• 제목/요약/키워드: Scapular

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목덜미와 어깨의 통증에 관한 연구 (Studies on the Neck and Shoulder Pain)

  • 최중립
    • The Korean Journal of Pain
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    • 제5권2호
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    • pp.239-248
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    • 1992
  • Two hundred sisty five patients who complained of neck pain with stiffness and pain of the suprascapular area were studied. In most cases the anatomical locations of pain were in the levator scapulae muscles or trapezius muscles. Hyperactivity of dorsal scapular nerve or spinal accessory nerve which innervate those muscles was thought to be responsible for these pains. The hyperactivity of the nerves may be due to the spasm of the sternocleidomastoid muscle and the scalenus medius muscle which the nerves meet during their courses to the levator scapulae or trapezius muscles. Therefore, spasmolytic treatment on the scalenus medius provided effective relief for neck or shoulder pain.

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흉곽출구 증후군의 평가 및 물리치료에 대한 고찰 (A Study for Evaluation and Treatment of Thoracic Outlet Syndrome)

  • 임인혁
    • 대한물리치료과학회지
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    • 제6권2호
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    • pp.943-951
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    • 1999
  • Thoracic outlet syndrome's chief symptom has numbness and tingling sensation of tharm, hand and fingers. In the morning, patient complain of pins and needles of the hands and weakness. TOS classified three categories : Anterior scalene syndrome, Claviculocostal syndrome, Pectoralis minor syndrome Physical therapy of the TOS is heat, massage for soft tissue, stretching exercise for scalene muscles and pectoralis minor muscles, and strengthening exercise for upper trapezius and levator scapular and neck muscles. A main problem of soft tissue is mechanical causes, so physical therapists have to solve that problem by mechanical manual methods.

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The effect of applying a head-weight device on cervical angle and pain of neck muscles

  • Kim, Jin-Hong;Kim, Jong-Gun;Do, Kwang-Sun;Yim, Jongeun
    • Physical Therapy Rehabilitation Science
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    • 제5권2호
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    • pp.101-105
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    • 2016
  • Objective: The purpose of this study was to measure the change in pain threshold of levator scapular muscle, carniovertebral angle, and head position angle when applying a head-weight device on healthy adult. Design: Cross-sectional study. Methods: This study was conducted with 21 healthy adult male and female who voluntarily agreed to participate in this study after being informed of the purpose and method of this study. After measuring the cervical angle and pain threshold of levator scapular muscle, subject was instructed to walk for 5 minutes on a treadmill at a speed of less than 5 km/h while wearing after wearing head-weight device of 0.5 kg. Then, cervical spine angle and pain threshold of levator scapula muscle were re-measured. Measurement of cervical spine angle was conducted with photo by using the Bluebeam Revu software and the pain pressure thresholds (PPTs) were measured using an electronic algometer over potential trigger points on the body. Results: The results cervical angle showed a significant change, from $49.62^{\circ}$ to $52.10^{\circ}$ (p<0.05). PPT showed a significant change, from 30.71 to 36.89 (p<0.05). Conclusions: These findings suggest that applying head-weight device has a positive influence on increasing cervical angle and reducing pain when applied as a therapeutic intervention method of forward head posture.

Osteokinematic analysis during shoulder abduction using the C-arm

  • Lee, Seung Hoo;Kim, Younghoon;Lee, Dong Geon;Lee, Kyeong-Bong;Lee, Gyu Chang
    • Physical Therapy Rehabilitation Science
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    • 제6권4호
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    • pp.208-213
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    • 2017
  • Objective: Despite reliable evidence of abnormal scapular motions increases, there is not yet sufficient evidence of abnormal humeral translations. This study aims to analyze the motion of the humeral head toward the scapula when the shoulder is actively abducted using the C-arm. Design: A case report. Methods: The participant was a healthy man without any limitation and pain during shoulder movement. The participant's shoulder was abducted; this movement in the frontal plane was measured using a C-arm (anterior-posterior view) and was analyzed with computer-aided design. The starting posture was $15^{\circ}$, and as the participant abducted his shoulder measurements were taken and analyzed at $30^{\circ}$, $60^{\circ}$, $90^{\circ}$, $120^{\circ}$, $150^{\circ}$, and ending at $165^{\circ}$. A line was drawn perpendicularly to the line connecting the humeral head axis to the glenoid, and another line was drawn perpendiculary to the line connecting the scapular axis to the glenoid. The distance between the two lines measured is defined as the e value. Results: At the starting posture ($15^{\circ}$), the central axis of the humeral head was located 1.92 mm inferior to the central axis of the scapula. The humeral head was superiorly translated from the starting posture to $120^{\circ}$, and then, showed an inferior translation to the ending posture ($165^{\circ}$). Conclusions: The results of this study showed that the humeral head moved upward from the starting posture ($15^{\circ}$) up to $120^{\circ}$ indicating, superior translation, and it moved downward when the posture was past $120^{\circ}$, indicating inferior translation.

Clinical and Radiological Results of Reverse Total Shoulder Arthroplasty Using a 25-mm Glenoid Baseplate

  • Lee, Ji Min;Kim, In Bo;Jung, Dong Wook
    • Clinics in Shoulder and Elbow
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    • 제18권4호
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    • pp.242-247
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    • 2015
  • Background: The size of the baseplate used in reverse total shoulder arthroplasty (RTSA) tends to be larger than the average size of the glenoid in the Korean population. The mismatch between the sizes of the baseplate and the patient's glenoid may result in improper fixation of the glenoid baseplate. This in turn may lead to the premature loosening of the glenoid component. Thus, we evaluated the short-term results of using a 25-mm baseplate in RTSA. Methods: Seventeen patients with cuff tear arthropathy underwent RTSA with a 25-mm baseplate. The mean age of the patients was 70.1 years, and the mean follow-up period was 14.0 months. We evaluated clinical outcomes preoperatively and postoperatively: the range of shoulder motion, the American Shoulder and Elbow Surgeons (ASES) score, and the Korean Shoulder Society (KSS) score. Results: We found that the mean ASES score and KSS improved from 35.0 to 74.4 (p<0.001) and from 46.9 to 71.8 (p<0.001) with RTSA. The mean forward elevation and abduction, external rotation also improved from $78.6^{\circ}$ to $134.3^{\circ}$ (p<0.05) and from $66.6^{\circ}$ to $125.0^{\circ}$ (p<0.05), from $20.2^{\circ}$ to $28.4^{\circ}$ (p=0.43). Postoperative complications were seen in 12% of patients, but neither the loosening of the glenoid baseplate nor inferior scapular notching were observed. Conclusions: In sum, the results of using a 25-mm baseplate in RTSA were similar to those of previous reports. Even though the outcomes are those of a short-term follow-up, neither the loosening of the glenoid baseplate nor the scapular notching were observed.

상지 부하감소 다이나믹 테이핑 기법이 정상인의 어깨 올림 시 어깨뼈 주위근의 근활성도에 미치는 영향 (The Effectiveness of Upper Limb Offload Dynamic Taping Technique on Scapular Muscles Activation During Elevation in Healthy Subjects)

  • 황천종;김선엽
    • 한국전문물리치료학회지
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    • 제27권2호
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    • pp.93-101
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    • 2020
  • Background: For performing various movements well, cooperation between the muscles around the scapula and shoulder has been emphasized. Taping has been widely used clinically as a helpful adjunct to other physiotherapy methods for shoulder pathology and dysfunction treatment. Previous studies have evaluated the effect of taping techniques using dynamic tapes on shoulder function and pain. However, no study investigated the electromyographic (EMG) changes in the shoulder muscles. Objects: This study aimed to investigate the effect of the upper limb offload taping technique using a dynamic tape on EMG activities of the upper trapezius (UT), lower trapezius, serratus anterior (SA), and middle deltoid (MD) muscles during scaption plane elevation. Methods: A total of 26 healthy subjects (19.85 ± 6.40 years, male = 20) volunteered to participate in this study. The subjects were instructed to perform scaption elevation with and without dynamic taping on the shoulder. Shoulder elevation strength tests were performed at 100%, 75%, 50%, and 25%, for the maximal isometric contraction force. Results: There were statistically significant interaction effects between the taping application and shoulder scaption elevation force in EMG activities in the UT (p < 0.05) and MD (p < 0.05). EMG activities in the UT showed significant increases in 50%RVC (reference voluntary contraction, p < 0.05) and 25%RVC (p < 0.01). Furthermore, the EMG activity of the SA significantly increased in 50%RVC (p < 0.01) and 25%RVC (p < 0.01) after dynamic taping. For the MD, the EMG activity level significantly decreased in 100%RVC (p < 0.05). Conclusion: These results indicated that upper limb offload dynamic taping application affects the muscle activities of some shoulder muscles depending on different scaption elevation strength levels. Therefore, we suggest that the upper limb offload dynamic taping can be applied to the shoulders when patients need middle deltoid inhibition or upper trapezius facilitation, such as patients with shoulder impingement syndrome.

견관절충돌증후군 환자에 대한 수정된 슬링운동과 일반적 등척성운동의 효과 비교 (A Comparison of Modified Sling Exercise and General Isometric Exercise in Patients with Shoulder Impingement Syndrome)

  • 장광호;최종덕;이문환;김창용
    • The Journal of Korean Physical Therapy
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    • 제22권5호
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    • pp.9-16
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    • 2010
  • Purpose: The purpose of this study was to compare modified sling exercise and general isometric exercise in patients with shoulder impingement syndrome. Methods: Twenty subjects were studied. The control group, n1 = 10, received instructions for doing general isometric (ISO) exercise. An experimental group, n2 = 10, received instructions for doing push-ups from standing and sitting positions and modified scapular exercises using a sling (3 sets, 3 times per week for 6 weeks). To evaluate the effects of exercise, subjects were evaluated using a visual analog scale for pain, a goniometer for range of motion, and electromyography for onset time of muscle contraction. Statistical analysis was done using the Wilcoxon Signed rank and Mann-Whitney U tests. Results: Pain in the sling group was significantly decreased after 6 weeks of treatment (p<0.05) pain in the general ISO exercise group was not significantly decreased (p>0.05). Flexion and external rotation were significantly increased after 6 weeks of treatment in both groups (p<0.05) and the change in the Sling group was greater than in the ISO group (p<0.05) in the flexion test. Time of onset of contractions in the Sling group for the upper trapezius, lower trapezius and serratus muscle were significantly decreased after 6 weeks of treatment (p<0.05), but the onset time for the middle trapezius did not significantly decrease (p>0.05). Conclusion: Scapular stabilizing exercise using a sling increases range of motion and decreases pain, and onset time of muscle contraction in patients with impingement syndrome.

Osteocutaneous flaps for head and neck reconstruction: A focused evaluation of donor site morbidity and patient reported outcome measures in different reconstruction options

  • Kearns, Marie;Ermogenous, Panagiotis;Myers, Simon;Ghanem, Ali Mahmoud
    • Archives of Plastic Surgery
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    • 제45권6호
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    • pp.495-503
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    • 2018
  • With significant improvements in success rates for free flap reconstruction of the head and neck, attention has turned to donor site morbidity associated with osteocutaneous free flaps. In this review, we address the morbidity associated with harvest of the four most commonly used osteocutaneous flaps; the free fibula flap, the scapula flap, the iliac crest flap and the radial forearm flap. A comprehensive literature search was performed to identify articles relevant to donor site morbidity for these flaps. We assessed morbidity in terms of incidence of delayed healing, chronic pain, aesthetic outcomes, site specific complications and patient satisfaction/quality of life. Weighted means were calculated when sufficient studies were available for review. The radial forearm and free fibula flaps are associated with high rates of delayed healing of approximately 20% compared to the scapular (<10%) and iliac flaps (5%). The radial forearm flap has higher rates of chronic pain (16.7%) and dissatisfaction with scar appearance (33%). For the majority of these patients harvest of one of these four osteocutaneous does not limit daily function at long-term follow-up. The scapular osteocutaneous flap is associated with the lowest relative morbidity and should be strongly considered when the recipient defect allows. The radial forearm is associated with higher morbidity in terms of scarring, fractures, chronic pain and wrist function and should not be considered as first choice when other flap options are available.