• Title/Summary/Keyword: Posterior shoulder pain

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Comparison of the EMG Activities of Scapular Upward Rotators and Other Scapular Muscles Among Three Lower Trapezius Strengthening Exercises (아래등세모근 근력강화 운동방법들 사이의 어깨뼈 위쪽 돌림근과 다른 어깨 근육들의 근활성도 비교)

  • Yong, Joon-Hyoung;Weon, Jong-Hyuck
    • Physical Therapy Korea
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    • v.20 no.3
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    • pp.27-35
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    • 2013
  • The aim of this study was to compare the electromyographic (EMG) activity levels of the scapular upward rotators [upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA)] and other scapular muscles [posterior deltoid (PD), levator scapulae (LS), and infraspinatus (IS)] during isometric lower trapezius exercises. Twenty males with no medical history of shoulder pain or upper extremity disorders were recruited for this study. EMG activity was recorded from the UT, LT, SA, PD, LS, and IS while subjects performed three different exercises: Prone arm lift (PAL), Backward rocking diagonal arm lift (BRDAL), Modified Prone Cobra (MPC). One-way analysis of variance (ANOVA) was used to determine any significant differences among the three exercises. A lower relative activation of UT, LT, and SA was seen with the MPC than with the other exercises (p<.05). The relatively lower activation of the UT identified, the MPC exercise as the preferred choice for preferential strengthening the LT (p<.05). However, a higher activation in the PD, LS, and IS occurred with the MPC than with the other exercises (p>.05). The recruitment pattern of synergist varied depending on the exercise posture. These findings suggest that exercise posture is an important factor in the selection of strengthening exercise for weak muscle.

Diaphragmatic Paralysis Following Cervical Herpes Zoster (경부 대상포진에 의한 횡격막 신경 마비 1예)

  • Kim, So Young;Hwang, Ki Eun;Jung, Jong Hoon;Park, Jung Hyun;Kim, Hwi Jung;Kim, Hak Ryul;Yang, Sei Hoon;Park, Hyun Young;Jeong, Eun Taik
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.80-82
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    • 2006
  • Herpes zoster is well-known viral disease in immune compromised that produces inflammatory lesions in the posterior root ganglia and is characterized clinically by pain and skin eruptions along the distribution of the affected ganglia. However, motor involvement after a herpes zoster is an uncommon complication. We report a case of diaphragmatic paralysis that occurred after a herpes zoster in 63-year-old woman. The diaphragmatic paralysis occurred one month after the typical herpes zoster eruptions affecting the C3 and C4 dermatomes in the right neck, shoulder and back area.

Upper Extremity Biomechanics of Manual Wheelchair Propulsion at Different Speeds (수동 휠체어 추진 속도에 따른 상지 관절 생체역학적 영향 분석)

  • Hwang, Seonhong
    • Journal of Biomedical Engineering Research
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    • v.43 no.4
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    • pp.241-250
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    • 2022
  • It is known that chronic pain and injury of upper limb joint tissue in manual wheelchair users is usually caused by muscle imbalance, and the propulsion speed is reported to increase this muscle imbalance. In this study, kinematic variables, electromyography, and ultrasonographic images of the upper limb were measured and analyzed at two different propulsion speeds to provide a quantitative basis for the risk of upper extremity joint injury. Eleven patients with spinal cord injury for the experimental group (GE) and 27 healthy adults for the control group (GC) participated in this study. Joint angles and electromyography were measured while subjects performed self-selected comfortable and fast-speed wheelchair propulsion. Ultrasound images were recorded before and after each propulsion task to measure the acromiohumeral distance (AHD). The range of motion of the shoulder (14.35 deg in GE; 20.24 deg in GC) and elbow (5.25 deg in GE; 2.57 deg in GC) joints were significantly decreased (p<0.001). Muscle activation levels of the anterior deltoid, posterior deltoid, biceps brachii, and triceps brachii increased at fast propulsion. Specifically, triceps brachii showed a significant increase in muscle activation at fast propulsion. AHD decreased at fast propulsion. Moreover, the AHD of GE was already narrowed by about 60% compared to the GC from the pre-tests. Increased load on wheelchair propulsion, such as fast propulsion, is considered to cause upper limb joint impingement and soft tissue injury due to overuse of the extensor muscles in a narrow joint space. It is expected that the results of this study can be a quantitative and objective basis for training and rehabilitation for manual wheelchair users to prevent joint pain and damage.

Arthroscopic Capsular Release in Refractory Adhesive Capsulitis of the Shoulder (견관절 난치성 유착성 관절 낭염에서 관절경 하의 관절낭 유리술)

  • Ko, Sang-Hun;Cho, Sung-Do;Choi, Seoung-Won;Jeong, Ji-Young;Jung, Kwang-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.109-114
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    • 2004
  • Purpose: To evaluate the clinical results and prove the effectiveness of arthroscopic capsular release in refractory adhesive capsulitis of shoulder. Materials and Methods: We preformed arthroscopic capsular refractory adhesive capsulitis that not responded by stretching execies for above 1 year. 21 cases were followed above 1 year and average follow up 3 years 1 months (1${\sim}$5 years). We checked VAS of pain, ADL of function. UCLA score which were evaluated at preoperation, postoperation 6 months, 1 years and last follow up period, and compared with each other at last follow up. Results: The VAS score improved average preoperative score 8 to average postoperative score1, the ADL score improved average preoperative score 7 to average postoperative score 26, the UCLA score improved average preoperative score 8 to average postoperative score 34. Forward elevation improved average preoperative 75 degrees to average postoperative 175 degrees, external rotatiion at side improved average preoperative 4 degrees to average postoperative 52 degrees, abduction improved average Preoperative 60 degrees to average postoperative 170 degrees, internal rotation at posterior improved preoperative thigh-lumbar 3 spinous process to postoperative 7th thoracic spinous process~9th thoracic spinous process. Conclusion: Arthroscopic capsular release in refractory adhesive capsulitis that non responsive to stretching exercise for above 1 year were effective treatment method.

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A Study on the Back shape and self-conscious symptoms of the students in S High school Using the Moire measurement and Questionnaire investigation (모아레 측정법과 설문지 조사를 통한 경기도 S고등학교 재학생의 신체자각증상과 배부체형에 대한 실태조사)

  • Chang, Gyu-Tae;Kim, Jang-Hyun;Baek, Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.17 no.2
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    • pp.55-74
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    • 2003
  • Objective : The purpose of this study was to investigate the back shape and self-conscious symptoms of the students in S High school using the phase-shifting scanning grating projection Moire interferometer and Questionnaire investigations. Methods : In this study the subjects consisted of 317 pupils[168 boys(53%), 149girls(47%)] attending S high school in Sungnamsi, Kyoungkido in 2002. Their ages ranged from sixteen to eighteen. With the phase-shifting scanning grating projection moire interferometer, the posterior views of the body were taken to see if there are correlation of remainder value of the height spot of left & right shoulder blade and gluteal region in Moire topography. And using questionnaire investigation, we investigated the self-conscious symptoms. Results : 1. In questionnaire investigation, we observed that the ratios of self-conscious symptoms of girls are more than that of boys. The ratios of headache, neck pain, lower back pain, digestive symptom were more than 70% in boys and girls. 2. In Moire topography, more frequent findings of scapular region were observed that left scapular area were higher than right(in boys 69.3%, 60%, 100%, aged 16,17,18, in girls 66.8%, 40.5%, 58.8% aged 16,17,18). 3. More frequent findings of gluteal region were observed that left scapular area were higher than right(in boys 75.2%, 60%, 36.4% aged 16,17,18, in girls 61.1%, 46.8%, 64.7% aged 16,17,18) 4. More frequent findings of reminder value of the vertical lines of cervical and buttock region in Moire topography were observed that the vertical lines of cervical region were inclined to left than the vertical lines of buttock(in boys 73.3%, 92.2%, 100% aged 16,17,18, in girls 72.2%, 77.2%, 73.5% aged 16,17,18) Conclusion : From these results, we found that the self-conscious symptoms were more than in girls than boys; the ratio of headache, neck pain, Lower back pain, digestive symptom was more than the others; the back shape of high school students were not balanced in scapular and buttock region; necks were inclined to left than buttock.

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Antegrade Interlocking Intramedullary Nailing in Humeral Shaft Fractures (상완골 간부 골절에서의 전향적 교합성 골수강내 금속정 고정술)

  • Cho, Chul-Hyun;Song, Kwang-Soon;Kim, Sin-Ki
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.1-6
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    • 2010
  • Purpose: To evaluate the results and complications of antegrade intramedullary interlocking nailing in humerus shaft fractures. Materials and Methods: We evaluated the clinical outcomes, radiologic results and complications in 47 patients with humerus shaft fracture treated with antegrade intramedullary interlocking nailing, and followed up until bony union. Bony union was confirmed by serial plain radiographs and the clinical outcomes were assessed according to the ASES scoring system. Results: Bony union was confirmed in 41 (87.2%) out of a total 47 patients, and the mean union period was 14.5 weeks. Major complications were as follows: 6 non-union, 3 delayed union, 2 intraoperative posterior cortex fracture in the distal humerus and 2 permanent shoulder pain, including 1 case of adhesive capsulitis. The clinical outcomes were as follows: 29 excellent, 11 good, 4 fair and 3 poor. Satisfactory outcomes were demonstrated in 40 patients (85.1%). Conclusion: Anterograde intramedullary interlocking nailing as treatment for humerus shaft fracture showed satisfactory bony union and clinical outcomes. It is considered an efficacious treatment, especially in patients with associated injury, such as multiple fractures and segmental fracture.

Multiple Symmetric Lipomatosis: Characteristics and Treatment in Korean Patients (다발성 대칭성 지방종증: 한국인에서의 특징 및 치료)

  • Cheon, Young Woo;Roh, Tae Suk;Kim, Yong Oock;Kwon, Ji Eun;Tark, Kwan Chul;Yoo, Won Min
    • Archives of Plastic Surgery
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    • v.34 no.4
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    • pp.478-484
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    • 2007
  • Purpose: Multiple symmetric lipomatosis (MSL) is a relatively rare disorder characterized by presence of multiple, symmetric, nonencapsulated fat masses in face, neck, shoulder and other areas. There has been only a few cases reported in Korea. The main purpose of this research is to examine the Korean patients to see what kinds of special characteristics occurred due to this disease and to decide the proper treatment.Methods: A total of 16 patients were evaluated retrospectively. 5 patients were treated at our hospital. The other patients were reviewed from literature. We analyzed the biological characters of patients, location of fat deposit, morphologic characters of patients, clinical evidence of neuropathy, associated metabolic disorders and treatment modality.Results: All cases were male patient. The mean age of onset was 47.43 years. All patients were moderate to heavy alcoholics. The most common location of fat deposition was posterior neck and abdomen. In neurologic exam of 9 patients, 5 patients showed muscle weakness, tremor, pain and autonomic nerve dysfunction. In metabolic studies of 9 patients, total cholesterol values were higher in 1 patient. A glucose tolerance test was abnormal in 1 patient. In treatment modality, 14 patients were treated with surgical resection, 1 patient was treated with liposuction and surgical excision, 1 patient was treated only with liposuction. Conclusion: To treat MSL patients successfully, we should concentrate not only on the removal of the fatty tissue but also on neurologic abnormities, metabolic disorders and associated diseases.

The Prevalence Study of TMD and the Associated Factors in Korean Malocclusion Patients (한국인 부정교합자의 측두하악장애(TMD) 유병율과 그 기여요인에 관한 연구)

  • Kim, Myung-Hee;Nahm, Dong-Seok
    • The korean journal of orthodontics
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    • v.27 no.4 s.63
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    • pp.523-538
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    • 1997
  • In order to investigate TMD prevalence in malocclusion patients and to study its relationship with occlusal factors, 205 malocclusion patients (M67, F138, 6Y1M-46Y8M) were examined. The following examinations were carried out, Questionnaire personal history, TMD symptoms, and the associated factors Clinical examination : TMJ sound and maximum mouth opening Orthopantomogram : condyle abnormalities, length of Co'-Inc' and Co'-Go', ratio Co'- Inc'/ Co'-Go', and depth of antegonial notch Transcranial view limitation of anterior movement of condyle Model Angle classification, overjet, overbite, midline discrepancy, missing of posterior teeth, posterior crossbite, attrition of palatal cusp of maxillary molars, crowding/spacing The results could be summarized as follows, 1. The prevalence of TMD showed that Helkimo Anamestic Inder(Ai) 0 was $46.8\%$, Ai I was $22.0\%$, Ai II was $31.2\%$ and subjective symptoms increased with aging (p<0.001) and were frequent in females (p<0.05). 2. Flattening ($4.4\%$) was the most frequent condyle abnormality on Orthopantomogram, and $8.3\%$ of subjects showed some abnormalities on Orthopantomogram. 3. The cases with neck and shoulder pain (p<0.001), clenching, lip biting (p<0.01), and headache (p<0.05) showed higher scores of Ai. 4. Angle class II showed high frequency of condylar abnormalities on Orthopantomogram, and subjects whose palatal cusp of maxillary molars had been attrided had the tendency to show high hi scores (p<0.05). The other occlusal factors had nothing to do with the symptoms of TMD. 5. In the cases that 1)the value of Co'-Inc', Co'-Go' or Co'-Inc'/Co'-Go' were low or 2)the differences of Co'-Go' or Co'-Inc'/Co'-Go' between the right and the left were large, condylar abnormalities were frequently obserbed on Orthopantomogram.

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The Result of Rotator Cuff Repair Using Arthroscopic Margin Convergence Technique in Irreparable Large and Massive Rotator Cuff Tears (해부학적 봉합이 불가능한 회전근 개 파열에서 관절경하 모서리 맞춤 술식을 이용한 봉합의 결과)

  • Choi, Eui-Sung;Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Shon, Hyun-Chul;Cho, Byung-Ki;Park, Ji-Kang;Lee, Hyung-Joon
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.46-52
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    • 2011
  • Purpose: This study was performed to assess the usefulness of non-anatomical repair for irreparable large and massive rotator cuff tears by the arthroscopic margin convergence technique. Materials and Methods: Twenty-two patients were followed up more than 1 year after non-anatomical repair for irreparable large and massive rotator cuff tears using the arthroscopic margin convergence technique. The clinical evaluation was performed according to the KSS score, the UCLA score and the Visual analogue scale (VAS). The measurement of the acromio-humeral distance was performed using the shoulder anterior-posterior radiographs. The measurement of fatty degeneration and the healing status was performed using the shoulder MRI after 6 months. Results: Among twenty-two patients, follow up MRI was performed in eleven cases. Three cases were well healed, four cases were partial healed and another four cases were re-torn. The KSS and UCLA scores had significantly improved from a preoperative average of 45.0${\pm}$8.014 and 10.8${\pm}$2.302 points to 77.1${\pm}$10.151 and 30.0${\pm}$1.521 points, respectively, and the pain VAS had decreased from a preoperative average of 7.7${\pm}$0.616 points to 3.0${\pm}$1.021 points at the last follow up. Less favorable results were obtained when the patient had a grade of fatty degeneration higher than grade 3 on the preoperative MRI. Conclusion: Non-anatomical repair for irreparable large and massive rotator cuff tears by the arthroscopic margin convergence technique showed good functional results. It seems to be one of the effective treatment methods for irreparable large and massive rotator cuff tears.

Conservative Treatment of Impingement Syndrome and Rotator Cuff Tear (충돌 증후군 및 회전근 개 파열의 보존적 치료)

  • Jung, Hong Jun;Jeon, In-Ho;Chun, Jae Myeung
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.79-86
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    • 2012
  • The conservative treatment for impingement and rotator cuff tear includes rest, nonsteroidal anti-inflammatory drugs (NSAIDs), local steroid injection and physiotherapy depending on the purpose to relieve the pain and inflammation, in addition, stretching exercise to recover flexibility and strengthening exercise to recover the function could be used. When these conservative treatments are divided into multiple steps, the first one contains pain relief, modification of daily activity and stretching exercise. Second step includes strengthening exercise of the anterior/posterior cuff and peri-scapular muscles and eventually. The third step includes training program to return to job, housework and hobby activities and maintain. Thus, the key of these step wise approach for the treatment of impingement and rotator cuff tear is exercise program. Understanding of various exercise program and apply to the patients properly is most important for the conservative treatment of impingement and cuff tear.

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