• Clinics in Shoulder and Elbow
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• v.26 no.3
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• pp.267-275
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• 2023

Background: Physical therapy (PT) plays an important role in the recovery of function following anatomic total shoulder arthroplasty (aTSA). While several PT protocols have been published for these patients, there is no standardized protocol for aTSA rehabilitation. This lack of standardization may lead to confusion between patients and physicians, possibly resulting in suboptimal outcomes. This study examines how PT protocols provided by academic orthopedic surgery programs vary regarding therapeutic goals and activities following aTSA. Methods: PT protocols for aTSA available online from the Accreditation Council for Graduate Medical Education accredited orthopedic surgery programs were included for review. Each protocol was analyzed to evaluate it for differences in recommendation of length of immobilization, range of motion (ROM) goals, start time for and progression of therapeutic exercises, and timing for return to functional activity. Results: Of 175 accredited programs, 25 (14.2%) had protocols publicly available, programs (92%) recommended sling immobilization outside of therapy for an average of 4.4±2.0 weeks. Most protocols gave recommendations on starting active forward flexion (24 protocols, range 1-7 weeks), external rotation (22 protocols, range 1-7 weeks), and internal rotation (18 protocols, range 4-7 weeks). Full passive ROM was recommended at 10.8±5.7 weeks, and active ROM was 13.3±3.9 weeks, on average. ROM goals were inconsistent among protocols, with significant variations in recommended ROM and resistance exercise start times. Only 13 protocols (52%) gave recommendations on resuming recreational activities (mean, 17.4±4.4 weeks). Conclusions: Publicly available PT protocols for aTSA rehabilitation are highly variable. Level of evidence: IV.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.4
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• pp.85-94
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• 2018

PURPOSE: This study was conducted to determine the effects of therapeutic exercise on range of motion (ROM), the manual muscle test (MMT), functional movement screen (FMS) and radiological evaluation in a youth football player with football-specific anterior pelvic tilt (APT). METHODS: The subject of this case report was a 12-year-old youth football player, who presented with football-specific APT. Therapeutic exercise consisted of hamstring stretch, prone hip extension, abdominal crunch, bridging with isometric hip abduction, plank exercise with posterior tilt and posterior pelvic tilting exercise using a swiss-ball for 40 min/day, twice a week for 8-weeks. ROM, MMT, FMS (deep squat, hurdle step, inline lunge, shoulder mobility, active straight-leg raise, rotary stability and trunk stability push-up) and radiographs (lumbar lordotic and sacral horizontal angle) were analyzed before and after week 8 of therapeutic exercise. RESULTS: The ROM, MMT, and FMS increased and the lumbar lordotic angle and sacral horizontal angle improved after 8-weeks of therapeutic exercise. CONCLUSION: The results of this case report suggest that therapeutic exercise improves ROM, MMT and radiography associated parameters in youth football players with football-specific APT. These findings have clinical implications for therapeutic exercise in youth football players with football-specific APT.

• The Journal of Korean Physical Therapy
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• v.22 no.1
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• pp.19-26
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• 2010

Purpose: The purpose of this study was to compare the effectiveness of (a) a self stretching exercise (SSE) maintained below the level of pain with (b) physical therapy (PT) performed without pain limitation in patients with adhesive capsulitis. Methods: Forty-three subjects with frozen shoulder were recruited. Subjects were randomly assigned to one of two groups - an experimental group (SSE group, $n_1=18$) and a control group (PT group, $n_2=25$). The duration of each intervention was five weeks. We assessed night pains, range of motion (ROM), and shoulder function. Results: Overall, subjects in both groups improved over five weeks (p<0.05). The change in the PT group was greater (p<0.05) Conclusion: SSE carried out under the pain threshold may be used to treat patients with adhesive capsulitis SSE can be prescribed with PT as part of a home program or of group management.

• Journal of Korean Medicine Rehabilitation
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• v.15 no.2
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• pp.155-167
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• 2005

Objectives : The purpose of this study is evaluate of the effect of Dong-gi Acupuncture(DGA) on rehabilitation after stroke. Methods : 32 patients who had a stroke of paralysis were randomized into two groups. 17 patients were treated with DGA on sound side combined active or passive exercise on affected side. The other 15 patients were exclusive DGA group and the method retaining needles on acupoints of affected side for about 20 minutes were applied. We evaluated by Manual muscle test, Range Of Motion(ROM), Visual Analog Scale(VAS) and Modified Barthel index(MBI) before treatment, after 10 days and after 20 days. Results : In terms of power of lower limb, active ROM of shoulder abduction and MBI, the sample group showed statistically significant improve. In terms of power of lower limb ROM of hip joint abduction and affected side pain, significant difference between two groups was not shown. Conclusions : In this clinical study, Dong-gi Acupuncture therapy can be used for improving the power of upper limb, active ROM of shoulder abduction and MBI score after hemiplegic stroke.

• Physical Therapy Korea
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• v.27 no.1
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• pp.38-44
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• 2020

Background: Posterior shoulder tightness, which is a problem mainly seen in patients with shoulder impingement syndrome, disrupts the scapulohumeral rhythm between the humerus and scapulae. Objects: The aim of this study was to compare the effects of joint mobilization and stretching on shoulder muscle activity and internal rotation range of motion (ROM) of the glenohumeral joint in patients with impingement syndrome with posterior shoulder tightness. Methods: The research subjects included 22 in-patients with impingement syndrome with posterior shoulder tightness. They were randomly divided into two groups: one group (12 patients) was treated with joint mobilization and the other group (10 patients) was treated with stretching for the posterior shoulder tightness. Each treatment was performed five times a week for two weeks, and there were 15 sessions for each treatment. The ROM of the internal rotation and muscle activities of shoulder joint were evaluated pretest and posttest in each group. Electromyography data were collected from the upper, middle, and lower trapezius and serratus anterior during shoulder abduction of 90°, 120°, and 150°. Results: Both the joint mobilization and stretching groups showed significant decreases in muscle activity in the upper, middle, and lower trapezius on the posttest (p < 0.05). There was a significant difference in serratus anterior at 150° (p < 0.05), but there was no significant difference between group in post-hoc analysis (p > 0.025). The internal rotation ROM was significantly increased in the stretching group compared to that in the joint mobilization group (p < 0.025). Conclusion: This study found that both joint mobilization and stretching for posterior shoulder tightness were effective in muscle activity during arm abduction, also in order to increase internal rotation ROM of shoulder joint, stretching was effective in patients with impingement syndrome with posterior tightness.

• The Journal of Korean Physical Therapy
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• v.21 no.4
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• pp.1-7
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• 2009

Purpose: Cervical pain is caused mainly by a static position, lasting work, bad habits and stress, and is accompanied by pain in the upper trapezius. Traditionally, heat and traction, exercise, mobilization, manipulation have been used to treat cervical pain. This study examined the effect of stretching and manipulation (high-velocity low-amplitude: HVLA) on the pain and ROM in women with chronic cervical and upper shoulder pain. Methods: Fifty-two women diagnosed with chronic cervical and upper shoulder pain were enrolled in this study. Among them, 26 patients (experiment group) were managed by passive stretching and manipulation, and another 26 patients (control group) were treated with physical therapy intervention (hat pack: HP, transcutaneous electrical nerve stimulation: TENS, ultra sound: US). Each group made use of a Visual Analogue Scale (VAS) and the highly reliable (flextion: 0.92, extention: 0.99) cervical range of motion (CROM) to compare the possible changes in pain and ROM in the two groups after treatment. Results: In the experimental group, the pain decreased and the ROM has increased in all directions. In the control group, the pain decreased but the ROM was not changed in all directions. Conclusion: According to the results, passive stretching and manipulation is effective for increasing the ROM and decreasing the level of pain. Moreover, physical therapy intervention (HP, TENS, US) is effective for immediately decreasing the pain but has little effect on the ROM.

• Clinics in Shoulder and Elbow
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• v.7 no.1
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• pp.41-45
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• 2004

In adhesive capsulitis of the shoulder of no response to nonoperative treatment, an arthroscopic capsular release and manipulation improves range of motion and pain relief. We performed an arthroscopic examination in the stiff shoulder, of which she had no response to nonoperative treatment, after the conservative treatment of a clavicular shaft fracture by motorcycle-driver traffic accident. We found the intra-articular 'rotator interval bridging scar adhesion' between subscapularis tendon and antero-superior glenoid fossa under the rotator interval which was no adhesion and contracture itself. We performed the scar adhesion removal and synovectomy, maintaining the rotator interval. We recommended nonsteroidal anti-inflammatory drug for postoperative pain relief and continuous active and passive range of motion (ROM) exercise to gain motions. Preoperatively, active and passive range of motion were 70° for forward elevation, 60° for abduction and especially 0° for external rotation. After postoperative 2 months, active ROM were 150° for forward elevation, 130° for abduction and 80° for external rotation. After postoperative 6 months, passive and active ROM were full. UCLA score improved from preoperative 9 points to postoperative 29 points.

• Clinics in Shoulder and Elbow
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• v.3 no.1
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• pp.54-60
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• 2000

As a surgical treatment of ulnar nerve entrapment syndrome includes simple decompression, medial epicondylectomy, and anterior transposition of the ulnar nerve into a subcutaneous or submuscular bed have been widely used. Despite many reports of these surgical procedure, there is little to guide the choice of one surgical technique. The purpose of our study is to analyse clinical and electrodiagnostic result after minimal invasive decompression by decompression and medial epicondyloplasty(deepening of ulnar groove). We have experienced 9 cases of ulnar nerve entrapment syndrome who were treated with decompression and medial epicondyloplasty. Male were five and female were four. The mean age at operation was 36 years ranging from 23 to 47 years. Operative procedure was to incise the medial intermuscular septum and aponeurotic arch of flexor carpiulnaris and to deepen the ulnar groove. Patients are allowed to do range of motion(ROM) exercise on the average 5days. All patient were relieved pain and improved motor and sensory function, and this procedure allows early ROM exercise after operation because the muscle have not been detached.

• Physical Therapy Korea
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• v.18 no.2
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• pp.67-75
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• 2011

The purpose of this study was to investigate the effects of virtual reality (VR) therapy with compensation inhibition and feedback (CIF) on upper extremity function in chronic stroke patients. Seven chronic stroke patients participated in this study, which was a randomized controlled trial with a crossover design. Self upper extremity exercise, conservative VR therapy, and VR therapy with CIF were performed for one hour per session, 5 times per week, over a 3 week period. The main outcome measures involved range of motion (ROM) including shoulder, elbow, and wrist joints, a Manual Function Test (MFT), and a Motor Activity Log (MAL). Data were calculated as posttest and pretest changes in every session and were analyzed using Friedman and Wilcoxon signed-rank tests at p<.05. The results were as follows: 1) Statistically significant increase in ROM measurements of shoulder and elbow joints were seen with VR therapy with CIF compared to VR therapy and self upper extremity exercise (p<.05), whereas no significant increasing was noted for the wrist joint (p>.05). 2) Statistically significant increase in the MFT was seen with VR therapy with CIF compared with VR therapy and self upper extremity exercise (p<.05). 3) VR therapy with CIF also resulted in statistically significant increase in both activity of use (AOU) (p<.05) and quality of movement (QOM) (p<.05) on the MAL test when compared with VR therapy and self upper extremity exercise, respectively. In conclusion, VR therapy with CIF was more effective than conservative VR therapy and self upper extremity exercise in improving the upper extremity function in hemiplegic patients with chronic stroke.

• Journal of Korean Physical Therapy Science
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• v.4 no.1
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• pp.229-242
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• 1997

This study was performed to figure out effects of stroke rehabilitation on education using isokinetic exercise on physical function recovery. It is considered isokinetic exercise will playa primary role in muscle strength, ROM of joint, and body balance recovery for stroke rehabilitation and so far can be used as a basic references to increase the health of all people. The study consisted of 42 stroke patient(21 training group, 21 control group) diagnosed as cerebral hemorrhage from Oriental Rehabilitation Department of Kyung Hee University. Upper extremity and lower extremity exercise was performed in the training group using isokinetic ergometer. The recovery of physical function(muscle strength, ROM of joint, body balance) data between the two groups were compared and ana lysed by paired t-test are as followed. 1. Muscle testing record showed increased in the strength of elbow flexion, knee flexion, knee extension, ankle extension of the training group com paired to control group(p < .05). In the measurement of ROM, however other parts of the body motion showed no significant changes, only shoulder extension of the training group was increased(p < .05). 2. Body balance increase was highly significant in all training group compaired to control group(p<001). Based on these findings, stroke rehabilitation education with isokinetic ergometer showed available effects on recovery of physical function rehabilitation program with isokinetic exercise will play a primary role in the recovery of physical function of stroke or brain injury patients as well as to promote the health of all people.