• Clinics in Shoulder and Elbow
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• 제20권4호
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• pp.217-221
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• 2017

Background: The purpose of this study was to evaluate the clinical and radiographic outcomes of internal fixation with locking T-plates for osteoporotic fractures of the proximal humerus in patients aged 65 years and older. Methods: From January 2007 through to December 2015, we recruited 47 patients aged 65 years and older with osteoporotic fractures of the proximal humerus. All fractures had been treated using open reduction and internal fixation with a locking T-plate. We classified the fractures in accordance to the Neer classification system; At the final follow-up, the indicators of clinical outcome-the range of motion of the shoulder (flexion, internal rotation, and external rotation) and the presence of postoperative complications-and the indicators of radiographic outcome-the time-to-union and the neck-shaft angle of the proximal humerus-were evaluated. The Paavolainen method was used to grade the level of radiological outcome in the patients. Results: The mean flexion was $155.0^{\circ}$ (range, $90^{\circ}-180^{\circ}$), the mean internal rotation was T8 (range, T6-L2), and the mean external rotation was $66.8^{\circ}$ (range, $30^{\circ}-80^{\circ}$). Postoperative complications, such as plate impingement, screw loosening, and varus malunion were observed in five patient. We found that all patients achieved bone union, and the mean time-to-union was 13.5 weeks of the treatment. The mean neck-shaft angle was $131.4^{\circ}$ at the 6-month follow-up. According to the Paavolainen method, "good" and "fair" radiographic results each accounted for 38 and 9 of the total patients, respectively. Conclusions: We concluded that locking T-plate fixation leads to satisfactory clinical and radiological outcomes in elderly patients with proximal humeral fractures by providing a larger surface area of contact with the fracture and a more rigid fixation.

• 대한통합의학회지
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• 제10권2호
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• pp.177-185
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• 2022

Purpose : The purpose of this study was to compare the effect of additional isometric contraction of trunk, shoulder, and hip muscles during abdominal crunch exercise on abdominal muscle thickness and to identify the most effective intervention for core muscle activation. Methods : This study was conducted on 22 healthy male adults. Subjects performed three types of crunch exercises (abdominal crunches accompanied by internal and external isometric rotation of the hip, horizontal shoulder adduction and abduction, and rotation of the trunk). The thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) were evaluated using ultrasonography. The collected data used one-way repeated ANOVA statistics. Wilcoxon signed-rank test of nonparametric statistics was used for post-test analysis. Results : The IO thickness was significantly lower than general abdominal crunch when shoulder adduction was added (p<.05). The crunch with shoulder abduction, hip external rotation, and ipsilateral trunk rotation was significantly higher than the abdominal crunch (p<.05). The EO thickness was significantly greater in the crunch with hip external rotation than in the abdominal crunch (p<.05). Conclusion : The level of contraction in abdominal muscles appears to vary when isometric contractions of the trunk, shoulder, and hip muscles are added to the abdominal crunch exercise. Therefore, the use of isometric contractions of other joints to selectively induce contraction of the abdominal muscles may be considered.

• 대한스포츠의학회지
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• 제36권4호
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• pp.173-179
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• 2018

A variety of theories have been reported as causes of shoulder pain in overhead throwing athletes. Recently, an explanation with microinstability of the shoulder and internal impingement has been proposed. The concept of the microinstability is that pathologic laxity of the anterior capsule caused by repeated abduction and external rotation of the shoulder leads to abnormal glenohumeral biomechanics and causes internal impingement of the shoulder. Based on the understanding of the pathology, it is recommended to identify the causes of shoulder pain in the overhead throwing athletes and perform appropriate rehabilitation or surgical treatment.

• 한국운동역학회지
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• 제20권2호
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• pp.197-204
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• 2010

Scapular position and motion are essential for normal upper limb mobility; Further, the posture of patients with thoracic kyphosis is related to shoulder girdle function and disorder. The purpose of this study was to examine the effects of thoracic posture on the shoulder range of motion and on three-dimensional scapular kinematics. Thirty healthy subjects performed right-arm abduction along the frontal plane while standing in both erect and in slouched trunk posture. The scapular position and rotation, and shoulder and thoracic angles were recorded using a motion analysis system. The scapular upward rotation and internal rotation were significantly altered according to postural tatiges; however, scapular tilt was not affected. Shoulder angle was significantly decreased in the slouched posture as c rpared to tatt in the erect posture. Thus, a slouched posture(thoracic kyphosis) significantly affects the shoulder range of motion and scapular kinematics during shoulder abduction in the frontal plane.

• Clinics in Shoulder and Elbow
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• 제26권1호
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• pp.3-9
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• 2023

Background: Modifications of the medialized design of Grammont-type reverse shoulder arthroplasty (RSA) using a bony increased offset (BIO-RSA) has shown better clinical results and fewer complications. The aim of this study is to compare the clinical results, complications, and radiological outcomes between patients undergoing standard RSA and BIO-RSA. Methods: A retrospective review was performed of 42 RSA procedures (22 standard RSA and 20 BIO-RSA). With a minimum of 1 year of follow-up, range of motion (ROM), Constant shoulder score (CSS), visual analog scale (VAS), and subjective shoulder score (SSS) were compared. Radiographs and computed tomography (CT) scan were examined for scapular notching, glenoid and humeral fixation, and graft healing. Results: At a mean follow-up of 27.6 months (range, 12-48 months), a significant difference was found for active-internal rotation (P=0.038) and for passive-external rotation (P=0.013), with better results in BIO-RSA. No other differences were found in ROM, CSS (P=0.884), VAS score, and SSS. Graft healing and viability were verified in all patients with CT scan (n=34). The notching rate was 28% in the standard RSA group and 33% in the BIO-RSA group, but the standard RSA had more severe notching (grade 2) than BIO-RSA (P=0.039). No other significative differences were found in glenoid and humeral fixation. Conclusions: Bone-graft lateralization is associated with better internal and external rotation and with less severe scapular notching compared to the standard RSA. Integration of the bone graft occurs effectively, with no relevant changes observed on radiographic evaluation. Level of evidence: III.

• 대한물리의학회지
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• 제6권4호
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• pp.397-406
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• 2011

Purpose : Recently ultrasound images has been used to measure the subacromial space with a linear measurement of the acromiohumeral distance. The purpose of this study was to comparison of distance of subacromial space using ultrasonographic measurement on arm positions of shoulder injured patients. Methods : The subjects were 30 shoulder injured patients (19 males and 11 females). Ultrasonography was performed to measure subacromial space during each shoulder resting position, $45^{\circ}$ abduction, internal rotation with $45^{\circ}$ abduction and external rotation with $45^{\circ}$ abduction. Results : Subacromial space was a significantly difference between injured arm and normal arm at shoulder resting position. At $45^{\circ}$ abduction, subacromial space was narrowing significantly between injured arm and normal arm. At external rotation with $45^{\circ}$ abduction, subacromial space were wider in normal arm than in injured arm but it was not significantly. Intra-observer reliability for ultrasonography measurement of subacromial distance was excellent (.96~.99). Conclusion : These results identified that positions of injured shoulder was related to subacromion space.

• The Journal of Korean Physical Therapy
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• 제17권4호
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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.

• 대한정형도수물리치료학회지
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• 제12권1호
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• pp.27-36
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• 2006

The purpose of this study was to compare the effects of Mulligan method and PNF method on the pain and limitation of range of motion in patients with frozen shoulder. The subjects of this study were 20 patients, 10(50%) males and 10(50%) females. They visited clinic for physical treatment within 6 months after onset of shoulder pain and limitation of range of motion with frozen shoulder. One group was applied with Mulligan method and other group was with PNF method. The patient were treated 5 times session weekly for 6 weeks from March 4th, 2002. And each treatment session was 15min. with physiotherapy. The pain was measured by visual analogue scale (V AS) and rage of motion (ROM) of flexion, abduction, external rotation, internal rotation were measured by goniometer. The data was analysed by paired T-test and independent T-test. The results of this study were summarized as follow : 1. The ROM of Mulligan method group increase in after treatment in comparison with ROM in before treatment, it is significant increase. Although the V AS of MMG decrease in before than after treatment, it is significant difference. 2. There is significant difference in before and after treatment of ROM of shoulder flexion, abduction, internal rotation, external rotation between PNF method group. The V AS of PMG is decreasing in before than after treatment, it is significant difference. 3. There is significant difference in before movement and after movement ROM of flexion, abduction, internal rotation, external rotation and VAS between Mulligan method session and PNF method session then the scale which measured by Mulligan method was more increased than that of PNF method. The results showed that both Mulligan method and PNF method were effective in pain reduce and ROM increase, but Mulligan method was superior to PNF method in ROM increase and pain reduce.

• 대한정형외과스포츠의학회지
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• 제12권1호
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• pp.29-36
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• 2013

목적: 고유 수용성 감각 기능은 견관절의 안정성에 중요한 역할을 하는 것으로 알려졌으나 회전근개 파열 환자에 대하여는 크게 알려진 바가 없다. 본 연구의 목적은 회전근개 파열 환자의 고유 수용성 감각 기능에 대하여 조사하고자 하였고 특히 파열크기, 견갑하근의 파열 유무 등에 따라 조사하고자 하였다. 대상 및 방법: 2011년 7월부터 2012년 2월까지 회전근개의 파열로 본원에서 수술적 치료가 시행된 76예(남자 28명, 여자 48명)를 대상으로 하였고 평균 나이는 61.7세(범위, 38세~76세)였다. 수술전 고유 수용성 감각 기능 평가를 위하여 외회전 및 내회전에 대한 위치 감각(joint position sense)를 측정하였고 방식은 능동적 재위치법(active re-positioning)을 사용하였다. 정해진 회전 각도와의 편차의 절대값을 측정하였다. 회전근개의 파열 크기, 견갑하근의 파열 유무, 통증(pain visual analogue scale), 견관절 기능 점수(American society of elbow and shoulder score), 견관절 운동 범위를 조사하였으며 이들 변수에 따른 차이를 비교하였다. 결과: 외회전의 경우 정상 관절은 $4.9^{\circ}{\pm}2.9^{\circ}$, 이환된 관절은 $4.9^{\circ}{\pm}3.0^{\circ}$의 절대 편차를 보였고 이는 통계적으로 유의하지 않은 차이를 보였다(p=0.87). 내회전의 경우 정상관절은 $4.0^{\circ}{\pm}2.7^{\circ}$인데 비하여 이환된 관절은 $4.8^{\circ}{\pm}3.7^{\circ}$로 편차가 증가하였으며 이는 통계적으로 유의하였다(p=0.043). 회전근개의 파열 크기에 따라 파열이 더 큰 경우(중파열 이상)가 파열이 더 작은 경우(부분파열 및 소파열)에 비하여 내회전의 고유감각기능 감소가 더 뚜렷한 경향을 보였으며(5.0 vs. 4.0, p=0.061), 견갑하근의 파열이 있는 환자군에서 내회전의 고유감각 기능 감소가 더 뚜렷한 경향을 보였다(4.8 vs. 4.0, p=0.065). 통증이 클수록, 견관절 기능 검사 점수가 낮을수록 내회전에 대한 고유감각기능이 감소하였으며(각각 p=0.04 및 p=0.005) 견관절 운동 범위의 제한이 있는 환자군에서 내회전 고유감각기능이 더욱 감소되는 것이 관찰되었다(5.3 vs. 3.7, p=0.041). 결론: 회전근개 파열 환자에서 내회전에 대한 고유감각기능 감소가 관찰되었으며 특히 이는 회전근개의 파열 정도가 심하고 견갑하근의 파열이 동반된 경우 뚜렷한 경향을 보였다. 또한 통증이 심하거나 견관절 기능 점수가 낮으며 운동 범위의 제한이 있는 경우 내회전에 대한 고유감각기능이 감소하는 것으로 관찰되었다.

• 한국운동역학회지
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• 제26권4호
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• pp.369-375
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• 2016

Objective: The purpose of this study was to investigate the possibility of injuries and the types of movement related to damage by body parts, and to prepare for prevention of injuries and development of a training program. Method: For this study, the experiment was conducted according to levels of 60 percentages (ST) and 85 percentages (MA) and 10 subjects from the Korean elite national weightlifting team were included. Furthermore, we analyzed joint moment and muscle activation pattern with three-dimensional video analysis. Ground reaction force and EMG analyses were performed to measure the factors related to injuries and motion. Results: Knee reinjuries such as anterior cruciate ligament damage caused by deterioration of the control ability for the forward movement function of the tibia based on the movement of the biceps femoris when the rectus femoris is activated with the powerful last-pull movement. In particular, athletes with previous or current injuries should perceive a careful contiguity of the ratio of the biceps femoris to the rectus femoris. This shows that athletes can exert five times greater force than the injury threshold in contrast to the inversion moment of the ankle, which is actively performed for a powerful last pull motion and is positively considered in terms of intentional motion. It is activated by excessive adduction and internal rotation moment to avoid excessive abduction and external rotation of the knee at lockout motion. It is an injury risk to muscles and ligaments, causing large adduction moment and internal rotation moment at the knee. Adduction moment in the elbow joint increased to higher than the injury threshold at ST (60% level) in the lockout phase. Hence, all athletes are indicated to be at a high risk of injury of the elbow adductor muscle. Lockout motion is similar to the "high five" posture, and repetitive training in this motion increases the likelihood of injuries because of occurrence of strong internal rotation and adduction of the shoulder. Training volume of lockout motion has to be considered when developing a training program. Conclusion: The important factors related to injury at snatch include B/R rate, muscles to activate the adduction moment and internal rotation moment at the elbow joint in the lockout phase, and muscles to activate the internal rotation moment at the shoulder joint in the lockout phase.