• Journal of Korean Physical Therapy Science
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• v.24 no.1
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• pp.49-58
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• 2017

Purpose: To determine the effect of Functional movement screen(FMS) of Healthy subjects. Method: 18 subjects were randomly assigned toFunctional movement screen test. To measure functional movement screen(deep squat, hurdle step, in line lunge, shoulder mobility reaching, active straight leg raise, trunk stability push up, rotary stability). Result: FMS scores were deep squat 2.61score, right hurdle step 2.67 score, lift hurdle step 2.83 score, in line lunge 2.83 score, right shoulder mobility 2.67 score, left shoulder mobility 2.61 score, right active straight-leg raise 3.00 score, left active straight-leg raise 3.00 score, trunk stability push up 2.33 score, rotary stability 1.94 score. Conclusion: FMS can improve functional movement in healthy adults.

• Physical Therapy Korea
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• v.24 no.1
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• pp.19-29
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• 2017

Background: Patients after rotator cuff (RC) surgery experienced pain, weakness and limited of motion of the shoulder. Physical therapists have used heat therapy, electrotherapy, range of motion (ROM) exercise and other methods to treat patients after RC surgery. In addition, functional taping is also used to support joint movement and to increase shoulder joint stability. Objects: The purpose of this study was to determine the initial effects of functional taping using non-elastic tape on pain, strength and ROM of the shoulder following RC surgery. Methods: Forty-eight patients with who underwent RC surgery volunteered for this study. The subjects were randomly divided into an experimental group (EG, $n_1=25$) and a control group (CG, $n_2=23$). First, non-allergic tape was applied to the shoulder to prevent skin irritation. The EG applied functional taping using non-elastic tape and the CG applied sham taping using elastic tape. Assessment tools included the shoulder pain and disability index for functional activity score, visual analog scale for level of pain, shoulder muscle strength, hand grip strength and ROM testing. Results: Pain score in the both group significantly decreased (p<.05), and change in pain score of in the EG increased significantly than in the CG (p<.05). Shoulder strength and ROM in the both group significantly increased (p<.05). Especially external rotation and extension of the shoulder ROM in the EG increased significantly more than in the CG (p<.05), but the rate of change in the two groups showed no significant difference. Conclusion: These results suggest that functional taping using non-elastic tape was initially effective in decreasing pain score level in patients with RC surgery.

• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.119-124
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• 2016

Background: The purpose of this study is to evaluate the functional outcomes of reverse total shoulder arthroplasty (RTSA) and to assess factors affecting the patients' subjective satisfaction after RTSA. Methods: Forty-three patients (mean age, $75.0{\pm}5.2years$) who underwent RTSA for cuff tear arthropathy or irreparable cuff tears with preoperative magnetic resonance imaging and pre- and postoperative radiographs at 1 year, and whose various functional outcomes including pain visual analogue scale (VAS), simple shoulder test, Constant score, American Shoulder and Elbow Surgeons score, and active range of motion were evaluated preoperatively and at the last follow-up (>12 months) were enrolled. The outcome parameter was set as a satisfaction scale. Various clinical and radiographic factors were analyzed, and their correlations with postoperative satisfaction were evaluated. Results: All functional scores, VAS pain score, and active forward flexion showed significant improvement after surgery (all p<0.001). Twenty-nine patients were satisfied with the results and 14 were dissatisfied. The presence of pseudoparalysis (p=0.028) and worse preoperative function (all p<0.05) were related with higher satisfaction. Any radiologic parameters did not affect patients' postoperative satisfaction. Conclusions: All patients showed a good functional outcome after RTSA, however the patients' subjective postoperative satisfaction was affected by preoperative functional status (higher satisfaction in poor preoperative function), not by radiological findings.

• Clinics in Shoulder and Elbow
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• v.3 no.2
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• pp.61-67
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• 2000

Purpose: Most proximal humeral fractures are minimally displaced and can be treated satisfactorily with a conservative method. But in many comminuted fractures, hemiarthroplasty is usually done as a primary treatment. The authors evaluated how much functional improvement was achieved after hemiarthroplasty and which factors influence on the final functional results. Materials and Methods: Eleven hemiarthroplasties were performed for three- and four-part fractures(including fracture-dislocation) between April 1992 and June 1999. There were eight women and three men, and the mean age was 65 years. According to Neer classification, six was three-part fracture and five was four-part fracture. Six patients were injured on their right shoulder and five on the left shoulder. Among the five four-part fractures, three had axillary nerve injury and among the six three-part fractures, only one patient had axillary nerve injury. The average follow-up period was 2.4 years(1 year-7 years) after operation. The functional results were evaluated with the UCLA scoring system(Modification for hemiarthroplasty). In addition to the overall results, we compared the results according to the classification of the fracture, the cause of injury, and whether the axillary nerve was injured. Results: At the last follow-up, average total UCLA score was 18.2. The mean score for pain was 7.0, mean muscle power and motion score was 5.5 and 5.7 respectively. The pain relief was more satisfactory than any other functional results. The average score for three-part fractures was 22, and the average for four-part fractures was 13.6. The average score for the patients fractured by vehicle accidents was 15.3, and 19.3 for the patients fractured by slip-down injury. In patients without axillary nerve injury, the average score was 20, and with axillary nerve injury, the score was 15. Conclusion: Shoulder hemiarthroplasty, for the treatment of proximal humeral fractures, cannot restore the shoulder function to normal, but can achieve the functional result to some degree, especially for the activity of daily living. And as for pain, we think that it is relatively effective measure. And we think that the severer the comminution, the more the chance of axillary nerve injury, and the poorer the functional results. In conclusion, the severity of initial injury seems to be the major prognostic factor.

• Clinics in Shoulder and Elbow
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• v.6 no.1
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• pp.27-36
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• 2003

Antegrade interlocking intramedullary nailing (AIIN) for the humeral shaft fracture can induce shoulder pain and decrease of shoulder function postoperatively. The purpose of this study was to estimate the outcome of the shoulder functions after AIIN through the rotator interval between the subscapularis and the supraspinatus to decrease the shoulder pain. Out of consecutive 43 cases that underwent AIIN 42 had been followed for two years or more. Among them we analysized 40 cases of 39 Patients excluding two cases of Pathologic fractures. The average was 47 years. There were 17 men and 23 women. The average follow-up was 34 months. Open nailing was performed in 26 fractures and closed nailing in 14. Bone graft was done in 7 fractures with open nailing. With a single operation, all but two patients achieved osseous union. Average pain score with visual analog scale was one (range; 0∼4) postoperatively By the Neer's score 37 patients received a excellent or satisfactory results while 3 patients' unsatisfactory or failed results. By the functional score of ASES (American Shoulder and Elbow Society) 6 cases received the fair or poor results. Except three cases with persistent nerve palsy and one case of technique failure with protruded nail over humeral head, all patients could achieved satisfactory results with Neer's score and 35 cases (94%) satisfactory results with functional score of ASES. An insertion of antegrade nail to the rotator interval was recommended for better shoulder functions and less pain postoperatively.

• Clinics in Shoulder and Elbow
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• v.20 no.2
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• pp.95-99
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• 2017

Background: The purpose of this study was to investigate the clinical and radiological outcomes of locking plate fixation with fibular strut allograft to manage unstable osteoporotic proximal humerus fractures. Methods: We retrospectively reviewed 15 patients who underwent open reduction and locking plate fixation with fibular strut allograft for osteoporotic proximal humerus fracture between July 2011 and June 2015. For functional evaluation, we evaluated visual analogue scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) shoulder score, and active range of motion. For radiological evaluation, shoulder true anteroposterior (AP) and AP in $20^{\circ}$ external rotation, as well as the axillary view were taken at two weeks, six weeks, three months, six months, and one year. And the neck-shaft angle was measured on the AP view in $20^{\circ}$ external rotation view. Results: At the one-year follow-up, mean VAS pain score and all shoulder scores, including ASES score and UCLA shoulder score, exhibited satisfactory clinical outcomes. All patients obtained bone union between three and six months post-procedure. Moreover, the mean immediate postoperative neck-shaft angle was $138^{\circ}{\pm}4^{\circ}$, and at one-year follow-up, the neck shaft angle was $137^{\circ}{\pm}5^{\circ}$. There was no significant difference between the preoperative and postoperative values (p=0.105). Conclusions: For the unstable two-part and three-part osteoporotic proximal humerus fractures with medial calcar comminution, the use of fibular strut allograft with locking plate fixation was effective in maintaining the initial status of reduction and exhibiting the satisfactory functional and radiological outcomes.

• Journal of Korean Physical Therapy Science
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• v.19 no.2
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• pp.35-42
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• 2012

Background : This study was conducted to know the effect of resistance exercise using thera-band in parallel with conservative therapy in patients with frozen shoulder. Methods : We analyze subjective pain scale, ROM and shoulder functional scale 24 patients diagnosed with adhesive capsulitis were included for study. Among them, 12 patients(experiment group) were managed by resistance exercise as well as conservative physical therapy, another 12 patients(control group) were only treated by conservative therapy alone. All the patients were treated three times a week for 4 weeks, and after, and after each treatment subjective pain scale, ROM, shoulder functional score(SFI) were measured. Results : The VAS were significant reduced between experimental group and control group according to pre-treatment and post-treatment. In experimental group, the ROM and SFI has increased than control group according to pre-treatment and post-treatment. Conclusion : According to the results, we concluded that both conservative therapy and self resistance exercise using thera-band technique are more effective for increasing ROM especially flexion, abduction, internal rotation and SFI than conservative therapy alone.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.2
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• pp.153-163
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• 2019

Purpose : This study was to identify the effects of Mobilization with Movement combined with exercise (EMWM) on acromio-humeral distance (AHD), range of motion (ROM), pain intensity, and functional performance in patients with impingement syndrome of the shoulder. Methods : The subjects were 40 patients diagnosed with impingement syndrome of the shoulder. Twenty subjects are randomly assigned to each 2 different groups; Group 1. (exercise group), Group 2. (EMWM group). Three weekly interventions were given for 4 weeks. The main outcome measures were ultrasound, goniometer, visual analogue scale (VAS), and Korean Constant shoulder score (K-CSS). The ultrasound (AHD), ROM (flexion, abduction), pain intensity (for shoulder flexion) and functional performance (K-CSS) were compared between the groups. Results : The AHD was significantly increased in Group 2 compared to Groups 1. No significant difference was observed between the groups in the range of abduction of the shoulder, but the range of flexion was significantly increased in Group 2 compared to Groups 1. Pain intensity was significantly lower in Group 2 than in Group 1, and functional performance was significantly increased in Group 2 compared to Group 1. Conclusion : An intervention that combined mobilization with movement with exercise was more effective than exercise alone for rapid recovery from shoulder injury and improvement in functional performance.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.573-582
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• 2013

PURPOSE: The purpose of this study was to establish the reliability and validity of the Wheelchair User's Shoulder Pain Index (WUSPI), which was translated into Korean for long-term wheelchair users. This index measured 15 functional activities, including transfer, self-care, wheelchair mobility and general activities. METHODS: To assess test-retest reliability, 23 long-term wheelchair users completed this self-administered index twice within the same day. Reliability was determined by the intraclass correlation coefficient (ICC), and Cronbach's alpha was used to measure internal consistency. To examine concurrent validity, 21 long-term wheelchair users completed the questionnaire, and we examined the correlation between the index score and the shoulder range of motion measurements. RESULT: The results showed that the intraclass correlation for test-retest reliability of the total index score ranging from .88 to .99 was good to excellent. Additionally, Cronbach's alpha was .96. The internal consistency indicated excellent. Concurrent validity showed negative correlations of total index score to range of motion measurements of shoulder flexion (rho=-.58), extension (rho=-.09), abduction (rho=-.59), external rotation (rho=-.07) and internal rotation (rho=-.3), suggesting a relationship of total index score to loss of shoulder range of motion. CONCLUSION: The Korean WUSPI shows not only high reliability and internal consistency, but also concurrent validity with loss of shoulder flexion and abduction.

• Clinics in Shoulder and Elbow
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• v.22 no.4
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• pp.190-194
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• 2019

Background: The duration of immobilization after arthroscopic rotator cuff repair and the optimal time to commence rehabilitation are still the subject of ongoing debates. This study was undertaken to evaluate the functional outcome and rotator cuff healing status after arthroscopic rotator cuff repair by comparing early and delayed rehabilitation. Methods: Totally, 76 patients with small, medium, and large sized rotator cuff tears underwent arthroscopic repair using the suturebridge technique. In early rehabilitation group, 38 patients commenced passive range of motion at postoperative day 2 whereas 38 patients assigned to the delayed rehabilitation group commenced passive range of motion at postoperative week 3. At the end of the study period, clinical and functional evaluations (Constant score, the University of California, Los Angeles [UCLA] shoulder score) were carried out, subsequent to measuring the range of motion, visual analogue scale for pain, and isokinetic dynamometer test. Rotator cuff healing was confirmed by magnetic resonance imaging at least 6 months after surgery. Results: No significant difference was obtained in range of motion and visual analogue scale between both groups. Functional outcomes showed similar improvements in the Constant score (early: 67.0-88.0; delayed: 66.9-91.0; p<0.001) and the UCLA shoulder score (early: 20.3-32.3; delayed: 20.4-32.4; p<0.001). Furthermore, rotator cuff healing showed no significant differences between the groups (range, 6-15 months; average, 10.4 months). Conclusions: Delayed passive rehabilitation does not bring about superior outcomes. Therefore, early rehabilitation would be useful to help patients resume their daily lives.