Kim Seung-Ho;Ha Kwon-Ick;Kim Hyeon-Sook;Kim Seon-Woo;Park Jong Hyuk;Kim Young-Min
Clinics in Shoulder and Elbow
/
v.3
no.2
/
pp.87-94
/
2000
Purpose : The purpose of this study was to evaluate the activity of the biceps brachii muscle in the vulnerable abduction and external rotation position of the shoulder in patients with anterior instability. Materials and Methods: This experimental study include a prospective analysis of the electromyographic(EMG) data on a group of patients with traumatic unilateral anterior instability of the shoulder. The EMG data of unstable shoulders was compared with those of opposite shoulders as control. The optimal sample size for the case-control study was calculated using an nQuery Advisor program(nQuery Adviser 3.0, Statisticl solutions Ltd., Ireland). The EMG analyses were conducted in 76 shoulders in 38 patients who had a traumatic anterior instability in one shoulder. The EMG records were obtained at different position of shoulder, which included 0° , 45° , 90° and 120° of shoulder abduction. In each angle of shoulder abduction, the arms were placed in an external rotation as tolerated by the anterior apprehension. The paired-sample T test was used to compare the difference of the root mean square(RMS) voltages between the stable and unstable shoulders in each degree of arm position. Results : The RMS voltage of the biceps muscle was significantly greater in the unstable shoulder than opposite stable shoulder in all position of the arm(p<0.001). The RMS voltage of the biceps was maximal at 90° and 120° of external rotation in the unstable shoulder(p<0.05). The RMS voltage of the supraspinatus muscle revealed no differences in any of the test conditions(p=0.904, 0.506, 0.119 and 0.781 in 0° , 45° , 90° and 120° , respectively) Conclusion: In the vulnerable abduction and external rotation position, the biceps muscle plays an active compensatory role in the unstable shoulder while not in the stable shoulder.
The purpose of this study was to find the effects of scapular pattern and hold-relax technique of propriocetive neuromuscular facilitation(PNF) on the range of motion(ROM) and to find the effects of pain relieve through visual analogue scale(VAS) in frozen shoulder patients. The subjects were consisted of thirty frozen shoulder patients(men ; 9, women ; 21). The measurement of the shoulder range of motion was taken by measuring the degrees of flexion, abduction, and external rotation with a goniometer and the measurement of pain was performed by VAS from pre treatment to one to four weeks The results were as follows : 1. There was the statistical significance not only in the range of motion such as shoulder flexion, abduction, and external rotation, but also in VAS during four weeks(p<.05). 2. By the result of Scheffe's multiple comparison test. there was statistical significance between the values of pre treatment and treatment after one week in the range of motion of shoulder flexion. In that of shoulder external rotation, there was statistical significance between the values of pre treatment and treatment after one week, and between those of treatment after one and two weeks. As the result of this statistical significance of shoulder external rotation, the early treatment was thought to be more effective. However, there was statistical significance in the treatment after two and three weeks in shoulder abduction and was statistical significance between the values of pre treatment and the treatment after one weeks, and between those of treatment after two and three weeks in VAS (p<.05). 3. There was not statistical significance between men and women in the range of motion of the shoulder and in VAS(p>.05). 4. There not statistical significance between th right and left frozen shoulder patients in the range of motion of shoulder and in VAS(p>.05).
The purpose of this investigation was to analyze A kinematic analysis of the Kuzushi-arm motion when performing Morote-Seoinage in judo who was 5 females university representative judokas of light weight category in judo, and filmed on video cameras(60field/s). The data of this study digitizied by KWON3D 2.1 program computed the average and standard deviation calculated individual 5 trials with Programing Lab view 6i. From the data analysis & discussion, the following conclusions were drawn : 1) distance variable of attacking hand arm in kuzushi motion Left right(X direction) displacement variable was all of A, B, C pattern with moving left to right and leaning. Strip of displacement variable was ordo. to C(55.6cm), A(53.3cm), B(43.9cm) pattern, C pattern largely leaned to left Front Rear(Y direction) displacement variable was different A($131.3cm{\pm}3.1cm$), B($128.7{\pm}4.0cm$) and C(111.0cm) on ready position, 3 pattern leaned to rear direction. Strip of displacement was order to B(43.4cm), A(41.1cm) and C pattern(28.3cm). Up down(Z direction) displacement variable was all of A, B, C pattern leaned to up in the Kuzushi-phase and leaned to down in the Kake-phase. Strip of displacement was order to A(83.9cm), B(80.4cm), C pattern(71.9cm). 2) Shoulder joint angle variable Flexion and extension Ready position' angle was A($138.3{\pm}4.9^{\circ}$), B($142.9{\pm}3.7^{\circ}$) and C($164.5^{\circ}$) pattern, strip of flexion extension was order to C($80.9^{\circ}$), A($79.9^{\circ}$) and B($39.0^{\circ}$) pattern, greatly C pattern had largely angle change. Adduction and abduction : B and C pattern's angle change were adduction and abduction in the Kuzushi-phase after adduction in the Kake phase, A pattern's angle change was abduction in the Kuzushi-phase after adduction in the Kake phase. internal and external rotation : 3 pattern were internal rotation in the Tsukuri phase and external rotation in the Kake phase. After B and C pattern were external rotation and A pattern was internal rotation. 3) Elbow joint angle variable Flexion and extension 3 pattern's ready position angle were A($142.0{\pm}4.4^{\circ}$), B($123.5{\pm}5.5^{\circ}$) and C($105.5^{\circ}$) and flexion. Strip of flexion extension were order to A($57.9^{\circ}$), C($34.6^{\circ}$) and B($25.2^{\circ}$) pattern.
Thirty normal adults were tested to measure the electrical activity of the anterior (AD), middle (MD), and posterior portion (PD) of the deltoid muscle and sternal portion of the pectoralis major muscle (PM) during the performance of four upper extremity PNF diagonal patterns with elbow flexion angle in $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$. The PNF patterns in which these muscles function optimally have been theoretically advanced by Kabat and further described by Knott and Voss. They theorize that the MD should be most active with shoulder flexion, abduction, and external rotation (D2F); the PD with shoulder extension, abduction, and internal rotation (D1E); the AD with shoulder flexion, adduction, and external rotation (D1F); and the PM with shoulder extension, adduction and internal rotation (D2E). The patterns were performed through range of motion, with an isometric contraction performed in the shortened range. When the EMG activity of AD, MD, PD and PM in its optimal patterns was measured, it does not have significant difference among fixed elbow flexion angle $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$ (p>.05). In addition, suggestions were made for study of patients who exhibit imbalance of muscle strength and have muscle weakness.
In volleyball, the most common injuries are anterior cruciate ligament (ACL) tears. For this reason, volleyball players frequently use knee brace as prophylactic and rehabilitation measures. The purpose of the study was to investigate the effects of knee brace on anterior cruciate ligament injuries risk factors during spike take off in female volleyball players. Fifteen female volleyball players were recruited and performed randomly spike take off with and without knee brace. Kinematics and ground reaction data were collected to estimate the anterior cruciate ligament injuries risk factors. The ACL risk factors are knee maximum flexion angle, thigh maximum adduction angle, thigh maximum internal rotation angle, shank maximum abduction angle, shank maximum external rotation angle, knee maximum extension moment and knee maximum abduction moment. Data were analyzed with paired samples t-test with Bonfferoni collection. Female volleyball players with knee brace had no significant results in knee maximum flexion angle, thigh maximum adduction angle, thigh maximum internal rotation angle, shank maximum abduction angle and shank maximum external rotation angle compare to without knee brace. Female volleyball players, however, with knee brace showed more reduced knee maximum extension moment and knee maximal abduction moment than without knee brace. In conclusion, Female volleyball players with knee brace reduced anterior cruciate ligament stress.
Purpose: This study aimed to investigate the effect of angular joint mobilization (AJM) on the shoulder pain, range of motion, and functional improvement in a patient with shoulder adhesive capsulitis. Methods: The patient diagnosed with right shoulder adhesive capsulitis by an orthopedic surgeon was a 60-year-old male, right hand/arm dominant, with a height of 175 cm and weight of 75 kg. The patient received 12 sessions of AJM once or twice per week for eight weeks. AJM was applied for 5 min each of flexion, abduction, external rotation, internal rotation, for a total of 20 min per session. The visual analog scale, the goniometer, and the Oxford shoulder score were used to measure pain, range of motion, and shoulder pain & disability index, respectively. Results: After all the treatments, the pain decreased from 6 to 2 points. The range of motion increased in flexion by $54.3^{\circ}$ from $125^{\circ}$ to $179.3^{\circ}$, abduction by $38^{\circ}$ from $140^{\circ}$ to $178^{\circ}$, external rotation by $54.4^{\circ}$ from $30.3^{\circ}$ to $84.7^{\circ}$, and internal rotation by $25^{\circ}$ from $45^{\circ}$ to $70^{\circ}$. The shoulder disability index decreased from 33 points to 17 points. Conclusion: This study found that AJM has a positive effect on the improvement of shoulder pain, range of motion, and function in a patient with shoulder adhesive capsulitis. Further studies on AJM are needed in the future.
Background: The purpose of this study was to evaluate the clinical and radiographic outcomes of internal fixation with locking T-plates for osteoporotic fractures of the proximal humerus in patients aged 65 years and older. Methods: From January 2007 through to December 2015, we recruited 47 patients aged 65 years and older with osteoporotic fractures of the proximal humerus. All fractures had been treated using open reduction and internal fixation with a locking T-plate. We classified the fractures in accordance to the Neer classification system; At the final follow-up, the indicators of clinical outcome-the range of motion of the shoulder (flexion, internal rotation, and external rotation) and the presence of postoperative complications-and the indicators of radiographic outcome-the time-to-union and the neck-shaft angle of the proximal humerus-were evaluated. The Paavolainen method was used to grade the level of radiological outcome in the patients. Results: The mean flexion was $155.0^{\circ}$ (range, $90^{\circ}-180^{\circ}$), the mean internal rotation was T8 (range, T6-L2), and the mean external rotation was $66.8^{\circ}$ (range, $30^{\circ}-80^{\circ}$). Postoperative complications, such as plate impingement, screw loosening, and varus malunion were observed in five patient. We found that all patients achieved bone union, and the mean time-to-union was 13.5 weeks of the treatment. The mean neck-shaft angle was $131.4^{\circ}$ at the 6-month follow-up. According to the Paavolainen method, "good" and "fair" radiographic results each accounted for 38 and 9 of the total patients, respectively. Conclusions: We concluded that locking T-plate fixation leads to satisfactory clinical and radiological outcomes in elderly patients with proximal humeral fractures by providing a larger surface area of contact with the fracture and a more rigid fixation.
This study was to analysis three dimension angle of the upper extremity segment and trunk to putting the protector in women bowlers. For this study, the subjects selected 4 players of national and university team. All subjects putted in the same wrist support to satisfy the experiment conditions. To get three dimensions position coordination of swing motion used for 6 ProReflex MCU 240 camera produced by Qualisys. After position coordination calculation, Three dimension angle of the trunk and the upper extremity segment calculated for Matlab 6.5. the result is following; In the trunk motion, there were little differences among the subjects in a flexion and extension change. There were a lot of differences in motion change of the abduction-adduction and internal-external rotation, but the motion types translated to the adduction-abduction-adduction and from the internal rotation toward the external rotation. In the upper arm segment the Flexion and extension showed a consistent motion in the down swing and up swing phase. And the motion change of abduction-adduction and pronation-supination showed a abduction-adduction-abduction and pronation-supination change during swing phase. In the forearm segment changes, it showed a lot of differences among the subjects and a similar change with the upper arm segment. Especially, the hand segment showed a supination motion from the backswing apex to release phase, but for increasing a rotation velocity of ball, the hand segment translated toward pronation in follow throw phase.
Purpose: This study aimed to determine the interaction among the neck, trunk, and lower extremities on the non-paretic side in head rotation along with non-paretic-side weight shifting of stroke patients. To compare stroke patients' ability to control posture through muscle activity variation related to pertubation during head rotation along with the non-paretic limb. Methods: We tested 15 hemiplegic patients and 15 normal individuals. Each group's muscle activity was measured by electromyography in neutral head position and head rotation position. We compared each group's resu lt based on measured values in patients' non-paretic neck muscles, trunk muscles, and lower limbs muscles activation. Results: The study showed that muscle activity increased in the sternocleidomastoid muscle (102.26%, 53.00%), splenius capitis muscle (97.93%, 54.93%), erector spinae muscle (241.00%, 127.60%), external oblique abdominal muscle (256.66%, 152.00%), and internal oblique abdominal muscle (252.80%, 152.6%), peroneus longus muscle (117.53%, 137.13%) and gastrocnemius muscle (119.06%, 137.20%), while the results for the sternocleidomastoid muscle, splenius capitis muscle, erector spinae muscle, external oblique abdominal muscle, internal oblique abdominal muscle, peroneus longus muscle, and gastrocnemius muscle showed a statistically significant difference (p<0.05). Conclusion: It is hard for stroke patients to engage in normal movement control under suggested conditions because of the insufficient movement against gravity on the stroke patient's non-paretic side and impaired cooperative patterns. To solve these problems, patients need their bodies to improve through effective movement, resulting in advanced control of their effective and functional activity.
The purpose of this study was to quantify the isokinetic peak torque and range of motion at the shoulder in 8 national male volleyball players who played during the 2008 professional leagues. In this study the strength and range of motion data in the internal rotation(IR) and external rotation(ER) of shoulder joint were measured with isokinetic measurement system(Biodex Inc) and motion analysis system (Simi motion system Inc.) from 3 volleyball players with atrophy of the infrasupinatus and 5 volleyball players without atrophy of the infraspinatus. Peak torques were determined using isokinetic measurement on the shoulder joint rotator at the point of angular velocities of $60^{\circ}$/s. Significant difference was found in the peak torque, IR / ER ratio and the range of motion through assessment of the dominant shoulder between two groups. we recommended functional exercises that improve both external rotators strength and stretching exercise for internal rotation in the dominant side during the prevention programs in volleyball players.
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