• Clinics in Shoulder and Elbow
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• v.21 no.1
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• pp.15-21
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• 2018

Background: This study was undertaken to compare the outcome of supervised and home exercises with respect to range of motion (ROM), pain, and Single Assessment Numeric Evaluation (SANE). We further correlated the ROM recovery and pain reduction as well. Methods: The study included 49 patients who underwent arthroscopic rotator cuff repair. Rehabilitation was initiated after 4 weeks of immobilization. A total of 29 patients performed supervised exercise 3 times a week. Standardized education and brochures for review were provided to the remaining 20 patients who insisted on home rehabilitation. Statistical analysis was performed for comparing pain Numerical Rating Scale (NRS), SANE, and ROM. In addition, we also evaluated the correlation between pain and ROM. Results: Comparison of the two groups revealed no significant differences in forward flexion, internal rotation, abduction, and pain NRS. However, SANE at the 9th week (63.8 vs. 55.0, p=0.038) and improvement of external rotation from the 5th to the 9th week (17.6 vs. 9.3, p=0.018) were significantly higher in the supervised exercise group as compared to the home exercise group. Correlation of pain NRS with forward flexion, external rotation, internal rotation and abduction were statistically not significant (correlation coefficient=0.032 [p=0.828], -0.255 [p=0.077], 0.068 [p=0.642], and -0.188 [p=0.196], respectively). Conclusions: The supervised rehabilitation after arthroscopic rotator cuff repair showed better improvement in external rotation and higher SANE score after 4 weeks of rehabilitation exercise. However, no statistically significant correlation was observed between the recovery of ROM and short-term pain relief.

• The Journal of Korean Physical Therapy
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• v.17 no.4
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• pp.477-484
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• 2005

Purpose: The purpose of this study was to evaluate effect of Thera-Band stretching exercise on flexibility of shoulder joint. Methods: The research deign was a experimental pre-post control group design. Sixteen subject were randomly divided into two groups; experimental group(n=8) and control group(n=8). Experimental group performed Thera-Band PNF stretching for 4 weeks and control group was not performed. To compare with the effectiveness of Thera-Band PNF stretching between two groups, I measured flexibility of shoulder joint with an Apley scratch test. The data were analyzed by Independence T-test. Results: The experimental group was significantly increased the flexibility at the right and left shoulder internal rotation. But the experimental group was not significantly increased the flexibility at the right and left shoulder external rotation. Conclusion: These result suggest that home-based exercise programs with Thera-Band can serve as a practical and effective means of flexibility gains in general people.

• Physical Therapy Korea
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• v.26 no.3
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• pp.11-22
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• 2019

Background: Sling exercises are frequently used for the rehabilitation process of patients with shoulder joint injuries, but research on the significant frequency intensity and appropriate treatment duration for sling exercises with local vibration stimulation is lacking. Objects: The aim of this study was to investigate the effects of sling exercise with vibration on shoulder range of motion (ROM), muscle strength, pain, and dysfunction in patients with a medical diagnosis of shoulder joint injury. Methods: Twenty-two patients were randomly assigned to the experiment and control groups. Six sling exercises with and without 50 Hz vibrations were applied in the experiment and control groups, respectively. Each exercise consisted of 3 sets of 5 repetitions performed for 6 weeks. The assessment tools used included shoulder joint range of motion, muscle strength, pain level, and shoulder pain and disability index for functional disability. We conducted re-evaluations before and 3 and 6 weeks after intervention. The changes in the measurement variables were analyzed and compared between the two groups. Results: The ROM of the external rotation of the shoulder joint had a significant interaction between the group and the measurement point (F=3.652, p<.05). In both groups, we found a significant increase in external rotation angle between the measurement points (p<.05). The flexor strength of the shoulder joint significant interaction between the group and the measurement point (F=4.247, p<.05). Both the experiment (p<.01) and control groups (p<.05) showed a significant increase in shoulder flexor strength at the measurement points. After 6 weeks of the interventions, both the groups showed significantly improved VAS (p<.01), SPADI (p<.01), and orthopedic tests (p<.01). However, there was no significant difference between the group and the measurement point in terms of the clinical outcomes observed. Conclusion: The sling exercise with local vibration of 50 Hz affected the external rotation of the shoulder range of motion and improved shoulder flexor strength in the patients with shoulder injuries. Therefore, we propose the use of the sling exercise intervention with vibration in the exercise rehabilitation of patients with shoulder joint injuries.

• Physical Therapy Korea
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• v.7 no.2
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• pp.88-95
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• 2000

Thirty normal adults were tested to measure the electrical activity of the anterior (AD), middle (MD), and posterior portion (PD) of the deltoid muscle and sternal portion of the pectoralis major muscle (PM) during the performance of four upper extremity PNF diagonal patterns with elbow flexion angle in $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$. The PNF patterns in which these muscles function optimally have been theoretically advanced by Kabat and further described by Knott and Voss. They theorize that the MD should be most active with shoulder flexion, abduction, and external rotation (D2F); the PD with shoulder extension, abduction, and internal rotation (D1E); the AD with shoulder flexion, adduction, and external rotation (D1F); and the PM with shoulder extension, adduction and internal rotation (D2E). The patterns were performed through range of motion, with an isometric contraction performed in the shortened range. When the EMG activity of AD, MD, PD and PM in its optimal patterns was measured, it does not have significant difference among fixed elbow flexion angle $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$ (p>.05). In addition, suggestions were made for study of patients who exhibit imbalance of muscle strength and have muscle weakness.

• Korean Journal of Applied Biomechanics
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• v.19 no.3
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• pp.549-555
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• 2009

The purpose of this study was to quantify the isokinetic peak torque and range of motion at the shoulder in 8 national male volleyball players who played during the 2008 professional leagues. In this study the strength and range of motion data in the internal rotation(IR) and external rotation(ER) of shoulder joint were measured with isokinetic measurement system(Biodex Inc) and motion analysis system (Simi motion system Inc.) from 3 volleyball players with atrophy of the infrasupinatus and 5 volleyball players without atrophy of the infraspinatus. Peak torques were determined using isokinetic measurement on the shoulder joint rotator at the point of angular velocities of $60^{\circ}$/s. Significant difference was found in the peak torque, IR / ER ratio and the range of motion through assessment of the dominant shoulder between two groups. we recommended functional exercises that improve both external rotators strength and stretching exercise for internal rotation in the dominant side during the prevention programs in volleyball players.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.219-228
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• 2022

Purpose : The purpose of this study was to suggest a more effective method by comparing the effects of changes in pain intensity, muscle strength, and athletic performance after applying a 6-week eccentric training program (ET-MWM) or concentric training program (CT-MWM) with MWM for high school baseball players with shoulder internal impingement (SII). Methods : A total of 75 participants were randomly assigned to each group and divided into two groups, "ET-MWM group (n=35)" and "CT-MWM group (n=32)" according to the intervention method. Pain intensity, muscle strength (external rotation, internal rotation), and athletic performance were first measured before the intervention, and after the intervention 3 times a week for a total of 6 weeks, both groups were re-measured in the same way. Visual analog scale (VAS) was used for pain intensity, biodex dynamometer for muscle strength (60 °/sec.), and Kerlan-Jobe orthopedic clinic shoulder & elbow score (K-KJOC) for athletic performance. Results : As a result of analyzing the homogeneity of the pre-intervention characteristics and initial measurement variables of the study subjects, there was no significant difference between the two groups in all variable values. Pain intensity (VAS) was significantly reduced in the ET-MWM group than in the CT-MWM group (p<.05). In addition, the maximum muscle strength of external rotation & internal rotation of the shoulder (60 °/sec.) and athletic performance (K-KJOC) were significantly increased in the ET-MWM group than in the CT-MWM group (p<.05). Conclusion : Compared with the CT-MWM training program, the ET-MWM training program reduced shoulder joint pain and further increased the muscle strength required for throwing motion in high school baseball players. As the result showed better athletic performance improvement, the ET-MWM training program can be clinically recommended as a more effective intervention.

• The Korean Journal of Pain
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• v.35 no.2
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• pp.152-159
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• 2022

Background: Subjects with frozen shoulder (FS) might not be comfortable with vigorous physical therapy. Clinical trials assessing the effect of graded motor imagery (GMI) in FS are lacking. The aim of this study was to determine the effect of GMI as an adjunct to conventional physiotherapy in individuals with painful FS. Methods: Twenty subjects aged 40-65 years having stage I and II of FS were randomly divided into two study groups. The conventional physiotherapy group (n = 10) received electrotherapy and exercises while the GMI group (n = 10) received GMI along with the conventional physiotherapy thrice a week for 3 weeks. Pre- (Session 1) and post- (Session 9) intervention analysis for flexion, abduction, and external rotation range of motion (ROM) using a universal goniometer, fear of movement using the fear avoidance belief questionnaire (FABQ), pain with the visual analogue scale, and functional disability using the shoulder pain and disability index (SPADI) was done by a blinded assessor. Results: Statistically significant difference was seen within both the groups for all the outcomes. In terms of increasing abduction ROM as well as reducing fear of movement, pain, and functional disability, the GMI group was significantly better than control group. However, both groups were equally effective for improving flexion and external rotation ROM. Conclusions: Addition of GMI to the conventional physiotherapy proved to be superior to conventional physiotherapy alone in terms of reducing pain, kinesiophobia, and improving shoulder function for stage I and II of FS.

• 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.

• Journal of The Korean Society of Integrative Medicine
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• v.1 no.1
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• pp.97-107
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• 2013

Purpose : The purpose of this study was conducted to patients undergoing shoulder surgery rotator cuff tear group physical therapy to improve the patient's level of depression and any impact on the shoulder's ability to heal should learn. Method : This research participated in 20 patients four weeks from June 11, 2012 June 8 il experiment was carried out. Experimental group conducted physical therapy(n=10) and control group(n=10) was not conducted Results : A comparative analysis of experimental group and the control group in the levels of depression (BDI) was not significantly different. A comparative analysis of experimental group and the control group in the VAS was not significantly different. ROM(flexion, extension, abduction, and internal rotation) was significantly increased in the experimental group, whereas external rotation significantly did not increased. Conclusion : ROM of external rotation between the experimental and control groups, except for the change showed a statistically significant, the above findings, the level of pain and depression, there were no statistically significant differences.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.2
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• pp.37-42
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• 2018

Background: The Purpose of this study was to evaluate the value of Spencer technique on the range of motion (ROM), Pain, function in patients with shoulder adhesive capsulitis. Methods: subjects consisted of 30patients who were diagnosed shoulder adhesive capsulitis. All subjects are randomly assigned to 2groups: Spencer technique (ST) group (n=15), self assistive ROM exercise(S-A ROM E) group (n=15). The subjects performed an intervention program 30 minuets per day and was repeated 3 times a week for 4 weeks a total of 12 times. ROM of flexion, abduction, external rotation, internal rotation were measured using a goniometer. The visual analog scale (VAS), Shoulder pain and disability index (SPADI) were used to measure pain, functional ability. Results: In the intergroup comparisons after the intervention, ROM of flexion, abduction, internal rotation, VAS, SPADI were significantly different(p<.05). Spencer technique was more effective for improving ROM, pain, functional ability than self assistive ROM exercise. Conclusions: Our study suggest that considering Spencer technique for the patient with shoulder adhesive capsulitis. Further studies on Spencer technique are needed in the future.