• PNF and Movement
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• 제18권3호
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• pp.305-313
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• 2020

Purpose: The aim of this study was to investigate the relationship between a functional evaluation model and the Fugl-Meyer assessment (FMA) scale in evaluating the upper extremities of stroke patients Methods: Thirty-eight stroke patients were evaluated using the FMA and performed reaching and grasping motions using a three-dimensional motion analysis (Qquas 1 series, Qualisys AB, Sweden). The participants sat on a chair with a backrest. The position of the cup was located at a distance of 80% to the front arm length. The markers were attached to the sternum, acromion, elbow lateral epicondyle, ulnar styloid process, three metacarpal heads, and the distal phalanges of the thumb and index finger. The variables of the correlation between the functional evaluation model and the FMA scale were analyzed. Multiple regression (stepwise) was used to investigate the effect of the kinematic variables. Results: A significant negative correlation was found between the movement time (p < 0.05), movement unit (p < 0.05), and trunk displacement values (p < 0.05) in the FMA total scores, while a positive correlation was found between the peak velocity (p < 0.05) and maximum grip aperture values (p < 0.05). As a result of the multiple regression analysis, the most significant factor was the movement unit, followed by the general movement assessment and trunk displacement. The explained FMA total score value was 62%. Conclusion: This study presents a new functional evaluation model for assessing the reaching and grasping ability of stroke patients. The factors of the proposed functional evaluation model showed significant correlations with the FMA scale scores and confirmed that the new functional evaluation model explained the FMA by 67%. This suggests a new functional evaluation model for reaching and grasping stroke patients.

• Clinics in Shoulder and Elbow
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• 제24권3호
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• pp.125-134
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• 2021

Background: To evaluate clinical and radiological outcomes of bony increased offset-reverse total shoulder arthroplasty (BIO-RSA) in the Asian population at mid-term follow-up. Methods: From June 2012 to August 2017 at a single center, 43 patients underwent BIO-RSA, and 38 patients with minimum 2 years follow-up were enrolled. We evaluated the clinical and radiological outcomes, and complications at the last follow-up. In addition, we divided these patients into notching and no-notching groups and compared the demographics, preoperative, and postoperative characteristics of patients. Results: Visual analogue scale, American Shoulder and Elbow Surgeons, University of California-Los Angeles Shoulder Scale, and Simple Shoulder Test scores improved significantly from preoperative (5.00, 3.93, 1.72, 3.94) to postoperative (1.72, 78.91, 28.34, 7.66) (p<0.05) outcomes. All range of motion except internal rotation improved significantly at the final follow-up (p<0.05), and the bone graft was well-incorporated with the native glenoid in all patients (100%). However, scapular notching was observed in 20 of 38 patients (53%). In the comparison between notching and no-notching groups (18 vs. 20 patients), there were no significant differences in demographics, radiological parameters, and clinical outcomes except acromion-greater tuberosity (AT) distance (p=0.003). Intraoperative complications included three metaphyseal fractures and one inferior screw malposition. Postoperative complications included ectopic ossification, scapular neck stress fracture, humeral stem relaxation, and late infection in one case each. Conclusions: BIO-RSA showed improved clinical outcomes at mid-term follow-up in Asian population. However, we observed higher scapular notching compared to the previous studies. In addition, adequate glenoid lateralization with appropriate humeral lengthening (AT distance) might reduce scapular notching.

• 대한수의학회지
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• 제27권2호
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• pp.167-183
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• 1987

The anatomical structure of the Skeleton of thoracic limb of thirty-one adult Korean native goats(body weight: 14~17kg) was observed after skeletal preparation, and the osteometry was performed in each bone. The results were as follows; 1. The thoracic limb of the Korean native goat was composed of scapula, humerus, radius, ulna, carpal bones, metacarpal bones, phalanges and sesamoid bones. 2. The scapula was flat and triangular in shape. There were no distinct tuber of spine and acromion in the spine. The subscapular fossa was deep and triangular in shape and the vertebral border was sigmoid form. The coracoid bone was formed as the coracoid process at the medial aspect of the supraglenoid tubercle but the clavicle wa.s not observed. The left and right scapular indexes were 57.92 and 58.31 and the glenoid cavity indexes were 89.23 and 86.82, respectively. 3. The greater tubercle of the humerus was devided into cranial and caudal parts. The third tubercle was observed and the face for the infraspinatus muscle was rectangular form. The left and right humerus indexes were 32.44 and 32.63, the head indexes were 94.13, 96.62 and the trochlear-epidondyle indexes were 67.32 and 65.81, respectively. 4. The radius and ulna were fused entirely except at the broad proximal and narrow distal interosseous spaces. The ulna was longer than the radius, and its reduced body and distal end were fused at the caudomedial surface of the radius. 5. The carpal bones were six in number. There were radial, intermediate, ulnar, accessory, second-third and fourth carpal hones in carpal bones. 6. The metacarpal bone was composed of a large metacarpal bone resulted from the fusion of the third and fourth metacarpal bones, and there was a metacarpal tubercle at the dorsolateral part of the proximal end. There were no vestiges of the second and fifth metacarpal bones. 7. The digits were composed of third and fourth digits and each digit was composed of the proximal, middle and distal phalanges. 8. The sesamoid bones were six in number. There were two at the fetlock joint and one at the coffine joint palmarly in each digit. 9. The ratios of the lengths among the scapula, humerus, antebrachium and metacarpal bone were 1.42 : 1.47 : 1.77 : 1.00 in the left and 1.42 : 1.45 : 1.77 : 1.00 in the right, respectively.

• 대한통합의학회지
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• 제3권1호
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• pp.91-103
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• 2015

Purpose: The purpose of this study was to investigate the effects of home exercise program and exercise program of round shoulder adjustments on the level of trapezius muscle activity and attention capacity for middle school students. Method: The participants in this study were composed of 21 middle school students. We made the students lie on the floor in prone position, then measured the height of their acromion from the floor. We chose participants for our study whose measurement values were over 2.5cm. We divided them into two groups, one is for the experimental group, and the other is for the control group. The experimental group exercised three days a week for 6 weeks, including home training, and the control group didn't exercise. We used EMG to measure the trapezius muscle's activity and used a Stroop test for the measurement of the students' attention capacity. Results: The results of our study are as follows. There was no significant difference between the experimental group and the control group. However, there was a significant difference within the experimental group when comparing pre and post training results for Trapezius muscle activity and attention capacity. Conclusion: We found that correcting round shoulder symptom increases the Trapezius muscle activity and students' attention capacity. Future experiments should investigate with systemical management. Also, we need to increase the frequency of the exercise and participants.

• 한국의류학회지
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• 제18권2호
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• pp.252-262
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• 1994

성인 남자 목부위의 연령별 형태 변화를 슬라이딩 게이지법에 의하여 측정하고자 하였으며,피험자는 20대 청년층 15명, 40대 중년층 11명, 60대 노년층 11명으로 하였다. 측정 부위는 후두융기점, 목뒷점, 목앞점, 어깨점을 지나는 목부위의 수평단면형태로 하였으며, 목부위의 측면형태, 각 수평단면의 둘레, 수평단면의 전후$\cdot$좌우길이에 대하여 연령별 특징을 파악하였다. 실험결과를 요약하면 다음과 같다. 1. 목뒷점에서 수평으로 인체의 전방을 향하여 그으진 수평선에 대한 후두융기점의 위치로서 목의 측면 형태를 분석하였으며, 20대에서는 피험자 15명중 14명이 자세I과 자세II에 속하므로서 경부 자세가 바른 체형을 보여 주었으며, 40대에서는 피험자 11명중 자세II에 속하는 피험자가 3명이었으며 나머지 8명은 경부 자세가 앞으로 수그러진 체형인 자세III에 속하였다. 60대에서는 피험자 11명 모두가 자세III에 속하였다. 2. 후두융기점, 목뒷점, 목앞점, 어깨점을 지나는 각 수평 단면도의 특징에 대하여 보면,목뒷점 수평단면의 형태는 젊은층은 원형을, 중년층과 노년층으로 갈수록 타원형의 모양으로 변화하는것을 볼 수 있었다. 또한, 후두융기점의 위치가 앞으로 수그러지면서 후두융기점 을 지나는 수평단면도의 형태 역시 나이가 들수록 청년층에 비하여 뒷목 부위가 크게 되어지는 경향을 볼수 있었다. 목앞점을 지나는 수평단면은 나이가 들수록 청년층에 비하여 단면의 전후$\cdot$좌우길이가 커지는 경향을 볼 수있었으며 40대가 최대치를 나타내었다. 어깨점을 지나는 수평단면의 특징은 나이가 들수록 전후길이(두께)는 증가하고 좌우길이(너비)는 감소하는 경향을 보였다.

• 한국전문물리치료학회지
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• 제24권2호
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• pp.48-57
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• 2017

Background: Rounded shoulder posture (RSP), a postural abnormality, might cause shoulder pain and pathologic conditions. Although most previous research has investigated RSP focusing on the proximal structures of the shoulder, such as the scapula and pectoralis muscles, the relationship between RSP and anterior distal structures of the upper extremity, such as the biceps brachii muscle and elbow joint, is not clearly understood. Objects: This study aimed to investigate the correlations between RSP and the biceps brachii length, elbow joint angle (EJA), pectoralis minor length, general pectoralis major length, humeral head anterior translation (HHAT), glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HAD). Methods: Twelve subjects with RSP (6 male, 6 female) were recruited. All subjects fulfilled the RSP criteria indicated by a distance ${\geq}2.5cm$ from the posterior aspect of the acromion to the table in the supine position. The examiner measured each of the following parameters twice: RSP, biceps brachii length, EJA, pectoralis minor length, pectoralis major length, HHAT, glenohumeral IR, ER, and HAD. Pearson's correlation coefficient(r) was used to assess the correlation between RSP and all the variables. Results: There was a significant moderate positive correlation between RSP and biceps brachii length (r=.55, p=.032), moderate negative correlation between RSP and pectoralis minor length (r=-.62, p=.015), and moderate positive correlation between RSP and HHAT (r=.53, p=.038). Conclusion: The biceps brachii length, pectoralis minor length, and HHAT could be used to evaluate patients with RSP. Better understanding of the correlation between these factors and RSP could help in the development of effective methods to treat patients with this condition in clinical management.

• 한국전문물리치료학회지
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• 제30권1호
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• pp.50-58
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• 2023

Background: This study was carried out to determine whether non-face-to-face physical therapy would have similar exercise effects to face-to-face physical therapy. Hence, we developed an approach for patients, unable to visit hospitals due to circumstances such as the COVID-19 pandemic, to conduct physical therapy comfortably at home. Objects: This study aimed to compare the effects of a face-to-face and a non-face-to-face physical therapy treatment on improving a rounded shoulder posture. Methods: The participants with rounded shoulders were randomly divided into a face-toface group (n = 15) and a non-face-to-face group (n = 15), and each group performed exercises for four weeks. The exercise program consisted of the bare hands exercise, Thera-Band exercise, and foam roller exercise. The participants in the face-to-face group came to a designated place to perform their exercises, and those in the non-face-to-face group performed the exercises at their own home using Google Meet (Google). Acromial height, total scapular distance (TSD), shoulder pain and dysfunction index (SPADI), and pectoralis minor thickness were measured. Data analysis was performed using the R Statistical Software (R Core Team), and a normality test was performed using the Shapiro-Wilk test. Results: There were no significant differences between the face-to-face and the non-face-toface groups (p > 0.05). When comparing the differences before and after the exercises, both the face-to-face and the non-face-to-face groups showed significant differences in acromial height, SPADI, and pectoralis minor thickness (p < 0.05), and both groups showed no significant difference in TSD before and after the exercises (p > 0.05). Conclusion: The results of this study support the results of previous studies reporting that shoulder stabilization exercise and pectoralis minor stretching training improves round shoulders. In addition, this study revealed that both the face-to-face and the non-face-to-face physical therapy treatments had therapeutic effects.

• 대한관절경학회지
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• 제13권1호
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• pp.34-38
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• 2009

목적: 견봉하 충돌증후군에서 견봉하 점액낭의 염증과 견봉 모양 및 통증과의 연관성을 연구하였다. 대상 및 방법: 견봉하 충돌증후군으로 수술을 시행 한 24예를 대상으로 하였다. 18명은 남자, 6명은 여자였다. 평균 나이는 58.3세(44-71세)였다. 모든 환자는 수술 중 관절경 칼을 사용하여 $1{\times}1cm$크기의 견봉하 점액낭을 채취하여 조직검사를 시행하였다. 견봉 형태에 대한 방사선학적 분류는 Bigliani grading system에 의하여 평편형, 곡선형, 갈고리형으로 분류하였다. 환자의 통증 정도는 VAS(visual analog scale)에 의해 측정하였다. 병리조직학적으로 8가지 병리학적 인자를 사용하여, 점액낭의 염증을 급성 및 만성 분류하였고, 염증의 정도는 field에서 차지하는 비율을 사용하여3단계(mild, moderate, severe)로 분류하였다. 결과: 총 24례 중 병리학적으로 단계 1에 해당하는 증례는 9례, 단계 2는 15례였다. 단계 3에 해당하는 증례는 없었다. 병리학적 단계 1에 해당하는 증례 9례중 방사선학적 분류상 곡선형에 해당하는 경우는 6례, 갈고리형은 3례였다. 또한 병리학적 단계 2에 해당하는 증례 15례 중 방사선학적 분류 곡선형은 5례, 갈고리형은 10례였다. 환자의 견관절 통증 정도는 병리학적 단계 1에서 7점, 단계 2에서 8점이었다. 통계학적 분석 상, 병리학적 단계와 견봉의 형태와는 통계학적 의의가 있었다(p<0.05). 하지만 견관절 통증과는 연관성이 없었다(p>0.05). 결론: 본 연구는 견봉하 충돌증후군에서 견봉하 점액낭의 염증 정도와 견봉의 형태와는 연관성이 있는 것으로 생각된다. 하지만 점액낭의 염증 정도와 환자의 통증과는 연관성이 없었다.

• 대한방사선기술학회지:방사선기술과학
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• 제32권3호
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• pp.253-259
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• 2009

연구목적 : 편마비 환자에 있어 견부 아탈구 진단에 유용한 촬영법을 알아보고, 편마비 상태를 고려한 촬영방법을 알아보고자 하였다. 연구방법 : 뇌졸중으로 인한 편마비 환자 중 마비측 견관절 부위의 견봉 끝과 상완골두 사이가 1 수지폭 이상인 33명의 환자를 대상으로 견관절 전후방향촬영은 누운 자세와 앉은 자세의 영상을 비교하였고, 흉곽을 통한 상완골 측방향 촬영은 앉은 자세에서 건측과 환측의 영상을 비교하였다. 축방향 촬영은 누운 자세에서 건측과 환측을 비교하였고, 상완골두의 중심, 관절와의 중심, 견봉의 최하외측단의 3가지 기준점으로 거리를 측정하여 평균비교 분석(t-test)을 시행하였다. 연구결과 : 대상자를 누운 자세에서 앉히고 견관절 자연지위를 취한 후 견관절 아탈구가 되기까지의 시간은 평균 123초였다. 견관절 전후 방향 촬영에서 상완골두의 중앙점과 견봉의 최하외점과의 거리가 누운 자세에서는 평균 $49.90{\pm}13.6\;mm$이었고, 앉은 자세에서는 $60.72{\pm}16.3\;mm$이로 유의한 차이가 있었다. 흉곽을 통한 측방향 촬영에서는 환측 $35.92{\pm}6.2\;mm$, 건측 $28.76{\pm}5.4\;mm$으로 유의한 차이가 있었다. 누운 자세의 견관절 축방향 촬영에서는 건측과 환측 각각 $23.01{\pm}9.0\;mm$, $22.45{\pm}8.2\;mm$로 유의한 차이가 없었다. 결론 : 견관절 아탈구 진단을 위한 견관절 촬영은 촬영 전 수지폭 검사를 통해 아탈구가 진행됨을 확인한 후 촬영을 하여야 진단적 가치가 있다. 이를 위해 앉은 자세에서 견관절 자연지위로 120초 지난 후 촬영을 하여야 한다. 또한 견관절 전후방향 영상과 흉곽을 통한 측방향 촬영은 아탈구를 평가하는데 유효하였고, 견관절 축방향에서는 아탈구의 차이가 없으므로 진단적 가치가 떨어진다고 볼 수 있다.