• Clinics in Shoulder and Elbow
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• 제15권2호
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• pp.143-147
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• 2012

상부 견갑 현수 복합체(Superior shoulder suspensory complex)의 3중 붕괴는 몇몇 저자들에 의해서만 보고된 극히 드문 손상이다. 저자들은 오구돌기, 견갑극 골절 및 견봉-쇄골 관절의 탈구가 동반된 상부 견갑 현수 복합체의 3중 붕괴 환자를 경험하였기에 보고하고자 한다. 본 환자의 경우 견봉-상완 및 오구-상완 간격을 유지하기 위하여 관혈적 정복 및 내고정을 시행하여 상부 견갑 현수 복합체의 3중 붕괴 모두를 해부학적으로 복원하여 치료하였다. 술 후 6개월에 증상 없이 관절운동범위를 모두 회복하였다. 최종 추시인 5년에는 상부 견갑 현수 복합체의 기능이 완전히 회복된 것을 확인할 수 있었으며, 환자는 수술 결과에 대하여 크게 만족하였다.

• Journal of Nutrition and Health
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• 제28권5호
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• pp.415-425
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• 1995

This study was performed to investigate the effect of dietary protein level on the metabolic changes of Ca and skeletons in postmenopausal women, using ovariecotomized rats as an animal model. The female rats of 200∼250g were fed either 8%(L) or 50%(H) casein diet for 15 weeks(1st experiment). At 15th week, the rats of each diet group were undergone ovariectomy or sham-operation and they were continued to feed the same experimantal diet for 9 more months(2nd experiment). Ca metabolism, kidney function and bone composition were determined at the end of 1st experiment, 3rd and 9th month of 2nd experiment. After 1st experiment, high protein group showed higher urinary Ca and protein excretion, however, there was no difference in GFR and urinary hydroxyproline excretion. The weights, ash and Ca content of femur, scapular and vertebra tended to be higher in high protein groups which tells that high protein promoted skeletal growth. In 2nd experiment, high protein group showed higher urinary Ca and protein excretion and lower Ca absorption and balance. GFR was not affected by dietary protein and ovariectomy but increased with time, as well as kidney weight which shows the continuous development of kidney at this age of 15 month in rats. There were no difference in urinary hydroxyproline, serum ALP, and PTH among experimental groups. The weights of femur, scapular, 4th vertebra increased with time, showing the skeleton continues to grow at this age in rats. However, Ca contents, Ca/wt, Ca/ash were decreased with time and tended to be lower in high protein group especially in femur. In conclusion, prolonged feeding of high protein diet deteriorated Ca metabolism and induced bone loss as time after menopause is extended.

• 한국임상수의학회지
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• 제34권5호
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• pp.396-399
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• 2017

This is a case report of a northern goshawk (Accipiter gentilis), admitted to the wildlife rescue center with right coracoid and scapular fracture which received conservative treatment and was soft-released successfully. At the admission, the goshawk had callus formed on the fractured bones, scars on eyebrows and severely damaged tail feathers with inability to fly. Cage rest was indicated to prevent further occurrence of fracture and to promote reunion of the fracture surface. The bird went through a rehabilitation process with appropriate physical training in flying cage to recover its fitness and flying ability. Complete molting of flight feathers with damaged rectrices was achieved during the rehabilitation period and its flight ability was recovered favorably. It was released into a proper habitat for northern goshawks, but the bird was found near the aviary where its last phase of rehabilitation was performed. A soft-release program was applied and finally the bird returned to near the first rescue location 235 km away from the release site.

• 한국전문물리치료학회지
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• 제25권1호
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• pp.62-70
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• 2018

Background: Sitting posture influences movements of scapulothoracic and glenohumeral joints and changes the shoulder muscle activities. The development and maintenance of correct sitting posture is important for the fundamental treatment of shoulder pain during rehabilitation. Objects: The purpose of this study was to investigate the effects of the sitting postures and the shoulder movements on shoulder muscle activities for both male and female. Methods: Twenty-eight subjects without shoulder-related diseases participated in this experiment. The subjects had randomly adopted three different sitting postures (upright posture, preferred posture, maximum slouched posture) and shoulder flexion angles in scapular plane ($30^{\circ}$, $90^{\circ}$, $120^{\circ}$). Surface electrodes were collected from upper trapezius (UT), anterior deltoid (AD), and posterior deltoid (PD) and the active shoulder range of motion was measured in each sitting posture and shoulder flexion angle. Results: The active range of motions of the shoulder external rotation and the flexion in the scapular plane decreased from the upright posture to the maximum slouched posture (p<.05, mixed-effect linear regression with random intercept, Tukey post-hoc analysis). All muscles showed the highest EMG activities at $120^{\circ}$ shoulder flexion with the maximum slouched posture and did not show the gender differences. Conclusion: Increased shoulder muscle activities may become the potential risk factor for the shoulder impairment and pain if people continuously maintain the maximum slouched posture. Therefore, an upright position is necessary during shoulder exercises, as well as in activities of daily living, including motions involving lifting the arms.

• 대한한방소아과학회지
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• 제17권2호
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• pp.161-171
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• 2003

This study was to investigate the relationship of headache and back shape using the Moire interferometer and Questionnaire investigations. In this study the subjects consisted of 317 pupils[168 boys(53%), 149girls(47%)] attending S high school in Sungnamsi, Kyoungkido in 2002, and their ages ranged from sixteen to eighteen. The results are following. 1. In questionnaire investigation, we observed that the ratio of headache was more than 70% and the ratio of girls are more than that of boys. The inclination for ages was not shown. 2. In moire topography, the remainder values of scapular region were from 0.5 cm to 1.1 cm in boys, and from 0.45 cm to 1 cm in girls. The remainder values of gluteal region were from 0.2 cm to 0.8 cm in boys, and from 0.4 cm to 0.6 cm in girls. The reminder values of the vertical lines of cervical and buttock region were from 0.71 cm to 1.51 cm in boys, and from 0.96 cm to 1.43 cm in girls. More frequent findings of reminder value of the vertical lines of cervical and buttock region were observed that the vertical lines of cervical region were inclined to left than the vertical lines of buttock 3. Through the Pearson's Correlation analysis of headache and Moire topography, we found the close relationship of headache and the remainder values of scapular region(Pearson correlation coefficient : 0.116, P<0.05) and gluteal region(Pearson correlation coefficient : 0.153, P<0.01). But the relevances to headache and the remainder values of neck lines, sacral lines and neck-sacral lines were not found.

• 대한통합의학회지
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• 제4권2호
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• pp.29-36
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• 2016

Purpose : The purpose of this study was to find out the effects on muscle activations of serratus anterior and upper trapezius muscles when push-up plus exercise togu applied differently depending on the body part. Method : Thirty six volunteers took part in this study and we divided into three groups(upper arm togu group 12, leg togu group 12, upper arm-leg togu group 12). Each experimental group performed push-up plus exercise. All volunteers received a total of 18 exercise session over a 6 week period (three times per week). Exercise program was composed of serratus anterior and upper trapezius push-up plus exercise. Then we measured muscle activation of scapular stabilizer by electromyography. Repeated ANOVA was used to examine the effects of the intervention on each outcome measure. Result : After the six week intervention, there was a significant difference between the pre and 6 week in serratus anterior and upper trapezius muscle activity(p<0.05). After the six week intervention, there was a significant difference among the three group in serratus anterior muscle activity but no significant difference in upper trapezius muscle activity(p>.05). Conclusion : Serratus anterior and upper trapezius showed high muscle activity during push-up plus exercise. Therefore have a positive impact of scapular stabilizer. The larger the area of the unstable support surface, the larger muscle activity was larger of variation quantity.

• 한국전문물리치료학회지
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• 제17권3호
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• pp.1-10
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• 2010

The purpose of this study was to measure intra-rater and inter-rater reliability and range of motion for measurement of passive shoulder internal rotation range of motion and to compare anterior glide distance of humeral head in three methods. Fifty healthy subjects and fifty patients with shoulder musculoskeletal pain were recruited for this study. The subjects' passive shoulder internal rotation range of motion was measured by visual estimation, manual stabilization, and pressure biofeedback unit methods. In two trials, measurements were performed on each subject by two examiners. Intraclass correlation coefficient (ICC(3,1)) was used to determine the reliability of each measurement. The intra-rater reliability of the three methods was excellent (ICC=.77~.93) in both groups. The inter-rater reliability of the visual estimation method was poor (ICC=.20, .29), the manual scapular stabilization method was poor and fair (ICC=.09, .50), and the pressure biofeedback unit method was excellent (ICC .86, .75) in the experimental and control groups. In the experimental group, the difference of examined range of motion by each examiner was significant in the visual estimation method and manual scapular stabilization method, but there was an insignificant difference between the groups is the pressure biofeedback unit method. This result suggests that the intra-rater and inter-rater reliability of a pressure biofeedback unit was better than the other methods. The difference in distance of the anterior glide of humeral head was insignificant among all the methods. The pressure biofeedback unit method was the most reliable method, so it is proposed to be a new and reliable method to measure internal rotation range of motion.

• 한국전문물리치료학회지
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• 제25권3호
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• pp.39-50
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• 2018

Background: High string instrument (violin, viola) players are at high risk for developing musculoskeletal problems. In particular, a higher prevalence of shoulder problems has been reported. However, evidence of the effectiveness of therapeutic exercise for musicians with this condition is lacking until now. Objects: This case series study investigated the effect of a specific exercise program on shoulder pain, dysfunction, and posture of professional orchestral high string musicians. Methods: Five professional orchestral high string players with shoulder pain participated in this study. A six-week specific exercise program focus on scapular stability for shoulder pain consisted of scapular muscle exercise. Physical examinations for pain and dysfunction, posture were performed, were identified among all subjects before starting the exercise program. Results: The results revealed that shoulder pain decreased by 67.86% and the effect of pain on instrument play decreased by 63.33%. The shoulder pain and disability Index and the performing arts module-quick disability of the arm, shoulder and hand scale decreased by 71.72% and 51.61% respectively. The exercise program improved function and posture. Conclusion: A specific exercise program for high string players was effective in managing shoulder pain. This case series is intended to provide empirical data on the effectiveness of an exercise program aimed at assessing the effect of exercise on pain, dysfunction, and posture of professional orchestra musicians associated with specific instrument groups.

• 대한정형도수물리치료학회지
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• 제24권2호
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• pp.29-36
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• 2018

Background: The purpose of this study was to investigate the effect of leg lift difference on serratus and upper trapezius when exercising in a scapula in a prone position, a typical waist stabilization exercise for subjects with a winged scapula. Method: Twenty normal adults and 20 subjects with winged scapula participated in the experiment. The surface EMG recordings were obtained from external oblique muscle and internal oblique muscle during scapula protraction exercise. The presence or absence of winging of the shoulder bone was measured using an electronic digital caliper for the distance the medial border of the scapula is lifted to the rear. In prostrate pier movement posture in both groups, both legs supporting, dominant leg lifting, and non-dominant leg lifting including the scapula protraction were conducted respectively. Results: In the results of comparison between the two groups, the dominant external oblique muscle and the non-dominant internal oblique muscle tended to increase according to the difference of the leg lifting of normal people. In the winged scapula group, internal oblique muscle showed increased muscle activity more than external oblique muscle. Conclusion: It was most effective to exercise with lifting the same position leg for strengthening the same external oblique muscle, and the opposite internal oblique muscle. Also, it is effective to exercise in prone pier movement posture for trunk stability. In addition, internal oblique muscle shows increased muscle activity in subjects with winged scapula. Therefore, appropriate adjustment of external oblique muscle and internal oblique muscle may have a positive effect on scapula dysfunction for trunk stability.

• Clinics in Shoulder and Elbow
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• 제21권4호
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• pp.186-191
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• 2018

Background: To determine the normal range of humeral head positioning on magnetic resonance imaging (MRI). Methods: We selected normal subjects (64 patients; group A) to study the normal range of humeral head positioning on the glenoid by MRI measurements. To compare the MRI measurement method with the computed tomography (CT), we selected group B (70 patients) who underwent both MRI and CT. We measured the humeral-scapular alignment (HSA) and the humeral-glenoid alignment (HGA). Results: The HSA in the control group was $1.47{\pm}1.05mm$, and the HGA with and without reconstruction were $1.15{\pm}0.65mm$ and $1.03{\pm}0.59mm$, respectively, on MRI. In the test group, HSA was $2.67{\pm}1.47mm$ and HGA with and without reconstruction was $1.58{\pm}1.16mm$ and $1.49{\pm}1.08mm$, on MRI. On CT, the HSA was $1.72{\pm}1.01mm$, and HGA with and without reconstruction were $1.54{\pm}0.96mm$ and $1.59{\pm}0.93mm$, respectively. HSA was significantly different according to image modality (p=0.0006), but HGA was not significantly different regardless of reconstruction (p=0.8836 and 0.9234). Conclusions: Although additional CT scans can be taken to measure decentering in patients with rotator cuff tears, reliable measurements can be obtained with MRI alone. When using MRI, it is better to use HGA, which is a more reliable measurement value based on the comparison with CT measurement (study design: Study of Diagnostic Test; Level of evidence II).