• Title/Summary/Keyword: Shoulder Limited of Motion

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Pharmacoacupuncture for the Treatment of Frozen Shoulder: protocol for a systematic review and meta-analysis

  • Ji-Ho Lee;Hyeon-Sun Park;Sang-Hyeon Park;Dong-Ho Keum;Seo-Hyun Park
    • Journal of Pharmacopuncture
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    • v.27 no.1
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    • pp.14-20
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    • 2024
  • Objectives: Frozen shoulder (FS) is one of the most challenging shoulder disorders for patients and clinicians. Its symptoms mainly include any combination of stiffness, nocturnal pain, and limitation of active and passive glenohumeral joint movement. Conventional treatment options for FS are physical therapy, nonsteroidal anti-inflammatory drugs, injection therapy, and arthroscopic capsular release, but adverse and limited effects continue to present problems. As a result, pharmacoacupuncture (PA) is getting attention as an alternative therapy for patients with FS. PA is a new form of acupuncture treatment in traditional Korean medicine (TKM) that is mainly used for musculoskeletal diseases. It has similarity and specificity compared to corticosteroid injection and hydrodilatation, making it a potential alternative injection therapy for FS. However, no systematic reviews investigating the utilization of PA for FS have been published. Therefore, this review aims to standardize the clinical use of PA for FS and validate its therapeutic effect. Methods: The protocol was registered in Prospero (CRD42023445708) on 18 July 2023. Until Aug. 31, 2023, seven electronic databases will be searched for randomized controlled trials of PA for FS. Authors will be contacted, and manual searches will also be performed. Two reviewers will independently screen and collect data from retrieved articles according to predefined criteria. The primary outcome will be pain intensity, and secondary outcomes will be effective rate, Constant-Murley Score, Shoulder Pain and Disability Index, range of motion, quality of life, and adverse events. Bias and quality of the included trials will be assessed using the Cochrane handbook's risk-of-bias tool for randomized trials. Meta analyses will be conducted using Review Manager V.5.3 software. GRADE will be used to evaluate the level of evidence for each outcome. Results: This systematic review and meta-analysis will be conducted following PRISMA statement. The results will be published in a peer-reviewed journal. Conclusion: This review will provide scientific evidence to support health insurance policy as well as the standardization of PA in clinical practice.

Effects of Thoracic Mobility Exercise on Cervicothoracic Function, Posture and Pain in Individuals With Mechanical Neck Pain (등뼈 가동성 운동이 기계적 목통증 환자의 목등뼈부 기능 수준과 자세, 통증 수준에 미치는 영향)

  • Lee, Hwa-jeong;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.26 no.3
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    • pp.42-56
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    • 2019
  • Background: Individuals with mechanical neck pain show biomechanical and neurophysiological changes, including cervical spine muscle weakness. As a result of deep muscle weakness, it causes stability disability and reduced upper thoracic spine mobility, which finally leads to functional movement restriction such as limited range of motion and dysfunction. Recent studies have shown that thoracic spine manipulation and mobilization could reduce symptoms of mechanical neck pain in patients. Objects: The purpose of this study was to investigate the effects of thoracic mobility exercise on cervicothoracic function, posture feature, and pain intensity in individuals with mechanical neck pain. Methods: The study subjects were 26 persons who were randomly assigned to the experimental (with thoracic mobility exercise) and control groups (without thoracic mobility exercise), with 13 subjects in each group. The cervicothoracic function (neck functional disability level and cervicothoracic range of motion), posture feature, and pain rating (using a quadrupled visual analogue scale [QVAS]) were measured before, after 3 weeks, and after 6 weeks. Results: Statistically significant group-by-time interactions were found with repeated analyses of variance for the Korean neck disability index (KNDI), all cervical range of motion (CROM), all thoracic range of motion (TROM), cranial rotation angle, sagittal shoulder posture (SSP), and QVAS (p<.05). All groups showed significant improvements from all times in all the evaluated methods. The KNDI, CROM, TROM of left rotation, and SSP in the experimental group showed significant improvements after 3 weeks, and the TROM of the right rotation and QVAS in the experimental group showed significant improvements after 6 weeks when compared with the control group. Conclusion: Thoracic mobility exercise during 6 weeks might be effective intervention to improve the functional level, posture feature, and QVAS pain rating for managing individuals with mechanical neck pain.

The Open Surgical Treatment for Stiff Elbow (주관절 구축의 관혈적 치료)

  • Lee, Ji-Ho;Ra, In-Hoo;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.293-298
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    • 2010
  • Purpose: Since an injured elbow joint can disturb the activity of daily life by limiting motion, especially if the motion is restricted over 40 degree of flexion contracture and under 105 degree of further flexion, it is imperative to select the best method and the timing of treatment of the elbow stiffness. Therefore this review will discuss open surgical techniques for stiff elbows based on the literature. Materials and Methods: It is important to take sufficient clinical examination of the patient, including history taking. And, a surgeon should select appropriate procedure after accurately understanding about the status and cause of the stiff elbow with radiographic methods. Surgical methods include arthroscopic release open release, distraction arthroplasty, total elbow replacement and there are four approachs in the open release - anterior approach, medial "over the top" approach, limited lateral approach: column procedure, posterior extensile approach-. Results and Conclusion: Although at present the arthroscopic technique is emphasized for the treatment of elbow stiffness, a surgeon should know conventional open techniques.

Two Clinical Cases of Active Release Technique with Koeran Medicine Treatment for Supraspinatus Tendon Partial Tear (능동이완기법(active release technique)을 병행한 한방치료로 호전된 극상근건 부분 파열 호전 2례)

  • Lee, Sung-Joon;Park, Jae-Hyun;Nam, Su-Hyeon;Kang, Jun-Hyuk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.9 no.1
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    • pp.89-101
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    • 2014
  • Objectives : The purpose of this study is to report the effect of Korean medicine treatment combined with active release technique on supraspinatus tendon partial tear. Methods : Two patients with supraspinatus tendon partial tear were treated by Korean medicine treatment in combination with active release technique. Visual analog scale(VAS), range of motion(ROM) were used to measure changes during treatment. Results : After treatment, shoulder pain and limited range of motion were improved significantly. Conclusions : Korean medicine treatment in combination with active release technique is proved to be helpful to improve the symptoms of the supraspinatus tendon partial tear patients. And, further studies will be needed.

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A Clinical Case of Axillary Web Syndrome after Glandular Tissue and Skin Removal for Axillary Osmidrosis (한선 및 피부절제술을 이용한 액취증 수술 후 발생한 Axillary Web Syndrome의 치험례)

  • Choi, Min-Seok;Kim, Woo-Seob;Kim, Han-Koo;Bae, Tae-Hui
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.301-303
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    • 2010
  • Purpose: The axillary web syndrome (AWS) is a selflimiting cause of morbidity in the early postoperative period after axillary surgery. This article presents a rare complication developed after surgical treatment for axillary osmidrosis. Methods: A 55-year-old male patient underwent surgical excision of skin and glandular tissue for axillary osmidrosis. Three weeks after the surgery, he visited our department due to a visible web of left axillary skin overlying palpable cord extends into the medial ipsilateral arm. There was a taut and tender cord of tissue under the skin and shoulder abduction was limited to less than 90 degrees. He was diagnosed with AWS and treated with conservative management. Results: Four months later, AWS resolved completely without any treatment and patient was free of pain or motion restriction. Conculsion: Axillary web syndrome has been described as frequent complication after axillary lymph node dissection or sentinel node biopsy, but not after surgical treatment of axillary osmidrosis. Surgeons must be aware of the risk of axillary web syndrome after treatment of axillary osmidrosis.

A Comparision of Functional Outcomes after Successful Replantation versus Thenar Flap for Single Fingertip Amputations (수지 첨부 절단 후 성공적 재접합술대 무지구 피판술의 기능적 결과 비교)

  • Kwon, Gi-Doo;Ahn, Byung-Moon
    • Archives of Reconstructive Microsurgery
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    • v.21 no.1
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    • pp.1-7
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    • 2012
  • Purpose: This retrospective study was to determine the functional results of patients who were amputated of their fingertip between patients who were treated with replantation and patients who were treated with thenar flap. Materials and Methods: From 2004 to 2007, we identified and operated 159 patients who were diagnosed with fingertip amputations. Of 159 patients, Eighty-two patients were treated by replantation (67 in men and 14 in women) and the mean age at the operation was 41 years (range, 15-68 years). Seventy-nine patients was treated with thenar flap(54 in men and 25 in women) and the mean age at the operation was 43 years(range, 21-70 years). We compared variables between two groups including, age, gender, diagnosis, duration of hospital admission, grip strength, two-point discrimination, Semmes Weinstein monofilament test, active range of motion (ROM) of the proximal and distal interphalangeal (PIP and DIP) joint, pain (or tenderness), paresthesia, cold intolerance, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and finger for activities of daily living (ADLs). Results: The duration of admission was longer in Replantation group than in Thenar flap group(p=0.001). However, the grip strength (p=0.003) and Semmes Weinstein monofilament test (p=0.029) in the Replanation group were statistically superior to the Thenar flap group. The average DASH disability (p=0.003)/symptom score (p=0.007) and ADLs (p<0.001) in the Replantation group was statistically better. In addition, cold intoleranace test of Thenar flap group is worse than the Replantation group. Conclusion: This study demonstrate that fingertip replantation have demonstrated not only to obtain the best appearance but also to gain better functional outcome. However, it is impossible to perform replatation, the thenar flap can be limited alternative method for fingertip amputation in aspect of preservation of range of motion and hospitalization time.

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A study of the movement adaptability of classical opera costume - Focusing on 19th century women's jacket - (클래식 오페라 무대의상의 동작기능성 개선방안 연구 - 19세기 여성 재킷을 중심으로 -)

  • Kwon, Kyounghyun;Chun, Jongsuk
    • The Research Journal of the Costume Culture
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    • v.25 no.3
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    • pp.301-314
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    • 2017
  • This study focused on the movement adaptability of $19^{th}$ century classical opera stage costumes. Researchers focused on a basic $19^{th}$ century women's jacket. The study analyzed movement adaptability using ROM (range-of-motion) tests of the upper limb flexion and abduction postures. It developed two research garments to mimic basic $19^{th}$ century style jackets with or without gussets at the axilla. The ROM experiment identified the gusset size as 11cm in length. Experimental postures included upper limb flexion and abduction. The study measured subjective comfort at 8 postures. These postures included the flexion and abduction of the arms and torso. Subjects also evaluated the subjective comfort of the rotation posture of the torso. Researchers evaluated the similarities between research garments' silhouettes and the $19^{th}$ century women's jacket. The study used a 3D virtual fitting system to evaluate fit, and specialists further analyzed fit with photographs and 3D virtual graphics. The results are as follows. The silhouettes of both research garments were similar to the silhouettes of the $19^{th}$ century western women's jacket. The jacket with axilla gusset had a better fit than the basic style jacket. The basic style jacket without the axilla gusset showed limited movement adaptability at the shoulder joint and it caused discomfort at the axilla and elbow. The 3D virtual fit test was not a suitable method for analyzing silhouette similarity.

The Effectiveness of Buprenorphine Transdermal Patch on Patients with Shoulder Pain: Short-Term Follow-up Study (견관절 통증을 동반한 동결견 환자에게서 Buprenorphine transdermal patch의 효과: 단기 추시 결과)

  • Hong, Jin Ho;Park, Yong Bok;Ryu, Ho Young;Jeon, Sang Jun;Park, Won Ha;Yoo, Jae Chul
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.7-12
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    • 2014
  • Purpose:The effectiveness of transdermal buprenorphine patch on the patients with frozen state of frozen shoulder was evaluated. Materials and Methods: Between March and September in 2013, 127 patients with pain and limited range of motion in shoulder joint over 6 months were included. Every patient was confirmed the diagnosis through MRI or ultrasonogram and each patient received intra-articular injection of steroid once. After 2~4 weeks, every patient was interviewed via telephone survey and finally 105 patients were included, 54 patients received only oral NSAIDs (NP group) while 51 patients received additional transdermal buprenorphine patch (BP group). Pain and functional visual analog scale (PVAS, FVAS), American Shoulder Elbow Society (ASES) score was checked. Results: Generally, every outcome variables showed improvements in both groups (p<0.001). PVAS score after treatment showed superior result in NP group but it was not significant (p=0.088). In ASES score, NP group had superior result than BP group and it had significant difference. Similarly in FVAS, NP group showed superior result but the data before treatment was significantly different (p=0.028) Conclusion: Transdermal buprenorphine patch didn't show superior treatment result in the patient with frozen state of frozen shoulder which was applied with oral NSAIDs after single intra-articular glenohumeral steroid injection in short-term follow-up.

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Change in Each Vertebral Segment During Smartphone Usage with Both Hands while in the Standing Position

  • Cho, Sung-Hak;Moon, Hyun-Ju
    • PNF and Movement
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    • v.17 no.1
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    • pp.41-46
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    • 2019
  • Purpose: Continuous use of a smartphone increases the angle of forward bending of the user's cervical vertebrae, causing pain in the shoulders and back, including the thorax, lumbar region, and vertebrae. Although there are many studies on changes in the cervical spine due to smartphone usage, the changes in the shoulders, thoracolumbar spine, and pelvic have rarely been compared. The purpose of this study is to investigate the change in the spinal segments, shoulders, and pelvic when using a smartphone with both hands while in the standing position. Methods: This study was conducted on 35 adults in their twenties. The selection criteria for the subjects were limited to those in a similar age group, thus excluding posture differences according to age, and to those who did not have specific diseases or pain in the spinal and musculoskeletal system for 12 months prior to the study. In this study, we used a 3D spinal diagnostic imaging system (Back Mapper, Frickenhausen) to compare the changing conditions in each vertebral segment before and during smartphone usage with both hands while in the standing position. Posture differences according to smartphone usage were compared using the paired t-test for the motion of each spinal segment. Results: This study showed that the thoracic and lumbar angle increased posteriorly during smartphone usage (p<0.05). In addition, the anterior rotation angle of the shoulder bone significantly increased, but no significant difference occurred in the pelvic region. Conclusion: Based on the results of this study, smartphone usage with both hands while in the standing position showed that the spine, as a whole, forms a kyphotic curve. Therefore, we propose to present a postural guideline for correct smartphone usage, considering the change in each vertebral segment.

Arthroscopic Repair of Type V SLAP lesion with Bio-knotless Anchor (제 5형 SLAP 병변에 대하여 Bio-knotless 봉합 나사못을 이용한 관절경적 봉합 수술의 임상적 결과)

  • Yum, Jae-Kwang;Lee, Sang-Lim;Ra, Ho-Jong
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.32-38
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    • 2007
  • Purpose: This study reports the clinical results of the arthroscopic repair of type V SLAP lesion with bio-knotless anchor. Materials and Methods: 10 cases of 10 patients (10 male) were included in this study. The average age was 32.7 years old and the period from the first injury to operation was average 47.2 months. Preoperative Rowe score was average 37.5. Arthroscopic SLAP repair with 1 or 2 bio-knotless anchors were performed and arthroscopic Bankart repair with bio-knotless anchors were performed in all cases; 3 anchors were used in 7 cases and 2 anchors in 3 cases. The average follow up period was 15.7 months. Results: The Rowe score improved to 93 at last follow up period and 8 cases had full range of motion of the shoulder. 2 case had mild limited range of motion of the shoulder (one case; 170 degrees in flexion, 60 degrees in external rotation and T12 level in internal rotation, the other case; 160 degrees in flexion, 45 degrees in external rotation and T12 level in internal rotation.) without any problem in normal activity. Conclusion: Arthroscopic repair with bio-knotless anchor in type V SLAP lesion is one of the good methods because of the good clinical results.

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