• Clinical Pain
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• 제19권2호
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• pp.124-128
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• 2020

Motor paralysis is a less common neurologic complication of herpes zoster. Until now, a few cases have been reported, and most of these cases showed brachial plexopathy involving one or two segments. We report a patient with pain and weakness on upper extremity diagnosed as brachial plexopathy after herpes zoster infection. An 88-year-old female patient complained not only tingling sense, pain, and swelling on right whole arm, but also weakness on this right upper extremity. On physical examination, weakness is seen in right shoulder abduction·shoulder flexion·elbow flexion·elbow extension· wrist extension (grade 4), finger flexion·finger abduction·finger extension·finger DIP flexion (grade 3). In electrodiagnostic study and magnetic resonance imaging study, she was diagnosed as the brachial plexopathy, whole branch involved. This is the only case of post-herpetic brachial plexopathy involving whole branch in domestic.

• 산업기술연구
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• 제21권B호
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• pp.265-272
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• 2001

The human arm is modeled by three rigid bodies(the upper arm, the forearm and the hand)with seven degree of freedom(three in the shoulder, two in the elbow and two in the wrist). The objective of this work is to present a method to determine the three-dimensional kinematics of the human elbow joint using a magnetic tracking device. Euler angle were used to determine the elbow flexion-extension, and the pronation-supination. The elbow motion for the various driving conditions is measured through the driving test using a simulator. Discomfort levels of elbow joint motions were obtained as discomfort functions, which were based on subjects' perceived discomfort level estimated by magnitude estimation. The results showed that the discomfort posture of elbow joint motions occurred in the driving motion.

• The Journal of Korean Physical Therapy
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• 제22권6호
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• pp.43-51
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• 2010

Purpose: This study examined the influence of visuomotor congruency on learning a relative phase relationship between a single joint movement and an external signal. Methods: Participants (N=5) were required to rhythmically coordinate elbow flexion-extension movements with a continuous sinusoidal wave (0.375 Hz) at a $90^{\circ}$ relative phase relationship. The congruent group was provided online feedback in which the elbow angle decreased (corresponding to elbow flexion) as the angle trajectory was movingup, and vice versa. The incongruent group was provided online feedback in which the elbow angle decreased as the angle trajectory was moving down, and vice versa. There were two practice sessions (day 1 and 2) and each session consisted of 6 trials per block (5 blocks per session). Retention tests were performed 24 hours after session 2, and only the external sinusoidal wave was provided. Repeated ANOVAs were used for statistical analysis. Results: During practice, the congruent group was significantly less variable than the incongruent group. Phase variability in the incongruent group did not significantly change across blocks, while variability decreased significantly in the congruent group. In retention, the congruent group produced the required $90^{\circ}$ relative phase pattern with significantly less phase variability than the incongruent group. Conclusions: Congruent visual feedback facilitates learning. Moreover, the deprivation of online feedback does not affect the congruent group but does affect the incongruent group in retention.

• 한국전문물리치료학회지
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• 제7권1호
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• pp.22-31
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• 2000

Despite research to treat delayed onset muscle soreness (DOMS), no effective treatment has been reported. The purpose of this study is to investigate the effect of a hold-relax technique and cryotherapy on DOMS. Thirty-three subjects were randomly assigned to one of three treatment groups: control, hold-relax technique, or hold-relax technique and cryotherapy. DOMS was induced in the non-dominant biceps muscle through repeated eccentric contractions. Resting elbow joint position, flexion and extension (universal goniometer), pain (Visual Analogue Scale; VAS), and WBC count (blood analysis) were measured one hour before DOMS was induced and 24, 48, and 72 hours after DOMS was induced. The data were analyzed by repeated measure of two-way ANOVA. The results of this study were summarized as follows: 1) While analysis showed no significant differences between groups in relation to a resting elbow joint position, there were significant differences over time, especially at 24, 48 hours after DOMS was induced compared with resting elbow joint position before DOMS was induced. 2) While analysis showed no significant differences between groups in relation to range of flexion, there were significant differences between range of flexion before DOMS was induced and range of flexion 72 hours after DOMS was induced. 3) There were no significant differences between groups or over time in relation to range of extension. 4) While analysis showed no significant differences between groups in relation to VAS, there were significant differences over time in different hours. 5) There were no significant differences between groups or over time in relation to WBC count. 6) There were no interactions between groups or over time in all variables. This results suggested that hold-relax technique and cryotherapy were not effective to reduce DOMS.

• Clinics in Shoulder and Elbow
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• 제6권1호
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• pp.37-43
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• 2003

Purpose: To evaluate the results in patients who received total elbow replacement for posttraumatic destroyed or unreduced elbow joint. Materials and Methods: Six patients with posttraumatic destroyed, or unreduced elbow joint, who were nearly impossible to move actively and had pain and grossly unstable joint, were followed up average 42 months. 3 cases were soft tissue injuries and bone defects which were caused by severe comminuted fracture, 1 was a nonunion with comminuted fracture, and 2 were unreduced elbow joint. Total elbow replacement was performed average 10 months after the injury. All the cases were used by semiconstrained prosthesis, and the results were estimated by Mayo elbow perfomance score. Results: Pain was decreased in all the cases postoperatively. Average ranges of motion were improved with active extension 20° and flexion 120°. Mayo elbow performance scores were pain 42.5 points, range of motion 17.5 points, stability 8.3 points, function 19.2 points and totally 87.5 points, and final results were 3 excellent and 3 good. Loosening of prosthesis was not found in all the cases by final follow-up radiograph. Conclusicon: Semiconstrained TER can be used as a effective treatment improving pain and active ranges of motion caused by posttraumatic destroyed or unreduced elbow joint, however, long term follow-up is needed because early loosening of TER can be occurred due to severe bone defects.

• 대한인간공학회지
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• 제36권5호
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• pp.589-599
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• 2017

Objective: The objective of this study was to measure the upper-limb motions and postures of grapes-harvesting tasks using electrical goniometers and analyze the upper-limb motions in a kinematic way to assess the risk of musculoskeletal disorders. Background: Grapes farmers are exposed to various risk factors of musculoskeletal disorders (MSDs) such as repetitive upper-limb motions, non-neutral postures, and manual handling of heavy items. The farmers have to use scissors repetitively while harvesting grapes with their being arms elevated over the shoulder height, which presumed to increase the physical workload. It has been reported that the grapes farmers feel the harvesting task as the one of the hardest work in cultivating grapes. We tried measure the wrist and elbow angles while the farmers were carrying out harvesting tasks to understand how much workload the work impose on the farmers, which can be helpful in making interventions of preventing musculosksletal disorders among grapes farmers. Method: We measured joint angles at the right wrist and elbow with a wireless measuring system with two electrical goniometers from five grape farmers. The grapes-harvesting task was classified into 6 different subtasks: 1) searching, 2) picking, 3) cleaning, 4) carrying, 6) storing, and 7) miscellaneous tasks. The subtasks were compared by mean angles, 10%, 50%, and 90% APDF values of wrist flexion/extension, ulnar/radial deviation, and elbow flexion. Results: The Kruskal-Wallis tests showed that the 10th percentiles of APDF of ulnar/radial deviation and flexion/extension of the wrist significantly differs among subtasks (p<0.05). It was found that the farmers assumed more deviated wrist postures in the ulnar direction when they picking and adjusting the grapes. The use of scissors seemed to force the farmers to severely bend their wrist in the directions of ulnar deviation and flexion. The grapes-harvesting task showed similar wrist postures and motion with poultry deboning and milking tasks. Conclusion: The grapes harvesting tasks make the farmers take ulnar deviated and extended postures in the wrist. The use of scissors makes them take more severely deviated postures in the wrist. Safety guidelines including use of ergonomic scissors can be provided to the farmers to improve their work conditions. Application: The results of this study can be used as a basic data for the development of safety guidelines for agricultural work.

• Archives of Reconstructive Microsurgery
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• 제6권1호
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• pp.73-79
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• 1997

Complete denervation after severe brachial plexus injury make significant muscle atrophy with loss of proper function. It is much helpful to reconstruct the essential function of the elbow flexion movement in patient with total loss of elbow flexion motion after brachial plexus lesion which was not recovered with nerve surgery or long term conservative treatment from onset. In whole arm type brachial plexus injury, if there were no response to neurotization or neglected from injury, the volume of the denervated muscle is significantely reduced month by month. About 18 months most of the muscle fibers change to fibrous tissues and markedly atrophied irreversibly, further waiting is no more meaningful from that period. Authors performed 14 cases of functioning gracilis muscle transfer from 1981 to 1995 with microneurovascular technique, neuromusculocutaneous free flaps were performed for reconstruction of lost elbow flexion function. Average follow-up period was 5 years and 6 months. We used couple of intercostal nerves as a recipient nerve which were anastomosed to muscular nerve from obturator nerve in all cases. Recipient vessels were three deep brachial artery and eleven brachial artery which were anastomosed to medial femoral circumflex artery with end to end or end to side fashion. Average resting length of the transplanted gracilis were 24 cm. We can get average 54 degree flexion range of elbow with fair muscle power from flail elbow. There were one case of muscle necrosis with lately developed thrombosis of microvascular anastomosed site which comes from insufficient recipient arterial condition, 3 cases of partial marginal necrosis of distal skin of the transplanted part which were not significant problem with spontaneously solved with time goes by gracilis muscle has constant neurovascular pattern with relatively easy harvesting donor with minimal donor morbidity. Especially it has similar length and shape with biceps brachii muscle of upper arm and longer nerve pedicle which can neurorrhaphy with intercostal nerve without nerve graft if sufficient mobilization of the nerves from both sides of gracilis and intercostal region. Authors can propose gracilis muscle transplantation with intercostal nerves neurotization is helpful method with minimal donor morbidity for neglected brachial plexus palsy patients.

• 대한임상전기생리학회지
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• 제7권1호
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• pp.1-6
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• 2009

Purpose : We investigated the effects of microcurrent(MC) electrical stimulation on each intensity($100{\mu}A,\;200{\mu}A,\;500{\mu}A$ - 30pps frequency was same) on delayed onset muscle soreness(DOMS). Methods : Subjects were assigned randomly divided into three groups of eight for three different treatment protocoals($100{\mu}A,\;200{\mu}A,\;500{\mu}A$-experimental groups). Twenty-four healthy males and females subjects were participated in this study. All subjects performed eccentric exercise of elbow flexor(biceps brachii) until exhausted. The measured items of elbow flexor muscle strength were Nicholas Manual Muscle Taster(NMMT). The measured items of elbow joint range of motion ROM) were Goniometer. The measured items of elbow flexor muscle pain were visual analogue scale(VAS). Treatment were applied at 30 minute exercise after and again at 24 hours and at 48 hours and at 72 hours after. Measurements were taken after treatment. Analysis of Results using repeated measures analysis of variance(ANOVA) and post hoc tests were as follows: two-way ANOVA with repeated measurement for muscle strength, flexion ROM, extension ROM and VAS. Results : This results showed eccentric exercise casused DOMS, DOMS response to eccentric exercise were reduces by microcurrent therapy. DOMS was significant decreased at $100{\mu}A,\;200{\mu}A,\;500{\mu}A$. Muscle strength was significant difference at all intensity. Elbow flexion ROM was significant difference at all intensity but elbow extension ROM was insignificant difference at all intensity. VAS score was significant difference at $100{\mu}A$ and $500{\mu}A$ but insignificant difference at $200{\mu}A$. All experimental groups showed insignificant difference with all intensity MENS. Conclusion : These findings indicate that microcurrent therapy is had effect on recovery from exercise induced muscle damage. In our's suggestion, microcurrent therapy is particularly more appropriate therapeutic modality.

• Clinics in Shoulder and Elbow
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• 제23권1호
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• pp.27-30
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• 2020

Osborne-Cotterill lesion is an osteochondral fracture located in the posterolateral margin of the humeral capitellum, which may be associated with a defect of the radial head after an elbow dislocation. This lesion causes instability by affecting the lateral ulnar collateral ligament over its capitellar insertion, which is associated with a residual capsular laxity, thereby leading to poor coverage of the radial head, and hence resulting in frequent dislocations. We present a 54-year-old patient, a physician who underwent trauma of the left elbow after falling from a bike and suffered a posterior dislocation fracture of the elbow. The patient subsequently presented episodes of instability, and additional work-up studies diagnosed the occurrence of Osborne-Cotterill lesion. An open reduction and internal fixation of the bony lesion was performed, with reinsertion of the lateral ligamentous complex. Three months after surgery, the patient was asymptomatic, having a flexion of 130° and extension of 0°, and resumed his daily activities without any limitation. Currently, the patient remains asymptomatic 2 years after the procedure. Elbow instability includes a large spectrum of pathological conditions that affect the biomechanics of the joint. The Osborne-Cotterill lesion is one among these conditions. It is a pathology that is often forgotten and easily overlooked. Undoubtedly, this lesion requires surgical intervention.

• Clinics in Shoulder and Elbow
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• 제23권3호
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• pp.131-135
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• 2020

Background: Resection of the radial head is a surgical indication for comminuted radial head fracture in which internal fixation is inaccessible. Some complications from the surgery can alter the function of the patient's elbow. The objective of this study was to assess functional outcome of the elbow after resection of the radial head. Methods: A retrospective longitudinal study was performed with patients who underwent radial head resection between 2008 and 2018. Elbow function was assessed by the Mayo Elbow Performance Index (MEPI) for 11 patients comprising three women and eight men. The mean follow-up was 47.6 months. The mean age was 41±10.3 years. Results: Nine patients had a stable and painless elbow. The mean extension-flexion arc was 97.73°±16.03°. The mean values of pronation and supination were 76.8° and 74.5°, respectively. The mean MEPI score was 83.2 points, and restoration of overall function was achieved in 81% of the cases. Poor function was noted in one in 10 that presented with a terrible triad. Conclusions: Resection of the radial head restored elbow functionality at a rate of 81%, which was a good outcome for patients.