• Clinics in Shoulder and Elbow
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• v.17 no.4
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• pp.151-151
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• 2014

• 대한관절경학회:학술대회논문집
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• 2006.11a
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• pp.35-39
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• 2006

Posterior capsular tightness with glenohumeral internal rotation deficit is usually considered to be an acquired condition of the throwing shoulder and is usually treated conservatively. However, because posterior capsular tightness is sometimes irreversible, we have performed arthroscopic capsular release for painful throwing shoulder with posterior capsular tightness. The true loss of internal rotation and posterior stiffness was confirmed by examination with the patient under anesthesia, and contracture of the posterior capsule and the posterior band of the inferior glenohumeral ligamant was observed arthroscopically. Because an extensive adhesion between the capsule and the fascia of the external rotators was noted, a capsular release was performed from 6 o'clock to 11 o'clock (in the right shoulder) to completely expose the muscle belly of the external rotators. Of the first 16 consecutive patients, 4 had no concomitant lesions and underwent posterior capsular release alone. With a minimum of 2 years' follow-up, it was ascertained that the throwing pain completely disappeared in 14 patients and improved in 2. In all, 11 patients returned to their preinjury performance level, and 5 returned to a lower level of function. In the 4 patients who had no concomitant lesions, throwing pain completely disappeared, and all were able to return to their preinjury performance level.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.29 no.3
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• pp.122-128
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• 2018

Objectives: This study evaluated the psychometric properties of the Korean version of the attention-deficit/hyperactivity disorder (ADHD) Stigma Questionnaire (ASQ) and the effect of the source of information about mental health on ADHD stigma. Methods: The Korean translation of the ASQ was prepared, and 673 participants, 20-64 years of age, completed the questionnaire using an online panel survey in South Korea. The participants also completed questionnaires detailing sociodemographic variables and the source of their mental health knowledge. Cronbach's alpha coefficient was used to explore the internal consistency of the ASQ. Factor analysis using Varimax rotation was conducted to investigate the structure of the ASQ. Results: The 26-item ASQ demonstrated excellent internal consistency (Cronbach's alpha=0.940). Factor analysis supported a three-factor structure, including Concerns with Public Attitudes, Negative Self-Image, and Disclosure Concerns. There were no significant differences in the total ASQ scores according to sociodemographic characteristics. Participants who reported the internet as their major source of information about mental health showed higher ASQ scores compared to those who used other sources for mental health information. Conclusion: The Korean translation of the ASQ has acceptable psychometric properties among Korean adults. Inaccurate information from the internet could increase the stigma toward ADHD.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.11a
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• pp.153-161
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• 2007

견관절의 ABER position에서 posterosuperior rotator cuff 가 posterior glenoid에 contact 하여 internal impingement가 일어나는 현상은 운동선수가 아닌 일반인에게도 발생하는 physiologic phenomenon이며 과도한 반복 동작으로 인하여 증상이 발현한다. Internal impingement는 증상이 모호할 뿐만 아니라 견관절 내 여러 병소가 함께 존재하기 때문에 각각의 pathology에 대한 자세하고 정확한 evaluation이 필수적이다. 아직 controversy가 있지만 internal impingement의 pathologic factors로서는 anterior capsular laxity (true anterior laxity), posteroinferior capsular tightness (pseudo anterior laxity)와 이로 인한 glenohumeral internal rotation deficit (GIRD), 그리고 SICK scapula syndrome (scapular dyskinesis) 등으로 요약할 수 있다. 진단은 주로 병력 청취와 신체 검사로 내려지며 ultrasonogram, MRA등으로 확진한다. Sleeper stretching exercise 등과 같은 보존적 치료에 반응이 좋지만 6개월간의 재활 치료에도 호전이 없다면 증상과 직접 관련된 주 병소(appropriate pathology)를 찾아 이에 대한 적절한 수술이 이루어져야 한다.

• Journal of Korean Orthopaedic Sports Medicine
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• v.12 no.1
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• pp.29-36
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• 2013

Purpose: Proprioceptive function has been known to be important to shoulder stability. However, the function in rotator cuff tear patients is rarely investigated. The purpose of current study is to report the proprioceptive function in rotator cuff tear patients and to analyze the proprioceptive function regarding the tear size and the presence of subscapularis tear. Materials and Methods: Between 2011 and 2012, total 76 patients (male 28 and female 48) were recruited and average age was 61.7 years old (range, 38~76). Preoperatively, joint position senses in internal and external rotation were measured for proprioceptive function testing by method of active re-positioning technique. The absolute difference from set point was measured. Proprioceptive function was further analyzed according to tear size of rotator cuff, the presence of subscapularis tear, visual analogue scale of pain, shoulder functional score (American society of elbow and shoulder score), and ranges of motion in shoulder. Results: The absolute difference for external rotation was $4.9^{\circ}{\pm}2.9^{\circ}$, in normal joint and $4.9^{\circ}{\pm}3.0^{\circ}$for involved joint in rotator cuff tear patients. This difference was not significant statistically (p=0.87). The absolute difference for internal rotation was $4.0^{\circ}{\pm}2.7^{\circ}$in normal joint whereas $4.8^{\circ}{\pm}3.7^{\circ}$ for involved joint showing statistically significant difference (p=0.043). There was some trend that the proprioceptive function of internal rotation was more impaired in the bigger tear size group (more than medium tear) compared to the smaller tear size group (partial thickness and small tear, 5.0 vs. 4.0, p=0.061). The impairment of internal rotation proprioception was also accentuated in patients with subscapularis tear (4.8 vs. 4.0, p=0.065). The proprioceptive function of internal rotation was decreased when the pain visual analogue scale was increased (5.2 vs. 4.0 p=0.04), shoulder functional score was decreased (6.1 vs. 4.2, p=0.005), or range of motion in shoulder joint was restricted (5.3 vs. 3.7, p=0.041). Conclusion: The deficit of proprioceptive function was observed in rotator cuff tear patients. Proprioception for internal rotation was impaired in patients with the bigger tear size and subscapularis tear. Pain, shoulder function score, and range of motion were also shown to be related with the deficit in proprioceptive function.

• Physical Therapy Korea
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• v.22 no.4
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• pp.62-70
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• 2015

The aims of the current study were to assess reliability of range of motion (ROM) measurement of glenohumeral internal rotation (GIR) with a pressure biofeedback stabilization (PBS) method and to compare the reliability between manual stabilization (MS) and the PBS method. In measurement of pure glenohumeral joint motion, scapular stabilization is necessary. The MS method in GIR ROM measurement was used to restrict scapular motion by pressing the palm of the tester's hand over the subject's clavicle, coracoid process, and humeral head. The PBS method was devised to maintain consistent pressure for scapular stabilization during GIR ROM measurement by using a pressure biofeedback unit. GIR ROM was measured by 2 different stabilization methods in 32 subjects with GIR deficit using a smartphone clinometer application. Repeated measurements were performed in two test sessions by two testers to confirm inter- and intra-rater reliability. After tester A performed measurements in test session 1, tester B's measurements were conducted one hour later on the same day to assess the inter-rater reliability and then tester A performed again measurements in test session 2 for confirming the intra-rater reliability. Intra-class correlation coefficient (ICC) (2,1) was applied to assess the inter-rater reliability and ICC (3,1) was applied to determine the intra-rater reliability of the two methods. In the PBS method, the intra-rater reliability was excellent (ICC=.91) and the inter-rater reliability was good (ICC=.84). The inter-rater and intra-rater reliability of the PBS method was higher than in the MS method. The PBS method could regulate manual scapular stabilization pressure in inter- and intra-rater measuring GIR ROM. Results of the current study recommend that the PBS method can provide reliable measurement data on GIR ROM.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.53-57
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• 2010

Purpose: The goal of this study was to evaluate differences in strength deficits between (i) patients with stage 1 or 2 impingement syndrome and (ii) patients with rotator cuff tears. Materials and Methods: We enrolled 43 patients with stage 1 or 2 impingement syndrome (group 1) and 21 patients with rotator cuff tears (group 2). The isokinetic strength of both groups was evaluated at $60^{\circ}/sec$ for external rotation, internal rotation, adduction and abduction. We measured the peak torque, total work, average power of bilateral sides, peak torque relationship to body weight, and the ratio between unilateral agonist and antagonist. Results: The isokinetic strength deficits assessed in ratio of peak torque to body weight for group 1 and group 2 respectively were; $28.48{\pm}23.76%$ and $29.12{\pm}32.81%$ for abduction (p=0.929), $7.20{\pm}13.98%$ and $18.94{\pm}19.52%$; for adduction (p=0.021), $16.88{\pm}13.76%$ and $25.80{\pm}24.07%$; for external rotation (p=0.221), and $14.1{\pm}25.67%$ and $29.02{\pm}35.06%$ for internal rotation (p=0.059). For average power and total work, group 2 showed a significantly greater deficit for adduction and internal rotation than group 1. Conclusion: Those with rotator cuff tears have more isokinetic muscle strength deficits than those with stage 1 or 2 impingement syndrome. Progression from stage 1 and 2 impingement syndrome to stage 3 may result in greatest changes in strength deficits for internal rotation and adduction.

• Physical Therapy Korea
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• v.28 no.1
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• pp.27-35
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• 2021

A weak or dysfunctional gluteus medius (Gmed) is related to several pathologies, and individuals with hip abductor weakness have Gmed weakness. This study aimed to systematically review the literature associated with the anatomy and function of the Gmed, and the prevalence, pathology, and exercise of Gmed weakness. Papers published between 2010 and 2020 were retrieved from MEDLINE, Google Academic Search, and Research Information Sharing Service. The database search used the following terms: (glut* OR medius OR hip abduct*) AND weak*. The Gmed plays an important role in several functional activities as a primary hip abductor by providing pelvic stabilization and controlling hip adduction and internal rotation. Weakness of the Gmed is associated with many disorders including balance deficit, gait and running disorders, femoroacetabular impingement, snapping hip, gluteal tendinopathy, patellofemoral pain syndrome, osteoarthritis, iliotibial band syndrome, anterior cruciate ligament injury, ankle joint injuries, low back pain, stroke, and nocturia. Overuse of the tensor fasciae latae (TFL) as a hip abductor due to Gmed weakness can also cause several pathologies such as pain in the lower back and hip and degenerative hip joint pathology, which are associated with dominant TFL. Similarly, lateral instability and impaired movements such as lumbar spine lateral flexion or lateral tilt of the pelvis can occur due to compensatory activation of the quadratus lumborum for a weakened Gmed while exercising. Therefore, the related activation of synergistic muscles or compensatory movement should be considered when prescribing Gmed strengthening exercises.