• Archives of Reconstructive Microsurgery
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• v.18 no.2
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• pp.55-61
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• 2009

Purpose: To analyze the clinical and radiologic results of the shoulder arthrodesis in brachial plexus injury patients with flail upper extremity. Material and Method: From Aug 1978 to April 2008, 29 shoulders in 29 patients with brachial plexus injury with shoulder fusion, we evaluated 20 shoulders in 20 patients, more than 1 year follow up. The average follow-up period was 6.45years (range: 1year~24years). There were 13 men and 7 women, and the mean age at the time of trauma was 32.0years(2~65 years). The type of injury was a motorcycle accident in 11 patients, in car accident in 5, pedestrian accident in 3, and fall from a height in 1. The lesion of injury was root and trunk in 1 patient, trunk and cord in 1, trunk in 18. Surgery was performed on the whole arm type paralysis in 12 patients, lower arm type paralysis in 8 patients. The preoperative visual analog scale score was 8.7(7~10). When the trapezius and serratus anterior muscle were in function, operation was performed. 18 patients were processed to the additional operation. Gracilis free flap in 6 patients, neurotization in 3, Steindler flexor plasty in 6, and tendon transfer in 3 were performed. Fixation was conducted with cancellous screws in 13 patients, Knoles pins in 5, and cancellous screws and Knoles pins in 2. The position of the arthrodesis at operation was $28.5^{\circ}$($20~45^{\circ}$) in abduction, $30.3^{\circ}$($20~45^{\circ}$) in flexion, and $30.8^{\circ}$($20~40^{\circ}$) in internal rotation. Result: The follow up visual analog scale score was 3.4(0~7). Postoperatively, shoulder spica cast was applied for 15.3weeks(8-20weeks). The median time to bony union was 17.7weeks(9~28weeks). Average range of motion was $32.0^{\circ}$($15~40^{\circ}$) of abduction, $24.0^{\circ}$($10~40^{\circ}$) of flexion, and $18.5^{\circ}$($10~30^{\circ}$)of internal rotation. Conclusion: The shoulder fusion in brachial plexus injury patients is one of the good methods to relieve pain, improve the function and stabilize the flail shoulder joint.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.3
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• pp.1258-1265
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• 2013

The objective of this study is to investigate the association between touchpad &buttons locations in a laptop computer and EMG amplitude and median frequency in muscles related with wrist and shoulder. Based on previous studies it was shown how abductions in wrist and shoulder could cause musculoskeletal disorders in those body parts, on which research hypotheses were established. Touchpad &buttons positions consisted of bottom center(BC), bottom center with $45^{\circ}$ rotation counterclockwise(BCR), and bottom right(BR). 10 subjects performed the task that required only touchpad &buttons usage with their preferred hand and EMG amplitude and median frequency data were recorded during 5min and analyzed afterwards. Upper trapezius and flexor carpi ulnaris were selected as target muscles. The results showed that in flexor carpi ulnaris BC resulted in greater amplitude and less median frequency than BCR and BR, but there was no significant difference between BCR and BR. In upper trapezius BC and BCR induced higher amplitude and lower median frequency than BR, but the significant difference between BC and BCR was not observed. Those phenomena occurred since BC gave rise to both wrist and shoulder abduction, BCR caused only shoulder one, and BR did not lead to abductions in both wrist and shoulder.

• Korean Journal of Radiology
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• v.2 no.4
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• pp.216-221
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• 2001

Objective: To compare, in terms of their demonstration of tears of the anterior glenoid labrum, oblique axial MR arthrography obtained with the patient's shoulder in the abduction and external rotation (ABER) position, with conventional axial MR arthrography obtained with the patient's arm in the neutral position. Materials and Methods: MR arthrography of the shoulder, including additional oblique axial sequences with the patient in the ABER position, was performed in 30 patients with a clinical history of recurrent anterior shoulder dislocation. The degree of anterior glenoid labral tear or defect was evaluated in both the conventional axial and the ABER position by two radiologists. Decisions were reached by consensus, and a three-point scale was used: grade 1=normal; grade 2=probable tear, diagnosed when subtle increased signal intensity in the labrum was apparent; grade 3=definite tear/defect, when a contrast material-filled gap between the labrum and the glenoid rim or deficient labrum was present. The scores for each imaging sequence were averaged and to compare conventional axial and ABER position scans, Student's t test was performed. Results: In 21 (70%) of 30 patients, the same degree of anterior instability was revealed by both imaging sequences. Eight (27%) had a lower grade in the axial position than in the ABER position, while one (3%) had a higher grade in the axial position. Three whose axial scan was grade 1 showed only equivocal evidence of tearing, but their ABER-position scan, in which a contrast material-filled gap between the labrum and the glenoid rim was present, was grade 3. The average grade was 2.5 (SD=0.73) for axial scans and 2.8 (SD=0.46) for the ABER position. The difference between axial and ABER-position scans was statistically significant (p<0.05). Conclusion: MR arthrography with the patient's shoulder in the ABER position is more efficient than conventional axial scanning in revealing the degree of tear or defect of the anterior glenoid labrum. When equivocal features are seen at conventional axial MR arthrography, oblique axial imaging in the ABER position is helpful.

• Journal of Acupuncture Research
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• v.28 no.6
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• pp.43-51
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• 2011

Objectives : The purpose of this research was to investigate the effect of oriental medicine public-health program on frozen shoulder patients. Methods : Oriental medicine public-health program was done to 50 frozen shoulder patients who visited Eumseong-gun public health center. Oriental medicine treatment(twice a week for 12 weeks) and prevention-educaiton program was included in public-health program. The schedule was proceeded from 16th March 2010 to 3rd June 2010. The efficacy of program was measured by visual analog scale (VAS), ROM(range of motion), Apley scratch test and Life function score, sleep quality score of their first and last visit. Then we analyzed the improvement in the same group. Results : 1. In VAS change, program showed statistically significant improvement. 2. In ROM(flexion, extension, abduction, adduction) and apley scratch test, program showed statistically significant improvement. 3. In Life function score, program showed statistically significant improvement. 4. In sleep quality score, program also showed improvement, but didn't do statistical significans. Conclusions : The above results suggest that oriental medicine public-health program can be used as effective method for frozen shoulder's treatment and care.

• Journal of Haehwa Medicine
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• v.21 no.1
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• pp.135-141
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• 2012

Objectives : This study was conducted to understand 4 groups in tentatively named "muscle coordinative manipulation" by Korean medicine. Methods : We researched some articles on meridian-muscle theory and muscle's action that are classified into 4 groups in muscle coordinative manipulation. Results : The outcome of examining the hypothesis is as follows: 1. The 1st hypothesis : 'Elevated shoulder' group mainly consists of muscles that are involved with shoulder elevation, abduction and external rotation. 'Lowered shoulder' group is mainly composed of muscles that acts of shoulder depression, adduction and internal rotation. 'Elevated pelvis' & 'Lowered pelvis' groups didn't show significant features by the movement of the hips. 2. The 2nd hypothesis : Most of muscles in 'elevated & lowered shoulder' groups are classified into 'hand taiyang' meridian-muscle. Most of muscles in 'elevated pelvis' group are included in 'foot jueyin' meridian-muscle. Most of muscles in 'lowered pelvis' group are classified into 'foot taiyang & foot yangming' meridian-muscle. Conclusions : There is no significant classification in muscles that comprise 4 groups in muscle coordinative manipulation when it comes to meridian-muscle theory and muscle function. More studies on chain reaction of muscle and subsequent analysis in Korean medicine are needed.

• Journal of the Ergonomics Society of Korea
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• v.15 no.2
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• pp.15-24
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• 1996

To generate workspace analytically using the robot kinematics, data on range of human joints motion, especially range of two degrees of freedom motion, are needed. However, these data have not been investigated up to now. Therefore, in this research, we are to investigate an interaction effect of motions with two degrees of freedom occurred simultaneously at the shoulder, virtual hip(L5/S1) and hip joints, respectively, for 47 young male students. When motion with two degrees of freedom occurred at a joint such as shoulder, virtual hip and hip joints, it was found from the results of ANOVA that the action of a degree of freedom motion may either decrease or increase the effective functioning of the other degree of freedom motion. In other words, the shoulder flexion was decreased as the shoulder was adducted or abducted to $60^{\circ}C$TEX>or abducted from $60^{\circ}C$TEX>to maximum degree of abduction, while the shoulder flexion increased as the joint was abducted from $60^{\circ}C$TEX> to $60^{\circ}C$TEX> The flexion was decreased as the virtual hip was bent laterally at the virtual hip joint, and also did as the hip was adducted or abducted from the neutral position. It is expected that workspace can be generated more precisely based the data on the range of two degrees of joint motion measured in this study.

• Clinics in Shoulder and Elbow
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• v.3 no.1
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• pp.26-32
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• 2000

Purpose : The aim of this study is the assessment of the clinical outcomes after percutanous pinning of unstable two-parts fracture of surgical neck in humerus. Materials and Methods: This study was based on thirteen cases of non-comminuted unstable surgical neck fracture of humerus among 19 cases, which followed-up more than one year. Follow-up averaged 29 months. We treated with percutaneous pinning techniques and assessed clinical outcomes. Functional evaluation was performed using the standard method of research committee of American Shoulder and Elbow Surgeons(ASES). Results: Last follow-up ROM of shoulder joint were 142 degrees of forward elevation, 57 degrees of external rotation, 72 degrees of external rotation in 90 degrees abduction, and T8 of internal rotation. Pain scale was l(range : 0∼3). ASES scores was 86.2(range : 63.3~98.3). Patient satisfaction based on ASES were excellent in 6 cases, good in 5 cases, fair in 1 case, poor in 1 case. A case of fair result was caused by limitation of motion in shoulder joint and poor case was paraplegia patient after traffic accident. Conclusion : Percutaneous pinning is recommended for non-comminuted unstable fracture of surgical neck in humerus.

• PNF and Movement
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• v.22 no.1
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• pp.151-158
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• 2024

Purpose: The present study investigated how variations in diagonal exercises affect shoulder muscle activity, examining changes in neuromuscular activation during scapular and shoulder diagonal patterns of exercises. Furthermore, we explored whether the exercise phase affects muscle activation. Methods: Sixteen asymptomatic male participants were recruited. Four diagonal pattern exercises (scapular anterior elevation, posterior elevation, flexion-adduction-external rotation, flexion, abduction-external rotation), and two exercise phases (concentric and eccentric) were administered. Surface electromyography data were collected. Results: Upper trapezius activity was significantly higher during the concentric phase of scapular posterior elevation exercises compared with the others (p<0.05). The serratus anterior, anterior deltoid, and infraspinatus activities were significantly higher during shoulder diagonal pattern exercises compared with the scapular diagonal pattern exercises (p<0.05). Except for the lower trapezius, muscular activities during the concentric phase were significantly greater compared with the eccentric phase (p<0.05). Conclusion: The current study suggests that the diagonal pattern of exercise may contribute to selective strengthening of the shoulder complex muscles and that the form of exercise should be tailored to the subject. It also suggests that diagonal exercises with concentric contractions tend to be more beneficial than eccentric contractions for overall muscle recruitment, but the effects vary for specific diagonal patterns.

• Physical Therapy Korea
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• v.8 no.1
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• pp.35-50
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• 2001

The purposes of this study were to investigate the therapeutic effects of an early exercise program after mastectomy and to provide the early exercise program protocol for patients who had undergone mastectomy. The subjects were seventy women who were diagnosed with breast cancer. They were randomly as signed either to a experimental group (n=35) that received early postoperative exercise program or to a control group (n=35) that received only education by nurses. Data were obtained for each patient from goniometric measurements of shoulder flexion, abduction, external rotation, 10 elements of functional performance, and subjective pain evaluation using visual analogue scale (VAS). All variables were measured preoperatively, three days postoperatively, and one month postoperatively. Data were compared by groups using independent t-test and Mann-Whitney U test for parametric or non-parametric data, respectively. There were no significant differences between the groups for all variables preoperatively and at three days postoperatively. But there were significant differences at one month postoperatively. The experimental group showed a statistically significant increases in shoulder flexion, abduction, and external rotation and in the pain VAS at one month postoperatively (p<.05). Also, at one month postoperatively, the experimental group had less difficulty with three elements of functional performance-doing up a 'back' zippered article of clothing, reaching the ipsilateral scapula, and contralateral scapula with the fingers on the operated side-than the control group (p<.05). The results of this study suggest that, after mastectomy, the early exercise program conducted by a well-trained physical therapist can make a significant contribution to the return of more normal shoulder function and activities of daily living and to an increased quality of life.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.174-174
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• 2009

The acromioclavicular-hook-plate is one of the surgical treatments for distal clavicle fracture and traumatic acromioclavicular (AC) joint dislocation. Although this procedure can obtain rigid and accurate anatomical reduction of the AC joint, secondary widening of the hook-hole in the acromion is often seen during postoperative follow-up. This complication is owing to the high-degree of mobility of the AC joint. Therefore, it is important to evaluate the effect on these complications due to the position of the hook-hole. The purpose of the present study is to investigate three-dimensionally the effect due to the position of the hook-hole during arm abduction motion. We studied in vivo and three-dimensional kinematics of the normal shoulder joint with use of a markerless bone-registration technique. Magnetic resonance images of 14 shoulders of 7 healthy volunteers were acquired in 7 positions between $0^{\circ}$ and $180^{\circ}$ of abduction. We created three-dimensional computer models of the bones and the acromioclavicular-hook-plate. Based on the three-dimensional kinematics data, we simulated the widening of the hook-hole each different positioning of the hook-hole. The widths of the hook-holes almost linearly increased. And these widths significantly increased, when we put the hook-hole on the acromion from AC joint to 20 mm and 25 mm posterior position.