• Clinical Pain
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• 제18권2호
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• pp.76-81
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• 2019

Objective: To examine (1) the degree of reduction of passive range of motion (PROM) on the affected side compared to that on the unaffected side and (2) the degree of increase in PROM following intra-articular corticosteroid injection (IACI) in patients with frozen shoulder. Method: The medical records of 120 patients with frozen shoulder were retrospectively reviewed. PROM of the unaffected and affected shoulder (flexion, extension, abduction, internal rotation, external rotation) was compared, and changes in PROM of the affected shoulder after a single IACI (triamcinolone 20 mg) were evaluated after 12 weeks. Results: At the time of diagnosis, PROM of the affected shoulder was most limited in external rotation, followed by internal rotation, abduction, extension, and flexion, compared to that of the unaffected shoulder. Compared to before IACI, PROM of external rotation demonstrated the greatest increase compared to all the other movements after IACI. Conclusion: Limitation in PROM of the frozen shoulder at the time of diagnosis was greatest for external rotation. Moreover, external rotation experienced the greatest improvement after IACI. Our findings should help to further clarify the clinical characteristics of frozen shoulder, aid in its diagnosis, and allow the prediction of the effects of IACI.

• PNF and Movement
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• 제16권2호
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• pp.169-178
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• 2018

Purpose: This study aimed to investigate the effect of angular joint mobilization (AJM) on the shoulder pain, range of motion, and functional improvement in a patient with shoulder adhesive capsulitis. Methods: The patient diagnosed with right shoulder adhesive capsulitis by an orthopedic surgeon was a 60-year-old male, right hand/arm dominant, with a height of 175 cm and weight of 75 kg. The patient received 12 sessions of AJM once or twice per week for eight weeks. AJM was applied for 5 min each of flexion, abduction, external rotation, internal rotation, for a total of 20 min per session. The visual analog scale, the goniometer, and the Oxford shoulder score were used to measure pain, range of motion, and shoulder pain & disability index, respectively. Results: After all the treatments, the pain decreased from 6 to 2 points. The range of motion increased in flexion by $54.3^{\circ}$ from $125^{\circ}$ to $179.3^{\circ}$, abduction by $38^{\circ}$ from $140^{\circ}$ to $178^{\circ}$, external rotation by $54.4^{\circ}$ from $30.3^{\circ}$ to $84.7^{\circ}$, and internal rotation by $25^{\circ}$ from $45^{\circ}$ to $70^{\circ}$. The shoulder disability index decreased from 33 points to 17 points. Conclusion: This study found that AJM has a positive effect on the improvement of shoulder pain, range of motion, and function in a patient with shoulder adhesive capsulitis. Further studies on AJM are needed in the future.

• 종양간호연구
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• 제4권1호
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• pp.62-70
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• 2004

The purpose of this study was to use as a basic data to develop suitable nursing intervention program and decide an appropriate intervention time after assessing shoulder range of motion in postmastectomy from 2 weeks to 3 month. 147 patients are chosen as study subject among patients who were in recovery of 2weeks, 1month, 2months and 3 months after surgical operation which is modified radical mastectomy. Data were collected at oncology medicine local and general surgery local in Seoul National University Hospital from May, 2003 to October, 2003. The range of motion of the shoulder(flexion, extension, abduction, internal rotation, external rotation) were examined. Analysis of data that shoulder range of motion average and standard deviation, percentage of the unaffected side and affected side compare with normal shoulder range of motion. Paired t-test was adopted to analyze the difference between affected side and unaffected side. Conclusion from this study is as following, 1. The most serious problem was external rotation (0.56%) and internal rotation is the next (19.9%) in 5 kinds of shoulder range of motion in 2 weeks after surgical operation 2. There was no difference in internal rotation after post operation 3 months but there were differences and shown to recover more than 90% in flexion and abduction. Also shoulder function incresed in flextion less than 80% and more than 80% in external rotation. As this study finding was shown that shoulder range of motion did not get back perfectly except of internal rotation and extension in point of 3 months after breast cancer surgical operation. External rotation was specially shown the lowest result so it is needed to exercise for improving their physical functioning recovery in postmastectomy patients. And it is suggested to study for helping to postmastectomy patients' physical and psycosocial functions with the early rehabilitation program which is based on these results.

• 대한인간공학회지
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• 제28권3호
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• pp.125-134
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• 2009

The muscle strengths in various postures are used in our daily life with or without our recognition. Also, many works are still performed with strengths, although mechanization and automation have been fairly accomplished at the industry site. Since the late seventies, various body measurements have been conducted periodically in Korea, however, muscle strengths have not been measured actively. For this reason, the muscle strength data have been hardly accumulated. The aims of this study are to learn more about the physical strength of young-aged Koreans and to provide basic information for designing equipments, tools and facilities in the work site and daily life. The muscle strengths that are related to shoulder and upper limbs joints, which are used frequently, are measured in this study. Eighteen muscle strengths, from seven different movements such as elbow flexion, elbow extension, shoulder abduction(seated), shoulder adduction(seated), shoulder rotation(internal and external), lifting a tray, and turning a key(inward and outward) were measured. For every movement, the muscle strengths for both hands were measured. In each measurement, five seconds averaged value and peak value were collected. Comparing the average value, the strength of shoulder adduction was the strongest for male and female, while strength of turning a key inward with left hand was the weakest for male and female. Strengths of preferred hand in elbow extension, shoulder abduction, shoulder external rotation, lifting a tray, and turning a key were stronger than those of non-preferred hand for both male and female. Rohrer's index considerably had an effect on muscle strength. The results of this study can provide some basic information not only in designing the equipment and facilities in work site or daily life, but also in selection, training and management of workers.

• The Journal of Korean Physical Therapy
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• 제15권3호
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• pp.126-152
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• 2003

The purpose of this study was to evaluate the value of passive caudal gliding mobilization of the glenohumeral joint on the range of motion (ROM) of active and passive abduction; to evaluate the value of pain relief through visual analogue scale (VAS); to evaluate the correlation between improvement of shoulder abduction and intra-articular movement measured by fluoroscopy in frozen shoulder patients. The subjects consisted of twenty-one patients with clinically diagnosed frozen shoulder (11 males, 10 females) between 40 and 63 years of age (mean age : 52.7 years). The traction and caudal gliding mobilization based on the convex-concave rule in the resting position and at end range of abduction was peformed for 15 minutes per day and was repeated 10 times during a 2 week period. The ROM of abduction was measured by goniometer and pain was measured by VAS. The intra-articular movement was measured by fluoroscope, Neurostar Plus TOP (Siemens, Germany). ROM measurements of each patient was acquired at pre-treatment, immediate post-treatment and 2 week post-treatment. Statistical analysis was performed using SPSS 10.0 for Windows software and data was analyzed using the paired-test and the pearson correlation. The results of this study are as follows: 1. There was a significant decrease of VAS between pre-treatment data and 2 week post-treatment data (P<.05) but no significant difference between pre-treatment and immediate post-treatment data (P>.05). 2. There was a significant increase in ROM of active and passive abduction in the pre-treatment data, immediate post-treatment data, and in 2 week post-treatment data (P<.05). 3. With regard to results of the joint play test, there was a significant difference in the grade of traction between pre-treatment data and immediate post-treatment data and between pre-treatment data and 2 week post-treatment data (P<.05). There was no significant difference between immediate post-treatment data and 2 week post-treatment data (P>.05). 4. With regard to results of the joint play test, there was a significant difference in the grade of caudal gliding between pre-treatment data and immediate post-treatment data and between pre-treatment data and 2 week post-treatment data (P<.05). There was no significant difference between immediate post-treatment data and 2 week post-treatment data (P>.05), 5. With regard to the results of fluoroscopic findings, there was a significant change of the glenohumeral joint space between pre-treatment data and immediate post-treatment data and between immediate post-treatment data and 2 week post-treatment data (P<.05). There was no significant change of the glenohumeral joint space between immediate post-treatment data and 2 week post-treatment data (P>.05). 6. With regard to the results of fluoroscopic findings, there was a significant change of acromiohumeral joint space between the three data (pre-treatment data, immediate post-treatment data, 2 week post-treatment data) (P<.05). 7. Mobility grade by joint play test was significantly increased and was correlated to improved ROM of active and passive abduction (P<.05). In this study of frozen shoulder, passive caudal gliding techniques of the glenohumeral joint results in statistically significant changes in active and passive abduction as well as in VAS. There is also a significant correlation between joint play test and ROM of abduction.

• 대한정형외과 초음파학회지
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• 제1권1호
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• pp.6-9
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• 2008

목적: 견봉하 점액낭염에 대한 초음파 하 증식과 국소 스테로이드 병합 주사 요법을 시행하고 효과를 판정하고자 하였다. 대상 및 방법: 38예를 대상으로 하였으며 초음파 하에서 확인하고 견봉하 주사 요법을 시행하였으며 시술 전과 3주 후 기능과 통증을 평가하였다. 결과: 시술전 견관절의 외전 각도는 $77.89{\pm}14.17$에서 $148.68{\pm}13.39$로 호전되었고(P<0.05), VAS는 $6.8{\pm}1.4$에서 $1.4{\pm}0.8$로 호전되었다(p<0.05). 결론: 초음파 하 견봉하 점액낭염 증식 주사 요법은 정확도를 높일 수 있고 효과적으로 증상과 관절 운동기능을 호전시킬 수 있는 술식으로 사료된다.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2009년도 제17차 학술대회
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• pp.175-175
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• 2009

Despite its importance for the understanding of joint kinematics in vivo, there has been few studies about shoulder joints. The purpose of this study is to analyze the glenohumeral joint during internal and external rotation at 90 degrees of abduction using in vivo noninvasive motion analysis system. MRI was performed for the following seven positions from maximum internal rotation to maximum external rotation at intervals of 30 degrees. We used 3D-gradient echo sequencing (TR: 12 ms, TE: 5.8 ms, 0.8 mm-slice thickness). Our method is based on matching three-dimensional MR images by the similarity of the image intensity. We analyzed the in vivo three-dimensional motions of the glenohumeral and scapulothoracic joint during this motion. In scapla plane, the mean rotation angle of the glenohumeral join was 105.5 degrees ($SD{\pm}39.0^{\circ}$). The mean rotation angle of the scapulothracic joint was 27.5 degrees ($SD\;{\pm}\;7.7^{\circ}$). The contribution ratio is almost 3.8:1 of glenohumeral and scapulothracic joint respectively.

• PNF and Movement
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• 제21권1호
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• pp.95-105
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• 2023

Purpose: The study aims to determine the effect of a breathing exercise on shoulder pain, range of motion (ROM), and forward head posture in patients with rotator cuff repair. Methods: In total, 25 patients with rotator cuff repair were included in this study. The experimental group (n = 13) underwent a breathing exercise, while the control group (n = 12) received traditional physical therapy. The visual analogue scales (VASs) for pain, flexion and abduction ROM, and the craniovertebral angle (CVA) of both groups were recorded at both pre- and post-intervention. Paired t-tests were used to determine significant changes in the post-intervention compared with the pre-intervention period, and independent t-tests were used to analyze differences in dependent variables between the two groups. Results: After the two-week intervention, the experimental group experienced a significantly decreased VAS (p < 0.05) and significantly increased ROM and CVA (p < 0.05), while the control group experienced a significantly decreased VAS (p < 0.05). Further, the experimental group that underwent the breathing exercise showed greater improvements in flexion and abduction ROM and in the CVA than the control group (p < 0.05). Conclusion: The results suggested that a breathing exercise can reduce shoulder pain and enhance ROM and posture in patients with rotator cuff repair.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2008년도 제16차 학술대회
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• pp.164-164
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• 2008

The beach-chair traction position is designed to allow the use of traction while allowing the surgeon to orient the shoulder in an upright position and convert to an open procedure, if necessary. The patient is placed in the beach-chair position under general anesthesia. A three-point shoulder holder (Arthrex, Naples, Florida) is attached to the rail of the operating table on the same side as the surgeon, whereas it is placed on the side opposite the surgeon in the lateral decubitus position. A shoulder traction and rotation sleeve (Arthrex) are affixed to the arm following the manufacturer's instructions. Positioning the thumb toward the closed side of the sleeve ensures a field for the anterior portion of the rotator cuff and prevents the tendency of the suspension apparatus to place the arm in internal rotation. The arm is maintained in 30 to 40 degree abduction and 30 to 40 degree flexion by controlling the length and height of the bar and the location of the universal clamp. The universal clamp allows multiple planes of adjustment to control abduction and forward movement of the arm. The sleeve is attached to the longitudinal traction cable using a sterile hook, and a lateral strap is secured around the proximal portion of the sleeve to the overhead traction cable to ensure a field for glenohumeral reconstruction. The use of a lateral strap permits ideal shoulder positioning for improved access to the anterior and inferior glenohumeral joint. The lateral strap can be released or removed to widen the subacromial space during subacromial decompression or rotator cuff repair. A 10-lb weight is attached to the longitudinal traction cable for an average-sized person.

• 대한물리의학회지
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• 제4권4호
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• pp.231-240
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• 2009

Purpose：The aim of this study was to determine the effect of active sling exercise on shoulder subluxation in hemiplegic patients. Methods：Twenty persons with shoulder subluxation were randomly divided into two groups; the experimental group(10 persons) and the control group(10 persons). Usual physical therapy and occupational therapy were applied in all groups in a day for 4 weeks. Additionally the experimental group was received 30 minutes sling active exercise (flexion, extention, adduction, abduction, intenal rotation, external rotation, horizontal adduction, horizontal abduction) for shoulder joint in a day for 4 weeks. I investigated the therapeutic effect of sling exercise through the Wolf motor function test (WMFT), Quantitative radiographic measurements and range of motion test at pre and post intervention period. Results：The passive range of motion was significantly increased in the experimental group compare with the control group. However, the active range of motion was no statistically significantly difference in both of the experimental and the control group. The level of WMFT was significantly decreased in the experimental group compared with control group. Although, there was no significantly difference the degree of the shoulder subluxation was more decreased in experimental group than control group. Conclusion：Taken together, these results suggest that sling exercise could be beneficial therapeutic method for hemiplegic shoulder. But to generalize it, more study and exercise program might be needed to confirm its availability.