• Asian Oncology Nursing
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• v.4 no.1
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• pp.62-70
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• 2004

The purpose of this study was to use as a basic data to develop suitable nursing intervention program and decide an appropriate intervention time after assessing shoulder range of motion in postmastectomy from 2 weeks to 3 month. 147 patients are chosen as study subject among patients who were in recovery of 2weeks, 1month, 2months and 3 months after surgical operation which is modified radical mastectomy. Data were collected at oncology medicine local and general surgery local in Seoul National University Hospital from May, 2003 to October, 2003. The range of motion of the shoulder(flexion, extension, abduction, internal rotation, external rotation) were examined. Analysis of data that shoulder range of motion average and standard deviation, percentage of the unaffected side and affected side compare with normal shoulder range of motion. Paired t-test was adopted to analyze the difference between affected side and unaffected side. Conclusion from this study is as following, 1. The most serious problem was external rotation (0.56%) and internal rotation is the next (19.9%) in 5 kinds of shoulder range of motion in 2 weeks after surgical operation 2. There was no difference in internal rotation after post operation 3 months but there were differences and shown to recover more than 90% in flexion and abduction. Also shoulder function incresed in flextion less than 80% and more than 80% in external rotation. As this study finding was shown that shoulder range of motion did not get back perfectly except of internal rotation and extension in point of 3 months after breast cancer surgical operation. External rotation was specially shown the lowest result so it is needed to exercise for improving their physical functioning recovery in postmastectomy patients. And it is suggested to study for helping to postmastectomy patients' physical and psycosocial functions with the early rehabilitation program which is based on these results.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.1
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• pp.43-49
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• 2017

PURPOSE: This study investigated the relationship among hip adduction angle, tibial rotation, and ITB length during an Ober test to determine the most appropriate position for performing the test. METHODS: The study included thirty-nine asymptomatic participants (23 males, 16 females). Their hip adduction angles were measured using the Ober test during three tibial rotation conditions (internal tibial rotation, external rotation, and neutral position). ITB length was calculated by measuring the position of the patella to lateral femoral condyle using ultrasonography (patella-condyle distance; PCD). RESULTS: The relationship among hip adduction angle, tibial rotation, and ITB length was analyzed under the three conditions using the Pearson correlation. The hip adduction angle of the internal tibial rotation, the external rotation, and the neutral position were significantly related to ITB length. Moreover, the hip adduction angle measured during the internal tibial rotation had the highest correlation with ITB length among the three conditions (r=.58, p<.001). CONCLUSION: Internal tibial rotation caused by the Ober test led to increased iliotibial band (ITB) tension and a decreased adduction angle. These findings support that tibial rotation influences the flexibility of ITB. Therefore, therapists should consider the position of the internal tibial rotation when taking measurements using an Ober test.

• Korean Journal of Applied Biomechanics
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• v.21 no.4
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• pp.467-477
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• 2011

This study was performed to investigate the effects of tibial rotation while going up stair on muscle activity of vastus medialis oblique and vastus lateralis, and on patellar displacement. The subjects included 30 people (male: 15; female: 15) who were randomly assigned to the tibial internal-rotation, neutral-rotation, and external-rotation groups. The subjects went up the stair while performing the assigned rotations, and the rotation of the hip and the displacement of the patella were measured using a 3D motion analyzer. In addition, the maximum voluntary isometric contraction (MVIC) of the vastus medialis oblique and vastus lateralis were measured using surface electromyogram. On the tibial internal rotation, the hip rotation significantly appeared in the same direction and so did on the tibial neutral and external rotations(p<.001). Although the MVIC of the vastus medialis oblique and vastus lateralis did not significantly differ by tibial rotation during the stair ascent, the MVIC of the vastus medialis oblique was higher than that of the vastus lateralis during the internal and neutral rotations (p<.05). In addition, during the stair ascent, the displacement of the patella was more significant during the tibial external rotation than during the tibial internal and neutral rotations(p<.001). Thus, patients with patellofemoral pain are required to be considered the effects of tibial rotation for their rehabilitation.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.175-175
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• 2009

Despite its importance for the understanding of joint kinematics in vivo, there has been few studies about shoulder joints. The purpose of this study is to analyze the glenohumeral joint during internal and external rotation at 90 degrees of abduction using in vivo noninvasive motion analysis system. MRI was performed for the following seven positions from maximum internal rotation to maximum external rotation at intervals of 30 degrees. We used 3D-gradient echo sequencing (TR: 12 ms, TE: 5.8 ms, 0.8 mm-slice thickness). Our method is based on matching three-dimensional MR images by the similarity of the image intensity. We analyzed the in vivo three-dimensional motions of the glenohumeral and scapulothoracic joint during this motion. In scapla plane, the mean rotation angle of the glenohumeral join was 105.5 degrees ($SD{\pm}39.0^{\circ}$). The mean rotation angle of the scapulothracic joint was 27.5 degrees ($SD\;{\pm}\;7.7^{\circ}$). The contribution ratio is almost 3.8:1 of glenohumeral and scapulothracic joint respectively.

• Journal of the Korean Society of Radiology
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• v.6 no.4
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• pp.299-303
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• 2012

Shoulder MRArthrography was performed to get an accurate diagnosis about complex anatomical structure in shoulder joint. We carried out how the changes of anatomical rotations in shoulder joint could bring certain diagnosis effects on MRI images for various shoulder humerus positions; Neutral position, Internal rotation position and External rotation position. In addition, we prepared an aid tool in oder to maintain the right posture of a patient. This aid tool was made by adapting Modeling Design Program. By virtue of this aid, we obtained the following result. Shoulder MR Arthrography by the External rotation position for anatomical structure diagnosis was the most suitable in diagnostic evaluations of important anatomical structures in shoulder joint such as Biceps tendon, Supera-spiatus tendon, Sub-scapularis tendon, Labrum and Sub-acromial space.

• PNF and Movement
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• v.18 no.2
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• pp.255-263
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• 2020

Purpose: The purpose of this study was to investigate the effect of proprioceptive neuromuscular facilitation (PNF) lower extremity pattern on the dominant leg on muscle activity of the lower extremity supported by the ground. Methods: The subjects were 20 healthy males living in Busan. All subjects performed four direction PNF lower extremity patterns, and data were collected by surface electromyography from the gluteus medius (GM), tensor fascia latae (TFL), vastus medialis oblique (VMO), vastus lateralis oblique (VLO), and semitendinosus (STD) muscles of the opposite lower extremity during PNF lower extremity pattern. The PNF lower extremity pattern applied to the dominant leg was (1) flexion/adduction/external rotation with knee flexion; (2) extension/abduction/internal rotation with knee extension; (3) flexion/abduction/internal rotation with knee flexion; and (4) extension/adduction/external rotation with knee extension pattern, repeated 3 times per pattern and using the average value of the collected results. Collected muscle activity values were analyzed by one-way ANOVA, and post-hoc Tukey testing was performed to check between-group differences. The statistical significance level was set at α = 0.05. Results: GM and TFL flexion/abduction/internal rotation pattern with knee flexion was significantly higher than other patterns. VMO and VLO extension/adduction/external rotation pattern with knee extension was significantly higher than other patterns. STD flexion/adduction/external rotation pattern with knee flexion was significantly higher than other patterns. Conclusion: The study confirms differences in lower extremity muscle activity for the PNF lower extremity pattern, indicating that selective muscle contraction induction is possible using a pattern appropriate to the purpose of treatment.

• Journal of Korean Foot and Ankle Society
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• v.15 no.1
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• pp.22-26
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• 2011

Purpose: To report the effectiveness of adding distal fibular external rotation stress test on the traditional lateral stress Cotton test in evaluating distal tibiofibular syndesmotic injuries. Materials and Methods: We evaluated syndesmotic injuries with intraoperative stress test during treating ankle fractures from March 2009 to September 2010. External rotation of distal fibula using small elevator was added on traditional stress test in case of suspicious syndesmotic injury. We retrospectively reviewed and compared the results of each test in 44 cases for which we tried both tests. Results: In 9 cases of positive traditional lateral stress tests, positive results were obtained in all cases by additional external rotation tests. In 21 cases of negative traditional stress tests, additional stress tests results were also negative. But there were 10 cases of positive additional tests and 4 of negative additional tests in equivocal results cases by the traditional stress tests. Conclusion: Using additional external rotation stress test in case of equivocal test result by the traditional lateral stress Cotton test for evaluation of syndesmotic injury during operation for ankle fracture can be a supplemental method to clarify syndesmotic injury needs fixation.

• Clinics in Shoulder and Elbow
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• v.27 no.1
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• pp.59-71
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• 2024

Background: Restoration of external (ER) and internal rotation (IR) after Grammont-style reverse shoulder arthroplasty (RSA) is often unreliable. The purpose of this systematic review was to evaluate the influence of RSA medio-lateral offset and subscapularis repair on axial rotation after RSA. Methods: We conducted a systematic review of studies evaluating axial rotation (ER, IR, or both) after RSA with a defined implant design. Medio-lateral implant classification was adopted from Werthel et al. Meta-analysis was conducted using a random-effects model. Results: Thirty-two studies reporting 2,233 RSAs were included (mean patient age, 72.5 years; follow-up, 43 months; 64% female). The subscapularis was repaired in 91% (n=2,032) of shoulders and did not differ based on global implant lateralization (91% for both, P=0.602). On meta-analysis, globally lateralized implants achieved greater postoperative ER (40° [36°-44°] vs. 27° [22°-32°], P<0.001) and postoperative improvement in ER (20° [15°-26°] vs. 10° [5°-15°], P<0.001). Lateralized implants with subscapularis repair or medialized implants without subscapularis repair had significantly greater postoperative ER and postoperative improvement in ER compared to globally medialized implants with subscapularis repair (P<0.001 for both). Mean postoperative IR was reported in 56% (n=18) of studies and achieved the minimum necessary IR in 51% of lateralized (n=325, 5 cohorts) versus 36% (n=177, 5 cohorts) of medialized implants. Conclusions: Lateralized RSA produces superior axial rotation compared to medialized RSA. Lateralized RSA with subscapularis repair and medialized RSA without subscapularis repair provide greater axial rotation compared to medialized RSA with subscapularis repair. Level of evidence: 2A.

• The Journal of Korean Physical Therapy
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• v.34 no.4
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• pp.140-148
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• 2022

Purpose: The purpose of this study was to investigate the effects of the scapulothoracic mobilization on subject with lateral epicondylalgia. This was done through lateral slide scapular test, grip strength, visual analogue scale, glenohumeral joint external rotation range of motion. Methods: Before the experiment, Lateral slide scapular test, grip strength, visual analogue scale, glenohumeral joint external rotation range of motion were measured. Scapulothoracic joint mobilization was applied and then measurements were taken again to compared the changes. Results: After applying the scapulothoracic joint mobilization, lateral slide scapular test, grip strength, visual analogue scale, glenohumeral joint external rotation range of motion significantly improved. Conclusion: This study found that the scapulothoracic mobilization was effective in improving functional aspects and pain on subject with lateral epicondylalgia. The results suggest that the scapulothoracic joint mobilization is a significant considered intervention method that could be used for subject with lateral epicondylalgia.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.1
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• pp.101-111
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• 2020

Purpose : The purpose of this study was to identify the comparison of the effects of manual therapy combined with exercise on range of motion (ROM), muscle strength, and functional performance in adolescent baseball players with internal impingement syndrome of the shoulder. Methods : The subjects were 30 patients diagnosed with impingement syndrome of the shoulder. Thirty subjects are randomly assigned to each 3 different groups; Group 1. (exercise group), Group 2. (exercise+mobilization; EMOB group), Group 3. (exercise+mobilization with movement; EMWM group). The interventions were performed three times a week for 4 weeks. The main outcome measures were goniometer, Biodex dynamometer, and Korean Kerlan Jobe shoulder-elbow (K-KJOC) scores. The ROM (external and internal rotation), muscle strength (external and internal rotation: 60 °/sec., 180 °/sec.), and functional performance were compared among the groups. Results : No significant difference was observed among the groups in the range of external rotation of the shoulder before and after the intervention, but the range of internal and total rotation was significantly increased in Group 2, 3 compared to Groups 1. Muscle strength of external and internal rotation (60 °/sec., 180 °/sec.) was not significantly different among Group 1, 2, 3, and functional performance was significantly increased in Group 2, 3 compared to Group 1. However, there was no significant difference between Group 2 and Group 3 in all measurements. Conclusion : An intervention with manual therapy such as EMOB and EMWM was more effective than exercise alone for rapid recovery from shoulder injury and improvement in functional performance. However, further efforts are needed to identify effects of specific interventions with manual therapy.