구에 참여하였으며 정상군 30명과 견관절 질환을 가진 환자 40명으로 분류하였다. 견관절 질환을 가진 환자 40명은 4가지 질환(회전근개 파열, 유착성 활액막염, 충돌 증후군, 회전근개 관절병증)으로 세분화하였다. 총 3회 반복된 외전 및 내전 운동 시 시간에 따른 각도를 깊이 센서 기반 동작 분석 시스템으로 측정하였으며, 최대 외전 각도, 최대 외전 각 속도, 최대 내전 각속도, 외전/내전 시간 비를 계산하였다. 상기 매개 변수들에 대해 정상군 30명과 환자군 40명을 비교하는 한편, 정상군 30명과 4가지 질환군별 10명, 총 5개 군을 비교하였다. 결과: 견관절 질환을 가진 환자군에서는 정상군에 비해 감소된 최대 외전 각도(θ_max), 최대 외전 각속도(ω_max), 최대 내전 각속도(ω_min)를 보였으며, 증가된 외전/내전 시간 비(t_abd/t_add)를 보였다. 세분화된 질환군별 비교에서는 최대 외전 각도(θ_max)와 최대 외전각속도(ω_max)가 정상군에 비해 유착성 활액막염 환자군 및 회전근개 관절병증 환자군에서 감소되었고, 외전/내전 시간 비(t_abd/t_add)가 정상군에 비해 유착성 활액막염 환자군, 회전근개 파열 환자군 및 회전근개 관절병증 환자군에서 증가되었다. 결론: 깊이 센서 기반 동작 분석 시스템을 사용한 견관절의 운동 분석을 통해 관절 운동 범위뿐 아니라 각속도 등의 동적 운동 변수를 측정할 수 있었으며, 이를 통해 견관절의 더 정확한 기능 평가 및 심도 있는 질환의 이해가 가능할 것이다.

• 대한물리의학회지
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• 제13권2호
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• pp.11-19
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• 2018

PURPOSE: The aim of this study was to identify the effects of joint mobilization intervention combined with exercise on range of motion (ROM), pain intensity, and functional performance in adolescent baseball players with internal impingement syndrome of the shoulder. METHODS: The subjects were 30 adolescent baseball players diagnosed with internal impingement. Ten subjects were randomly assigned to each of 3 groups: Group 1 (exercise only), Group 2 (joint mobilization combined with exercise), and Group 3 (rest-only control group). Three weekly interventions were given for 4 weeks (the control group rested for 4 weeks). The main outcome measures were goniometer, visual analogue scale (VAS), and Korean Kerlan Jobe shoulder-elbow (K-KJOC) scores. The ROM (external and internal rotation), pain intensity (at the moment of throwing), 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 rotation was significantly increased in Group 2 compared to Groups 1 and 3. Pain intensity was significantly lower in Group 2 than in Group 1 and 3, and functional performance was significantly increased in Group 2 compared to Group 1 and 3. CONCLUSION: An intervention that combined joint mobilization with exercise was more effective than resting or exercise alone for rapid recovery from sports injury and improvement in athletic performance.

• 한국전문물리치료학회지
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• 제27권1호
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• pp.19-29
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• 2020

Background: Stretch-oriented home exercise programs are often used as treatments for patients with adhesive capsulitis; however, there is lack of research on home exercise programs to strengthen rotator cuffs. Objects: The aim of this study is to investigate the effect of home exercise programs for rotator cuff strengthening on pain, range of motion (ROM), disability level, and quality of life in patients with adhesive capsulitis. Methods: Twenty-two patients with adhesive capsulitis volunteered to participate in this study. The subjects were randomly divided into an experimental group (n = 11) and control group (n = 11). For the experimental group, manual therapy and home exercise programs for rotator cuff strengthening were applied for 6 weeks; for the control group, only manual therapy was applied for 6 weeks. Shoulder pain (quadruple visual analogue scale, QVAS), ROM, disability (shoulder pain and disability index-Korean version, SPADI), and quality of life (world health organization quality of life scale-Korean version, WHOQOL-BREF) were evaluated at baseline, after 3 weeks, and after 6 weeks of intervention. The changes in the measurement variables were analyzed by using repeated measure analysis of variance. Results: Significant differences were observed between the experimental group and control group in the QVAS; SPADI-pain scores; SPADI-disability scores; SPADI-total scores; flexion, abduction, internal and external rotation ROM of the glenohumeral joint; and WHOQOL-BREF total, overall, physical health, and psychological scores. All groups displayed statistically significant improvements as observed in the QVAS, SPADI, flexion, abduction, external and internal rotation ROM of the glenohumeral joint, and WHOQOL-BREF. Conclusion: Home exercise programs for rotator cuff strengthening had a positive impact on shoulder pain, shoulder ROM, disability level, and quality of life in patients with adhesive capsulitis. Therefore, we propose the use of home exercise programs for rotator cuff strengthening in the exercise rehabilitation of patients with adhesive capsulitis.

• PNF and Movement
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• 제17권2호
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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.

• PNF and Movement
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• 제20권2호
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• pp.223-233
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• 2022

Purpose: The study aimed to determine the effect of extra thoracic mobilization exercises on shoulder pain and function in patients who had undergone rotator cuff repair. Methods: Following the recording of baseline measurements, 20 subjects who had undergone rotator cuff repair were randomized into two groups: the experimental group (n = 10), which did thoracic mobilization exercises, and the control group (n = 10), which received traditional physical therapy. Each group participated in the intervention five times per week for two weeks. The pain (using the visual analogue scales [VAS]), the flexion and abduction range of motion (ROM), and the shoulder pain and disability index (SPADI) scores of both groups were recorded pre- and post-intervention. Paired t-tests were used to determine whether post-intervention scores were significantly different from pre-intervention scores, and independent t-tests were used to analyze differences in the dependent variables between the two groups. Results: After the two-week intervention, both groups experienced significantly decreased VAS and SPADI scores (p < 0.05) and significantly increased flexion and abduction ROM (p < 0.05). The experimental group that undertook the thoracic mobilization exercises showed greater improvements in pain, flexion and abduction ROM, and the SPADI than the control group (p < 0.05). Conclusion: These results suggest that thoracic mobilization exercises reduce shoulder pain and disability and enhance function in patients who have undergone rotator cuff repair.

• PNF and Movement
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• 제21권1호
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• pp.53-61
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• 2023

Purpose: The study aims to examine the effects of the proprioceptive neuromuscular facilitation pattern exercise and scrambler therapy on pain, range of motion (ROM), and shoulder dysfunction in breast cancer patients. Methods: In total, 30 breast cancer patients were recruited and randomized to group I (n = 10), group II (n = 10), and group III (n = 10). Pain was measured using a visual analogue scale, ROM was measured using a goniometer, and shoulder dysfunction was measured using a shoulder pain and disability index. Group I practiced the proprioceptive neuromuscular facilitation pattern exercise and underwent scrambler therapy, group II underwent scrambler therapy only, and group III practiced the proprioceptive neuromuscular facilitation pattern exercise only. Results: A within-groups comparison showed that all groups demonstrated significant differences in pain, ROM, and shoulder dysfunction after the experiment (p<0.05). Further, according to a comparison of the three groups, group I showed a more significant difference in effectiveness than groups II and III in terms of pain, ROM, and shoulder dysfunction before and after the experiment (p<0.05). Conclusion: This study showed that the proprioceptive neuromuscular facilitation pattern exercise and scrambler therapy are effective in treating pain, ROM issues, and shoulder dysfunction in breast cancer patients.

• 대한물리치료과학회지
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• 제31권2호
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• pp.63-74
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• 2024

Background: This study aimed to determine the effects of static stretching on the pain and range of motion (ROM) of shoulder joints in middle aged women patients with frozen shoulders. Design: One group pretest-posttest design Methods: The participants were 15 middle aged women patients with frozen shoulders in their 40s to 60s. Subjective and objective pain and joint ROM(range of motion) were measured, and the static stretching intervention consisted of 15 minutes of flexion, abduction and external rotation stretching. Results: The results of this study indicated that the daily pain of shoulder joints and pressure pain thresholds of the muscles surrounding the shoulder joints were generally improved after the intervention with the static stretching, for which significant differences were observed (p<0.05). The ROM of shoulder joint flexion, abduction, and external rotation was significantly increased (p<0.05) after the intervention with the static stretching. Conclusion: Static stretching intervention in patients with frozen shoulders relieved shoulder joint pain and had positive effects on the ROM of shoulder joints. Thus, the application of static stretching in middle aged womenpatients who experience severe pain could be effective at enhancing the function of shoulder joints without pain.

• 대한통합의학회지
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• 제8권1호
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• pp.47-56
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• 2020

Purpose : The purpose of this study was to determine the effects of upper extremity volume, pain, and range of motion after participation in thera-band exercises according to the hand grip type in patients with breast cancer with upper extremity edema. We also aimed to determine the most efficient type of grip. Methods : The subjects were 10 female patients diagnosed with stage 2 breast cancer who had stage 2 lymphedema. Randomly, 5 patients each were allocated to the experimental and control groups. For six weeks, the patients in both the experimental and control groups exercised daily. In both groups, manual lymph drainage was applied for 1 hour. Afterward, patients in the experimental group placed their hands in the thera-band ring and exercised with their fingers outstretched. Patients in the control group exercised while holding the thera-band ring with a finger. Both the experimental group and the control group underwent measurements of the circumference of the upper extremity, pain, and range of motion of the shoulder joint at weeks 1, 2, 4, and 6 before and after exercise. Results : The upper arm circumference decreased by more in the experimental group in all weeks than before than that in the control group, and there was a statistically significant difference at 6 weeks. Compared with the difference between pre-exercise and 6 weeks post-exercise, the change in pain significantly decreased in the experimental group and showed a statistically significant difference. The shoulder range of motion increased in extension, external rotation, and internal rotation compared with that in the control group, and there was a statistically significant difference. Although the operating range increased in flexion and abduction, there were no statistically significant differences. Conclusion : In this study, we found that thera-band exercises with an open-hand grip are more efficient than thera-band exercises with a closed-hand grip in edema reduction, pain, and range of motion. In addition, it was found that it was more effective to continue the thera-band exercises with open-hand grip extended for at least 6 weeks rather than for a short time.

• 한국전문물리치료학회지
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• 제26권3호
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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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제8권1호
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• pp.92-100
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• 1997

뚜렛장애는 운동틱과 음성틱이 복합적으로 나타나는 만성적인 질환으로써 임상적인 특성, 동반된 행동상의 문제들에 대해 전세계적으로 많은 연구가 이루어지고 있다. 이 연구의 목적은 한국의 뚜렛장애 환자의 임상적인 특성과 동반된 행동상의 특징을 비교적 다수 환자집단을 대상으로 연구한 것이다. 연구대상은 157명의 뚜렛장애 환자로서 1988년부터 1994년까지 연세대학교 정신과 뚜렛클리닉을 방문한 환자들이었다. 진단을 위해 DSM-III-R의 진단기준을 사용하였다. 인구학적 자료, 증상, 경과 등 임상적인 특성, 가족력 및 과잉행동, 강박성, 충동성, 야뇨증, 자기파괴행동, 수면장애 등 동반된 행동상의 특징은 본 연구를 위해 고안된 반구조화된 설문지와 전반적 임상적 인상(global clinical impression)을 이용해 평가하였다. 연구결과는 다음과 같다. 환자들의 평균연령은 14.49(${\pm}7.99$)세였다. 남자가 138명(87.9%), 여자는 19명(12.1%)으로 남녀의 성비가 약 7：1의 비율로 남자가 많았다. 133명(84.7%)은 오른손잡이였고 24명(15.3%)은 양손잡이거나 왼손잡이였다. 평균발병연령은 8.85(${\pm}4.56$)세였고 발병연령의 범위는 2세에서 16세였다. 반수 이상의 환자가 6세에서 10세 사이에 발병하는 양상을 보였다. 발명연령에 있어 두번의 높은 발병빈도가 관찰되었는데 처음에는 6세경에 높은 양상을 보였고 이후 10세 무렵에 다시 한번 높은 발병빈도가 관찰되었다. 이러한 경향은 남녀간에 공통적이었다. 처음 증상중 가장 흔한 것은 눈깜박임으로 55% 이상의 환자에서 나타났다. 다음으로는 고개 돌리기, 음성틱 등이었다. 환자들이 발병후 내원할 때까지 보였던 모든 틱증상의 빈도를 보면 전체 환자중 129명(82.2%)에서 눈깜박임이 있었고 91명(57.9%)이 고개짓, 83명(52.7%)이 어깨 움추리기 혹은 돌리기, 51명(32.6%)이 팔흔들기가 있었다. 101명(64.3%)은 증상이 신체의 상부에서 하부로 향했고 25명(15.9%)은 신체의 하부에서 상부로 증상이 진행하는 양상을 보였다. 나머지는 음성틱과 고개돌리기가 비슷한 시기에 나타나는 등 증상의 진행방향에서 상향성 혹은 하향성을 정하기 어려운 환자들이었다. 환자의 아버지중 19명(12%)이 강박장애의 병력이 있었고 17명(10.6%)은 틱장애의 병력이 있었다. 반면, 환자의 어머니중 7명(4.5%)이 강박장애의 병력이 있었고 4명(2.5%)은 틱장애의 병력이 있었다. 환자중 118명(75.1%)에서 과잉행동이 동반되었고 95명(60.5%)에서 강박증상이 동반되었고 55명(35.0%)에서 자기파괴적인 행동이 있었으며 46명(29.3%)에서 충동성이 동반되었고 35명(22.3%)에서 유뇨증이 관찰되었다. 환자의 발병연령과 내원시 연령, 병의 이병 기간, 강박증상의 정도 사이에 통계적으로 유의한 양성의 상관관계가 있었고 과잉행동성과 음성의 상관관계가 있었다. 과잉행동성과 충동성, 강박성, 야뇨증, 자기파괴적 행동사이에 통계적으로 유의한 양성의 상관관계가 있었다. 환자의 강박증상의 정도와 과잉행동성, 수면장애, 자기파괴적 행동 사이에 통계적으로 유의한 양성의 상관관계가 있었다. 본 연구 결과 저자들은 외래에 내원한 뚜렛장애 환자의 임상적 특성이나 동반된 행동상 문제들이 이전 연구와 크게 상이하지 않음을 확인할 수 있었으며 발병연령이 어릴수록 과잉행동성이 심했으며 발병연령이 늦을수록 강박성이 심했다. 과잉행동성과 충동성, 강박성, 야뇨증, 자기파괴적 행동 등은 상호 높은 관련성이 있었다.