Park, Jin-Young;Lhee, Sang-Hoon;Oh, Jeong-Hwan;Kim, Hong-Kyum
Clinics in Shoulder and Elbow
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v.12
no.2
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pp.271-277
/
2009
Purpose: Scapular dyskinesis is an alteration in the normal position or motion of the scapula during coupled scapulohumeral movements. Vast majority of shoulder pathologies are known to be related with scapular motion abnormalities. Because there being enthusiasm about scapular pathology in recent literatures, understanding scapular dyskinesis seems to be an important subject. The authors describe the importance of scapular abnormality in terms of shoulder pathology. Materials and Methods: Usually the inhibition or disorganization of activation patterns in scapular stabilizing muscles lead to scapular dyskinesis. This motion abnormality has more important values in Elite Athletes because it might be the sign of future shoulder pathology; for example, SLAP and internal impingement. Treatment of scapular dyskinesis is directed at managing underlying causes and restoring normal scapular muscle activation patterns by kinetic chain-based rehabilitation protocols. Treatment is also important to prevent secondary shoulder injuries. Results and Conclusion: Understanding scapular pathology may be the main key to approach to the shoulder pathology. Also treating scapular pathology might be important in preventing secondary shoulder injuries.
Background: The measurement of the strength of the shoulder muscles is an important element of the overall assessment of patients with various shoulder disorders. However, the clinical utilization of this measurement is dependent on its reproducibility. Objects: To explore the reproducibility of the measurements derived from testing of the isokinetic strength of shoulder muscles in patients with tendinitis of the rotator cuff. Methods: A total of 20 patients with tendinitis of the rotator cuff participated in this study and were assessed twice in 1 week. Isokinetic testing was performed concentrically for shoulder flexors, abductors, and external rotators and eccentrically for the shoulder extensors, adductors, and internal rotators. The relative and absolute reproducibility of the peak torque (PT) and ratios were assessed using intra-class correlation coefficients (ICC), standard error of measurement (SEM), and minimal clinically important difference (MCID), respectively. Results: Overall, high to excellent ICC, clinically acceptable SEM and MCID values were obtained for the PT (ICC: .83-.95, SEM: 1.2%-9%, MCID: 3.4%-25%) and ratios (ICC: .85-.93, SEM: 5.1%-10%, MCID: 14.2%-27.6%). Conclusion: These findings suggest that isokinetic tests may be effectively utilized for the determination of shoulder strength profiles and appropriate position are recommended to perform test without pain in patients with tendinitis of the rotator cuff.
Purpose: This study was to investigate whether the two different head postures, natural and ideal head posture, affect head/shoulder posture and muscle activity. Methods: Thirty healthy subjects with the forward head and round shoulder posture were participated in this study. This study utilized a within-subjects design with subjects being positioned into two sitting positions: natural head posture (NHP) and ideal head posture (IHP). Forward head angle (FHA) and forward shoulder angle (FSA) of each subject were measured for assessing the head/shoulder posture and muscle activities of upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) during the forward overhead reaching. Results: There were significant increases in both FHA and FSA after taking IHP, which showed greater angles than in taking NHP. In change of muscle activities, there were significant decreases in both LT and SA after taking IHP, which showed lower activities than in taking a NHP, whereas there was no significant change in UT. Conclusion: These findings demonstrate that postural alterations associated with forward head and rounded shoulder postures could alter scapular kinetics and muscle activity during the forward overhead reaching.
Purpose: The purpose of this study was to compare a control group and an experimental group, consisting of arthroscopic shoulder surgery patients who had received acute rehabilitation treatment and who were to perform scapular stabilization exercise. Methods: Sixteen subjects were studied. The control group, n=8, received instruction for basic physical therapy intervention. An experimental group, n=8, received instruction for doing scapular stabilization exercise (protraction, retraction, elevation, depression) 10 times, 6 times per week. To evaluate the effects of exercise, subjects were evaluated using a joint position sense of shoulder (JPS), disability of the arm, shoulder index (DASH), shoulder pain and disability index (SPADI). Results: Participants showed after the intervention, both groups saw their JPS errors at $30^{\circ}$, $60^{\circ}$, and $90^{\circ}$ significantly decrease relative to before the intervention (p<0.05). Both groups saw their JPS rates at $90^{\circ}$ significantly decrease (p<0.05), with no significant changes in JPS at $30^{\circ}$ and $60^{\circ}$ (p>0.05). SPADI and DASH significantly decrease after the intervention (p<0.05), with no significant decreases before the intervention (p>0.05). The change rates of SPADI and DASH significantly reduced (p<0.05). Conclusion: Low-intensity scapular stabilization exercise is considered effective as a clinical treatment for arthroscopic shoulder surgery patients who receive acute rehabilitation treatment.
Journal of the Korean Academy of Clinical Electrophysiology
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v.2
no.1
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pp.71-82
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2004
To compare the effectiveness of the hemisling, bobath sling, extension-type sling, and the newly designed Modified Triangular Bobath Sling with Distal Support on a hemiplegic shoulder subluxation. Fourteen hemiplegic patients with shoulder subluxation were evaluated by a simple X-ray with and without the slings and the vertical and horizontal distances on the plain AP views were measurement. The newly designed arm sling was compared in terms of the effects of correction with distal support attached with shoulder saddle sling. The arm sling designed for this study was developed for the purpose of maintaining patients hands in a functional position and performing ROM exercise of the shoulder easily, and prevention or correction to shoulder subluxation. The mean values of the vertical and horizontal distance were compared to determine if there was significant difference of function between the new sling and the conventional slings. The new sling provided the patients with good vertical correction of the subluxation(p<0.05) but did not increase the horizontal distance significantly. These results support the effectiveness of a new sling to decrease subluxation in hemiplegia. Further study on the long term effects or complication of the new sling is recommended.
Background/aim : Atherosclerotic disease at the origin of the vertebral arteries is one of the risk factors for vertebrobasilar ischemic disease. Assessment and visualization of the origin of the vertebral arteries with color doppler sonography is a non-trivial task. The aim of this study is to increase the visualization rate of the origin of the vertebral arteries with color doppler sonography. Materials and Methods : Color doppler sonography for the vertebral arteries included carotid arteries was performed to 198 patients. We first examined the vertebral artery in the upper neck in the direction of the subclavian artery to distinguish its origin more easily. If the vertebral artery origin was not visualized in natural position, the examiner pushed the transducer toward a clavicle or pushed the shoulder of patient by the other hand. The technical methods for visualization of the vertebral artery origin were classified into three grades: natural position, pushing the transducer, and pushing the shoulder of patient according to the depth (3.0 cm and shallower, deeper than 3.0 cm) of the origin. Results : The origin of the vertebral arteries could be visualized in 97% on the right and in 92% on the left. The origin of the vertebral arteries could be visualized in 98.6%, 1.4%, and 0.0% in natural position, pushing the transducer, and pushing the shoulder of patient, respectively, at shallower than 3.0 cm on the right side. The origin of the vertebral arteries could be visualized in 81.2%, 14.6%, and 4.2% in natural position, pushing the transducer, and pushing the shoulder of patient, respectively, at deeper than 3.0 cm on the right side. The origin of the vertebral arteries could be visualized in 85.4%, 10.7%, and 3.9% in natural position, pushing the transducer, and pushing the shoulder of patient, respectively, at shallower than 3.0 cm on the left side. The origin of the vertebral arteries could be visualized in 55.7%, 30.4%, and 13.9% in natural position, pushing the transducer, and pushing the shoulder of patient, respectively, at deeper than 3.0 cm on the left side. Conclusion : If the examiner pushes the transducer toward a clavicle or pushes the shoulder of patient by the other hand, when the vertebral artery origin during the color doppler sonography is not visualized in natural position, visualization rate of the origin of the both vertebral arteries is increased.
Journal of the Korean Society of Physical Medicine
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v.6
no.3
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pp.257-266
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2011
Purpose : To assess the relationship between post-stroke shoulder pain, motor function, and pain-related quality of life(QOL) Methods : Volunteer sample of 62 chronic stroke survivors with post-stroke shoulder pain and glenohumeral subluxation. The patients answered the question in shoulder pain with the Brief Pain Inventory question 12 (BP1-12), Pain-related Quality of life(BPI-23). Therapists measured the performance of combined upper-limb movement including the hand-behind-neck(HBN), hand-behind-beck(HBB) maneuver, added passive pain-free shoulder external rotation range of motion, and Modified Ashworth Scale(MAS) score of the elbow flexors. Physical performance assessments were used to measure basic activity daily living(Modified Barthel Index-self care, MBI-S/C), motor function of upper limb(Fugl-Meyer Upper/Lower Extremity, FM-U/E). Results : Stepwise regression analyses indicated that post-stroke shoulder pain is associated with the BPI 23, but not with the FM-U/E, MBI-S/C. Thus, the presence of shoulder pain is more important predicting pain-related QOL than its degree in predicting motor function of upper limb and basic activity daily living. Conclusion : Post-stroke shoulder pain was associated with reduced quality of life related to pain. The pain was not associated with the motor function of upper limb and basic activity daily living. The result imply that management of shoulder pain & anatomical position of shoulder joint after stroke should be emphasized. This provides a further incentive to develop effective rehabilitation prevention and treatment strategies for post-stroke shoulder pain.
Background: The purpose of this study is to assess the range of shoulder motion using an indirect evaluation method without physical examinations of patients based on questionnaires regarding several specific arm postures referenced by patient's own body parts. Methods: Nine criteria of specific shoulder motion including 4 forward flexion, 2 external rotation, and 3 internal rotation were decided as reference position which can represent a certain shoulder motion. Flexion contains postures such as lifting arm to waist-height, shoulder-height, eye-height, and raising arm above head with arm touching ears. External rotation comprises grasping ears and placing hands on back of the head. Vertebral height in internal rotation is determined by calculating the samples' motions, which are holding on to trouser belts, opposite-elbow, and scapula. These postures are included in questionnaires for patients to evaluate the validity and effectiveness of this indirect method. Results: The range of flexion was $77^{\circ}$ ($60^{\circ}$ to $100^{\circ}$), $96^{\circ}$ ($87^{\circ}$ to $115^{\circ}$), $135^{\circ}$ ($115^{\circ}$ to $150^{\circ}$), and $167^{\circ}$ ($150^{\circ}$ to $175^{\circ}$) when arms go up to waist, shoulder, eye, and high vertically. Range of external rotation was $39.6^{\circ}$ ($30^{\circ}$ to $50^{\circ}$) when grasping ears and $69.2^{\circ}$ ($60^{\circ}$ to $80^{\circ}$) with the hands on the back of the head. Range of internal rotation was L4 when placing trouser belts, T12 for holding opposite elbow, and T9 for reaching scapula. The mismatch rates of flexion, external rotation, and internal rotation were 11.6%, 9.6%, and 7.8%. Conclusions: The range of shoulder motion using this method is expected to be applied to an established shoulder scoring system which included shoulder motion evaluation item.
This study aimed to facilitate the use of virtual technologies such as sewing, appearance, and material expression in 3D virtual wear programs. For product production and education, we expounded how to express the shoulder shape and silhouette of sleeve-expanded power shoulder jackets. Two designs of sleeve-expanded power shoulder jackets were selected, and virtual jackets were produced using a virtual avatar based on the body dimensions of female subjects in their 20s. The essential purpose of a 3D virtual power shoulder jacket is to express the shoulder angle rise and shoulder width, which are much wider than the avatar's shoulder. Therefore, the virtual pad values were adjusted for the collision and rendering of each thickness. In addition, the position and angle of the virtual pads were controlled through simulation. Appearance similarity was evaluated using photographic data and the virtual jackets. For the set-in sleeve virtual power shoulder jacket, the wrinkle expressions of the torso and sleeve were rated as moderate, and material expression was slightly insufficient. The similarity of some ease and width items of the torso was tightly expressed, and the overall appearance, positions of lines, and details of jackets were rated high, especially at the neck and sleeve shapes. In the case of the kimono virtual power shoulder jacket, the expressions of the torso wrinkles and buttons were slightly lower; however, the overall similarity, basic lines, ease, shoulder and neck details, and material expression of the virtual jackets were highly evaluated.
To know the proper impact posture and changes for the various clubs, changes of impact variables according to the change of golf club length was investigated. Swing motions of three male low handicappers including a professional were taken using two high-speed video cameras. Four clubs iron 7, iron 5, iron 3 and driver (wood 1) were selected for this experiment. Three dimensional motion analysis techniques were used to get the kinematical variables. Mathcad and Kwon3D motion analysis program were used to analyze the position, distance and angle data in three dimensions. Major findings of this study were as follows. 1. Lateral position of the head remained more right side of the target up to 3.5cm compared to the setup as the length of the club increased. 2. Left shoulder raised up to 5cm and right shoulder lowered up to 2.5cm compared to setup. The shoulder line opened slightly (maximum 11 degrees) to the target line. 3. Forward lean angle of the trunk decreased up to 4 degrees (more erected) compared to setup. 4. Side lean angle of the trunk increased compared to setup and increased up to 16 degrees as the club length increased. 5. The pelvis moved to the target line direction horizontally and opened up to 31 degrees. Right hip moves laterally to the grip position at the setup. 6. Flexion of the left leg maintained almost constantly but the right leg flexed up to 11 degrees compared to setup. 7. Left arm is straightened but the right arm flexed about 20degrees compared to straight. 8. Center of the shoulders were in front of the knees and toes of the feet. 9. Hands moved to the left (8.7cm), forward (5.7cm) and upward (11.6cm) compared to the setup. This is because of the rotation of pelvis and shoulders. 10. Shaft angle to the ground was smaller than the lie angle of the clubs but it increased close to the lie of the clubs at impact.
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