• PNF and Movement
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• v.10 no.2
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• pp.9-16
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• 2012

본 연구는 43세 남성 환자의 관절가동술과 슬링을 이용한 유착성 관절낭염 환자의 치료사례를 조사하여 그 과정과 결과를 알아보고자 하였다. 어깨통증장애지수(shoulder pain and disability index) 측정과 어깨관절의 굽힘(flexion), 벌림(abduction), 바깥돌림(external rotation), 안쪽돌림(internal rotation)에 대한 관절가동범위를 측정하여 비교하였으며 견관절 주위에 비스테로이드 소염진통 주사 1회, 약물치료를 병행하며 주 3회 8주간 보존적인 물리치료인 온습포(hot pack)와 간섭파(ICT), 관절가동술, 그리고 슬링을 이용한 운동치료를 실시하였다. 결과는 관절가동술과 슬링운동치료의 적용이 유착성 관절낭염 환자의 통증을 줄이고 관절가동범위를 증진시키는데 효과가 있는 것으로 판단된다.

• Journal of Korean Physical Therapy Science
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• v.19 no.2
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• pp.35-42
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• 2012

Background : This study was conducted to know the effect of resistance exercise using thera-band in parallel with conservative therapy in patients with frozen shoulder. Methods : We analyze subjective pain scale, ROM and shoulder functional scale 24 patients diagnosed with adhesive capsulitis were included for study. Among them, 12 patients(experiment group) were managed by resistance exercise as well as conservative physical therapy, another 12 patients(control group) were only treated by conservative therapy alone. All the patients were treated three times a week for 4 weeks, and after, and after each treatment subjective pain scale, ROM, shoulder functional score(SFI) were measured. Results : The VAS were significant reduced between experimental group and control group according to pre-treatment and post-treatment. In experimental group, the ROM and SFI has increased than control group according to pre-treatment and post-treatment. Conclusion : According to the results, we concluded that both conservative therapy and self resistance exercise using thera-band technique are more effective for increasing ROM especially flexion, abduction, internal rotation and SFI than conservative therapy alone.

• Clinics in Shoulder and Elbow
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• v.8 no.1
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• pp.5-8
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• 2005

Rotator interval should be as loose as possible, though not so loose as to break the shoulder mechanism. This region is a source of significant shoulder pathology resulting in patient discomfort and dysfunction. The clinical features fall into two categories. Rotator interval tightness is associated with impingement, contracture with adhesive capsulitis, and widening with anteroinferior, posterior or multidirectional instability. Coracoid impingement can cause damage to the structures of the rotator interval, Injury of the interval are associated with subscapularis tears as well as biceps tendinitis, fraying, subluxation, and dislocation. An understanding of the normal and pathologic anatomy can lead to successful diagnosis and treatment of lesions in the rotator interval.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.423-437
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• 2023

Background: Radiofrequency has seen an increase in use in orthopedics including cartilage lesion debridement in the hip and knee as well as many applications in arthroscopic shoulder surgery. The purpose of this systematic review is to evaluate the safety and usage of radiofrequency in the shoulder. Methods: This systematic review was registered with PROSPERO (international registry) and followed the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) guidelines. Embase and PubMed were searched using: "shoulder," "rotator cuff," "biceps," "acromion" AND "monopolar," "bipolar," "ablation," "coblation," and "radiofrequency ablation." The title and abstract review were performed independently. Any discrepancies were addressed through open discussion. Results: A total of 63 studies were included. Radiofrequency is currently utilized in impingement syndrome, fracture fixation, instability, nerve injury, adhesive capsulitis, postoperative stiffness, and rotator cuff disease. Adverse events, namely superficial burns, are limited to case reports and case series, with higher-level evidence demonstrating safe use when used below the temperature threshold. Bipolar radiofrequency may decrease operative time and decrease the cost per case. Conclusions: Shoulder radiofrequency has a wide scope of application in various shoulder pathologies. Shoulder radiofrequency is safe; however, requires practitioners to be cognizant of the potential for thermal burn injuries. Bipolar radiofrequency may represent a more efficacious and economic treatment modality. Safety precautions have been executed by institutions to cut down patient complications from shoulder radiofrequency. Future research is required to determine what measures can be taken to further minimize the risk of thermal burns.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.17 no.1
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• pp.35-44
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• 2011

Background: This study was to suggest the process of making strategy for effective intervention and evaluation on functional problems of the frozen shoulder patient applied International Classification of Functioning Disability and Health (ICF) Tools. Methods: The patient was 48years old woman with right shoulder adhesive capsulitis and calcific tendinitis. In first phase, therapists could list the information relating to functional problems used by the ICF Core set and then could confirm the interaction among the problems using the ICF assessment sheet. In second phase, therapist is needed to make the hypothesis and hypothesis testing and then set a primary functional goals and therapeutic goals in detail after prioritizing the problems to be managed based on the problem list. Lastly, after setting the confirmed problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems. Results: This report illustrates how to apply the process based on ICF concept into physical therapy practice. The decided hypothesis and goal that are to solve the problems the client faced were remarkably meaningful. Conclusions: Clinical decision making for the most effective intervention requires that therapists use the clinical reasoning process based on ICF concept.

• Journal of the Korean Society of Radiology
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• v.7 no.3
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• pp.191-198
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• 2013

We verified reason of pain by rotator cuff disease using shoulder sonography and found a correlation between shoulder pain and stress. To find out the accuracy of sonographic prediction of rotator cuff disease among the patients with shoulder pain we surveyed 184 patients in S hospital in Seoul Korea between January to October 2012. These patients were previously diagnosed with the torn rotator cuff, adhesive capsulitis and impingement syndrom with shoulder pain. In most times, the rotator cuff disease was diagnosed among the physical workers who use shoulder excessively and also in the women in their 50~60 years of age(144 patients, 78.3%). There were significant correlation between rotator cuff disease and the stress of pain, between sonographic prediction and pain(p<.05). There were significance between shoulder pain and stress in daily life according to result for survey of BEPSI-K(p<.05).

• Clinics in Shoulder and Elbow
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• v.7 no.1
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• pp.41-45
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• 2004

In adhesive capsulitis of the shoulder of no response to nonoperative treatment, an arthroscopic capsular release and manipulation improves range of motion and pain relief. We performed an arthroscopic examination in the stiff shoulder, of which she had no response to nonoperative treatment, after the conservative treatment of a clavicular shaft fracture by motorcycle-driver traffic accident. We found the intra-articular 'rotator interval bridging scar adhesion' between subscapularis tendon and antero-superior glenoid fossa under the rotator interval which was no adhesion and contracture itself. We performed the scar adhesion removal and synovectomy, maintaining the rotator interval. We recommended nonsteroidal anti-inflammatory drug for postoperative pain relief and continuous active and passive range of motion (ROM) exercise to gain motions. Preoperatively, active and passive range of motion were 70° for forward elevation, 60° for abduction and especially 0° for external rotation. After postoperative 2 months, active ROM were 150° for forward elevation, 130° for abduction and 80° for external rotation. After postoperative 6 months, passive and active ROM were full. UCLA score improved from preoperative 9 points to postoperative 29 points.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.1
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• pp.57-65
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• 2018

Background: This study examined the effects of nerve mobilization exercise and scapula postural correction exercise and scapula postural correction exercise after applying conservative physical therapy to frozen shoulder. Methods: Thirty-four outpatients were divided into a nerve mobilization exercise and scapula postural correction exercise group and scapula postural correction exercise group. Each group performed its own exercise 30 minutes per day, three times per week, for 6 weeks. Pain intensity was measured by the visual analogue scale. Range of motion was measured by the goniometer. The scapular position was measured by scapular index. Grasping power was measured by the Grip Track Commander. Measurements were made at baseline and six weeks after the intervention. Results: the visual analogue scale, range of motion (except lateral rotation), and grasping power for each group showed significant changes at baseline and six weeks after the intervention (p<.05). Significant differences were also evident between the two groups for these three measurements (p<.05). Conclusions: Nerve mobilization exercise & scapula postural correction exercise is more effective than scapula postural correction exercise for reducing pain intensity and increasing grasping power, scapular index and range of motion (except lateral rotation) in frozen shoulder syndrome patients.

• The Korean Journal of Pain
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• v.24 no.4
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• pp.205-215
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• 2011

Background: Interventional pain management (IPM) is a branch of medical science that deals with management of painful medical conditions using specially equipped X-ray machines and anatomical landmarks. Interventional physiatry is a branch of physical medicine and rehabilitation that treats painful conditions through intervention in peripheral joints, the spine, and soft tissues. Methods: A cross-sectional study was conducted using three years of hospital records (2006 to 2008) from the Physical Medicine and Rehabilitation Department at Chittagong Medical College Hospital in Bangladesh, with a view toward highlighting current interventional pain practice in a tertiary medical college hospital. Result: The maximum amount of intervention was done in degenerative peripheral joint disorders (600, 46.0%), followed by inflammatory joint diseases (300, 23.0%), soft tissue rheumatism (300, 23.0%), and radicular or referred lower back conditions (100, 8.0%). Of the peripheral joints, the knee was the most common site of intervention. Motor stimulation-guided intralesional injection of methylprednisolone into the piriformis muscle was given in 10 cases of piriformis syndrome refractory to both oral medications and therapeutic exercises. Soft tissue rheumatism of unknown etiology was most common in the form of adhesive capsulitis (90, 64.3%), and is discussed separately. Epidural steroid injection was practiced for various causes of lumbar radiculopathy, with the exception of infective discitis. Conclusion: All procedures were performed using anatomical landmarks, as there were no facilities for the C-arm/diagnostic ultrasound required for accurate and safe intervention. A dedicated IPM setup should be a requirement in all PMR departments, to provide better pain management and to reduce the burden on other specialties.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.13 no.1
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• pp.67-72
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• 2007

Anatomy: The rotator cuff comprises four muscles-the subscapularis, the supraspinatus, the infraspinatus and the teres minor-and their musculotendinous attachments. The subscapularis muscle is innervated by the subscapular nerve and originates on the scapula. It inserts on the lesser tuberosity of the humerus. The supraspinatus and infraspinatus are both innervated by the suprascapular nerve, originate in the scapula and insert on the greater tuberosity. The teres minor is innervated by the axillary nerve, originates on the scapula and inserts on the greater tuberosity. The subacromial space lies underneath the acromion, the coracoid process, the acromioclavicular joint and the coracoacromial ligament. A bursa in the subacromial space provides lubrication for the rotator cuff. Etiology: The space between the undersurface of the acromion and the superior aspect of the humeral head is called the impingement interval. This space is normally narrow and is maximally narrow when the arm is abducted. Any condition that further narrows this space can cause impingement. Impingement can result from extrinsic compression or from loss of competency of the rotator cuff. Syndrome: Neer divided impingement syndrome into three stages. Stage I involves edema and/or hemorrhage. This stage generally occurs in patients less than 25 years of age and is frequently associated with an overuse injury. Generally, at this stage the syndrome is reversible. Stage II is more advanced and tends to occur in patients 25 to 40 years of age. The pathologic changes that are now evident show fibrosis as well as irreversible tendon changes. Stage III generally occurs in patients over 50 years of age and frequently involves a tendon rupture or tear. Stage III is largely a process of attrition and the culmination of fibrosis and tendinosis that have been present for many years. Treatment: In patients with stage I impingement, conservative treatment is often sufficient. Conservative treatment involves resting and stopping the offending activity. It may also involve prolonged physical therapy. Sport and job modifications may be beneficial. Nonsteroidal anti - inflammatory drugs(NSAIDS) and ice treatments can relieve pain. Ice packs applied for 20 minutes three times a day may help. A sling is never used, because adhesive capsulitis can result from immobilization.