• Clinics in Shoulder and Elbow
• /
• 제9권2호
• /
• pp.202-206
• /
• 2006

Synovial chondromatosis is an uncommon condition and involvement of the glenohumeral joint is rare comparing its involvement of knee and hip. We report a case of synovial chondromatosis with its radiography, MRI and microscopic findings and treatment by arthroscopic synovectomy & loose body removal which have been developed in right shoulder of a 46 year-old-female and presented as impingement syndrome.

• The Journal of Korean Physical Therapy
• /
• 제28권2호
• /
• pp.88-94
• /
• 2016

Purpose: The purpose of this study was to compare therapeutic climbing exercise and general isometric exercise in patients with shoulder impingement syndrome. Methods: Among 20 adults, study subjects were arbitrarily classified into an experimental group of 10 and a control group of 10. The control group performed general isometric exercise (ISE) and the experimental group performed therapeutic climbing exercise (TC) (3 sets, 3 times per week for 8 weeks). To evaluate the effects of exercise, subjects were evaluated using a Disabilities of the arm, shoulder and hand score (DASH), a goniometer for range of motion, and shoulder activity measured serratus anterior, upper trapezius, and lower trapezius. Independent and paired t-test were used for comparison of the effect between groups. Results: DASH scores showed a significant decrease in both groups after 8 weeks of treatment (p<0.001) and significant difference was observed between the TC groups (p<0.01). Flexion and abduction were significantly increased after 8 weeks of treatment in the ISE group (p<0.001) and flexion, abduction, external and internal rotation were significantly increased after 8 weeks of treatment in the TC group (p<0.001). Serratus anterior and lower trapezius activity were significantly increased after 8 weeks of treatment (p<0.001) and upper trapezius activity was not significantly increased after 8 weeks of treatment in the ISE group (p>0.05). Serratus anterior, lower trapezius, and upper trapezius activity were significantly increased after 8 weeks of treatment in the TC group (p<0.001). Conclusion: Scapular stabilizing exercise using a therapeutic climbing exercise increases range of motion and decreases DASH, and increases activity of shoulder muscles in patients with impingement syndrome.

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

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2005년도 제13차 춘계학술대회
• /
• pp.47-47
• /
• 2005

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2007년도 제5차 연수강좌
• /
• pp.153-161
• /
• 2007

견관절의 ABER position에서 posterosuperior rotator cuff 가 posterior glenoid에 contact 하여 internal impingement가 일어나는 현상은 운동선수가 아닌 일반인에게도 발생하는 physiologic phenomenon이며 과도한 반복 동작으로 인하여 증상이 발현한다. Internal impingement는 증상이 모호할 뿐만 아니라 견관절 내 여러 병소가 함께 존재하기 때문에 각각의 pathology에 대한 자세하고 정확한 evaluation이 필수적이다. 아직 controversy가 있지만 internal impingement의 pathologic factors로서는 anterior capsular laxity (true anterior laxity), posteroinferior capsular tightness (pseudo anterior laxity)와 이로 인한 glenohumeral internal rotation deficit (GIRD), 그리고 SICK scapula syndrome (scapular dyskinesis) 등으로 요약할 수 있다. 진단은 주로 병력 청취와 신체 검사로 내려지며 ultrasonogram, MRA등으로 확진한다. Sleeper stretching exercise 등과 같은 보존적 치료에 반응이 좋지만 6개월간의 재활 치료에도 호전이 없다면 증상과 직접 관련된 주 병소(appropriate pathology)를 찾아 이에 대한 적절한 수술이 이루어져야 한다.

• Clinics in Shoulder and Elbow
• /
• 제2권2호
• /
• pp.93-98
• /
• 1999

Purpose: The purpose of this study was to analyze the prognostic factors for arthroscopic subacromial decompres­sion and rotator cuff debridement in impingement syndrome. Materials and Methods : Arthroscopic subacromial decompression with or without rotator cuff debridement was performed in 46 cases of 44 consecutive patients with either stage n or stage ill impingement syndrome. The patients were classified by Neer's stage and size of tear according to the criteria of Cofield. The results were assessed with UCLA rating scale. We used repeated measures ANOVA and Chi-square test to assess correlation between the results and six variables including stage, rotator cuff tear size, age at the operation, duration of symptom, throwing sports activity, and trauma history. The follow-up period averaged 53 months(range, 27 to 92 months). Results: Lower stage by Neer's stage was correlated with higher postoperative scores and with significant difference between preoperative and postoperative scores of UCLA rating scale. However, other factors did not show significant influence upon the results. The patients with complete rotator cuff who showed satisfactory results after procedures were older and had shorter symptom duration, small cuff size. Conclusions : In patients with impingement syndrome treated by arthroscopic debridement and subacromial decompression, superior results were obtained when belonged to a lower Neer stage and when the rotator cuff was only partially tom. In cases with complete rotator cuff tear, higher success rates were obtained with smaller tear sizes. Age at operation, duration of symptoms, throwing athlete, traumatic tear did not affect the results.

• Journal of Acupuncture Research
• /
• 제38권3호
• /
• pp.175-182
• /
• 2021

To evaluate the effectiveness of acupuncture treatment for shoulder impingement syndrome (SIS) a literature review was conducted of randomized controlled trials (RCTs) where acupuncture was used as an intervention for patients diagnosed with SIS. Relevant clinical studies (N = 181) were retrieved from several databases based on the inclusion/exclusion criteria, and the interventions and results were analyzed. Six RCTs were selected to review based on the inclusion and exclusion criteria. In all 6 studies, the acupuncture treatment group showed significant positive changes in indicators evaluating pain, disability, and quality of life. A significant decrease in the evaluation indicators (Shoulder Pain and Disability Index, numeric rating scale, Visual Analogue Scale, Constant Murley Shoulder Assessment Score, patient's global assessment, and doctor's global assessment) and a significant increase in the questionnaire scores (UCLA, AL-score, EuroQol 5 Dimension Self-Report Questionnaire, and disabilities of the arm, shoulder, and hand) were observed. In addition, 1 study showed similar improvements in pain and quality of life measures in the acupuncture group and corticosteroid injection group. No major side effects were reported. Acupuncture may be an effective and safe treatment for SIS however, further RCTs are required.

• Journal of Acupuncture Research
• /
• 제39권3호
• /
• pp.213-221
• /
• 2022

Background: This study investigated the clinical effectiveness of Korean medicine (KM) treatment for shoulder impingement syndrome (SIS). Methods: There were 61 patients who were diagnosed with SIS in the Jaseng hospital network of KM (7 hospitals located in Korea: Gangnam, Daejeon, Bucheon, Haeundae, Bundang, Ulsan, and Gwangju) between January 1^st, 2015 and December 31^st, 2020 who were retrospectively reviewed. The patients were grouped according to complications, intake of analgesics, duration of illness preadmission, and treatment. Treatments consisted of herbal medicine, acupuncture, cupping, Chuna, pharmacopuncture, bee venom pharmacopuncture, medicinal steaming, Daoyin exercises, and physical therapy. By comparing the Numeric Rating Scale (NRS), Shoulder Pain and Disability Index, and European Quality of Life 5-Dimensions questionnaire scores, the effectiveness of integrated KM treatment was evaluated. Results: There were 14 males and 47 females. For inpatients diagnosed with SIS, the mean NRS score decreased from 5.78 ± 1.33 to 3.40 ± 1.43 (p < 0.001). The mean Shoulder Pain and Disability Index score decreased from 53.87 ± 14.76 to 38.56 ± 18.87 (p < 0.001), and the mean European Quality of Life 5-Dimensions questionnaire increased from 0.67 ± 0.13 to 0.76 ± 0.09 (p < 0.001) after KM treatment. Medicinal steaming (0.398; p < 0.001), acupuncture (0.290), cupping (0.288), bee venom pharmacopuncture (0.282), and Daoyin exercises (0.262; p < 0.05) had a positive correlation with improved changes in the NRS score. Conclusion: Conclusion: Treatment with integrated KM treatment improved the pain, range of motion, shoulder function, and quality of life of patients with SIS.

• 대한약침학회지
• /
• 제24권4호
• /
• pp.206-212
• /
• 2021

The aim of this study was to report on the improvement of shoulder pain resulting from disorders of the rotator cuff such as impingement syndrome and adhesive capsulitis, by manual acupuncture (MA) and pharmacopuncture (PA) following origin/insertion technique (OIT) of applied kinesiology (AK). Two patients were treated with MA and PA after OIT on shoulder muscles. The Numerical Rating Scale and the assessment of the Japanese Orthopedic Association scores were used to assess the pain, and ultrasound images were taken to compare treatment outcome. This study showed that MA and PA following OIT may be an effective treatment for impingement syndrome and adhesive capsulitis.

• Clinics in Shoulder and Elbow
• /
• 제13권1호
• /
• pp.53-57
• /
• 2010

목적: 1, 2단계 충돌 증후군과 회전근 개 파열이 있는 환자 사이의 근력 결핍 차이를 비교하였다. 대상 및 방법: 43명의 1, 2단계 충돌 증후군 환자 군 (1군)과 21명의 회전근 개 파열 환자 군 (2군)을 대상으로 하였다. 외회전, 내회전, 외전과 내전의 근력을 $60^{\circ}/sec$ 등속성 검사로 평가했다. 몸무게로 보정한 양측의 최대 우력, 총 일의 양, 평균 근력과 동측의 주동근과 길항근의 비율을 측정하였다. 결과: 양 군에서 몸무게로 보정한 최대 우력의 결핍은 외전에서 각각 $28.48{\pm}23.76%$ (1군), $29.12{\pm}32.81%$ (2군) (p=0.929), 내전에서 $7.20{\pm}13.98%$, $18.94{\pm}19.52%$ (p=0.021), 외회전에서 $16.88{\pm}13.76%$, $25.80{\pm}24.07%$ (p=0.221), 내회전에서 $14.15{\pm}25.67%$, $29.02{\pm}35.06%$ (p=0.059)로 측정되었다. 평균 근력과 총 일의 양에서 2군은 1군과 비교하여 내전력과 내회전력의 결핍이 유의하게 증가되었다. 결론: 2군에서 1군보다 더 큰 근력 결핍을 보였다. 1, 2단계 충돌 증후군 에서 3단계로 진행 시내회전과 내전 근력 결핍 변화가 더 크게 나타날 가능성이 있다.