The purpose is paper was to discuss current concepts related to anatomic stabilizing structures of the shoulder joint complex and their clinical relevance to shoulder instability. The clinical syndrome of shoulder instability represents a wide spectrum of symtoms and signs which may produce various levels of dysfunctions, from subtle subluxations to gross joint instability. The glenohumeral joint attains functional stability through a delicate and intricate interaction between the passive and active stabilizing structures. The passive constraints include the bony geometry, glenoid labrum, and the glenohumeral joint capsuloligaments structure. Conversely, the active constraints, also referred to as active mechanism, include the shoulder complex musculature, the projprioceptive system, and the musculoligamentous relationship. The interaction of the active and passive mechanism which provide passive and active glenohumeral joint stability will be throughtly discussed in this paper
Journal of the Korean Society of Physical Medicine
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v.10
no.2
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pp.17-27
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2015
PURPOSE: The purpose of this study was to compare the effects of three interventions (intervention by passive range of motion exercise plus manual cervical traction, Mulligan's joint mobilization, and strengthening exercises) after Kaltenborn's joint mobilization on the cervical spine alignment, and muscle activity in patients with a forward head posture. METHODS: The subjects were 39 students from H University in Chungnam and C University in Jeonbuk. The subjects in each group attended training sessions three times a week for four weeks. We used one-way ANOVA and Scheffe's post hoc test to compare values between groups, and used paired t-test to compare the values of the dependent variables within groups. RESULTS: The results showed that the active intervention group experienced a significant increase compared to the passive intervention group in terms of the craniovertebral angle, cervical lordosis angle, and had significant decreases compared to the passive intervention group in terms of the upper trapezius muscle activity. The active intervention group also had significant increases in craniovertebral angle and decreased anterior scalene muscle activity than the active-assistive intervention group. The active-assistive intervention group had significant decreases compared to the active intervention group in terms of the serratus anterior, levator scapulae, and splenius capitis muscle activity. CONCLUSION: It appears that the subjects with a forward head posture had significant improvements in the cervical lordosis angle, cranial rotation angle, craniovertebral angle, and muscle activity after intervention by Mulligan's joint mobilization (active-assistive intervention component) and strengthening exercises (active intervention component) after applying Kaltenborn's joint mobilization.
Park, Hyoung Joon;Lee, Dong Chul;Kim, Jin Soo;Ki, Sae Hwi;Roh, Si Young;Yang, Jae Won
Archives of Plastic Surgery
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v.36
no.4
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pp.450-457
/
2009
Purpose: The second toe PIP joint free flap is a method of reconstruction used for abnormalities of the PIP joint of the finger. We report the results of the additional tenolysis in patients with a difference between passive ROM and active ROM after second toe PIP joint free flap. Methods: From March 2001 to July 2008, tenolysis was performed in patients with a difference in their active and passive ROM after second toe PIP joint free transfer, performed on 14 fingers. We performed a retrospective analysis of the medical records, noting the clinical and radiological findings. In addition, we measured the preoperative and postoperative range of motion of the PIP joint. Results: The average active ROM was $22.5^{\circ}$ at the three months after the joint transfer surgery, and was $38^{\circ}$ after additional tenolysis between five months and twelve months after the joint transfer. Conclusions: Additional tenolysis, after the second toe PIP joint free flap, might be a good option for improved results in patients with difference in active and passive ROM of a transferred PIP joint.
The purpose of this study was primarily to determine the relationship between temporomandibular joint mobility and generalized benign joint hypermobility. The subjects were 85 men and 76 women, who were students of dental and dental hygiene schools, aged 18 to 30 years old. They had no disturbances or complaints of movement of temporomandibular joints and other joints in the body. The joint mobility was measured by a test which is a modification of a method developed originally by Carter and Wilkinson (1964). The mandibular mobility was measured during active and passive maximal opening, laterotrusion, protrusion, and retrusion by Ingervall's method (1970). The obtained results were as follows: 1. The distribution of joint hypermobility disclosed was 4.8% in men and 19.7% in women, and 11.8% of total subjects. 2. The joint mobility index was a mean of 0.37 for men and 0.51 for women in total subjects, and 0.80 for men and 0.73 for women in hypermobile subjects. 3. The angle of passive dorsiflexion of the little finger was greater in the left than in the right hand for both sexes and in hypermobile subjects than in total subjects. 4. There was a positive correlation between the joint mobility index and the angle of passive dorsiflexion of the little finger in total subjects. 5. The joint mobility was greater in women than in men, and in the left than in the right hand. 6. In the active maximal mandibular movements of total subjects, the mean values for the opening capacity was 56.01 mm and 52.04mm, the laterotrusion mean 8.07 and 8.08, the protrusion mean 8.72 and 8.24, and the retrusion mean 0.48 and 0.49 for men and women respectively. 7. In the passive maximal mandibular movements of total subjects, the mean values for the opening capacity was 59.07mm and 54.85mm, the laterotrusion mean 8.90 and 9.12, the protrusion mean 10.03 and 10.00, and the retrusion mean 0.69 and 0.72 in men and women respectively. The active and passive maximal opening capacity was larger in men than in women but in the other movements there were no significant differences between men and women. 8. The range of active and passive maximal mandibular movements of hypermobile subjects tended to be larger in men but no significant difference in women compared with that of total subjects. 9. The range of maximal mandibular movements was increased more in passive than in active.
Journal of the Korean Society of Physical Medicine
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v.11
no.4
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pp.27-32
/
2016
PURPOSE: This study compared the immediate effect of a passive mobilization of upper cervical spine (Kaltenborn's joint mobilization) and an active upper cervical stretching (Olaf's Auto-stretching) on patients with neck pain and ROM. METHODS: Twenty-three subjects were randomized selected in the passive group (Kaltenborn's joint mobilization) included twelve subjects and the active group (Olaf's Auto-stretching) included eleven subjects. VAS (Visual Analogue Scale) was measured before and after neck rotation performance. DUALER IQ PRO (JTECH Medical, U.S.A.) was used to measure the neck ROM. Mean value of double measurement was used before performance and after performance. SPSS version 18 was used to compare values independent t-test and paired t-test were used to compare pain and ROM. RESULTS: There are significant difference in the pain and the ROM in both of two group (p<.05). But there are no significant difference pain and ROM between two groups. CONCLUSION: Both of the passive mobilization of upper cervical spine and the active upper cervical stretching are effected on symptom improvement of patients with neck pain reduction and ROM increasing. Especially active upper cervical stretching is more economical, because it has similar effects with the passive mobilization, help to maintain the treatment effect of therapist by themselves and can help to save medical expenses of patients.
Purpose: The purpose of this study was to compare the effects of continuous passive motion(CPM) and continuous active motion(CAM) on proprioception of the knee after total knee replacement(TKR). Methods: Twenty patients with TKR were randomly allocated into two groups, the CPM group(n=10) and the CAM group(n=10). All subjects were evaluated for levels of pain, passive range of motion and angle reproduction of the knee. An angle reproduction test was used to assess the proprioceptive deficit. Two types of angle reproduction test were used: a passive angle reproduction(PAR) test and an active angle reproduction(AAR) test. The relevant examinations were performed before and after intervention(on the 5th day and the 10th day). The statistical significance were calculated using a t-test and a one-way repeated ANOVA. Results: A pre-intervention significant difference was not found between the two groups. Significantly better results were before and after the intervention at 10 days, for the PAR(flexion direction) test; however, only in the CAM group. There were no significant difference, either before or after the intervention, for the AAR test(flexion and extension direction) in both group. Both groups experienced similar levels of pain and passive range of knee motion before and after the intervention. Conclusion: This study revealed that CAM was a better effect to restore position sense of the knee joint after TKR.
Background: Individuals with scapular winging may have proprioceptive dysfunction which is important for motor control and causes shoulder instability. Reduced serratus anterior (SA) and lower trapezius (LT) muscle activity accompanied by over-active upper trapezius (UT), and pectoralis major (PM) may be contributing factors. Flexi-bar (FB) exercise may be used to increase joint position sense (JPS) and alter the target muscle activities. Objects: This study aimed to investigate the immediate effects of flexi-bar exercise prior to knee push-up plus (FPK) versus knee push-up plus (KPP) on JPS and muscle activity of SA, LT, UT, and PM in subjects with scapular winging. Methods: Eighteen subjects with scapular winging were recruited. JPS was investigated at baseline, after KPP and after FPK. Passive and active JPS errors were calculated by isokinetic equipment. Surface electromyography was used to record muscle activities during KPP and FPK. One-way repeated-measures analysis of variance and post hoc analyses were used to analyze the JPS error measured at baseline, after KPP and after FPK. Paired t-tests were used to compare muscle activities between KPP and FPK. Results: Passive JPS error was significantly decreased after KPP (p = 0.005) and after FPK (p = 0.003) compared to the baseline. Active JPS error was also significantly decreased after KPP (p = 0.016) and after FPK (p = 0.012) compared to the baseline. There was no significant difference in the passive and active JPS errors between KPP and FPK. SA activity during FPK was significantly increased (p = 0.024), and LT activity during FPK was significantly increased (p = 0.006). There were no significant differences in the UT and PM activity. Conclusion: FB might be recommended to immediately improve passive and active JPS and to selectively increase SA and LT muscle activities during KPP in individuals with scapular winging.
Coping patterns were investigated in a sample of 126 patients with chronic low back pain by means of self-reported questionnaire. Based on the previous researches, coping pat terns were divided into the active cognitive coping, the active behavioral coping, the passive cognitive coping, and the passive behavioral coping. While all the above coping patterns were used, the passive behavioral coping was found to be used most frequently. Six subgroups were identified by cluster analytic procedure using their scores of the coping scale : active cognitive coper, general active coper, passive behavioral coper, general passive coper, multidimensional coper, and multi dimensional non-coper. Six subgroups were compared regarding locus of control, self-efficacy, pain and demographic variables. Distinct differences appeared among subgroups in internal locus of control, self-efficacy, and pain. General active coper and active cognitive coper had higher internal locus of control, higher self-efficacy, and lower pain. General passive coper and multidimensional non-coper had lower internal locus of control, lower self-efficacy, and higher pain. Passive behavioral coper had higher internal locus of control, lower self-efficacy, and higher pain. It supports the concept of learned helplessness due to prior experiences. Multi dimensional coper had higher internal, higher powerful others, and higher self-efficacy. So it corresponds to 'believer in control' group Identified by Wallston et at(1982). Unexpectedly this group also complained more pain. It could be interpreted in two ways. The more coping methods they use, the more they complain pain ; which is the result of Folkman et al (1986). Or they might be typical 'yea sayers'. These unique groups-passive behavioral coper and multidimensional coper-identified by this study supports the suggestion of Wallston et al(1982), about locus of control : individual's pattern of responses across the three scales may be more predictive than his or her scores on each of the scale seperately. The fact that passive coping was used more than active coping also suggests that self controlled active co ping is encouraged to chronic patients as well as acute patients. And it is necessary to articulate the coping scale and self-efficacy scale. It is also necessary to study the relationship of coping and adjustment by experimental design.
Transactions of the Korean Society for Noise and Vibration Engineering
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v.26
no.2
/
pp.165-171
/
2016
A prosthetic knee for above-knee (AK) amputee is categorized into passive and active type. The passive prosthetic knee is generally made by elastic material. Although AK amputee can easily walk by using passive prosthetic leg, knee joint motions are not similar to ordinary persons. The active prosthetic leg can control the knee angle owing to the actuator and microprocessor. However, the active type is not cost-effective and the stability may be lost due to the malfunction of sensors. In order to resolve these disadvantages of passive and active type, a semi-active prosthetic knee which can control the knee angle is proposed in this work. The proposed semi-active one requires a less input energy but provides active type performance. In order to achieve this goal, in this work, a semi-active prosthetic knee using magneto-rheological (MR) damper for AK amputees is designed. The MR damper can support the weight of body by using less energy than actuator of active prosthetic. It can control knee angle by inducing the magnetic field at the time of stance phase. This salient characteristic is evaluated and presented in this work.
Purpose: Stretching exercises are commonly used in conjunction with sports and rehabilitation. Weassessed the immediate effects of stretching on passive stiffness of the hamstring muscles and knee range of motion (ROM) using three stretching techniques. Methods: A total of 45 participants were recruited. Isokinetic equipment was used to measure the passive stiffness of hamstring muscles and an inclinometer was used to measure active and passive ROM of the knee joint pre and post stretching. Stiffness was then calculated based on the incline of the torque-angle relationship. The test conditions for Group I were $3{\times}30$ seconds of static stretches using the hamstring muscle, Group II were $3{\times}30$ seconds of static stretches using the hamstring muscle with ankle dorsiflexion, and Group IIII had $3{\times}30$ seconds of active stretching. Results: Group II had significantly higher excursion of active ROM and Group IIIhad significantly higher excursion of passive muscle stiffness. All of the groups had significantly higher active and passive ROM and significantly lower muscle stiffness after stretching. The participants showed no change in hamstring muscle stiffness on the following day. Conclusion: Stretching has significant acute effects on ROM and muscle stiffness and canbe used in warm-up protocols for reducing muscle stiffness before a variety of exercise programs.
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