• Safety and Health at Work
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• 제1권2호
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• pp.158-166
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• 2010

Objectives: This study aimed to find gender distinctions in terms of the sociology of the population; to determine work-related factors; to analyze gender differences in daily living, work, sports, and art performances; and to identify gender-related factors that limited performance of daily living and work activities. Methods: A questionnaire was designed that included disabilities of the arm, shoulder, and hand (DASH), accident history, disease history, work duration at current workplace, marital status, job satisfaction, job autonomy, and physical demands of the job. Out of 1,853 workers surveyed, 1,173 questionnaires (63.3%; 987 males, 186 females) included responses to DASH disability and DASH optional work and were judged acceptable for analysis. Results: Upper extremity functional limitation during work and daily living was higher for females than males. The limitations for males increased according to their household work time, accident history, work duration, job satisfaction, physical demand, and job autonomy. Meanwhile, female workers' upper extremity discomfort was influenced by their disease history, job satisfaction, and physical demands. In addition, the size of the company affected male workers' upper extremity function, while marriage and hobbies influenced that of female workers. Conclusion: This study addressed sociodemographic factors and work-related factors that affect each gender's upper extremity function during daily living and working activities. Each factor had a different influence. Further studies are needed to identify the effect that role changes, not being influenced by risks at work, have on musculoskeletal disorders.

• 대한정형외과학회지
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• 제54권4호
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• pp.353-360
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• 2019

목적: 듀피트렌 구축의 이상적인 치료 방법은 재발률을 줄이고 합병증이 적게 발생하게 하는 것이다. 본 연구의 목적은 낮은 재발 및 합병증 발생을 위해 아전 근막절제술을 시행하여 치료한 듀피트렌 구축 환자의 결과를 보고하고자 함이다. 대상 및 방법: 2007년부터 2017년 3월까지 아전 근막절제술을 시행한 45명의 환자를 후향적으로 연구하였다. 아전 근막절제술은 구축된 결절과 끈과 함께 주변에 정상 근막을 포함하여 절제하는 수술 방법이다. 평균 추시 기간은 45.9개월이었으며, 92개의 수지가 이환되었다. 선행 인자 및 이환된 관절을 조사하였으며, 수술 전 후 관절 구축의 정도를 측정하였다. 임상 결과를 확인하기 위해 quick disabilities of the arm, shoulder, and hand (quick DASH) score를 사용하였다. 수술 후 피부 결손 및 상처 관련 문제, 신경손상, 혈종, 복합 부위 통증 증후군과 같은 합병증을 조사하였다. 결과: 수술 전 관절 구축은 근위지관절 평균 43.2°, 중수지관절 평균 32.9°였고, 수술 후 9예에서 평균 9.7° (범위, 5°-20°)의 잔여 구축이 남았으며, 전체 수지에 비교했을 때 평균 2.3°의 구축이 발생하였다. 수술 후 12개월 quick DASH score는 평균 12.4점이었고, 전체 합병증 발생률은 26.6%였다. 결론: 듀피트렌 구축에서 아전 근막절제술은 비관혈적 치료에 비해 현저히 낮은 재발률을 보이고, 타 수술치료에 비해 합병증 발생이 적은 효과적인 치료 방법이다.

• PNF and Movement
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• 제12권3호
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• pp.189-199
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• 2014

Purpose: The objective of this case report is to examine the impact of physical therapy using the proprioceptive neuromuscular facilitation (PNF) concept for a patient with shoulder impingement syndrome. Methods: The patient is a 35-year-old female who has felt pain in the right shoulder for one month. The physical examination evaluated sensory integration, pain, joint integration and mobility, posture, reflex integration, range of motion, muscular strength, analysis of movement, and shoulder function. Comprehensive physical therapy was given to the patient, including stretching, mobilization, strengthening, posture correction, coordination improvement, daily activities, and sports exercises. The therapy was given 5 times a week for the first 5 weeks, then 3 times a week for the next 5 weeks. In all, the intervention lasted for 10 weeks. Results: The patient's senses, posture, and muscular strength all improved to a normal level. The degree of pain fell from 3/10 to 0/10 for activities taking place below shoulder height, and from 8/10 to 1/10 for activities above the head. Additionally, joint integration, motility, range of motion, and movements also improved. The disabilities of the arm, shoulder and hand (DASH) for functional evaluation improved from 27.5 to 10.3. Conclusion: Physical therapy using the PNF concept is effective in improving the body structure, function, activity, and participation of patients with motor disorders of the shoulder impingement syndrome.

• 대한정형외과학회지
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• 제52권1호
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• pp.7-14
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• 2017

목적: 쇄골 간부 골절에서 경피적 골수강내 금속핀 고정술을 시행 후 결과를 보고하고자 한다. 대상 및 방법: 쇄골 간부 골절로 내원한 환자 중 2004년 1월부터 2014년 6월까지 경피적 골수강내 금속핀 고정술을 시행한 135예를 대상으로 하였다. 평균 추시 기간은 15개월(12-24개월)이었다. 기능적 평가로 Disabilities of the Arm, Shoulder and Hand(DASH) score와 Constant score, 임상적 평가로 쇄골의 단축, 수술 반흔의 길이, 수술 시간 및 Kang's criteria에 등에 의하여 분석하였다. 결과: 방사선적 골유합 기간은 평균 11.6주(8-16주), DASH score는 평균 11.8점, Constant score는 평균 91.2점이었다. 임상적 결과로 쇄골의 단축은 평균 20 mm 이하였으며, 수술 반흔의 길이는 평균 1.2 cm (0.7-1.5 cm), 수술 시간은 평균 18분(10-35분)이었으며 Kang's criteria를 기준으로 한 임상적 치료 결과는 우수 이상이 총 131예(97.0%)로 만족할 만한 치료 결과를 보였다. 합병증으로는 3예의 핀 전이, 그 중 2예에서 불유합이 관찰되었다. 결론: 쇄골 간부 골절에서 시도한 경피적 골수강내 금속핀 고정술은 유용한 수술법이라 생각된다.

• 한국산학기술학회논문지
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• 제14권6호
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• pp.2862-2868
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• 2013

본 연구는 비특이성 경부통 환자의 경부통증수준과 상지 기능장애간에 상관성을 알아보고자 실시하였다. 경부통증과 경부기능장애는 Northwick Park Neck Pain Questionnaire(NPQ)로 상지 기능장애는 상지기능장애 설문지(disabilities of arm, shoulder, hand questionnaire; DASH)를 이용하여 평가하였다. 잠재적인 교란변수로 작용할 수 있는 심리학적 변수는 통증 자아효능감(Pain Self Efficacy; PES)과 공포회피반응 설문지(fear-avoidence beliefs questionnaire; FABQ)를 이용하여 측정하였다. 분석 결과, NPQ 점수와 DASH 점수는 피어슨 상관 계수가 0.628점의 양의 상관관계가 있었으며, PES과 FABQ 점수와도 유의한 상관성을 나타내었다. 이 결과를 통해 경부통 환자의 경부통 및 경부기능장애 수준과 상지 기능장애 수준 간에 상관성이 나타날 수 있음을 알 수 있었다. 또한 통증에 대한 부정적인 인식과 공포회피반응이 심한 환자의 경우 상지 기능평가에 직접적인 영향을 줄 수 있는 것으로 확인되었다. 이에 경부통 환자의 관리 시 상지 기능장애와 심리학적 요인을 평가하여야만 할 것이다.

• Clinics in Shoulder and Elbow
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• 제26권2호
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• pp.140-147
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• 2023

Background: The management of acromioclavicular (AC) joint dislocation remains controversial. Recently, anatomic coracoclavicular (CC) fixation with a double clavicular tunnel and three flip-buttons has shown promising results. This study aimed to evaluate functional and radiological outcomes in patients with high-grade AC joint dislocation treated with anatomic CC fixation using double clavicular tunnels and three flip-buttons. Methods: A retrospective, unicentric study was performed. The study included patients with high-grade AC joint dislocation who underwent surgery with anatomic CC fixation using double clavicular tunnels and three flip-buttons. Demographic data were obtained from medical records. A functional evaluation using subjective shoulder value (SSV), visual analog scale (VAS), and disabilities of the arm, shoulder, and hand (DASH) questionnaires was performed, and an evaluation of preoperative and postoperative comparative Zanca view images was performed. Factors associated with functional outcomes and radiological AC reduction were analyzed. Results: A total of 83 patients completed follow-up and were included in the analysis. The mean SSV, VAS, and DASH scores were 92.8, 0.8, and 6.4, respectively. Patients who had complications experienced significantly worse functional outcomes (DASH: P=0.037). Suboptimal final AC reduction was observed in nine patients (11.1%), and significantly more frequently in patients older than 40 years (P=0.031) and in surgeries performed more than 7 days after injury (P=0.034). There were two reoperations (2.4%). Conclusions: Anatomic CC fixation with a double clavicular tunnel and three flip-buttons leads to good functional outcomes, low complication rates, and high rates of optimal AC reduction.

• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.142-148
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• 2016

Purpose: The aim of this pilot study was to determine the effect of soft tissue technique (STT) in Axillary Web Syndrome (AWS) following sentinel Lymph Node Biopsy in breast cancer patients by examining the upper extremity function, range of motion, and pain. Methods: Nineteen patients with breast cancer-related AWS were evaluated. STT was performed on the symptom area for treatment of AWS symptoms. We evaluated AWS symptoms and pain intensity using a visual analogue scale (VAS), and functional disability using the Korean version of the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire, glenohumeral joint (GHJ) flexion and abduction range of motion (ROM) with or without elbow extension. Results: Visual analyses of the data suggest a modest effect of STT in improving GHJ flexion, abduction ROM with or without elbow extension, DASH for upper extremity function, and Pain. The statistically significant improvement in baseline observed for pain, DASH, and ROM data made it impossible to assess the effects of STT on those outcomes. There were no adverse events. Conclusions: STT may be an effective and safe treatment option for AWS patients recovering from breast cancer treatment; however, further research is needed.

• 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.

• Clinics in Shoulder and Elbow
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• 제24권2호
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• pp.80-87
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• 2021

Background: Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR. Methods: Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups. Results: Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (p<001). Comparisons between the two groups were not significantly different, except for SF-36 "general health perception" (p<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema. Conclusions: CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.

• 대한통합의학회지
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• 제9권4호
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• pp.19-28
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• 2021

Purpose : The purpose of this study was to apply manual lymphatic drainage (MLD) and high-frequency diathermy (HFD) to patients with axillary web syndrome (AWS), one of the side effects of breast cancer surgery, and to treat upper extremity pain, volume, function of the upper extremity, (joint range of motion; ROM, disabilities of the arm, shoulder and hand; DASH) and quality of life before and after treatment. It is to determine the effect of treatment by checking the level change. Methods : This study is a case series. A total of 5 patients diagnosed with AWS after breast cancer surgery voluntarily participated in this study. The intervention program consisted of stretching, MLD and HFD. It was conducted 3 times a week for 30 minutes for 4 weeks. In order to compare the effects of pain (numeric pain rating scale; NPRS), volume, upper limb function (ROM, DASH) and quality of life (the European organization for research and treatment of cancer quality of life questionnaire-breast, EORTC QLQ-BR23) evaluations were compared before and after 4 weeks of intervention. All measured variables were analyzed and expressed as mean, standard deviation and percentage. Results : The shoulder NPRS level of the subjects in all case groups decreased, the volume decreased and the shoulder flexion, abduction ROM increased. It showed improvement in DASH and quality of life, QLQ-BR23. Conclusion : After breast cancer surgery, we confirmed the possibility that MLD and HFD treatments could be effective in improving pain, decreasing volume, increasing upper extremity function, and quality of life for patients who have difficulties with AWS. The possibility has been confirmed, and additional research is needed by increasing the number of participants in the experiment in the future.