• Clinics in Shoulder and Elbow
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• 제17권4호
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• pp.166-174
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• 2014

Background: Our study was to determine the effect on shoulder isokinetic muscle strength and muscle endurance in isolated full-thickness supraspinatus tendon tear and combined other rotator cuff tear. Methods: Total of 81 male patients (mean age $57.8{\pm}7.4$ years) who were diagnosed as a full-thickness supraspinatus tendon tear were included. They were classified into isolated or combined tear. The isokinetic muscle strength and muscle endurance were measured using the Biodex multi-joint system $PRO^{(R)}$ (Biodex Medical Systems, Shirley, NY, USA) in following movements: shoulder abduction, adduction, flexion, extension, external rotation, and internal rotation. Then, the difference in muscle function according to the type of tears were assessed. Fifty-seven patients had isolated supraspinatus tendon (mean age $56.9{\pm}7.3$ years). They were classified into either anteroposterior tear or modified mediolateral tear. The size were measured using T2-weighted magnetic resonance imaging scans in sagittal plane. Results: Between subjects categorized into the type of tear, we found significant inter-categorical differences in isokinetic muscle strength during abduction, adduction, flexion, extension, and internal rotation, and in muscle endurance during flexion, extension, and internal rotation. Anteroposterior diameter tear, we did not show significant differences in either isokinetic muscle strength or muscle endurance during any movements. However, with modified mediolateral diameter, we found significant differences with isokinetic muscle strength during adduction, and in muscle endurance the external rotation and internal rotation. Conclusions: We found that a supraspinatus tendon tear associated with more numbers of rotator cuff tears has lower isokinetic muscle strength and muscle endurance than a tear found alone.

• 한국운동역학회지
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• 제22권1호
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• pp.83-94
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• 2012

The purpose of this study was to analyse the effect of posture correction & stabilization according to horse rider's(n=10) skill levels of novice(0wk), mid-skill(12wk) & skill(24wk) in walk & trot. First, Mean posture of 3 times experiments; Anterior & posterior leaning posture of trunk showed rather unstable according to progress of the stages of TD1, TO, TD2 phase, and also shoulder & elbow angle, which effects to the distance from bit to rein, showed unstable riding posture. There was close relationship between shoulder and elbow Angle in walk and hip, knee & ankle angle in trot. Second, Posture correction & stabilization according to riding skill levels; Anterior & posterior leaning posture of trunk did not show significant difference statistically but showed approaching tendency to trunk's vertical line and showed significant difference(p<.05) according to improvement of skill levels in walk & trot horse riding. Hip angle showed significant difference according to progress of the stages of TD1, TO, TD2 phase(p<.05) and showed tendency maintaining the larger thigh flexion according to improvement of skill levels in walk & trot. Knee angle showed more stable posture by maintaining the larger flexion between thigh and shank according to improvement of skill levels in walk & trot(p<.05). Ankle angle also showed tendency maintaining the larger plantar flexion of foot according to improvement of skill levels in walk & trot. When considering the above, regular horse riding program could be useful in posture correction & stabilization according to improvement of skill levels of novice(0wk), mid-skill(12wk) & skill(24wk) in walk & trot.

• 재활간호학회지
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• 제6권2호
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• pp.213-225
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• 2003

The purpose of this study is to develop and evaluate the health promotion program to increase the functional status of the in-house stroke patients. The subjects for the experiment are 38 in-house stroke patients in a health center and welfare centers suffering from hemiplegia. The experimental group consists of 19 stroke patients and the control group consists of another 19 stroke patients. The program was applied to the experimental group for 8 weeks. The subjects were given health education at the first week. At the second and the fifth week they were given counselling on health by home visit. At the third, the fourth, the sixth and the seventh week they were interviewed by phone about health, and at the last week they shared their experiences through group meeting. The results of the study are as follows: 1. The degree of ADL in the experimental group increased significantly, compared with that of the control group. 2. In the experimental group the degree of Range of Motion in shoulder abduction, elbow flexion, hip flexion and ankle dorsiflexion increased significantly, compared with that of the control group. 3. In the experimental group the degree of muscle strength in elbow flexion, knee extension, and ankle dorsiflexion increased significantly, compared with that of the control group. 4. Systolic pressure, diastolic pressure in the experimental group decreased significantly, compared with that the control group. 5. HWR in the experimental group didn't decreased significantly, compared with that the control group. 6. The degree of depression in the experimental group decreased significantly, compared with that the control group. 7. The degree of social adaptation in the experimental group increased significantly, compared with that the control group. The results above show that the health promotion program for this study was effective in promoting the performance of lifestyle for health improvement of the in-house stroke patients. Therefore, it is considered that the program can be used as an efficient nursing intervention for the in-house stroke patients who need continuous health-improving behaviors.

• 대한물리치료과학회지
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• 제9권1호
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• pp.61-68
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• 2002

The purpose of this dissertation was to analyze the effect of trunk extension strengthening exercise on muscle performance of the upper limb in adolescent baseball player. The twenty people were studied : experimental group(10), comparative group(10). The experimental group has done trunk extension strengthening exercise for 8 weeks. The study analyzes isometric maximal strength of shoulder internal rotation. shoulder external rotation, elbow flexion, elbow extension, forearm pronation, forearm supination and ball speed. All of subjects were tested for 3 times ; pre, mid, post. The results were as follows; 1. Maximal isometric strength of upper limb, during trunk extension strengthening exercise in experimental group, shoulder internal rotation and external rotation showed it has slightly increased and comparative group showed it has no change, but not significant elbow flexion and extension significantly(p<0.05) increased after exercise either for 4 or 8 weeks compared with that of control group. Forearm pronation showed not significantly changed in both group, but significantly different between group either for 4 or 8 weeks. Forearm supination, significantly((p<0.05) increased after 8 weeks in experimental group. 2. Ball speed showed slightly increased but not significantly in experimental group. These results it may expect improvement of upper limb muscle performance of upper limb in adolescent baseball player. However, in case of shoulder a point of view of bunk extension strengthening exercise of this study hasn't a significant influence. More experimental studies are needs, hereafter which will use more experimental subjects and various methods of exercise and new application of treatment term to define significant change.

• Clinics in Shoulder and Elbow
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• 제17권3호
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• pp.120-126
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• 2014

Background: To compare the treatment of the proximal humerus fracture using a Polarus nail or Philos plate, we aimed to analyze the functional recovery and the factors affecting the selection between the two types of surgery. Methods: The study included 107 patients with proximal humerus fracture who underwent surgery at our institution. Of these patients, 67 underwent surgery with Polarus nails (G1) and 40 with Philos plates (G2). In G1, the cases of two- and three-part fractures were 60 and 7 cases, in G2, the cases of two-, three-, and four-part fractures were 28, 10, and 2 cases, respectively. The average age was 61 years old, and the average follow-up period was 32.5 months. We compared radiological results, the functional recovery retrospectively. Results: The radiological union time was 6.8 weeks and 8.7 weeks on average in G1 and G2 (p < 0.05). At the one-year follow-up period, these were visual analogue scale (VAS) 1.355, forward flexion (FF) 130.968, external rotation (ER) 50.161, internal rotation (IR) L2 in G1, and VAS 0.781, FF 135.806 ER 51.25, IR L1 in G2, respectively, showing no significant differences between the two groups (p > 0.05). Similar observations were made at the final follow-up. In terms of functional recovery, no significant differences were seen at the one-year or at the final follow-up period (p > 0.05). Conclusions: For the surgical treatment of proximal humeral fracture, the selection of the type of surgery is affected by the fracture pattern. However, both methods give satisfactory outcomes and do not show significant differences in the functional outcome after the surgery.

• Clinics in Shoulder and Elbow
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• 제22권2호
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• pp.93-99
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• 2019

Background: Modified Phemister operation has been widely used for the treatment of acute acromioclavicular (AC) joint dislocation. Additionally, the use of suture anchor for coracoclavicular (CC) fixation has been reported to provide CC stability. This study was conducted to evaluate the clinical and radiological results of a modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation. Methods: Seventy-four patients underwent the modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation and were followed-up for an average of 12.3 months. The visual analogue scale (VAS), range of motion, Constant score, and Korean shoulder scoring system (KSS) were used for clinical assessment. Acromioclavicular interval (ACI), coracoclavicular distance (CCD), and acromioclavicular distance (ACD) were obtained to evaluate the radiological assessments. Results: At the last follow-up, the mean VAS Score was 1.7 points, the mean joint range of the forward flexion was $164.6^{\circ}$, external rotation at the side was $61.2^{\circ}$ and internal rotation to the posterior was a level of T12. The mean Constant score and the mean KSS was 82.7 points and 84.2 points, respectively. At the mean ACI, CCD, and ACD, significant differences were found preoperatively and at the last follow-up. When the ACI, CCD, and ACD were compared with the contralateral unaffected shoulder at the last follow-up, the affected shoulders had significantly higher values. Conclusions: The modified Phemister operation with CC ligament augmentation using suture anchor is clinically and radiologically effective at acute AC joint dislocation.

• Clinics in Shoulder and Elbow
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• 제23권1호
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• pp.20-26
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• 2020

Background: High complication rate after open reduction and internal fixation can lead to use of primary total elbow replacement (TER) in treatment of complex distal humerus fractures in elderly patients. The purpose of this study was to investigate the short-term outcomes and complications after primary TER in patients with complex distal humerus fracture. Methods: Nine patients with acute complex distal humerus fracture were treated by primary TER using the semiconstrained Coonrad-Morrey prosthesis. The mean age of patients was 72.7 years (range, 63-85 years). Clinical and radiographic outcomes were evaluated over a mean follow-up of 29.0 months (range, 12-65 months) using visual analog scale (VAS) score for pain; Mayo elbow performance score (MEPS); Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score; and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, mean VAS, MEPS, and Quick-DASH scores were 1.2, 80.5, and 20, respectively. The mean range of motion was 127.7° of flexion, 13.8° of extension, 73.3° of pronation, and 74.4° of supination. There was no evidence of bushing wear or high-grade implant loosening on serial plain radiographs. Three complications (33.3%) comprising two periprosthetic fractures and one ulnar neuropathy were observed. Conclusions: Primary TER for treatment of complex distal humerus fractures in elderly patients yielded satisfactory short-term outcomes. However, surgeons should consider the high complication rate after primary TER.

• Clinics in Shoulder and Elbow
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• 제8권2호
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• pp.122-126
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• 2005

Purpose: To assess the long-term effect of ulnohumeral arthroplasty and the relationship between radiological recurrence and clinical outcome. Materials and Methods: Eleven elbows with primary osteoarthritis were analyzed at an average of eighty months after ulnohumeral arthroplasty. All patients were male with a mean age of fifty years. The outcomes were assessed using the Mayo Elbow Performance Score(MEPS) and the clinical and radiological results were compared. Results: Four elbows were not painful and six were mildly painful but one was not changed. The mean gain in extension was $15^{\circ}$, in flexion $10^{\circ}$. There were satisfactory results in 8 elbows(73%) and the mean MEPS was 81 points. All of eleven elbows had some degree of recurrent osteoarthritis and there was no correlation between radiological recurrence and clinical endpoints in nine elbows. But in two elbows, it appeared that recurrence of osteophyte at coronoid process was severe and caused fair outcome. Conclusion: Ulnohumeral arthroplasy is one of the effective treatment options for primary osteoarthritis of the elbow. The radiological recurrence did not correlated with the clinical outcome in most cases.

• Clinics in Shoulder and Elbow
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• 제23권2호
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• pp.94-99
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• 2020

Background: Intra-articular distal humeral fractures can be surgically challenging. It remains under discussion whether open reduction and internal fixation (ORIF) or total elbow arthroplasty (TEA) is more beneficial for treatment of the elderly. This study aimed to compare the clinical and functional outcomes of ORIF and TEA for managing intra-articular distal humerus fractures in patients aged 65 years or older. Methods: Patients who underwent ORIF (n=28) or TEA (n=43) for in intra-articular distal humerus fracture between May 2008 and December 2018 were reviewed. Range of motion, Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, radiologic outcomes, and surgical complications were evaluated at the final follow-up visit. Results: The ORIF and TEA groups showed a mean arc of flexion-extension of 97°±21° and 101°±12°, respectively. The mean MEPS and DASH scores were 94±15 and 27±12 points, respectively, in the ORIF group and 81±27 and 47±28 points in the TEA group. This difference was statistically significant. The incidence of total complications was similar between the groups. Conclusions: In patients older than 65 years with intra-articular distal humerus fracture, ORIF had better outcomes than TEA.

• Clinics in Shoulder and Elbow
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• 제23권4호
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• pp.183-189
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• 2020

Background: The purpose of the current study was to investigate short- to mid-term outcomes and complications following radial head replacement (RHR) for complex radial head fractures and to identify factors associated with clinical outcomes. Methods: Twenty-four patients with complex radial head fractures were treated by RHR. The mean age of the patients was 49.8 years (range, 19-73 years). Clinical and radiographic outcomes were evaluated for a mean follow-up period of 58.9 months (range, 27-163 months) using the visual analog scale (VAS) score for pain, the Mayo elbow performance score (MEPS), the quick disabilities of the arm, shoulder and hand (Quick-DASH) score, and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, the mean VAS score, MEPS, and Quick-DASH score were 0.6±1.1, 88.7±11.5, and 19.4±7.8, respectively. The mean range of motion was 132.7° of flexion, 4.7° of extension, 76.2° of pronation, and 77.5° of supination. Periprosthetic lucency was observed in six patients (25%). Heterotopic ossification was observed in four patients (16.7%). Arthritic change of the elbow joint developed in seven patients (29.2%). Capitellar wear was found in five patients (20.8%). Arthritic change of the elbow joint was significantly correlated with MEPS (P=0.047). Four cases of complications (16.6%) were observed, including two cases of major complications (one stiffness with heterotopic ossification and progressive ulnar neuropathy and one stiffness) and two cases of minor complications (two transient ulnar neuropathy). Conclusions: RHR for the treatment of complex radial head fractures yielded satisfactory short- to mid-term clinical outcomes, though radiographic complications were relatively high.