• Title/Summary/Keyword: Shoulder pain and disability index

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Long-Term Clinical and Radiologic Outcomes of Minimally Invasive Posterior Cervical Foraminotomy

  • Kwon, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.224-229
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    • 2014
  • Objective : To report long-term clinical and radiological outcomes of minimally invasive posterior cervical foraminotomy (MI-PCF) performed in patients with unilateral single-level cervical radiculopathy. Methods : Of forty-six patients who underwent MI-PCF for unilateral single-level radiculopathy between 2005 and 2013, 33 patients were included in the study, with a mean follow-up of 32.7 months. Patients were regularly followed for clinical and radiological assessment. Clinical outcome was measured by visual analogue scale (VAS) for the neck/shoulder and arm, and the neck disability index (NDI). Radiological outcome was measured by focal/global angulation and disc height index (DHI). Outcomes after MI-PCF were evaluated as changes of clinical and radiological parameters from the baseline. Mixed effect model with random patients' effect was used to test for differences in the clinical and radiological parameters repeat measures. Results : There were no complications and all patients had an uneventful recovery during the early postoperative period. VAS scores for neck/shoulder and arm improved significantly in the early postoperative period (3 months) and were maintained with time (p<0.001). NDI improved significantly post-operatively and tended to decrease gradually during the follow-up period (p<0.001). There were no statistically significant changes in focal and global angulation at follow-up. Percent DHIs of the upper adjacent or operated disc were maintained without significant changes with time. During the follow-up, same site recurrence was not noted and adjacent segment disease requiring additional surgery occurred in two patients (6%) on the contra-lateral side. Conclusion : MI-PCF provides long-term pain relief and functional restoration, accompanied by good long-term radiological outcome.

Clinical Observation of Acupuncture and Nerve Block Treatment for Adhesive Capsulitis Patients (유착성 관절낭염에 대한 침 및 신경차단술 처치의 임상적 관찰)

  • Nam, Dong-Woo;Lim, Sabina;Kim, Jong-In;Kim, Keon-Sik;Lee, Doo-Ik;Lee, Jae-Dong;Lee, Yun-Ho;Choi, Do-Young
    • Journal of Acupuncture Research
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    • v.24 no.4
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    • pp.143-155
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    • 2007
  • Objectives: To observe the effect of acupuncture and nerve block combination treatment on adhesive capsulitis patients. Methods : 59 voluntary patients were randomly assigned to acupuncture treatment group(E group, n=22), nerve block treatment group(W group, n=17) and acupuncture and nerve block combination treatment group(EW group, n=20). The E group received acupuncture treatment on LI15, $TE_{14}$, $GB_{21}$ and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. The EW group received the same treatment as the W group and after 5minutes of rest, successively received the treatment identical to that of E group. All three groups were instructed to practice groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after 1, 2, 3 and 4week treatment. Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), Range of Motion(ROM), the patient's treatment satisfaction measured by Visual Analogue Scale(VAS) and Digital Infrared Thermographic Imaging(DITI) were used as assessment tools. The obtained data were analyzed and compared. Results : The E group showed significant improvement(p<0.05) on CSA, SPADI, VAS and DITI. As for ROM, Adduction and Extension improved significantly(p<0.05). The W group showed significant improvement(p<0.05) on CSA, SPADI, VAS and DITI. As for ROM, Abduction and Extension improved significantly. The EW group showed significant improvement(p<0.05) on CSA, SPADI and VAS. As for ROM, Adduction, Abduction, Extension and Flexion improved significantly. The improvement of CSA, VAS and Abduction ROM in the EW group was significantly(p<0.05) superior compared to the groups treated with single type of treatment. Conclusion : It is suggested that acupuncture and nerve block combination treatment for adhesive capsulitis patients is more effective than the two single treatments. Through further studies, the acupuncture and nerve block combination treatment model may be developed into East-West Collaboration Model in treating adhesive capsulitis.

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Comparison of the Rehabilitation Program after Rotator Cuff Repair by Time Closed Chain Exercise (회전근개봉합술 후 닫힌사슬운동 적용 시점에 따른 효과 비교)

  • Song, Hyun-Seung;Kim, Suhn-Yeop
    • Journal of the Korean Society of Physical Medicine
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    • v.9 no.4
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    • pp.485-492
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    • 2014
  • PURPOSE: This study aimed to examine the pain, range of motion (ROM), upper extremity task performance, and functional levels of patients after rotator cuff repair according to the timing of a closed chain exercise thereby presenting basic data for an effective rehabilitation program. METHODS: The intervention was applied three times per week, one hour per day, for four weeks to 40 participants, 78 of whom had undergone rotator cuff repair. The participants were divided into four groups and assigned to usual general physical therapy and an open chain exercise. Group I consisted of the open chain exercise only. The closed chain exercise was applied to group II after the 4 times, group III after the 7 times, group IV after the 10 times. Measurement were used ROM, visual analogue scale (VAS), box and block test (BBT), and shoulder pain and disability index (SPADI). A one-way analysis of variance was conducted to test differences. RESULTS: There were significant differences in the internal/external rotation between group I and group II. The VAS significantly differed between group II and group I, group III, and group IV. The BBT results of group II and group I were significantly different compared to those of group IV. The SPADI significantly differed between group II and group I and between group II and group IV. CONCLUSION: The closed chain exercise was effective for patients following rotator cuff repair from the second week after active exercise was prescribed, verifying its applicability in rehabilitation programs.

Effect of Needle-embedding Therapy on Supraspinatus Tendon Partial Tear Combined with Oriental Medical Treatment : Case Report (극상근건 부분파열 환자에 매선과 한의치료를 시행한 증례 보고)

  • Cha, Eun Hye;Jung, Da Woon;Yang, Mu Hack;Kim, Byeong Han;Shin, Hee Ra;Kwon, Young Dal
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.32 no.4
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    • pp.277-282
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    • 2018
  • The purpose of this study was to investigate the clinical effects of Korean medical treatments combined with Embedding acupuncture on patients with supraspinatus tendon partial tear. We reviewed the medical records of 1 patients with supraspinatus tendon partial tear at Pureunsan oriental medical clinic from Oct, 2017 to November, 2017. The patient received embedding acupuncture therapy and oriental medical therapy. To evaluate the efficacy of the treatments, the patient was asked to complete a Visual analogue scale(VAS) and the Shoulder pain and disability index during treatment period. The VAS of the patient decreased more than the screening period. The SPADI change of the embedding acupuncture group were greater than non treatment period. Embedding therapy combined with Korean medical treatment might be effective in reducing pain and improving the life quality of patients with supraspinatus tendon partial tear. We hope that further studies will be done to produce more clinical data and ensure effective application of these results.

The Effects of Joint Mobilization with Combined Exercise Therapy of Sling on Post-traumatic Adhesive Capsulitis Patient: A Case Report (외상 후 유착성 견관절낭염 환자에서 관절가동술을 병행한 슬링 운동치료의 효과 : 단일사례연구)

  • Kwon, Won-An;Kim, Youn-Joung;Kwon, Hye-Mi;Kim, En-Ji;Park, Woo-Kyung;Shin, Hye-Won;Oh, Joung-Ik;Woo, Joung-Hee;Lee, Da-Hye;Lee, En-young;Jung, En-Ju;Jung, Jae-Young;Jung, Hyun-Kyung;Choi, Bo-Young;Heo, Eun-Young;Lee, Jae-Hong
    • PNF and Movement
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    • v.10 no.2
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    • pp.9-16
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    • 2012
  • 본 연구는 43세 남성 환자의 관절가동술과 슬링을 이용한 유착성 관절낭염 환자의 치료사례를 조사하여 그 과정과 결과를 알아보고자 하였다. 어깨통증장애지수(shoulder pain and disability index) 측정과 어깨관절의 굽힘(flexion), 벌림(abduction), 바깥돌림(external rotation), 안쪽돌림(internal rotation)에 대한 관절가동범위를 측정하여 비교하였으며 견관절 주위에 비스테로이드 소염진통 주사 1회, 약물치료를 병행하며 주 3회 8주간 보존적인 물리치료인 온습포(hot pack)와 간섭파(ICT), 관절가동술, 그리고 슬링을 이용한 운동치료를 실시하였다. 결과는 관절가동술과 슬링운동치료의 적용이 유착성 관절낭염 환자의 통증을 줄이고 관절가동범위를 증진시키는데 효과가 있는 것으로 판단된다.

Improvement of the Elbow Function with Early Mobilization and Rigid Fixation of Coronoid Fracture by Tension Band Technique (압박 긴장대 방법을 이용한 구상 돌기 골절의 견고한 고정과 조기 운동을 통한 주관절 기능의 향상)

  • Rhyou, In-Hyeok;Suh, Bo-Gun;Kim, Hyung-Jin;Chung, Chae-Ik;Kim, Kyung-Chul
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.159-166
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    • 2009
  • Purpose: We wanted to evaluate the surgical results of early mobilization after rigid fixation of small coronoid fracture using the tension band technique Materials and Methods: Eight cases of coronoid fracture were fixed with the tension band technique and using K-wire and wire through the medial approach. All the cases were Regan-Morrey type 2. According to O'Driscoll, they were classified as 5 cases of the tip type (subtype 2) and 3 cases of the anteromedial type (1 case of subtype 2, and 2 case of subtype 3). The associated collateral ligament injuries (6 cases) and radial head/neck fractures (4 cases) were managed simultaneously. After immobilization for 5~7 days, active ROM exercise with a fitted hinge brace started and continued till postoperative 6 weeks. The patients were assessed for pain, ROM and functional disability using the Mayo elbow performance score (MEPS) at an average of 11 months (range: 6~28 months). The ulnar nerve symptoms were also investigated. Results: We observed solid union in all the coronoid fractures without hardware failure. An average of 2.2 wires (range: 2~4) were used. The mean extension was $3^{\circ}$(range: $0^{\circ}\sim25^{\circ}$), the mean flexion was $137^{\circ}$(range: $130^{\circ}\sim140^{\circ}$), the mean pronation was $69^{\circ}$(range: $45^{\circ}\sim90^{\circ}$) and the mean supination was $78^{\circ}$(range: $45^{\circ}\sim90^{\circ}$). The mean MEPS was 96 (range: 65~100). Ulnar nerve symptoms occurred at postoperative one day and persisted in one patient with the terrible triad of taking radial head excision and residual medial instability. Conclusion: The tension band technique uses easily obtained, economic K-wires and the wire was strong enough to permit early elbow ROM exercise and the technique might improve the elbow function. It was especially useful for fixation of multiple small fragments.