• Clinics in Shoulder and Elbow
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• 제12권2호
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• pp.271-277
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• 2009

목적: 그동안 견관절과 견봉하 관절에 대한 연구는 전세계적으로 매우 많은 연구가 이루어져 왔고 많은 의사들의 관심분야로 각광받아왔다. 그러나 그에 비해서 견갑골과 그 주위근육들은 상대적으로 관심의 대상이 되어오지 못한 것이 사실이다. 이에 저자들은 견갑골의 운동장애에 대하여 기술해 보고자 하는 것이 목적이다. 대상 및 방법: 기본적으로 견관절의 움직임은 언제나 견갑골의 운동을 동반하게 되어있고, 견관절의 운동에 이상이 발생하면 이는 직접적으로 견관절 움직임에도 영향을 미칠 수 밖에 없다는 것은 이미 널리 알려진 사실이다. 결과 및 결론: 특히 운동선수에 있어서는 견갑골의 움직임과 견고한 고정이 매우 중요한 역할을 차지하게 된다. 이에 저자들은 견갑골의 움직임과 중요성에 대해서 조명해보고자 한다.

• 한국전문물리치료학회지
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• 제30권1호
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• pp.41-49
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• 2023

Background: Scapular dyskinesis may cause not only rotator cuff (RC) tear but also weakness of the upper extremity, studies on scapular dyskinesis that may occur after RC repair is still lacking. Objects: To determine whether scapular dsykinesis was present in patients after arthroscopic RC repair and to investigate the influence of passive scapular stabilization on upper extremity strength. Methods: A total of 30 patients after RC repair participated in this study. To compare the scapula of the arthroscopic RC repair shoulder and the contralateral shoulder, the winged scapula (WS) was measured using a scapulometer and scapular dyskinesis was also classified by type. Fixed instruments for muscle strength measurements were used to measure upper extremity muscle strength differences depending on passive scapular stabilization position or natural scapular position. A chi-square test, an independent t-test and a 2-way mixed measures analysis of variance (ANOVA) was used as statistical analysis. In analyses, p < 0.05 was deemed to be statistically significant. Results: Postoperative shoulder had a significant association with scapular dyskinesis and the WS compared to the contralateral shoulder (F = 0.052, p < 0.01). Postoperative shoulder, muscle strength in the shoulder abduction (p < 0.01), elbow flexion (p < 0.01) and forearm supination (p < 0.05) were significantly greater in the scapular stabilization position than in the scapular natural position. Conclusion: Patients underwent arthroscopic RC repair had a significant association with scapular dyskinesis and muscle strength was improved by a passive scapular stabilization position, therefore scapular stabilization is important in rehabilitation program.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2007년도 제5차 연수강좌
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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.

• 한국전문물리치료학회지
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• 제31권2호
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• pp.142-150
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• 2024

Background: Scapular dyskinesis (SD) is closely related to imbalance of the rotator cuff (RC) muscles. However, previous studies have only focused on isometric strength. To our knowledge, there has been no study examining potential differences in concentric and eccentric strength and functional strength ratio (FSR) of the RC muscles based on functional parameters related to throwing in with or without SD. Objects: This study aimed to determine whether there was a difference in the RC muscle strength and FSR between the dominant shoulder with SD and the non-dominant shoulder without SD in adolescent baseball players. Methods: Forty adolescent baseball players participated and classified types of SD based on movement patterns using the SD test by two examiners. The isokinetic concentric and eccentric peak torque of the internal rotation (IR) and external rotation (ER) were measured and quantified as peak torque to body weight (PT/BW). Also, the FSR was obtained by calculating the strength ratios of eccentric IR to concentric ER (IRecc/ERcon) and eccentric ER to concentric IR (ERecc/IRcon), respectively. Results: There was a significant decrease in the IR and ER PT/BW in the dominant shoulder with SD compared to the non-dominant shoulder without SD (p < 0.05), regardless of contraction types. However, no significant difference was observed in the FSR in both IRecc/ERcon and ERecc/IRcon ratios. Conclusion: The findings indicate that the isokinetic concentric and eccentric PT/BW of the IR and ER muscles were significantly lower in the dominant shoulder with SD than in the nonthrowing shoulder without SD. Therefore, when establishing a strategy for addressing RC muscle weakness in adolescent baseball players with SD, it is essential to consider an approach that accounts for scapular kinematic recovery.

• PNF and Movement
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• 제12권3호
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• pp.189-199
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• 2014

Purpose: The objective of this case report is to examine the impact of physical therapy using the proprioceptive neuromuscular facilitation (PNF) concept for a patient with shoulder impingement syndrome. Methods: The patient is a 35-year-old female who has felt pain in the right shoulder for one month. The physical examination evaluated sensory integration, pain, joint integration and mobility, posture, reflex integration, range of motion, muscular strength, analysis of movement, and shoulder function. Comprehensive physical therapy was given to the patient, including stretching, mobilization, strengthening, posture correction, coordination improvement, daily activities, and sports exercises. The therapy was given 5 times a week for the first 5 weeks, then 3 times a week for the next 5 weeks. In all, the intervention lasted for 10 weeks. Results: The patient's senses, posture, and muscular strength all improved to a normal level. The degree of pain fell from 3/10 to 0/10 for activities taking place below shoulder height, and from 8/10 to 1/10 for activities above the head. Additionally, joint integration, motility, range of motion, and movements also improved. The disabilities of the arm, shoulder and hand (DASH) for functional evaluation improved from 27.5 to 10.3. Conclusion: Physical therapy using the PNF concept is effective in improving the body structure, function, activity, and participation of patients with motor disorders of the shoulder impingement syndrome.