• Clinics in Shoulder and Elbow
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• 제7권1호
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• pp.41-45
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• 2004

In adhesive capsulitis of the shoulder of no response to nonoperative treatment, an arthroscopic capsular release and manipulation improves range of motion and pain relief. We performed an arthroscopic examination in the stiff shoulder, of which she had no response to nonoperative treatment, after the conservative treatment of a clavicular shaft fracture by motorcycle-driver traffic accident. We found the intra-articular 'rotator interval bridging scar adhesion' between subscapularis tendon and antero-superior glenoid fossa under the rotator interval which was no adhesion and contracture itself. We performed the scar adhesion removal and synovectomy, maintaining the rotator interval. We recommended nonsteroidal anti-inflammatory drug for postoperative pain relief and continuous active and passive range of motion (ROM) exercise to gain motions. Preoperatively, active and passive range of motion were 70° for forward elevation, 60° for abduction and especially 0° for external rotation. After postoperative 2 months, active ROM were 150° for forward elevation, 130° for abduction and 80° for external rotation. After postoperative 6 months, passive and active ROM were full. UCLA score improved from preoperative 9 points to postoperative 29 points.

• 대한통합의학회지
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• 제12권1호
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• pp.139-150
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• 2024

Purpose : Scapular dyskinesis, it have been shown to be common in overhead athletes and has been associated with RC muscle strength. Posterior shoulder tightness (PST) has been suggested as an important factor causing scapular dyskinesis. Therefore, rehabilitation programs should focus on a posterior shoulder stretch combined with scapular stabilization exercise (PSSE) intervention. Determine the effects of posterior shoulder stretch combined with scapular stabilization exercise on the rotator cuff (RC) muscles strength, functional strength ratio (FSR), range of motion (ROM), and pain. Methods : 30 adolescent baseball players participated and subjects were allocated PSSE group (n=15) or the SSE group (n=15). Both group performed a 6-weeks intervention and measured of isokinetic peak torque/body weight (PT/BW) of concentric external rotator (CER), eccentric external rotator (EER), concentric internal rotator (CIR), eccentric internal rotator (EIR), FSR, ROM, and pain. Results : After 6 weeks PSSE, significant increase CER PT/BW (+6.02±4.76 %), EER PT/BW (+5.39±4.22 %), EER to CIR ratio (+.17±.16), and internal rotation ROM (+15.08±3.57 °). Whereas, significant decrease EIR to CER ratio (-.14±.18), external rotation ROM (-12.00±6.94 °), and GIRD (-17.41±2.84 °) compared with pre-intervention. No significant difference of isokinetic PT/BW of CIR and EER post-intervention. In the SSE group showed no significant difference all measurements for isokinetic PT/BW, FSR, and ROM post-intervention. The pain was significant improve both PSSE group (-3.25±1.60) and SSE group (-2.83±1.85) post-intervention. Conclusion : Both the PSSE and SSE interventions led to more pain relief. However, only the PSSE group showed ROM, CER, EER PT/BW, and FSR improvements. These results might suggest that the PSSE intervention is a more effective program for improving RC muscle strength and balance, in particular, concentric and eccentric ER muscle strength, FSR and can expect to prevent shoulder injuries in adolescent baseball players with scapular dyskinesis.

• Clinics in Shoulder and Elbow
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• 제17권2호
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• pp.57-63
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• 2014

Background: To compare the effect of different starting periods of rehabilitative exercise (early or delayed passive exercise) on the rate of retear and other clinical outcomes after the arthroscopic repair of the rotator cuff. Methods: In total, 103 patients who underwent arthroscopic repair of the rotator cuff were included in the study. Determined at 2 weeks post-operation, patients who were incapable of passive forward elevation greater than $90^{\circ}$ were allotted to the early exercise group (group I: 79 patients; 42 males, 37 females), whilst those capable were allotted to the delayed exercise group (group II: 24 patients; 14 males, 10 females). The group I started passive exercise, i.e. stretching, within 2 weeks of operation, whilst group II started within 6 weeks. The results were compared on average 15.8 months (11-49 months) post-operation using the passive range of motion, the Visual Analog Scale (VAS) pain score, and the University of California at Los Angeles (UCLA) and Constant scores. Stiffness was defined as passive forward elevation or external rotation of less than $30^{\circ}C$ compared to the contralateral side. Follow-up magnetic resonance imaging (MRI) was carried out on average 1 year post-operation and the rate of retear was compared with Sugaya's criteria. Results: There were no differences between the two groups in gender, age, smoking, presence of diabetes, arm dominance, period of tear unattended, pre-operative range of motion, shape and size of tear, degree of tendon retraction, and tendon quality. There were no significant differences in clinical outcomes. Whilst stiffness was more frequent in group II (p-value 0.03), retear was more frequent in group I (p-value 0.028) according to the MRI follow-up. Conclusions: During rehabilitation after the arthroscopic repair of the rotator cuff, the delay of passive exercise seems to decrease the rate of retear but increase the risk of stiffness.

• 여성건강간호학회지
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• 제13권1호
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• pp.43-50
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• 2007

Purpose: There is a need to apply the Tai Chi program to help early mastectomy patients improve their upper limb functions and for the emotional state as well. Method: Participants were recruited at breast cancer centers of two general hospitals from February 17 to April 25, 2005. Twenty-five subjects in the experimental group and 23 subjects in the control group participated for 12 weeks. The Tai chi program consisted of breast cancer self management education and a Tai Chi exercise program. Range of motion of the shoulder joint was determined by the Uni-level inclinometer, and functional assessment of the shoulder was evaluated with the tool. Data was analyzed by SPSS 11. Results: The experimental group had significantly increased shoulder range of motion, especially in external rotation, upper limb function and emotional state compared with the control group after program for 12 weeks. Conclusion: This program makes it possible to be independent and have a positive everyday life. In addition, it can help keep a healthy lifestyle in mastectomy women.

• PNF and Movement
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• 제18권1호
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• pp.107-116
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• 2020

Purpose: To investigate the effects of electromyography (EMG) biofeedback on the muscle activity of the trapezius, shoulder pain, function, and range of motion (ROM) in patients with subacromial impingement syndrome (SAIS). Methods: Sixteen patients (9 males and 7 females) with SAIS participated voluntarily. The main outcome measures were muscle activity of the trapezius, shoulder pain (VAS), ROM, and the shoulder pain and disability index (SPADI). Exercises with EMG biofeedback consisted of shoulder flexion in a standing position, shoulder external rotation in a side-lying position, and shoulder horizontal abduction in a prone position. Post measurements were taken immediately after EMG biofeedback training. Results: Middle and lower trapezius activity, as well as ROM, was significantly increased by exercise with EMG biofeedback (p<0.05). In addition, VAS and SPADI scores significantly decreased post-EMG biofeedback training (p<0.05). Conclusion: EMG biofeedback intervention is an effective exercise for SAIS patients to restore activity of the middle and lower trapezius and to improve pain, shoulder function, and ROM.

• The Journal of Korean Physical Therapy
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• 제22권5호
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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.

• 종양간호연구
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• 제2권1호
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• pp.17-26
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• 2002

Purpose: This study was conducted to evaluate the effects of aerobic dance on physical functionnings of women with mastectomy. The study was single group pre- & post-test time series design. The aerobic dance program was performed three times a week for eight weeks, 45${\sim}$60 minutes per session. Method: The research variables used in the study were the period(seconds) of exercise that was taken for target heart rate, activity systolic pressure, range of motion of shoulder joint in affected side, and flexibility for physical functionnings. The data were analyzed with repeated measure ANOVA and Bonferroni multiple comparisons. Results: Over the period of aerobic dance, the degree of all the research variables were changed significantly, and also differed significantly every 2 to 4 weeks. The period(seconds) of exercise that was taken for target heart rate (p <.000), systolic pressure in exercise(p =.019), range of motions of shoulder joint on the affected side(flexion, abduction, over-adduction, over-extension, external & internal rotation), and flexibility(sit & reach, back & reach) (p= .003; p=.001; p(.001; p<.001; p= .014; p<.001; p=.036; p<.001) were differed significantly respectively. Conclusion: The results suggest that the aerobic dance program for women with mastectomy can improve and recover cardiopulmonary endurance and ROM of shoulder joint and that the period of exercise had to be performed over six to eight weeks and three times a week at least.

• PNF and Movement
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• 제15권3호
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• pp.237-246
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• 2017

Purpose: The purpose of this study was to investigate the effects of forward-and-backward shift trunk exercise using a proprioceptive neuromuscular facilitation (PNF) diagonal pattern in a closed kinematic chain exercise on the upper limb function and activity of daily living (ADL) in a stroke patient. Methods: One subject participated in this study. The study used a reversal A-B-A' design, where A and A' were the baseline period (no intervention), and B was the intervention period. The intervention was a forward-and-backward trunk shift exercise, using a PNF diagonal pattern on both a stand-on-hand position and a quadruped position of closed kinematic chain exercises, for 20 min per day for 2 weeks. The range of motion (ROM) of the shoulder joint was measured and a Fugl-Meyer assessment of upper extremity (FMA-UE) and a functional independence measure (FIM) were performed to measure upper limb function and activity of daily living (ADL). Results: ROMs of shoulder joint (flexion, extension, abduction, and external rotation) increased in the intervention phase. The FMA-UE score increased (from 28 to 36) in the intervention phase. The FIM score increased (from 20 to 25) in the intervention phase. These increases were maintained after intervention (Baseline II). Conclusion: These results suggest that forward-and-backward shift trunk exercises using a PNF diagonal pattern in a closed kinematic chain exercise have a positive effect on stroke patients' upper limb function and ADL ability.

• 대한간호학회지
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• 제34권5호
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• pp.809-819
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• 2004

Purpose: The purpose of this study was to investigate the effect of a comprehensive rehabilitation program on physical function, immune response, fatigue and quality of life in mastectomy patients. Method: The subjects included fifty-five patients with breast cancer (27 in the control group and 28 in the experimental group). The subjects in the experimental group participated in a comprehensive rehabilitation program for10 weeks, which was composed of 1 session of education, 2 sessions of stress management, 2 sessions of exercise, and 1 session of peer support group activity per week. Result: The results revealed anincrease in shoulder extension, abduction, external rotation, and internal rotation of the affectedupper extremity, and in shoulder extension and abduction of the healthy upper extremity. Also an increase in quality of life and a decrease in fatigue were significantly higher in the experimental group than the control group. However, the results revealed that the natural killer cell ratio of the experimental group increased but there was no significant difference from that of the control group. Conclusion: The 10-week comprehensive rehabilitation program showed a large affirmative effect on physical function, fatigue and quality of life of breast cancer patients after a mastectomy.

• Clinics in Shoulder and Elbow
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• 제26권3호
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• pp.267-275
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• 2023

Background: Physical therapy (PT) plays an important role in the recovery of function following anatomic total shoulder arthroplasty (aTSA). While several PT protocols have been published for these patients, there is no standardized protocol for aTSA rehabilitation. This lack of standardization may lead to confusion between patients and physicians, possibly resulting in suboptimal outcomes. This study examines how PT protocols provided by academic orthopedic surgery programs vary regarding therapeutic goals and activities following aTSA. Methods: PT protocols for aTSA available online from the Accreditation Council for Graduate Medical Education accredited orthopedic surgery programs were included for review. Each protocol was analyzed to evaluate it for differences in recommendation of length of immobilization, range of motion (ROM) goals, start time for and progression of therapeutic exercises, and timing for return to functional activity. Results: Of 175 accredited programs, 25 (14.2%) had protocols publicly available, programs (92%) recommended sling immobilization outside of therapy for an average of 4.4±2.0 weeks. Most protocols gave recommendations on starting active forward flexion (24 protocols, range 1-7 weeks), external rotation (22 protocols, range 1-7 weeks), and internal rotation (18 protocols, range 4-7 weeks). Full passive ROM was recommended at 10.8±5.7 weeks, and active ROM was 13.3±3.9 weeks, on average. ROM goals were inconsistent among protocols, with significant variations in recommended ROM and resistance exercise start times. Only 13 protocols (52%) gave recommendations on resuming recreational activities (mean, 17.4±4.4 weeks). Conclusions: Publicly available PT protocols for aTSA rehabilitation are highly variable. Level of evidence: IV.