• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.168-171
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• 2016

Fractures at the lateral end of the clavicle inevitably require surgical treatment as there is high potential for delayed union or nonunion. Acromioclavicular dislocation also requires stable and solid fixation for healing, and surgical treatment is recommended for the maintenance of joint function. The hook plate maintains the biomechanics of the acromioclavicular joint, enabling early range of motion. Therefore, for the past 10 years, the hook plate has been widely used in distal clavicle fractures and acromioclavicular joint injuries. However, the hook plate is associated with several complications, such as proximal clavicle fractures, widening of the hook hole, rotator cuff tear, subacromial impingement, and often acromial fractures. We report on two unusual cases of acromion fracture after hook plate fixation in patients with distal clavicle fracture and acromioclavicular dislocation alongside a literature review.

• Korean Journal of Adult Nursing
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• v.17 no.2
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• pp.298-309
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• 2005

Purpose: The purpose of this study was to investigate the effect of a comprehensive rehabilitation program on grip strength, pinch strength, the shoulder joint function, flexibility, and fatigue in mastectomy patients. Method: The subjects were fifty-five women 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 for 10 weeks, which was composed of education, stress management, exercise, and peer support group activity. Results: The results revealed that the increase in grip strength, key pinch, the shoulder joint function, and flexibility (Back & Reach test, Standing & Bending reach test) of the operated extremity, and the decrease in fatigue were significantly higher in the experimental group than in the control group. However, the results revealed that tip strength and palmar pinch of the experimental group increased but there was no significant difference from that of the control group. Conclusions: The 10-week comprehensive rehabilitation program showed much affirmative effect on physical function, and fatigue of breast cancer patients after mastectomy.

• The Korean Journal of Pain
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• v.35 no.3
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• pp.280-290
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• 2022

Background: This study aimed to determine the impact of complex decongestive therapy applications on upper extremity function in breast cancer patients who developed adhesive capsulitis after lymphedema. Methods: Thirty patients who developed adhesive capsulitis due to lymphedema were divided into two groups as study (n = 15) and control (n = 15) groups. Both groups received 20 minutes of exercise five days a week for three weeks using a Biodex isokinetic dynamometer, as well as a hot pack and TENS (Transcutaneous Electrical Nerve Stimulation) treatment to the shoulder joint. The study group received 45 minutes of intensive decongestive therapy along with the adhesive capsulitis treatment. The visual analogue scale was used to assess pain, circumference, and volumetric measurements were used to assess edema, and the Arm, Shoulder, and Hand Problems Questionnaire (DASH: Disabilities of the Arm, Shoulder, and Hand) was used to assess upper extremity functionality. The shoulder range of motion was evaluated. Results: Both groups had improvements in pain (P < 0.001), shoulder joint range of motion (P < 0.001), and upper extremity functionality (P < 0.001) after the treatment. There was a significant decrease in circumference and volumetric measurements in the study group (P < 0.001). However, no differences were seen in measurements in the control group. Conclusions: The results showed that complex decongestive therapy was beneficial in reducing lymphedema in breast cancer patients who acquired adhesive capsulitis due to lymphedema. Consequently, the authors believe that supplementing conventional physiotherapy with complex decongestive therapy will benefit patients.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.1
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• pp.49-61
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• 2022

PURPOSE: This study compared the effects of proprioceptive sensation, subacromial space, and dynamic function according to proprioceptive neuromuscular facilitation (PNF), static stretching (SS), and complex rotational stretching (CRS). METHODS: Thirty students without any musculoskeletal disease who volunteered to participate were included in this study. The following metrics were measured to evaluate the function and stability under the normal conditions, with the PNF, SS, and CRS: special test and flexion, extension, abduction, adduction, internal rotation, external rotation (shoulder range of motion) and reaching distance on the medial (ME), superolateral (SL), inferolateral (IL), and subacromial space and proprioceptive sensation were evaluated. All measures were analyzed using one-way ANOVA and repeated measures of ANOVA. RESULTS: A clear difference in adduction in the range of motion was observed in all groups (p < .05). Significant differences could not be identified in all values in the error test, except for Ab (p < .05). Significant differences in reach were noted in all directions of the SS and PNF in the Me, SL, and IL (p < .05). After the intervention, significant differences in the average values could be identified in all groups except for the SS group after rest (p < .05). After the intervention, there was a significant difference between the CRS and SS and PNF groups (p < .05). CONCLUSION: The application of CRS is as helpful as the existing SS and PNF for improving the joint range of motion improvement, shoulder balance, and subacromial space.

• Journal of the Korean Society of Physical Medicine
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• v.4 no.4
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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.

• Clinics in Shoulder and Elbow
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• v.26 no.2
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• pp.175-181
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• 2023

Background: Acromioclavicular (AC) osteoarthritis (OA) is a frequent pathology of the shoulder in elderly patients. Drug injection plays an important role in treatment of AC OA. Literature has demonstrated excellent short-term results regarding shoulder function and pain. However, mid- to long-term results are lacking. The aim of this study was to assess the efficacy of a single intra-articular AC injection in patients with AC OA and to identify predictive factors for success. Methods: A retrospective study was performed to analyze success rate, shoulder function, and pain perception after a single intra-articular injection in patients with AC OA. Success was defined as the absence of reinterventions such as additional injection or surgery. Outcome measures were 1-year success rate and clinical outcome scores of Numeric Rating Scale (NRS) for pain, Oxford Shoulder Score, and Subjective Shoulder Value. Results: Ninety-eight patients participated in this study. At a median final follow-up of 0.8 years (interquartile range, 0-6), 57 of these patients (58%) had undergone a reintervention. The 1-year success rate was 47% (95% confidence interval, 37%-57%), with NRS at rest as the sole factor significantly associated with success. Thirty patients not requiring reintervention reported significant improvement from baseline for all reported outcome measures at final follow-up. Conclusions: AC injections offer a 1-year success rate of 47%. The AC injection produces good mid- to long-term clinical outcomes regarding shoulder function, quality of life, and pain perception in one-third of patients. Further research is essential to analyze mid- to long-term outcomes of AC injections.

• The Journal of Korean Physical Therapy
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• v.15 no.4
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• pp.412-430
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• 2003

Functional stability is dependent on integrated local and global muscle function. Movement dysfunction can present as a local and global problem, though both frequently occur together. To good understand how movement induces pain syndrome, the optimal actions and interaction of the multiple anatomic and functional systems involved in motion must be considered. Minor alterations in the precision of movement cause microtrauma and, if allowed to continue, will cause macrotrauma and pain. These alteration of the movement result in the development of compensatory movement and movement impairment. Muscle that become tight tend to pull the body segment to which they are attached, creating postural deviation. The antagonistic muscles may become weak and allow postural deviations due to lack of balanced support. Both hypertonic and inhibited muscles will cause an alteration of the distribution of pressure over the joint(s) that they cross and, thus, may not only result from muscle dysfunction, but produce joint dysfunction as well. Alteration of the shoulder posture and movement dysfunction may sometimes result in compression of neurovascular structures in the shoulder and arm. There is a clear link between reduced proprioceptive input, altered motor unit recruitment and the neurovascular compression. This report start with understanding of the impaired alignment, movement patterns and neuromuscular compression of the shoulder girdle by movement impairment to approach method of the movement dysfunction.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.269-278
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• 2022

Objective: The aim of this study was to evaluate the effects on pain and function of patients with rotator cuff tendinopathy when applying trigger point of infraspinatus and teres minor to myofascial trigger point release (MFR) plus mobility exercise and MFR. Design: A randomized controlled trial. Methods: The total participants were 30patients and were separated to MFR plus mobility exercise group(n=15) and MFR group (n=15) according to the randomized treatment method. The MFR was performed at two infraspinatus tampon points and one teres minor tampon point for twice a week for 4 weeks and the treatment time was 6 minutes 20 seconds in each position. The MFR group also carried out the myofascial trigger point release in the same way as the MFR plus mobility exercise group. Results: The MFR plus mobility exercise group significantly reduced objective and subjective pain (p<0.05). The range of motion of the shoulder joint flexion and external rotation, Quick-Disability of the Arm, shoulder and Hand, and Shoulder Pain and Disability Index were significantly improved in the group to which MFR plus mobility exercise was applied (p<0.05). Conclusions: These results confirmed that MRF plus mobility exercise is more effective in relieving shoulder pain and improving function in rotator cuff tendinopathy.

• PNF and Movement
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• v.3 no.1
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• pp.47-53
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• 2005

Purpose : To describes the important aspects of scapular movement and function used when applying PNF technique to the upper limb and scapular. Method : The scapular was a very important roles in the upper limb movement. This study summarizes the physiologic movement of scapular to the PNF upper extremity patterns or scapular patterns. Result : The shoulder joint has the most freedom of range of motion in the human body, composed of the glenohumeral joint, the subacromial joint, the acromioclavical joint, the sternoclavicular joint, the scapulothoracic joint, the costosternal joint, and the costovertebral joint. During upper limb movement, the scapular position change at the sternoclavicular joint and the acromioclavical joint. This concerted motion was characterized by scapulohumeral rhythm. In clinical situations, it is import to understand factors affect the scapulohumeral rhythm so that optimal evaluation and therapeutic intervention can be devised. Conclusions : The scapular movement depend on the proper and coordinated contraction of muscles. Physical therapists need to understand the normal scapular movement relationships of the scapulohumeral rhythm under different interventions for PNF techniques application.

• Clinics in Shoulder and Elbow
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• v.19 no.1
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• pp.25-32
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• 2016

Background: The goal of this study was to evaluate whether a modified fluoroscopic technique for positioning a hook plate affected the clinical results of treating Neer type II distal clavicle fractures and Rockwood type V acromioclavicular (AC) joint separations with this device. Methods: The study was a retrospective consecutive case series with data analysis. Sixty-four patients with a Neer type II distal clavicle fracture or a Rockwood type V AC joint injury treated between March 2009 and June 2013 were divided into 2 groups: traditional fluoroscopic technique (traditional view, 31 patients) or modified fluoroscopic technique ('hook' view, 33 patients). A visual analogue scale (VAS) score, the modified University of California-Los Angeles (UCLA) shoulder scale score, and radiographic osteolysis were the main outcome measures. Results: The traditional group included a significantly larger number of patients with acromial osteolysis than the hook view group: 23 patients (74.2%) vs. 11 patients (33.3%), respectively (p=0.01). Before plate removal, the hook group reported less pain and higher UCLA shoulder scale scores than the traditional group: average VAS score, 1.55 vs. 2.26, respectively; average UCLA score, 30.88 vs. 27.06, respectively. However, there was no significant difference after plate removal. Conclusions: The hook view allows more accurate bending of the hook plate around the contour of the acromion, resulting in decreased osteolysis, decreased pain, and better function with the plate in situ.