• Title/Summary/Keyword: Passive range of motion

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Arthroscopic Treatment of Post-traumatic Stiff Shoulder by Rotator Interval Bridging Scar Adhesion - Case Report - (회전근 개 간격의 가교 반흔 유착에 의한 외상성 견관절 강직증의 관절경적 치료 - 증례 보고 -)

  • Kim Young-Mo;Rhee Kwang-Jin;Kim Kyung-Cheon;Byun Byung-Nam
    • Clinics in Shoulder and Elbow
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    • v.7 no.1
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    • pp.41-45
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    • 2004
  • In adhesive capsulitis of the shoulder of no response to nonoperative treatment, an arthroscopic capsular release and manipulation improves range of motion and pain relief. We performed an arthroscopic examination in the stiff shoulder, of which she had no response to nonoperative treatment, after the conservative treatment of a clavicular shaft fracture by motorcycle-driver traffic accident. We found the intra-articular 'rotator interval bridging scar adhesion' between subscapularis tendon and antero-superior glenoid fossa under the rotator interval which was no adhesion and contracture itself. We performed the scar adhesion removal and synovectomy, maintaining the rotator interval. We recommended nonsteroidal anti-inflammatory drug for postoperative pain relief and continuous active and passive range of motion (ROM) exercise to gain motions. Preoperatively, active and passive range of motion were 70° for forward elevation, 60° for abduction and especially 0° for external rotation. After postoperative 2 months, active ROM were 150° for forward elevation, 130° for abduction and 80° for external rotation. After postoperative 6 months, passive and active ROM were full. UCLA score improved from preoperative 9 points to postoperative 29 points.

Concurrent Validity and Clinical Usefulness of Universal Plastic Goniometer for Hip Internal and External Rotation Range Measurement (고관절 내외회전 가동범위 검사에 대한 범용플라스틱 측각기의 동시타당도와 임상적 유용성)

  • Kim, Yong-Wook
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.1
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    • pp.99-105
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    • 2018
  • PURPOSE: The aim of this study was to evaluate the concurrent validity and clinical usefulness of the universal plastic goniometer to measure the range of motion of the internal and external rotation of the hip joint using the three dimensional motion analysis which can analyze the joints and segment movements in the most objective and quantitative method. METHODS: Clinical and kinematic data were collected from thirty individuals using a universal plastic goniometer and a ten camera motion analysis system. Passive hip rotation range was obtained three trials for left and right hip joints using two measure methods simultaneously. RESULTS: There were significant differences between all matching measures of the two measures of internal and external rotation of the hip joint (p<.05). The relationship between the two tests for all measurements of the internal and external rotation of the hip was statistically significant with correlation coefficient form r=.87 to .96. (p<.01). CONCLUSION: Clinical measurement of the internal and external rotation of the hip using a universal plastic goniometer is effective to assess the hip condition. However, application of universal plastic goniometer requires careful attention in more accurate evaluation and research verification of the internal and external rotation of hip joint.

Clinical Application and Limitations of the Capsular Pattern (관절낭 패턴의 임상적 적용과 한계)

  • Lim, Wootaek
    • Physical Therapy Korea
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    • v.28 no.1
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    • pp.13-17
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    • 2021
  • A normal range of motion is essential for performing activities of daily living. The capsular pattern is the proportional motion restriction in range of motion during passive exercises due to tightness of the joint capsule. Although the capsular pattern is widely referred to in clinical practice, there is no scientific evidence to support the concept. In this review, the appropriateness of the capsular pattern for evaluation of joint pathology was assessed. In the Textbook of Orthopaedic Medicine written by Cyriax, the capsular pattern did not specify how much reduction in angular motion is considered motion restriction. As the definition proposed initially was unclear, different methods have been used in previous studies investigating capsular pattern. In addition, the capsular pattern described all the major joints of the human body, but only the hip joint, knee joint, and shoulder joint were studied in experimental studies. Sensitivity and specificity were reported in one study and were meaningful in specific pathologies (loss of extension to loss of flexion). There was no consensus on the reliability and validity. In summary, the capsular pattern suggested by Cyriax or Kaltenborn is not supported or applies only to certain conditions. Various components around a joint complement each other and provide stability to the joint. It is recommended that the therapist perform multiple assessments rather than rely on a single assessment when evaluating joints.

The Clinical Results of Conservative Treatment of Frozen Shoulder Using Continuous Passive Motion

  • Chung, Hoe-Jeong;Kim, Doo-Sup;Yoon, Yeo-Seung;Lee, Dong-Woo;Hong, Kyung-Jin
    • Clinics in Shoulder and Elbow
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    • v.18 no.4
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    • pp.217-220
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    • 2015
  • Background: The purpose of this study is to administer conservative treatment in 30 patients diagnosed with idiopathic frozen shoulder, following the suggested frozen shoulder rehabilitation program and to assess the clinical outcome using a prospective study. Methods: Thirty patients diagnosed with idiopathic frozen shoulder, treated with steroid hormone injection on the articular joint with an intra-articular steroid (triamcinolone 40 mg+lidocaine 4 ml) injection and started on stepwise shoulder extension exercise were chosen. The subjects were divided into two groups of 15 people each with one group undergoing rehabilitation with continuous passive motion (CPM) and the other group without it. Follow-ups were done before rehabilitation and at 4-week intervals with the 24th being the final week. At every follow-up, passive range of motion (ROM) was measured and surveys on pain and clinical score were administered. Results: In the last follow-up, both groups showed statistically significant improvements in all evaluation criteria. However, no statistical difference in all values of the ROM and Constant score evaluation criteria was observed between the groups. Only in the last follow-up, group 1 had a visual analog scale (VAS) score of $2.4{\pm}2.1$ points, which was lower, with statistical significance, than the VAS score of group 2, which was $4.4{\pm}3.1$ points (p<0.001). Conclusions: Study using CPM in treatment of frozen shoulder has been inadequate, meaning that there is still room for improvement and need for more study on setting a more specific protocol and guidelines for this procedure.

The Immediate Effects of Unilateral Contract-Relax Stretching on Contralateral Knee Extension Range -A Preliminary Study- (한쪽 다리에 적용한 수축-이완 기법이 반대쪽 무릎관절 폄 범위에 미치는 효과 -예비연구-)

  • Shin, Seung-Sub
    • PNF and Movement
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    • v.17 no.2
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    • pp.263-274
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    • 2019
  • Purpose: This article was conducted to determine the immediate effects of unilateral contract-relax (CR) stretching on contralateral knee extension range and to compare both sides of the knee extension range between experimental and control groups. Methods: This study recruited 16 adult males and females with straight leg raising abilities below $90^{\circ}$. The subjects were randomly divided into an experimental group and a control group comprising 8 subjects each. The experimental group performed direct CR stretching on the right hamstring muscles with straight hip extension adduction, and the control group performed indirect CR stretching on the right hamstring muscles with straight hip flexion abduction. Each group performed CR stretching 4 times with 4 repetitions comprising 10 sec of contraction and a 10 sec break between repetitions. Before and after the CR stretching exercises, the subjects' passive knee extensions were measured at the hip in a $90^{\circ}$ flexed position. The subjects' peak force on the right leg and peak pressure on the left leg during each CR stretching exercise were also measured. Results: After doing CR stretching 4 times, each group showed a significantly increased passive knee extension range on both sides, and there was no difference in the passive knee extension ranges between the groups. The peak force on the right leg was significantly higher in the experimental group than the control group. There was no difference in peak pressure between the groups. Conclusion: After applying unilateral CR stretching, the study subjects experienced a significantly increased passive knee extension range on the contralateral side. For patients who find it difficult to apply stretching techniques to knee joints directly, the use of the proprioceptive neuromuscular facilitation technique of CR stretching may be useful in improving the range of the knee joint on the contralateral side without direct treatment.

The Efficacy of Transverse Fixation and Early Exercise in the Treatment of Fourth Metacarpal Bone Fractures

  • Moon, Suk-Ho;Kim, Hak-Soo;Jung, Sung-No;Kwon, Ho
    • Archives of Plastic Surgery
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    • v.43 no.2
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    • pp.189-196
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    • 2016
  • Background Several techniques have been designed to treat fifth metacarpal fractures reported to be effective. However, these methods cannot be easily applied to the fourth metacarpal due to its central anatomical position. In this study, we sought to analyze the functional outcomes of patients who underwent transverse pinning for a fourth metacarpal bone fracture. Methods A total of 21 patients were selected and their charts were retrospectively reviewed. After fracture reduction, two transverse Kirchner wires were first inserted from the fifth metacarpal to the third metacarpal transversely at the distal part of the fractured bone, and then another two wires were inserted at the proximal part of the fractured bone. The splint was removed approximately one week postoperatively and the Kirchner wires were removed four to five weeks postoperatively. Patients started active and passive exercise one week after the operation. Pain visual analog scores, total active and passive motion, and the active and passive range of motion of the metacarpophalangeal joint and grip strength were evaluated. Results Dorsal angulation improved from a preoperative value of $44.2^{\circ}$ to a postoperative value of $5.9^{\circ}$. Six weeks after surgery, functional recovery parameters, such as range of motion and grip strength, had improved to 98% of the function of the normal side. No major complication was observed. Conclusions We suggest that the transverse pinning of fourth metacarpal bone fractures is an effective treatment option that is less invasive than other procedures, easy to perform, requires no secondary surgery, minimizes joint and soft tissue injury, and allows early mobilization.

The Effect of the Range of Motion Exercise on Powerlessness and Life Satisfaction in the Elderly (근관절운동이 노인의 무력감 정도에 미치는 영향)

  • 신재신
    • Journal of Korean Academy of Nursing
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    • v.23 no.1
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    • pp.107-117
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    • 1993
  • This study was a clinical Quasi-experiment to examine the effects of the range of motion exercise on powerlessness and life satisfaction among the E-Institutionalized elderly in Pusan. The purpose was to test the effect of the range of motion exercises on powerlessness and life satis-faction, and to examine the correlation between powerlessness and life satisfaction. The subjects for this study were 54 elderly people, both were over 60 and residing at I-Institution in Pusan. The research samples of 54 elderly were divided into an experimental and control group by matching randomized assignment. The instruments for this study were the Assessment Tool of Powerlessness in the elderly developed by Miller, Life satisfaction developed by Yoon Jin, and the Active-Passive Range of Motion Exercise Program which was developed and utilized by Shin, Jae-Shin. The data were collected from December 15, 1990 to November 1991. The paired t-test, t-test and ANCOVA were used to test hypothesis I and II, related to the Effect of the Range of Motion Exercises to powerlessness and life satisfaction. To identify the relationship of the range of motion exercises to powerlessness and life satisfaction, path analysis was done through multiple regression. The interrelationship of the variables was analyzed using t-test paired t-test. The results of the three hypothesis can be summarized as follows : 1. Hypothesis I -the experimental group which participated in the Range of Motion Exercise gets lower powerlessness score than that of the control group-was accepted by t-test (t = -3.40, p = .001) but not accepted by ANCOVA (F = .1, p =.96). 2. Hypothesis II - the experimental group which participated in the Range of Motion Exercise gets a higher Life Satisfaction Score than that of the control group-was not supported by t-test(t = 1.01, p = .316) but was accepted by ANCOVA (F = 4.39, p = .006). 3. Hypothesis III - if the powerlessness Score becomes higher, the Life Satisfaction Score will be-come lower - was accepted by Pearson Correlation Coefficient (pre-exercise : r : -.34, p=.006), (post exercise : r = -.06, p=.32) . The relation-ship between the score of powerlessness and life satisfaction was negatively correlated. The results obtained clearly showed that the effects of the range of motion exercises on powerlessness and life satisfaction are beneficial to the elderly The relation between the scores of powerlessness and life satisfaction was negatively correlated and the range of motion exercise had a direct influence to powerlessness. Therefore, it is concluded that the relationship between powerlessness and life satis-faction was not a causal one. Also it is concluded that the range of motion exercises can be applied as a nursing intervention to reduce powerlessness and to improve life satisfaction in the elderly.

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Changes in pain, swelling, and range of motion according to physical therapy intervention after total knee arthroplasty in elderly patients

  • Noh, Eun-Kyung;An, Chang-Sik
    • Physical Therapy Rehabilitation Science
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    • v.4 no.2
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    • pp.79-86
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    • 2015
  • Objective: This study was carried out to compare changes in pain, swelling and range of motion (ROM) between the two groups according to physical therapy intervention. Design: Randomized controlled trial. Methods: There were a total of 20 elderly subjects ages 65-75 years old who have been admitted to the hospital for a total knee arthroplasty. After surgery, the experimental group (n=10) carried out quadriceps femoris muscle strengthening exercise, hamstring stretching exercises and gastrocnemius stretching exercise with a physical therapist for 30 minutes and additionally, received ice pack therapy for 20 minutes once a day. The control group (n=10) carried out continuous passive motion for 30 minutes and received ice pack therapy for 20 minutes once a day. The experimental group and control group carried out each intervention program for 2 weeks 3 times a week. The Visual Analogue Scale was used to assess pain, tape measurements were taken to assess swelling, and a steel goniometer was used to assess knee joint ROM. Results: As a result, the experimental group showed a statistically significant decrease in the pain and swelling, and a significant increase in knee flexion ROM after the intervention, compared to the control group (p<0.05). There was a significant improvement in pain, edema, and knee flexion and extension ROM in all subjects after intervention (p<0.05). Conclusions: According the results of this study, exercise in the experimental group is effect on the pain, swelling and ROM for total knee arthroplasty.

The Effects of an Early Knee Joint Exercise Education Program on Pain, Knee Range of Motion, and Satisfaction in Patients after Undergoing Total Knee Replacement Arthroplasty (슬관절 전치환술 후 조기 슬관절 운동 교육 프로그램이 통증, 슬관절가동범위, 환자만족도에 미치는 영향)

  • Shin, Yi Seul;Lee, Young Hee
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.3
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    • pp.283-292
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    • 2018
  • Purpose: This study was conducted to evaluate the effects of early knee joint exercise education program on pain, knee ROM, and satisfaction among patients with a total knee replacement arthroplasty. Methods: An experimental study with non-equivalent groups was conducted using 32 patients for an experimental group and 32 patients for a control group. The experimental group received knee joint exercise education including systemic continuous passive motion (CPM) exercise and knee exercise. The control group received conventional CPM exercise. Pain, flexion and flexion contracture range of motion, and patient satisfaction were evaluated by $x^2$ test, Fisher's exact test, t-test, and repeated measures ANOVA using the SPSS 23.0 Windows program. Results: There were a significant improvement in patients' knee flexion and satisfaction in the experimental group compared to the control group. There was no significant difference in pain and flexion contracture between the two groups. Conclusion: The findings suggest that the proposed education program is efficient and effective when providing nursing care after a total knee replacement arthroplasty.