• Clinics in Shoulder and Elbow
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• v.18 no.4
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• pp.217-220
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• 2015

Background: The purpose of this study is to administer conservative treatment in 30 patients diagnosed with idiopathic frozen shoulder, following the suggested frozen shoulder rehabilitation program and to assess the clinical outcome using a prospective study. Methods: Thirty patients diagnosed with idiopathic frozen shoulder, treated with steroid hormone injection on the articular joint with an intra-articular steroid (triamcinolone 40 mg+lidocaine 4 ml) injection and started on stepwise shoulder extension exercise were chosen. The subjects were divided into two groups of 15 people each with one group undergoing rehabilitation with continuous passive motion (CPM) and the other group without it. Follow-ups were done before rehabilitation and at 4-week intervals with the 24th being the final week. At every follow-up, passive range of motion (ROM) was measured and surveys on pain and clinical score were administered. Results: In the last follow-up, both groups showed statistically significant improvements in all evaluation criteria. However, no statistical difference in all values of the ROM and Constant score evaluation criteria was observed between the groups. Only in the last follow-up, group 1 had a visual analog scale (VAS) score of $2.4{\pm}2.1$ points, which was lower, with statistical significance, than the VAS score of group 2, which was $4.4{\pm}3.1$ points (p<0.001). Conclusions: Study using CPM in treatment of frozen shoulder has been inadequate, meaning that there is still room for improvement and need for more study on setting a more specific protocol and guidelines for this procedure.

• Archives of Plastic Surgery
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• v.51 no.1
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• pp.52-61
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• 2024

Background Although prepectoral implant-based breast reconstruction has recently gained popularity, dual-plane reconstruction is still a better option for patients with poor-quality mastectomy skin flaps. However, shoulder morbidity is aggravated by subpectoral reconstruction, especially in irradiated patients. This study aimed to demonstrate shoulder exercise improvement in subpectoral reconstruction by delayed prepectoral conversion with an acellular dermal matrix (ADM) inlay graft technique at the time of expander-to-implant exchange after irradiation. Methods Patients with breast cancer treated for expander-to-implant exchange after subpectoral expander insertion and subsequent radiotherapy between January 2021 and June 2022 were enrolled. An ADM inlay graft was inserted between the pectoralis major muscle and the previously inserted ADM. The ADM was sutured partially overlapping the pectoralis muscle from the medial side with the transition part, to the muscle border at the lateral side. Perioperative shoulder joint active range-of-motion (ROM) for forward flexion, abduction, and external rotation was also evaluated. Results A total of 35 patients were enrolled in the study. Active shoulder ROM significantly improved from 163 degrees preoperatively to 176 degrees postoperatively in forward flexion, 153 to 175 degrees in abduction, and 69 to 84 degrees in external rotation. There was no difference in patient satisfaction regarding the final outcome between the conventional prepectoral reconstruction group and the study group. Conclusion Shoulder exercises in irradiated patients who underwent subpectoral reconstruction were improved by delayed prepectoral conversion using an ADM inlay graft. It is recommended that subpectoral reconstruction not be ruled out due to concerns regarding muscle contracture and shoulder morbidity in radiation-planned patients with poor mastectomy skin flaps.

• Physical Therapy Korea
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• v.20 no.1
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• pp.36-46
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• 2013

This study examined the effects of a physical therapy program on quality of life (QOL), and neck and shoulder disability in head and neck cancer patients. The program included neck and shoulder range of motion (ROM) exercises, massage, progressive strengthening exercises, and stretching exercises. Sixteen patients who were assigned to an experimental group performed physical therapy for 40 minutes three times a week for eight weeks. Fifteen other patients were assigned to a control group who did not performed the physical therapy program. The European organization for research and treatment of cancer (EORTC QLQ-C30) and head and neck (EORTC QLQ-H&N) instruments, and the Neck Disability Index (NDI) were assessed before and after the rehabilitation program. The 40-minute program consisted of a 10-minute ROM exercise for the neck and shoulder, a 10-minute massage and 15-minute of progressive resistance exercises, followed by a five-minute stretching exercises. Statistically significant differences were noted for changes in global health, physical function in the EORTC QLQ-C30 and cancer related symptoms in the EORTC QLQ-H&N35 (p<.05). The NDI also showed significant differences (p<.05). Physical therapy may therefore benefit the physical aspects and QOL and improve neck and shoulder disability in patients with head and neck cancer.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.1
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• pp.71-82
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• 2016

PURPOSE: The purpose of this case report was to determine the effect of therapeutic exercise on posture, pain, and muscle activity in two patients with forward head posture (FHP). METHODS: A-31-year-old male (patient A) and a 19-year-old women (patient B) presented with FHP, neck pain, and headache. The therapeutic exercise program consisted of cervical mobilization, deep cervical flexors strengthening, and cervical extensors stretching, for 40 min/d, 2 d/week, for 8 weeks. Neck pain (VAS), neck disability (NDI), cervical range of motion (CROM), lateral view of cervical spine X-ray (indicating the FHP), and asymmetrical neck and shoulder muscular activity ratio were measured before, after 4 weeks, and after 8 weeks of corrective exercise. RESULTS: VAS and NDI decreased in patients A and B after exercise compared to before the program. CROM increased in patients A and B at flexion, extension, side bending, and rotation after exercise compared to before the program. FHP decreased in patients A and B at distance after exercise compared to before the program. In addition, asymmetrical neck and shoulder muscles activity ratio improved in patients A and B after exercise compared to before the program. CONCLUSION: We demonstrated in a case report that therapeutic exercise increases ROM, decreases pain and disability of neck, FHP, and asymmetry muscle activity ratio in patients with FHP. These finding have clinical implications for therapeutic exercise in patients with FHP.

• Journal of Korean Academy of Nursing
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• v.36 no.7
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• pp.1111-1122
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• 2006

Purpose: This study examined the effects of aerobic exercise using a flex band on the improvement of physical functions & body image in breast cancer women undergoing radiation therapy after a mastectomy. Method: Women with breast cancer(n =26) were assigned to an experimental group(EG, n = 15) and control group(CG, n = 11). The E.G participated in an aerobic exercise program with a 60% to 80% intensity of maximal heart rate for 25 minutes during the main exercise, 3 times per week, for 6 weeks. The EG did not exercise regularly for 3 months before participating in this program. The CG received no exercise treatment during the research period. Data were analyzed using the $x^2-test$ and Mann-Whitney U test by the SPSS version 11.0 program at a 5% significant level. Results: Group analysis revealed that the EGwomen had significantly more improved cardio-pulmonary functions, ROM of the affected shoulder joint, and body image compared to the CG, Conclusion: Aerobic exercise using a flex band may be an effective rehabilitative measure for mastectomy women with respect to cardio-pulmonary functions, ROM, & body image. Further studies are recommended to study early rehabilitation programs within 10 days post-operatively.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.485-492
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• 2014

PURPOSE: This study aimed to examine the pain, range of motion (ROM), upper extremity task performance, and functional levels of patients after rotator cuff repair according to the timing of a closed chain exercise thereby presenting basic data for an effective rehabilitation program. METHODS: The intervention was applied three times per week, one hour per day, for four weeks to 40 participants, 78 of whom had undergone rotator cuff repair. The participants were divided into four groups and assigned to usual general physical therapy and an open chain exercise. Group I consisted of the open chain exercise only. The closed chain exercise was applied to group II after the 4 times, group III after the 7 times, group IV after the 10 times. Measurement were used ROM, visual analogue scale (VAS), box and block test (BBT), and shoulder pain and disability index (SPADI). A one-way analysis of variance was conducted to test differences. RESULTS: There were significant differences in the internal/external rotation between group I and group II. The VAS significantly differed between group II and group I, group III, and group IV. The BBT results of group II and group I were significantly different compared to those of group IV. The SPADI significantly differed between group II and group I and between group II and group IV. CONCLUSION: The closed chain exercise was effective for patients following rotator cuff repair from the second week after active exercise was prescribed, verifying its applicability in rehabilitation programs.

• Journal of Physiology & Pathology in Korean Medicine
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• v.32 no.5
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• pp.315-320
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• 2018

The purpose of this study is to investigate reasearch trend of acupuncture treatment on shoulder impingement syndrome. This study investigated the recent studies about acupuncture treatment for shoulder impingement syndrome via searching Korean and foreign electronic databases(Research Information Services, National Digital Science Library, Oriental Medicine Advanced Searching Integated Services, PubMed, China National Knowledge Infrastructure). The search term was searched by combining 'shoulder impingement sydrome', 'subacrominal pain', 'acupuncture', 'needle therapy', and was limited to the articles published from 2005 to 2017. 14 studies were found to be analyzed according to the type of study, the number of cases, the type of treatment, the instruments for assessment and published year. 14 studies were published since 2005, 6 case reports, 8 randomized controlled trials. In the treatment of shoulder impingement syndrome, treatments such as acupuncture, acupotomy, pharmacopuncture, laser acupuncture, combined treatment of exercise and rehabilitation were performed. Visual analogue scale(VAS), range of motion(ROM) and various questionnaires were used as primary assessments. In each study, acupuncture treatment was reported to have a significant effect in the pain, range of motion and disability of shoulder impingement syndrome. In order to ensure objective evidence on acupuncture treatment, large scale case reports and randomized controlled trials should be continued.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.2 no.1
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• pp.71-82
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• 2004

To compare the effectiveness of the hemisling, bobath sling, extension-type sling, and the newly designed Modified Triangular Bobath Sling with Distal Support on a hemiplegic shoulder subluxation. Fourteen hemiplegic patients with shoulder subluxation were evaluated by a simple X-ray with and without the slings and the vertical and horizontal distances on the plain AP views were measurement. The newly designed arm sling was compared in terms of the effects of correction with distal support attached with shoulder saddle sling. The arm sling designed for this study was developed for the purpose of maintaining patients hands in a functional position and performing ROM exercise of the shoulder easily, and prevention or correction to shoulder subluxation. The mean values of the vertical and horizontal distance were compared to determine if there was significant difference of function between the new sling and the conventional slings. The new sling provided the patients with good vertical correction of the subluxation(p<0.05) but did not increase the horizontal distance significantly. These results support the effectiveness of a new sling to decrease subluxation in hemiplegia. Further study on the long term effects or complication of the new sling is recommended.

• The Journal of Korean Physical Therapy
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• v.22 no.5
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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.

• The Journal of Korean Physical Therapy
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• v.24 no.2
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• pp.82-89
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• 2012

Purpose: In this study, the effects of stability exercise, extracorporeal shock wave therapy, and taping on pain and function in patients with myofascial pain syndrome of upper trapezius were compared. Methods: The subjects were divided into the stability exercise, ESWT and the taping treatment group and the clinical outcomes were evaluated by visual analog scale (VAS), pressure pain threshold (PPT) and a constant-murley scale (CMS) at pre-treatment and post-treatment. Paired t-test and ANOVA was used for statistical analysis. Results: All groups were statistical significance in the change in visual analog scale (p<0.05). The difference between the ESWT group and taping group was statistical significance in the change in pressure pain threshold (p<0.05) except for the taping group. Using the constant-murley scale, the stability exercise group showed a significant decrease in pain, and a significant increase in ROM, ADL, strength, total score of shoulder (p<0.05); however, the ESWT group showed no difference on ADL. In addition, there was no difference in strength for the taping group. The comparison of the effect between the stability exercise group, ESWT group and taping group in CMS showed a statistical significant difference in pain, ADL and ROM (p<0.05). Conclusion: These results indicate that stability exercise, ESWT and taping could be considered an effective and efficient treatment modality for myofascial pain syndrome of upper trapezius.