• The Korean Journal of Pain
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• 제35권2호
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• pp.152-159
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• 2022

Background: Subjects with frozen shoulder (FS) might not be comfortable with vigorous physical therapy. Clinical trials assessing the effect of graded motor imagery (GMI) in FS are lacking. The aim of this study was to determine the effect of GMI as an adjunct to conventional physiotherapy in individuals with painful FS. Methods: Twenty subjects aged 40-65 years having stage I and II of FS were randomly divided into two study groups. The conventional physiotherapy group (n = 10) received electrotherapy and exercises while the GMI group (n = 10) received GMI along with the conventional physiotherapy thrice a week for 3 weeks. Pre- (Session 1) and post- (Session 9) intervention analysis for flexion, abduction, and external rotation range of motion (ROM) using a universal goniometer, fear of movement using the fear avoidance belief questionnaire (FABQ), pain with the visual analogue scale, and functional disability using the shoulder pain and disability index (SPADI) was done by a blinded assessor. Results: Statistically significant difference was seen within both the groups for all the outcomes. In terms of increasing abduction ROM as well as reducing fear of movement, pain, and functional disability, the GMI group was significantly better than control group. However, both groups were equally effective for improving flexion and external rotation ROM. Conclusions: Addition of GMI to the conventional physiotherapy proved to be superior to conventional physiotherapy alone in terms of reducing pain, kinesiophobia, and improving shoulder function for stage I and II of FS.

• 한방재활의학과학회지
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• 제33권4호
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• pp.145-156
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• 2023

Objectives The purpose of this review is to analyze trends of domestic research in Korean medicine treatment for frozen shoulder. Methods Among the clinical papers published from January 1, 2000 to August 2023, papers that treated frozen shoulders with Korean medicine treatment were searched through five domestic databases (Oriental Medicine Advanced Searching Integrated System, KMbase, Research Information Sharing Service, Science ON, Korean studies Information Service System). Results Finally, 12 studies were included. Three studies were clinical trials and 9 were observational studies. The most commonly used treatment was acupuncture. Range of movement (range of motion) and visual analogue scale were frequently used as measurement methods. Studies with significant effects were 66.6% in controlled trials and 100% in studies without control group. Conclusions In this study, literature on Korean medicine treatment for frozen shoulder was reviewed. As a result of the review, Korean medicine treatment for frozen shoulder showed significant results. However, there have been several limitations and suggest that more research and higher levels of research on Korean medicine treatment of frozen shoulder need to be conducted.

• 혜화의학회지
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• 제15권1호
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• pp.59-69
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• 2006

Objectives & Methods : I investigated 45 literature of Oriental and Western medicine about the treatment of pain in shoulder and arm. Result and Conclusion : 1. The etiological causes of Pain in Shoulder and Arm based on literatures of Oriental medicine are attack of wind-heat on the lung, wind cold, damp-heat struggle between the vital energy and pathogenic factor and six pathogenic factors. And all these causes are the conception of blockage syndrome, Qi and blood stagnating in meridian system. 2. The treatment of Pain in Shoulder and Arm based on Oriental medicine is mainly composed of both medical therapy for Bi syndrome due to pathogenic wind, deficiency of both Qi and blood, consumption of the liver and the spleen, and also acupuncture and moxibustion treatment by selection for acupoint. And those treatments are for treating etiology. And also there are treatments using the meridian system and Twelve Muscle Region and Ashihyeol for the purpose of treating the symptoms. 3. The etiological causes of Pain in Shoulder and Arm based on literatures of Western medicine are degenerative cut of tendon and nerve symptoms caused by tendonitis, bursitis, calcification, ruptured cervical disc and thoracic outlet syndrome. 4. The treatment of Pain in Shoulder and Arm based on Western medicine is for alleviation of pain, such as giving an anodyne, steroid products, local anesthetic injection and stretching and strengthening the muscles.

• Clinics in Shoulder and Elbow
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• 제18권4호
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• pp.217-220
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• 2015

Background: The purpose of this study is to administer conservative treatment in 30 patients diagnosed with idiopathic frozen shoulder, following the suggested frozen shoulder rehabilitation program and to assess the clinical outcome using a prospective study. Methods: Thirty patients diagnosed with idiopathic frozen shoulder, treated with steroid hormone injection on the articular joint with an intra-articular steroid (triamcinolone 40 mg+lidocaine 4 ml) injection and started on stepwise shoulder extension exercise were chosen. The subjects were divided into two groups of 15 people each with one group undergoing rehabilitation with continuous passive motion (CPM) and the other group without it. Follow-ups were done before rehabilitation and at 4-week intervals with the 24th being the final week. At every follow-up, passive range of motion (ROM) was measured and surveys on pain and clinical score were administered. Results: In the last follow-up, both groups showed statistically significant improvements in all evaluation criteria. However, no statistical difference in all values of the ROM and Constant score evaluation criteria was observed between the groups. Only in the last follow-up, group 1 had a visual analog scale (VAS) score of $2.4{\pm}2.1$ points, which was lower, with statistical significance, than the VAS score of group 2, which was $4.4{\pm}3.1$ points (p<0.001). Conclusions: Study using CPM in treatment of frozen shoulder has been inadequate, meaning that there is still room for improvement and need for more study on setting a more specific protocol and guidelines for this procedure.

• Journal of Acupuncture Research
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• 제35권3호
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• pp.120-128
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• 2018

Background: Adhesive capsulitis (AC) is a common condition that includes shoulder pain and limited movement. Despite more than 100 years of AC treatment, the most efficacious treatment remains unclear. The aim of this study was to evaluate the feasibility of a randomized controlled trial (RCT) using acupuncture for AC. Methods: Thirty participants with AC were randomly assigned to acupuncture (A) or sham acupuncture (SA) groups. The participants received 15 acupuncture sessions over 6 weeks, and follow-up occurred for an additional 4 weeks thereafter. The primary clinical outcome was the numeric rating scale (NRS) for shoulder pain 6 weeks from the baseline. Secondary outcomes included range of motion (ROM) in the shoulder, the shoulder pain and disability index (SPADI), the EuroQol-5 dimensions (EQ-5D), the Pittsburgh sleep quality index (PSQI), and the patient global impression of change (PGIC). Results: Thirty participants were enrolled out of 37 screened individuals. Recruitment was conducted between August 2014 until May 2015. A total of 28 participants (93%) completed the 6-week intervention, and 26 participants (87%) completed the study. NRS, ROM, SPADI, EQ-5D, PSQI, and PGIC scores improved in both the experimental group and the sham group after 6 weeks, but the difference between the groups was not statistically significant. Adverse events were reported by 12 participants, although these events were not associated with acupuncture. Conclusion: A future RCT for AC may be feasible with some modifications to the recruitment plan and the secondary outcome measurement methods.

• Clinics in Shoulder and Elbow
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• 제11권1호
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• pp.19-23
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• 2008

목적: 비수술적 치료에 반응하지 않는 일차성 유착성 관절낭염 환자에서 견봉하 점액낭의 병변을 발견하고 임상적 의의를 파악하고자 하였다. 대상 및 방법: 유착성 관절낭염 환자 21예를 대상으로 하였으며 견봉하 점액낭 유리술을 시행하고 환자의 견관절 운동 범위의 호전 정도를 측정하였고, VAS 점수 및 UCLA 평가를 시행하였다. 결과: 발견된 병변은 점액낭염, 경도의 오구 견봉 인대의 마찰 소견, 충돌 소견 및 유착의 소견이 관찰되었으며 단순 견봉 상완 관절 유리술에 비하여 기능적, 통증의 호전 효과를 조기에 얻을 수 있음을 관찰할 수 있었다. 결론: 일차성 유착성 관절낭염 환자에서 견봉하 관절경을 시행하는 것은 숨겨진 이차성 동결견의 가능성과 이차변화를 평가하여 치료와 예후 판정에 도움이 될 것으로 보인다.

• 동의생리병리학회지
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• 제26권4호
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• pp.539-545
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• 2012

To evaluate of the ultrasonographic changes in hemiplegic and unaffected knee joints of hemiplegic ambulators with recent onset stroke. Twenty patients (40 knees) with prevalence duration of 14-39 weeks (mean 24.70 weeks) after a stroke insult were included. All participants were walking independently without leg dragging, had no previous knee injury. There were significant differences in intercondylar cartilage thickness and pes anserinous tendinopathy (PAT) between hemiplegic and unaffected knees (p<0.05). There were no differences in cartilage thickness of medial condyle and lateral condyle, patellar tendinitis/bursitis, suprapatellar effusion, synovitis, joint space narrowing, and Baker's cyst of ultrasonographic findings and x-ray findings in hemiplegic knee compared to the control except PAT (p<0.05). In hemiplegic knee, medial or lateral condylar cartilage thickness was significantly correlated with body weight, intercondylar cartilage thickness, and PAT (p<0.05). PAT was significantly correlated with Brunnnstrom stage and condylar cartilage thickness (p<0.05). Knee pain was significantly correlated with lateral condylar cartilage thickness (p<0.1). The hemiplegic knee had more ultrasonographic abnormalities including PAT and more cartilage thickness preservation in patient with recent onset stroke. Intraarticular sonographic findings including cartilage thickness was significantly correlated with extraarticular findings including PAT and a symptom of knee pain.

• The Korean Journal of Pain
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• 제35권3호
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• pp.280-290
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• 2022

Background: This study aimed to determine the impact of complex decongestive therapy applications on upper extremity function in breast cancer patients who developed adhesive capsulitis after lymphedema. Methods: Thirty patients who developed adhesive capsulitis due to lymphedema were divided into two groups as study (n = 15) and control (n = 15) groups. Both groups received 20 minutes of exercise five days a week for three weeks using a Biodex isokinetic dynamometer, as well as a hot pack and TENS (Transcutaneous Electrical Nerve Stimulation) treatment to the shoulder joint. The study group received 45 minutes of intensive decongestive therapy along with the adhesive capsulitis treatment. The visual analogue scale was used to assess pain, circumference, and volumetric measurements were used to assess edema, and the Arm, Shoulder, and Hand Problems Questionnaire (DASH: Disabilities of the Arm, Shoulder, and Hand) was used to assess upper extremity functionality. The shoulder range of motion was evaluated. Results: Both groups had improvements in pain (P < 0.001), shoulder joint range of motion (P < 0.001), and upper extremity functionality (P < 0.001) after the treatment. There was a significant decrease in circumference and volumetric measurements in the study group (P < 0.001). However, no differences were seen in measurements in the control group. Conclusions: The results showed that complex decongestive therapy was beneficial in reducing lymphedema in breast cancer patients who acquired adhesive capsulitis due to lymphedema. Consequently, the authors believe that supplementing conventional physiotherapy with complex decongestive therapy will benefit patients.

• 한방재활의학과학회지
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• 제33권2호
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• pp.77-85
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• 2023

Objectives The aim of this study is to retrospectively evaluate the shoulder lesions in patients experiencing shoulder pain through the use of musculoskeletal ultrasound during Korean medicine intervention treatments. Methods A total of 20 cases were collected, including biceps tendinitis (n=4), calcification (n=3), SASD bursitis (n=4), partial tear (n=2), full-thickness tear (n=1), tendinopathy (n=5), and impingement syndrome (n=1). Musculoskeletal ultrasound was used by Korean medicine doctors to perform real-time scanning and to explain the patient's condition during treatment sessions. Results The use of musculoskeletal ultrasound allowed Korean medicine doctors to perform treatments such as pharmacoacupuncture, acupotomy, and acupuncture more safely and effectively. Patients were able to better understand their conditions through real-time imaging and explanations provided by the doctors. Conclusions Musculoskeletal ultrasound has the potential to enhance the safety and efficacy of Korean medicine intervention treatments for patients with shoulder pain. Institutional or governmental support is needed to further promote the use of medical devices by Korean medicine doctors, ultimately leading to an increase in cases and clinical evidence.

• 한방재활의학과학회지
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• 제33권3호
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• pp.115-127
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• 2023

Objectives Through this study, we investigated the effects of Korean medicine treatments on range of motion recovery and pain reduction in patients with Frozen shoulder. Methods In this study, the medical records of 26 patients diagnosed with frozen shoulder were retrospectively observed and analyzed through the IBM SPSS Statistics 25 program. We used range of motion to observe the patient's motion recovery and numeric rating scale to evaluate pain reduction. Results The shoulder range of motion increased statistically significantly from 160.0 (123.5~170.0) to 170.0 (160.0~180.0) (flexion), 115.0 (90.0~135.0) to 167.5 (130.0~178.8) (abduction), 40.8±22.1 to 58.3±16.0 (external rotation) (p<0.001). The average of numeric rating scale reduced statistically significantly from 6.7±2.0 to 3.2±1.4 (p<0.001). Depending on the period, the range of motion increased statistically significantly when visited within 3 months, also the pain score decreased 7.0 (5.4~8.0) to 3.0 (1.8~3.6) statistically significantly when visited within 3 months. In the treatment intervention, the increase in the range of motion and the decrease in pain were statistically significant, especially when the bee venom acupuncture and chuna manaul therapy were used together. Conclusions Korean medicine treatments was effective in improving the range of motion and reducing pain in frozen shoulders. In particular, when treated within 3 months of onset and when bee venom acupuncture and chuna manual therapy were used together, it was effective in recovering the range of motion and reducing pain.