• Clinics in Shoulder and Elbow
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• 제3권2호
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• pp.79-86
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• 2000

Purpose: We analysed the clinical efficacy of inferior capsular shift operation in multidirectional instability of the shoulder joint in terms of functional aspects and patient's satisfaction Materials and Methods: From July, 1998 to March, 2000, we treated 23 cases of multidirectional instability of the shoulder joint with T-shaped inferior capsular shift and/or Bankart repair. All of them have complained of an experience about frank dislocations. Two of them has a voluntary component. We evaluated them according to complication, function, range of motion, stability and patient's satisfaction with an average follow-up of 15 months(the range of 9 to 27 months). Results: Eight cases were atraumatic multidirectional instability and coexisting Bankart lesion were present in 15. There was no redislocation, but one case of symptomatic subluxation, 3 cases of transient nerve palsy and 2 cases of feeling of laxity developed. Limitation of motion after surgery was an average of 3.4° in flexion, and 8.5° in external rotation. With Rowe scoring system, the clinical result was excellent or good in 22 cases and poor in one. According to American shoulder and elbow society, pain score improved to 1.4 from 6.1, and stability score also improved to 1.8 from 9.1. Conclusion: In multidirectional shoulder instability, one should pay attention to finding a coexisting Bankart lesion. In that case, adequate capsular volume reduction by using inferior capsular shift as well as repair of Bankart lesion is needed to get a good surgical outcome.

• Clinics in Shoulder and Elbow
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• 제2권1호
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• pp.53-59
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• 1999

Initial treatment of multidirectional instability of the shoulder would be a thorough rehabilitation program. If rehabilitation fails to resolve a patient's symptoms, the most commonly performed surgical procedure remains the inferior capsular shift. Eleven patients who had disabling multidirectional instability of the shoulder were managed with the inferior capsular shift. All of the procedure were performed by means of an anterior approach and a laterally based capsular shift. All of the patients were the contact athletes. The purpose of our study was to evaluate the efficacy of the inferior capsular shift procedure in the contact athletic patients, to review the loss of external rotation postoperatively and to discuss their return to sports. Mean follow up duration was 14.5 months(range, 12 to 24). Pain was relieved postoperatively in all cases and most patients could get stability except one case of recurrent subluxation. The average loss of external rotation and forward flexion after the operation were Y and 30 at last follow up. By the rating scale from American Shoulder and Elbow Society, overall scores improved from 49 points to 85 points. The results were excellent or good in 9 patients(82%) out of 11 patients. In reference to return to sports, 10 patients(91 %) of 11 patients returned to their sports with 7 patients (64%) returning at the same levels of competitiveness. The inferior capsular shift procedure was considered to be a recommendable method for the management of the multidirectional instability of the shoulder.

• 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.

• 한국전문물리치료학회지
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• 제7권2호
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• pp.66-75
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• 2000

A single subject experimental design (alternating treatment design) was used to compare the effects of Mulligan method and electrotherapy on the pain and limitation of range of motion in patients with frozen shoulder. In the Mulligan method sessions, the physiotherapist performed a posterior and caudal glide on the patient while the patient was performing shoulder flexion and abduction. In the electrotherapy sessions, the patient received ultrasound and interference current treatments. Mulligan method and electrotherapy were alternately performed on each patient. Pain was measured by visual analogue scale (VAS) and range of motion (ROM) was measured by modified finger ladder. The results showed that both Mulligan method and electrotherapy were effective in pain reduce and ROM increase, but Mulligan method was superior to electrotherapy in ROM increase while electrotherapy was superior to Mulligan method in pain reduce.

• 로봇학회논문지
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• 제14권4호
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• pp.318-325
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• 2019

NREX, an upper limb exoskeleton robot, was developed at the National Rehabilitation Center to assist in the upper limb movements of subjects with weak muscular strength and control ability of the upper limbs, such as those with hemiplegia. For the free movement of the shoulder of the existing NREX, three passive joints were added, which improved its wearability. For the flexion/extension movement and internal/external rotation movement of the shoulder of the robot, the ball lock pin is used to fix or rotate the passive joint. The force and torque between a human and a robot were measured and analyzed in a reaching movement for four targets using a six-axis force/torque sensor for 20 able-bodied subjects. The addition of two passive joints to allow the user to rotate the shoulder can confirm that the average force of the upper limb must be 31.6% less and the torque must be 48.9% less to perform the movement related to the axis of rotation.

• 생명과학회지
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• 제19권4호
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• pp.543-548
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• 2009

Treatment for breast cancer produces side effects that diminish functional capacity and quality of life (QOL) among survivors. Tai Chi is a moderate form of exercise that may improve functional capacity, physical activity and oxidative stress. The purpose of this study was to evaluate the effects of regular Tai Chi exercise on malondialdehyde (MDA), SOD and physical fitness (muscle strength, flexibility, flexion, extension, adduction, and abduction). Forty obese women were recruited from a public health center and divided into control (CON: n=20) and trained (EXP: n=20) groups. The Tai Chi exercise group participated in a 12-week (4 times/week) training program. Data were analyzed with T-test. MDA, SOD and physical fitness (muscle strength, flexibility, flexion, extension, adduction, and abduction) were evaluated before and after the Tai Chi program in both groups. There were significant improvements in shoulder flexibility, flexion, extension, abduction, and adduction. However, there was no improvement in muscle strength. There were also significant improvements in MDA and SOD. Based on these results, Tai Chi exercise has been shown to stimulate endogenous antioxidant enzymes and reduce oxidative damage markers. and also be effective in improving physical fitness and QOL. Further study is needed in this area.

• 대한간호학회지
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• 제36권2호
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• pp.403-414
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• 2006

Purpose: The purpose of this study was to investigate the effects of constraint-induced (CI) movement using self-efficacy on U/E function of chronic hemiplegic patients. CI movement discourages the use of the unaffected U/E, combined with intensive training of the affected U/E. Method: A non-equivalent pretest-posttest design was used. Study subjects were 40 hemiplegic patients conveniently selected from 2 different community health centers. The experimental subjects participated in the CI movement program for 6 hours daily over a period of two weeks. The exercises for affected U/E consisted of warming up, main exercise and ADL practice. To encourage the participants' behaviors self-efficacy enhancing strategies were used, which included performance accomplishment, vicarious experience, verbal persuasion and emotional arousal. Result: After 2 weeks of treatment, the grip power, pinch power, wrist flexion/extension, elbow flexion, and shoulder flexion/extension were significantly higher in the experimental subjects than in the control subjects. However, there was no significant difference in hand functions of the two groups. Conclusion: The above results show that the constraint-induced movement using self-efficacy could be an effective nursing intervention for improving U/E function of chronic hemiplegic patients. Long term studies are needed to determine the lasting effects of constraint-induced movement.

• Journal of Acupuncture Research
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• 제26권1호
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• pp.1-14
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• 2009

Objectives : The purpose of this research was to study the effect of Scolopendrid Pharmacopuncture on frozen shoulder patients. Methods : All of the 46 frozen shoulder patients who visited the department of Acupuncture & Moxibustion in Wonkwang Sanbon Medical Center from 1st March 2007 to 30th August 2008 had taken either the Scolopendrid Pharmacopuncture therapy or acupuncture therapy 10 times. There are 23 patients in each group. We evaluated the improvement of their shoulder pain and disability using the Visual Analog Scale(VAS), Shoulder Pain And Diability Index(SPADI), Range of Motion(ROM), and the Apley Scratch test at their first and last visit. Then we analyzed and compared the improvement shown by the two groups. Results : 1. Measures on all tests for the acupuncture group showed statistically significant improvement. 2. Measures on all tests for Scolopendrid Pharmacopuncture showed statistically significant improvement. 3. The Scolopendrid Pharmacopuncture group's VAS and ROM(external, internal rotation) showed statistically significant difference compared with those of the acupuncture group. SPADI, ROM(flexion, extension, abduction, adduction) and Apley scratch test had no statistically significant difference between the two groups. Conclusions : The above results show that Scolopendrid Pharmacopuncture therapy can be used as an effective treatment for reducing frozen shoulder pain.

• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.111-117
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• 2001

Introduction : The Functional muscle transfer is used to reconstruct the injuried muscle and paralysis of the shoulder. Especially transfer of the trapezius has been the treatment of choice but it has disadvantages of inadequate function and deformed contour, and instability of humeral head in case of acromion resection. We report an operation for shoulder reconstruction after wide resection of malignant fibrous histiocytoma, using rotational latissimus dorsi flap and review the operation method and clinical outcome. Materials and Methods : A patient, 53 year old, with malignant fibrous histiocytoma in the acromioclavicular joint area had been underwent wide excision, including the deltoid, clavicular head of pectoralis major, part of trapezius, lateral 1/3 of clavicle and acromion including scapular spine. The rotational latissimus dorsi flap with its neurovascular pedicle was dissected and then placed over the resected area and transfer of muscle attached at coracoid process was done to achieve stability of the humeral head. The range of motion of the shoulder and test of muscle power were evaluated for functional outcome. Total follow-up period is 2 years 11 months. Results : At last follow-up, the range of motion of the shoulder is abduction $90^{\circ}$, flexion $90^{\circ}$, internal rotation $40^{\circ}$, external rotation $50^{\circ}$ and the muscle power is 4 grade in all direction and then we obtained good functional results. There are no complications such as instability or subluxation of the humeral head and deformed contour and he is a disease-free survival state. Conclusions : The transfered latissimus dorsi flap provides adequate lever arm and stabilization and covering of the humeral head by sufficient muscle volume and width. This procedure can be useful not only for the paralysed deltoid reconstruction but also for use in reconstructive surgery after wide resection of the shoulder for malignant tumor.