• Clinics in Shoulder and Elbow
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• 제25권3호
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• pp.202-209
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• 2022

Background: The purpose of our study was to investigate short-term outcomes of two-stage reverse total shoulder arthroplasty (RTSA) with an antibiotic-loaded cement spacer for shoulder infection. Methods: Eleven patients with shoulder infection were treated by two-stage RTSA following temporary antibiotic-loaded cement spacer. Of the 11 shoulders, nine had pyogenic arthritis combined with complex conditions such as recurrent infection, extensive osteomyelitis, osteoarthritis, or massive rotator cuff tear and two had periprosthetic joint infection (PJI). The mean follow-up period was 29.9 months (range, 12-48 months) after RTSA. Clinical and radiographic outcomes were evaluated using the visual analog scale (VAS) score for pain, American Shoulder and Elbow Surgeons (ASES) score, subjective shoulder value (SSV), and serial plain radiographs. Results: The mean time from antibiotic-loaded cement spacer to RTSA was 9.2 months (range, 1-35 months). All patients had no clinical and radiographic signs of recurrent infection at final follow-up. The mean final VAS score, ASES score, and SSV were significantly improved from 4.5, 38.6, and 29.1% before RTSA to 1.7, 75.1, and 75.9% at final follow-up, respectively. The mean forward flexion, abduction, external rotation, and internal rotation were improved from 50.0°, 50.9°, 17.7°, and sacrum level before RTSA to 127.3°, 110.0°, 51.8°, and L2 level at final follow-up, respectively. Conclusions: Two-stage RTSA with antibiotic-loaded cement spacer yields satisfactory short-term clinical and radiographic outcomes. In patients with pyogenic arthritis combined with complex conditions or PJI, two-stage RTSA with an antibiotic-loaded cement spacer would be a successful approach to eradicate infection and to improve function with pain relief.

• Clinics in Shoulder and Elbow
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• 제12권2호
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• pp.109-114
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• 2009

목적: 광범위 회전근 개 파열에 대해 개방적 완전 봉합이 가능하였던 환자들을 대상으로 수술 전, 후의 방사선학적 소견의 변화와 진행 정도를 회전근 개 재파열 정도 및 임상적 결과와 함께 비교 분석하고자 하였다. 대상 및 방법: 광범위 회전근 개 파열에 대해 개방적 완전 봉합술을 시행 받고 24개월 이상 추시가 가능하였던 33예를 대상으로 하였다. 임상적 평가는 American Shoulder and Elbow Surgeons(ASES)의 견관절 기능 평가법을 기준으로 하였으며, 광범위 회전근 개 파열과 관련한 관절염의 정도는 Hamada의 분류법을 기준으로 하였다. 결과: ASES 점수는 수술 전 평균 37.6점에서 85.6점으로 호전되었다. 수술 전 acromiohumeral interval (AHI)은 평균 6.5 mm였으며, 수술 직후 평균 9.3 mm로 증가하였으나, 최종 추시에서 평균 6.5 mm로 다시 감소되는 소견을 보였다. Hamada 분류법에 따른 관절염의 방사선학적 단계는 수술 전과 수술 후 모두 그 단계가 낮을수록 보다 좋은 임상적 결과를 보였다. 결론: 광범위 회전근 개 파열에 대한 수술적 치료로서 개방적 완전 봉합술은 비록 수술 후 재파열이 발생하더라도 임상적으로는 통증 경감과 견관절 기능 향상 면에서 상당히 만족할만한 결과를 보였다.

• Clinics in Shoulder and Elbow
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• 제21권2호
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• pp.82-86
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• 2018

Background: Although a common shoulder disease, there are no accepted classification criteria for frozen shoulder (FS). This study therefore aimed to evaluate the accuracy of the conventionally used FS classification system. Methods: Primary FS patients (n=168) who visited our clinic from January 2010 to July 2015 were included in the study. After confirming restrictions of the glenohumeral joint motion and absence of history of systemic disease, trauma, shoulder surgery, shoulder muscle weakness, or specific x-ray abnormalities, the Zuckerman and Rokito's classification was employed for diagnosing primary FS. Following clinical diagnosis, each patient underwent a shoulder magnetic resonance imaging (MRI) and blood tests (lipid profile, glucose, hemoglobin A1c, and thyroid function). Based on the results of the blood tests and MRIs, the patients were reclassified, using the criteria proposed by Zuckerman and Rokito. Results: New diagnoses were ascertained including blood test results (16 patients with diabetes, 43 with thyroid abnormalities, and 149 with dyslipidemia), and MRI revealed intra-articular lesions in 81 patients (48.2%). After re-categorization based on the above findings, only 5 patients (3.0%) were classified having primary FS. The remaining 163 patients (97.0%) had either undiagnosed systemic or intrinsic abnormalities (89 patients), whereas 74 patients had both. Conclusions: These findings demonstrate that most patients clinically diagnosed with primary FS had undiagnosed systemic abnormalities and/or intra-articular pathologies. Therefore, a modification of the Zuckerman and Rokito's classification system for FS may be required to include the frequent combinations, rather than having a separate representation of systemic abnormalities and intrinsic causes.

• 대한산업공학회지
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• 제28권2호
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• pp.216-222
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• 2002

The ergonomic human model can be considered as a tool for the evaluation of ergonomic factors in vehicle design process. The proper anthropometric data on driver's postures are needed in order to apply a human model to vehicle design. Although studies on driver's posture have been carried out for the last few decades, there are still some problems for the posture data to be applied directly to the human model due to the lack of fitness because such studies were not carried out under the conditions for the human model application. In the traditional researches, the joint angles were evaluated by the categorized data, which are not appropriate for the human model application because it is so extensive that it can not explain the posture evaluation data in detail. And the human models require whole-body posture evaluation data rather than joint evaluation data. In this study a postural evaluation function was developed not by category data but by the concept of the loss function in quality engineering. The loss was defined as the discomfort in driver's posture and measured by the magnitude estimation technique in the experiment using a seating buck. Four loss functions for the each joint - knee, hip, shoulder, and elbow were developed and a whole-body postural evaluation function was constructed by the regression analysis using these loss functions as independent factors. The developed postural evaluation function shows a good prediction power for the driver's posture discomfort in validation test. It is expected that the driver's postural evaluation function based on the loss function can be used in the human model application to the vehicle design process.

• Physical Therapy Rehabilitation Science
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• 제5권2호
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• pp.95-100
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• 2016

Objective: The purpose of this study was to investigate effects of hand grip strength on the muscle activation of shoulder joint in breast cancer patients. Design: Cross-sectional study. Methods: Ten breast cancer patients who agreed to active participation were included. These patients were operated with either conservative surgery or segmental mastectomy, and then were treated with radiation therapy and chemotherapy. The activity of the upper trapezius, lower trapezius, supraspinatus and serratus anterior muscle were measured using surface electrodes during 4 hand gripping tasks (lowered their arms in standing position, 0%, 30%, and 50% of maximum voluntary contraction) in the scapular abduction plane. Results: The results were analyzed using a one-way repeated measures ANOVA. There was a significant difference in the lower trapezius and supraspinatus muscles according to grip strength, lower trapezius and supraspinatus muscles showed significantly difference according to grip strength (p<0.05). The result of the muscle activation according to hand strength (0%, 30%, and 50%) it showed a significant difference between the upper trapezius and supraspinatus in 0% grip strength (p<0.05). In addition, it did not show a significant difference between muscles in 30%, 50% hand strength. Conclusions: This study showed an increase in shoulder muscle activation with increasing hand grip strength with the upper trapezius muscle being more activated than other muscles in 0% grip strength. The finding of this study suggests usefulness for development of preventative measures and rehabilitation strategies for increasing shoulder motor function in patients with breast cancer.

• 대한물리치료과학회지
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• 제16권4호
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• pp.75-81
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• 2009

Background: The purpose of this study was to confirm whether surface FES was effective in the function of chronic stroke patients' affected shoulder and whether FES influenced their functional abilities in ADL, as well. Method: the subjects were inpatients at a general hospital in Gyeonggi-Do, Korea and had been diagnosed as a sub-luxation in their affected shoulder. They were 26 and were separated to an experimental group and a control group, in equal number. Both groups had gotten an exercise treatment for 6 weeks. The control group didn't get any FES as opposed to the experimental group. Result: in the experimental group there was no statistical significant difference in the vertical space and the joint space, even though the space was reduced. In the control group, there was no statistical significant difference, either. Moreover, each space of their shoulders was increased. In the range of motion of each group, there was no statistical significant difference. In functional independent ability, there was a significant difference in an experimental group. In contrast, there was no difference in a control group. Conclusion: this result suggests that FES should be effective in the sub-luxation of the patients' affected shoulder and the range of motion of their shoulders. On the other hand, compared to the previous items, FES was quite effective in the functional improvement.

• The Journal of Korean Physical Therapy
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• 제16권3호
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• pp.152-160
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• 2004

The purpose of this study was to investigate the effect of elastic band based of PNF pattern on the U/E function in the spinal cord injury patient. 11 subjects with spinal cord injury participated in this study. They took elastic band excercise 5 times per week for 8 weeks. One time excercise spent 35minutes. The therapeutic effect was evaluated by Cybex 6000, BTE Work Simulator, how many seconds they needed to walk 100 meters. 11 cases were examined before, after 8 week, elastic band excercise. The results of this study are as follows; 1. Isokinetic power by Cybex 6000 : The elbow flexion, shoulder flexion and extension were significant difference between test-retest(p<.05). but elbow extension were not significant difference between test-retest. 2. BTE Work Simulator : Wheelchair Propulsion and Steering Torque were significant difference between test-retest(p<.05). 3. Wheelchair Propulsion velocity : There were significant difference between test-retest(p<.05). The findings suggest that SCI patients can improve their Isokinetic power on shoulder and elbow joint, wheelchair propulsion and Steering Torque by BTE Work Simulator, Wheelchair Propulsion velocity through elastic band based of PNF pattern.

• Clinics in Shoulder and Elbow
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• 제25권4호
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• pp.274-281
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• 2022

Background: In the present study, the age- and sex-adjusted Constant score (CS) in a normal Indian population was calculated and any differences with other population cohorts assessed. Methods: The study participants were patients who visited the outpatient department for problems other than shoulder and healthy volunteers from the local population. Patients without shoulder pain/discomfort during activity were included in the study. Subjects with any problem that might affect shoulder function (e.g., cervical, thoracic spine, rib cage deformity, inflammatory arthritis) were excluded. Constant scoring of all participants was performed by trained senior residents under the supervision of the senior faculty. Shoulder range of movement and strength were measured following recommendations given by the research and Development Committee of the European Society for Shoulder and Elbow Surgery (2008). A fixed spring balance was used for strength measurement; one end was fixed on the floor and the other end tied with a strap to the wrist of the participant, arm in 90° abduction in scapular plane with palm facing down. Results: Among the 248 subjects (496 shoulders), the average age was 37 years (range, 18-78 years), 65.7% were males (326 shoulders) and 34.3% females (170 shoulders). The mean CS was 84.6±2.9 (males, 86.1±3.0; females, 81.8±2.9). CS decreased significantly after 50 years of age in males and 40 years of age in females (p<0.05). The mean CS was lower than in previous studies for both males and females. Heavy occupation workers had higher mean CS (p<0.05). A linear standardized equation was estimated for calculating the adjusted CS for any age. Conclusions: Mean CS and its change with age differed from previous studies among various population cohorts.

• 대한통합의학회지
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• 제9권4호
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• pp.19-28
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• 2021

Purpose : The purpose of this study was to apply manual lymphatic drainage (MLD) and high-frequency diathermy (HFD) to patients with axillary web syndrome (AWS), one of the side effects of breast cancer surgery, and to treat upper extremity pain, volume, function of the upper extremity, (joint range of motion; ROM, disabilities of the arm, shoulder and hand; DASH) and quality of life before and after treatment. It is to determine the effect of treatment by checking the level change. Methods : This study is a case series. A total of 5 patients diagnosed with AWS after breast cancer surgery voluntarily participated in this study. The intervention program consisted of stretching, MLD and HFD. It was conducted 3 times a week for 30 minutes for 4 weeks. In order to compare the effects of pain (numeric pain rating scale; NPRS), volume, upper limb function (ROM, DASH) and quality of life (the European organization for research and treatment of cancer quality of life questionnaire-breast, EORTC QLQ-BR23) evaluations were compared before and after 4 weeks of intervention. All measured variables were analyzed and expressed as mean, standard deviation and percentage. Results : The shoulder NPRS level of the subjects in all case groups decreased, the volume decreased and the shoulder flexion, abduction ROM increased. It showed improvement in DASH and quality of life, QLQ-BR23. Conclusion : After breast cancer surgery, we confirmed the possibility that MLD and HFD treatments could be effective in improving pain, decreasing volume, increasing upper extremity function, and quality of life for patients who have difficulties with AWS. The possibility has been confirmed, and additional research is needed by increasing the number of participants in the experiment in the future.

• 대한근관절건강학회:학술대회논문집
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• 대한근관절건강학회 2001년도 제14회 총회 및 춘계학술대회
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• pp.179-190
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• 2001

The purpose of this study was to explore the effects of GEAP on pain, joint function, activities of daily living(ADL) and fatigue in chronic arthritis patients. The GEAP was held twice a week for 6 weeks for chronic arthritis patients at one university hospital in Seoul, Korea. Thirty four subjects completed the program, who were recruited at four times from September, 1999 to September, 2000. The effect of GEAP were evaluated as follows: Pain severity and number of painful joints ADL, fatigue were measured before and after the GEAP. In order to examine the joint flexibility and strengthening, the followings were measured: the extent of the upward arm reach in both sides(flexibility of shoulder), the ability to touch fingertips of the both hands in back pat and rub(flexibility of arm), the degree of range of motion (ROM) of both ankles in their dorsiflexion(flexibility of ankle) and plantarflexion with standing with toe(strengthening of ankle), and the degree of knee extension, and the grip strength. Paired t-test and Wilcoxon signed rank test were used for data analysis and the significance of the differences in the variables was examined to compare the data obtained before and after the GEAP. After the GEAP, followings were found: 1. Pain severity and number of painful joints was significantly decreased. 2. The flexibility of both shoulders and arms, knee, both ankle were significantly improved. 3. The strengthening of both arms was significantly improved, but the strengthening of ankle was not changed. 4. ADL was significantly increased. 5. Fatigue was significantly decreased. In conclusion, GEAP used in this study was clearly proved to be an effective exercise program to reduce pain and fatigue, to enhance joint function and ADL in people with chronic arthritis. It is suggested that the GEAP should be recommended as one of the useful and appropriate nursing interventions for chronic arthritis patients.