• Clinics in Shoulder and Elbow
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• 제22권4호
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• pp.173-182
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• 2019

Background: Patient reported outcome measures assess clinical progress from the patient's perspective. This study explored the relationship between shoulder outcome measures (The Disability of the Arm, Shoulder and Hand [DASH], American Shoulder and Elbow Surgeons Standard Shoulder Assessment score [ASES], and Constant score) by comparing the best possible scores obtained in an asymptomatic population compared to overall perception of health, as measured by the SF-36 outcome measure. Methods: Volunteers (age range, 20-69 years) with asymptomatic shoulders and no history of shoulder pain, injury, surgery, imaging, or pathology (bilaterally) were included. The DASH and ASES measures were completed by 111 volunteers (72 female, 39 male), of which 92 completed the Constant score (56 female, 36 male). The SF-36 was completed by all volunteers (level of evidence: IV case series). Results: The mean (${\bar{x}}$) score for ASES measure on the right shoulder was higher for the left-hand dominant side (${\bar{x}}=100.00$ vs. 95.02, p-value<0.001); no other significant differences. Better SF-36 scores were associated with better DASH scores. Our prediction models suggest that perception of overall health affects the DASH scores. Sex affected all three shoulder measures scores. Conclusions: Comparing scores of shoulder outcome measures to the highest possible score is not the most informative way to interpret patient progress. Variables such as health status, sex, and hand dominance need to be considered. Furthermore, it is possible to use these variables to predict scores of outcome measures, which facilitates the healthcare provider to deliver individualized care to their patients.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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• pp.251-256
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• 2021

Objective: The forward head posture (FHP) is strongly related to the rounded shoulder posture (RSP), which is associated with shoulder pain. Design: Observational cross sectional study design Methods: A total of 37 were enrolled in the study, 22 individuals with FHP(experimental group) and 15 healthy adults(control group). Correlation with differences between groups was analysed through craniovertebral angle (CVA) representing FHP for both groups, neck disability index (NDI) indicating neck pain, disability of the arm, shoulder and hand (DASH) indicating shoulder pain. Results: There was a significant difference in the results of CVA, NDI, and DASH in FHP and healthy adults (p<0.05). Significant correlations were found between DASH and CVA in FHP participants (r = -0.656, p = 0.001). Also, in the regression analysis results of DASH and CVA, the regression model was found to be suitable and the variation in DASH could be explained by 43% (F = 15.118, p = 0.001). Conclusions: Shoulder pain and neck discomfort are potentially related, and an increase in shoulder pain can increase FHP.

• 한국산업보건학회지
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• 제19권2호
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• pp.156-169
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• 2009

In this study, the authors introduced DASH (Disabilities of the arm, shoulder, and hand), which had been developed for evaluating the functional impairment in the movement of upper extremities in regular daily activities, work ability and sports/performing arts ability. It is an ergonomic risk assessment tool used for industrial workers and also a disability measurement tool for upper extremity disorders arising from musculoskeletal disorders and symptom. This study intended to examine the applicability of DASH in occupational health field. Firstly, DASH development process and composition were reviewed through The DASH outcome measure user's manual and early articles. Secondly, reliability, validity, and responsiveness of the DASH in various languages at the application stage as well as its reliability and validity at the early stage of development were investigated. Thirdly, focusing on the application of DASH to clinical cases, workers with musculoskeletal symptoms, healthy workers, workers with other diseases, and general population were discussed besides workers with major musculoskeletal disorders. Lastly, DASH questionnaire was examined for its potential as a reference for assessing the functional impairment in the movement of upper extremities of workers with musculoskeletal symptoms in industrial workers in Korea.

• Journal of Acupuncture Research
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• 제24권6호
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• pp.123-135
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• 2007

Objectives : A number of instruments have been developed to measure the quality of life in patients with various shoulder disorders. Much progress has been made in this area, and currently an appropriate instrument exists for each shoulder state. The purpose of this study is to review the instruments that are currently in use for assessing the shoulder joint. Methods : A literature research was performed to choose appropriate scales for assessment of function and the disability of the shoulder. Theoretically based scales were selected for review. Therefore, 11 scales were reviewed. The status of scales involved in shoulder treatment of acupuncture throughout several countries was evaluated. Results : 11 scales: The American shoulder and elbow surgeons evaluation form(ASES), Constant Shoulder Score, The disabilities of the arm, shoulder and hand(DASH), Shoulder Disability Questionnaire (SDQ), The Shoulder Pain And Disability index(SPADI), The simple shoulder test(SST), Oxford Shoulder Questionnaire(OSQ), The Rotator Cuff quality-of-life Measure(RC-QoL), Western Ontario Shoulder Instability Index(WOSI), Western Ontario Osteoarthritis of the Shoulder Index(WOOS), Western Ontario Rotator Cuff Index(WORC), wereevaluated. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 3 domestic and 10 overseas papers about shoulder treatments using acupuncture assessed with shoulder scales. Conclusions : In clinical research, the selection of the measurement scale should take account of the condition of disease, the patient's traits and the characteristics of the research. Moreover, appropriate scales, which havevalidity, reliability, responsiveness and practical characteristics, are needed to enhance the quality of research.

• Physical Therapy Rehabilitation Science
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• 제11권2호
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• pp.269-278
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• 2022

Objective: The aim of this study was to evaluate the effects on pain and function of patients with rotator cuff tendinopathy when applying trigger point of infraspinatus and teres minor to myofascial trigger point release (MFR) plus mobility exercise and MFR. Design: A randomized controlled trial. Methods: The total participants were 30patients and were separated to MFR plus mobility exercise group(n=15) and MFR group (n=15) according to the randomized treatment method. The MFR was performed at two infraspinatus tampon points and one teres minor tampon point for twice a week for 4 weeks and the treatment time was 6 minutes 20 seconds in each position. The MFR group also carried out the myofascial trigger point release in the same way as the MFR plus mobility exercise group. Results: The MFR plus mobility exercise group significantly reduced objective and subjective pain (p<0.05). The range of motion of the shoulder joint flexion and external rotation, Quick-Disability of the Arm, shoulder and Hand, and Shoulder Pain and Disability Index were significantly improved in the group to which MFR plus mobility exercise was applied (p<0.05). Conclusions: These results confirmed that MRF plus mobility exercise is more effective in relieving shoulder pain and improving function in rotator cuff tendinopathy.

• 대한통합의학회지
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• 제11권3호
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• pp.171-183
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• 2023

Purpose : This study sought to investigate research trends regarding joint mobilization type among patients with shoulder joint diseases. Methods : A scoping review was conducted according to the five steps outlined by Arskey and O'Malley and PRISMA-ScR. We searched six domestic databases (ScienceOn, DBpia, Riss, Kmbase, Kiss, KCI) and three international databases (CINAHL, Pubmed, Cochrane central) between 2013 and June 2023. The keyword terms used were 'joint mobilization', 'Kaltenborn', 'Maitland', 'Mulligan', and 'shoulder joint'. Results : There were a total of 44 studies that investigated the topic, and these were divided into quantitative analysis and topic analysis. In terms of publication year, the number of studies within the last five years has increased more than compared to the previous five years, with most of them being randomized clinical trials. In shoulder joint diseases, it was found that the majority of joint movement studies focused on adhesive joint cystitis and shoulder collision syndrome. The Mulligan concept was the most commonly studied type of joint motion. The dependent variables used included pain, joint function (disability), and muscle function. The visual analog scale was the most commonly used for the pain variable, followed by the numeric rating scale. For joint function and disability variables, range of motion was the most commonly used, followed by shoulder pain and disability index, and disabilities of the arm, shoulder, and hand. For muscle function, variables such as muscle tone, strength, and activity were used. Conclusion : We believe that findings of this scoping review can serve as valuable mapping data for joint mobilization research on shoulder joint diseases. Further studies including systematic reviews and meta-analyses based on these results are recommended.

• The Journal of Korean Physical Therapy
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• 제30권6호
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• pp.239-245
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• 2018

Purpose: This study was to identify international classification of functioning, disability and health (ICF) categories that could be linked conceptually to disability of arm, shoulder and hand (DASH) items and short form of health survey 36 (SF-36) items for persons with shoulder pain. Methods: Linkage between each item in DASH and SF-36 and the categories in the ICF were assessed. The linking process was performed by ten health professionals following the linking rule. One hundred four patients with shoulder pain were enrolled from 12 private clinic outpatient departments and participated in this study. Pearson correlation coefficients were used to assess the relationships between each scale item and the linked ICF code. Results: Thirty DASH items were able to be linked to 30 ICF codes, whereas the 36 items in SF-36 were only linked to 17 ICF codes. General health items included in SF-36 could not be linked to a relevant ICF concept. There was a high correlation between the two measurement tools and the linked ICF codes, DASH and its ICF code list (r =0.91), SF-36-Physical Health and its code list (r =-0.62), and SF-36-Mental Health and its code list (r =-0.72). Conclusion: The results suggest that concepts within each item in DASH can be linked to ICF codes for patients with shoulder pain, however, the concepts in the SF-36 items had limited linkage to ICF codes. The shoulder-specific functional tool, DASH can be expressed with ICF codes and, therefore, its use can promote data standardization and improve communication between professionals.

• 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.

• 대한물리의학회지
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• 제19권1호
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• pp.143-154
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• 2024

PURPOSE: The present study was conducted to improve the understanding of the Korean Standard Functional, Disability, and Health Classification (KCF) and its ease of use in the clinical domain of the musculoskeletal system by comparing, analyzing, and linking the KCF codes with items from patient-reported outcome measures (PROMs), which are currently mainly used to evaluate patients with neck, shoulder, waist, and knee pain. METHODS: The items of the most widely used PROMs, the Neck Disability Index (NDI), Disabilities of the Arm, Shoulder, and Hand (DASH) scores, Oswestry Disability Index (ODI), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the codes of the KCF were linked by two experts according to the linking rules. RESULTS: The concordance between the items of each of the PROMs and the KCF code linked by the two experts was NDI,86.4%86.4%, DASH 83.3%, ODI 92.0%, and WOMAC 80.7%. The NDI, DASH, and WOMAC indexes were found to comprise items corresponding to physical function, activity, and participation areas, and were linked to 22, 43, and 31 KCF codes, respectively. In addition to these two areas, the ODI included items related to environmental factors and was linked to 25 codes (duplicated codes are treated as one). CONCLUSION: This research can be used by adding the KCF code to the questions of the currently used evaluation tool. This coding can be easily applied and will contribute to the easy understanding of the KCF.

• 한국전문물리치료학회지
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• 제25권3호
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• pp.39-50
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• 2018

Background: High string instrument (violin, viola) players are at high risk for developing musculoskeletal problems. In particular, a higher prevalence of shoulder problems has been reported. However, evidence of the effectiveness of therapeutic exercise for musicians with this condition is lacking until now. Objects: This case series study investigated the effect of a specific exercise program on shoulder pain, dysfunction, and posture of professional orchestral high string musicians. Methods: Five professional orchestral high string players with shoulder pain participated in this study. A six-week specific exercise program focus on scapular stability for shoulder pain consisted of scapular muscle exercise. Physical examinations for pain and dysfunction, posture were performed, were identified among all subjects before starting the exercise program. Results: The results revealed that shoulder pain decreased by 67.86% and the effect of pain on instrument play decreased by 63.33%. The shoulder pain and disability Index and the performing arts module-quick disability of the arm, shoulder and hand scale decreased by 71.72% and 51.61% respectively. The exercise program improved function and posture. Conclusion: A specific exercise program for high string players was effective in managing shoulder pain. This case series is intended to provide empirical data on the effectiveness of an exercise program aimed at assessing the effect of exercise on pain, dysfunction, and posture of professional orchestra musicians associated with specific instrument groups.