• Clinics in Shoulder and Elbow
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• 제19권1호
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• pp.43-47
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• 2016

Many types of osteotomy have been proposed for the treatment of cubitus varus deformity of the elbow, and various methods for fixation of the osteotomy site have also been described. However, no method has been perfect. We treated two cases of cubitus varus elbow deformity with step-cut osteotomy using a new fixation method with two crossing screws and an anatomically designed locking plate. Active assisted elbow range of motion (ROM) exercise was permitted at postoperative 3 days, after removal of the drainage. Preoperative and postoperative humerus-elbow-wrist angles and ranges of motion of the two patients were compared. At 3 months followup, each patient had recovered the preoperative elbow ROM, and achieved the complete bony union of the osteotomy site and proper correction of the cubitus varus deformity. In addition, the appropriate remodeling of the lateral bony protrusion was observed. Therefore, we introduce a new fixation method for achievement of stable fixation allowing immediate postoperative elbow motion after corrective osteotomy for cubitus varus deformity in young adults.

• 대한한의학회지
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• 제40권3호
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• pp.177-187
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• 2019

Objectives: The aim of this study was to report the clinical improvement of a patient who underwent arthroscopic Bankart repair using a rehabilitation protocol involving Korean medicine. Methods: The patient was treated with acupuncture, cupping, Korean Medicine, Chuna therapy, and Doin exercise therapy during the admission period. To estimate the patient's status, we used the Numeric Rating Scale (NRS), Pain Disability Index (PDI), assessments of the range of motion (ROM) and Muscle Manual Test (MMT) for the shoulder joint. Results: After administering the abovementioned treatments, we found that the patient's NRS, PDI, and ROM and MMT for the shoulder joint were improved. Conclusions: The rehabilitation protocol involving Korean medicine can be applied to and produce good results for patients who undergo arthroscopic repair for Bankart lesions. The limitation of the study was that the number of cases we studied was insufficient to prove the effectiveness. Hence, further studies are needed for designing the rehabilitation protocol involving Korean medicine.

• Clinics in Shoulder and Elbow
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• 제10권2호
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• pp.183-189
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• 2007

서론: 상완골 두의 비 외상성 골괴사는 흔치 않은 질환으로 환자의 증상이 심하고 골두 함몰이 진행된 경우 인공관절 치환술의 적응증이 된다. 저자들은 상완골 두 비 외상성 골괴사 환자에 시행한 견관절 반 치환술의 단기 추시 임상결과를 보고하고자 한다. 재료 및 방법: 상완골 두의 비 외상성 골괴사 환자로 견관절 반 치환술을 시행 받았던 환자 중 12개월 이상 ($12{\sim}56$개월)추시 가능하였던 5명, 7견관절을 대상으로 수술 전, 후의 통증 변화, 견관절 운동범위 및 ASES 점수를 비교하였고, 술후 환자의 만족도를 조사하여 임상적 결과를 분석하였다. 결과: 골괴사의 유발원인으로는 알코올 4예, 스테로이드 투여에 의한 경우가 3예였다. 운동시 통증은 수술 전 평균 7.6점에서 수술 후 1.9점으로 감소되었고 관절운동 범위는 전방거상, 외전 및 외회전이 술 전 평균 각각 105.7도, 80.0도, 22.1도였고 술후 146.6도, 139.3도, 44.3도로 호전되었다. ASES 점수는 술 전 평균 39.0점이었고, 술후 평균 84.1점으로 호전되었다. 술후 환자의 만족도는 흡족 5예, 양호 2예이었다. 결론: 단기 추시 결과이지만 상완골 두 비 외상성 골괴사의 치료 방법으로 견관절 반 치환술은 통증의 감소와 견관절 운동범위를 개선시켜주고, 양호한 술 후 환자 만족도를 제공할 수 있는 수술 방법이라고 생각한다.

• 대한정형외과스포츠의학회지
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• 제4권1호
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• pp.36-42
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• 2005

목적: 야구 선수에서 발생한 견관절 내부 후방 충돌에 대해 관절경 소견 및 치료 결과를 알아보고자 하였다. 대상 및 방법: 내부 후방 충돌로 진단하였던 5예를 대상으로 평균 15개월 추시하였다. 전 예에서 후기 거상기에 견관절 후방에 동통을 호소하였고, 외전 $120^{\circ}$에서 과수평-외전을 추가한 재위 검사상 전 예에서 양성을 보였다. 관절경하에 파열된 후방 관절와 순이나 SLAP 병변은 봉합하였고 회전근 개는 변연 절제하였으며 전방 관절낭 인대는 3예에서 관절낭 중첩술, 2예에서 관절낭 열 수축술을 시행하였다. 결과는 동통, 운동 범위, 운동 복귀 수준 등을 조사하였다. 결과: 관절경 소견상 전 예에서 후상방 관절와 순의 fraying이 있었고 2예에서는 후상방 관절와 순의 flap 파열, 1예에서는 제2형 SLAP 병변이 동반되었다. 전 예에서 극상근 건에 fraying이 관찰되었고 1예에서는 부분 파열을 보였다. 또한 전 예에서 $90^{\circ}{\sim}120^{\circ}$ 외전 및 외회전 상태에서 관절와 순에 회전근 개가 충돌하는 현상을 관찰할 수 있었다. 결과는 투구 시 전 예에서 동통이나 불안감은 없었으며, 평균 활동력은 이환 전의 활동력에 비해 평균 88% ($80{\sim}100%$)로 회복되었다. 결론: 내부 후방 충돌의 확진은 관절경 검사를 통해 가능할 것으로 사료되었으며, 내부 충돌의 원인이 되는 전방 미세 불안정성과 후방 관절낭 구축에 대해 전방 관절낭 중첩술이나 수축술 및 후방 관절낭 신연 운동은 비교적 만족스러운 결과를 보였다.

• 한국전문물리치료학회지
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• 제27권1호
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• pp.1-10
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• 2020

Background: Thoracic spine self-mobilization exercise is commonly used to manage patients with neck pain. However, no previous studies have investigated the effects of thoracic spine self-mobilization exercise alone in patients with chronic neck pain. Objects: The purpose of this study was to investigate the effects of thoracic self-mobilization using a tool on cervical range of motion (ROM), disability level, upper body posture, pain and fear-avoidance beliefs questionnaire (FABQ) in patients with chronic neck pain. Methods: The subjects were 49 patients (21 males, 28 females) with chronic neck pain. The subjects were randomly divided into an experimental group (EG, n = 23) and control group (CG, n = 26). For the EG, thoracic self-mobilization was applied. We placed a tool (made with 2 tennis balls) under 3 different vertebral levels (T1-4, T5-8, T9-12) of the thoracic spine and the subjects performed crunches, which included thoracic flexion and extension in supine position. Five times × 3 sets for each levels, twice a week, for 4 weeks. Cervical pain, disability, upper body posture, FABQ results, and ROM were evaluated at baseline, after 4 weeks of intervention, and at 8 weeks of follow-up. Assessments included the quadruple visual analogue scale (QVAS); Northwick Park neck pain questionnaire (NPQ); craniovertebral angles (CVA), forward shoulder angle (FSA) and kyphosis angle (KA) measurements for upper body posture; FABQ and cervical ROM testing. Results: The EG showed a statistically significant improvement after intervention in the QVAS (-51.16%); NPQ (-53.46%); flexion (20.95%), extension (25.32%), left rotation (14.04%), and right rotation (25.32%) in the ROM of the cervical joint; KA (-7.14%); CVA (9.82%); and FSA (-4.12%). Conclusion: These results suggest that, for patients with chronic neck pain, thoracic self-mobilization exercise using a tool (tennis balls) is effective to improve neck pain, disability level, the ROM, and upper body posture.

• Clinics in Shoulder and Elbow
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• 제1권2호
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• pp.198-204
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• 1998

Unstable fractures of the proximal humerus continue to be difficult problems for orthopaedic surgeons. The optimum treatment of these fractures has remained a matter of controversy. We analyzed the clinical results of open reduction and plate fixation underwent for patients of unstable fractures of proximal humerus after minimum 12 months follow up. The purpose of this study is to evaluate the efficacy of open reduction and rigid plate fixation. Twenty-two patients were managed with open reduction and plate fixation. Mean follow up duration was 20.6 months(range, 12 to 28 mon.). Because the age of patient as a maker of degree of osteoporosis was considered the key factor in the success of anatomic reconstruction, we divided into two groups according to age. Group A was comprised of 12 cases with younger than 50 yrs of age. Ten cases of older than 50 yrs of age were Group B. According to Neer's classification, five cases(22%) were two part fracture, 12 cases(64%) were three part fracture, and three cases(14%) were four part fracture. We used the Neer rating system for evaluating the results. In Group A, overall scores were 79.1. In Group B, overall scores were 76.8. Overall scores in two part fracture were 85, overall scores in three part fracture 78.4 and overall scores in three part fracture 68.3. We achieved excellent or good results in nine cases(75%) of Group A and seven cases(70%) of Group B. Also, we obtained excellent or good results in all cases of two part fracture, ten cases(71%) of three fracture and one case(33%) of four part fracture. The complications were three metal loosening, one avascular necrosis of humeral head, one severe stiff shoulder, one superficial wound infection and one ectopic ossification. The results were excellent or good in 16 cases(73%) out of 22 cases. In conclusion, rigid fixation and supervised early exercise would be a good option for unstable fracture of the proximal humerus.

• The Journal of Korean Physical Therapy
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• 제21권4호
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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.

• Journal of Acupuncture Research
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• 제23권5호
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• pp.219-228
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• 2006

Objectives : To observe the effect of acupuncture treatment on Digital Infrared Thermographic Imaging(DITI) in frozen shoulder patients. Methods : 17 voluntary patients received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The patients were instructed to practice self exercise during their daily lives. Evaluations were made before treatment, after 1 week of treatment, after 2 weeks, 3 weeks and after 4 weeks of treatment. Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), Range of Motion(ROM) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). DITI was measured before treatment and after 4weeks of treatment. The obtained data was analyzed. Results : CSA, SPADI, VAS, adduction and extension showed significant(p<0.05) improvement. Abduction and flexion both improved after 4 weeks of treatment, but the improvement was statistically insignificant(p>0.05). DITI showed improvement but the improvement was insignificant(p>0.05). Conclusion : 4 weeks of acupuncture treatment significantly improved CSA, SPADI, VAS, adduction and extension in frozen shoulder patients(p<0.05). The improvement of abduction and flexion after 4 weeks of acupuncture treatment was insignificant(p>0.05). DITI results improved after 4 weeks of acupuncture treatment. But the change of thermal difference was insignificant(p>0.05).

• 한국의류산업학회지
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• 제18권3호
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• pp.338-350
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• 2016

The purpose of this study is to analyze joint angle for a range of swing motion derived through 3D motion analysis in order to design the ergonomic golf wear, use it for evaluation method of apparel fit to improve exercise functionality and provide the basic materials necessary for designing clothes. In order to do this, the subjects for this study were 3 men of age 20s. The data for a range of motion of golf swing were collected by using equipment for 3D motion analysis and then were used for analysis of joint angles and evaluation method of apparel fit. Range of motion was derived through 3D motion analysis of golf swing motion and joint angles for items of joint motion item and of X, Y, and Z-axis were calculated, respectively. In order to set the evaluation questions for evaluation of apparel fit, to find a range of motion at the maximal value and the minimal value of swing motion. As a result, during the swinging motion, neck extension, right shoulder extension, right/left elbow extension, right/left elbow supination did not appear. Items of joint motion showing the maximum at range of each swing motion were applied into 55 questions and consisted. The results of this study were meaningful as a basic study to apply 3D motion analysis to the fashion industry. It's expected to be used to design functional clothing.

• 근관절건강학회지
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• 제6권2호
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• pp.278-294
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• 1999

The PACE (People nth Arthritis Can Exercise) is an exercise program developed by the Arthritis Foundation to improve muscle strength and joint flexibility for patients with arthritis. The purpose of this study was to explore the effects of PACE program on self-efficacy, pain, and joint function in the Korean immigrant elderly. The PACE program was held twice a week for 6 weeks for Korean immigrant elderly who had osteoarthritis. Twenty four subjects completed the program, who were recruited in two places : 10 elderly in a senior residential apartment, and 14 elderly in a senior center supported by Congregated Meal Program for Korean Elderly. Self-efficacy(Sherer et al., 1982), pain severity(by using Visual Analogue Scale), and number of painful joints were measured before and after the PACE program. To examine the joint flexibility and strengthening, the followings were measured : the extent of the upward arm reach in both sides(flexibility of shoulder), the ability to touch fingertips of the both hands in back pat and rub(flexibility of arm), the degree of range of motion(ROM) of both ankles in their dorsiflexion(flexibility of ankle) and plantarflexion with standing with toe(strengthening of ankle), and the degree of knee extension. Wilcoxon signed rank test was used for data analysis and the significance of the differences in the variables was examined to compare the data obtained before and after the PACE program. After the PACE, followings were found : 1. Self-efficacy was significantly increased. 2. Pain severity and number of painful Joints was significantly decreased. 3. The flexibility of both shoulders and arms were significantly improved, but the flexibility of knee was not changed. 4. The flexibility and strengthening of both ankle was significantly improved. In conclusion, PACE was clearly proved to be an effective exercise program to promote self-efficacy, to reduce pain, and to enhance joint function in the elderly with osteoarthritis. It is suggested that the PACE program should be recommended as one of the useful and appropriate nursing interventions for elderly with osteoarthritis.