• 대한물리의학회지
• /
• 제2권2호
• /
• pp.243-250
• /
• 2007

Purpose : Shoulder subluxation is a very common problem in patients with hemiplegia with stroke. Prevention of the low tone subluxed shoulder has been an issue for physical therapists working with neurological patients for many years. Methods : This study reviewed the literature to definite the management and a cause of shoulder subluxation with hemiplegia patients after stroke. Various modalities have been suggested for realigning the glenohumeral joint, but their use is controversial. The purpose of this paper is to review critically the evidence base in order to inform the clinical decision-making process for physiotherapists working in neurology. Results : Literature has identified supports, strapping and functional electrical stimulation(FES) in the management of low tone shoulders. Following review of this evidence it is suggested that there is a lack of reliable and valid research evidence on which to base conclusions. The modalities with the best supporting evidence for realigning the low tone subluxed glenohumeral joint are the triangular sling, Harris hemi sling and the Rolyan humeral cuff used in a standing position and the lap board and arm trough while the patient is sitting. However, due to soft tissue adaptation with associated lack of movement, over-correction and the need for careful patient positioning these supports need to be evaluated for each patient and should be used only in appropriate situations. Conclusion : Similarly, there is a lack of evidence on the effects of long-term use to this equipment. Electrical stimulation is also thought to have potential in the treatment to subluxed low tone shoulders but additional research is required to clarify the parameters for use and the long-term effects of these forms of management.

• 대한정형도수물리치료학회지
• /
• 제16권1호
• /
• pp.9-19
• /
• 2010

Purpose : To identify whether isometric shoulder horizontal extension (ISHE) exercise could sufficiently activate the lumbar multifidus muscle, and to determine appropriate exercise intensity to increase muscle strength. Methods : Twenty healthy volunteers (10 males and 10 females) participated in this study. ISHE exercises on the dominant side were performed with $90^{\circ}$ shoulder abduction held in $90^{\circ}$ elbow flexion so that their arms were in the horizontal plane. Electromyographic (EMG) measurements of multifidus activation were performed in standing and supine positions, and were taken under four strength conditions: 75%, 50% and 25% of maximum shoulder horizontal extension strength, and maximum strength. Results : The EMG activations of both lumbar multifidus increased significantly with ISHE exercises of larger % strength (p<.05). In their multifidus EMG data measured in standing and supine positions, men differed significantly in their 75%, 50% and 25% strength for both sides (p<.05), and women differed significantly in their 75%, 50% and 25% strength on their 5th lumbar vertebrae's left side, but 75% only for their 5th lumbar vertebrae's right side (p<.05). The EMG data of 5th lumbar vertebrae's left and 5th lumbar vertebrae's right sides appeared to differ significantly at all strength levels for men while standing, but only at the 25% level for women in the supine position (p<.05). These findings indicate that ISHE exercises can be considered a beneficial method to enhance the multifidus strength. Conclusion : This study provides useful information for further study in this field.

• Clinics in Shoulder and Elbow
• /
• 제21권4호
• /
• pp.179-185
• /
• 2018

Background: We analyzed the angle between the glenoid anterior surface and glenoid axis, the range of the glenoid apex and the location of the glenoid apex for assistance during shoulder surgery. Methods: Sixty-two patients underwent a computed tomography of the shoulder with a proximal humerus fracture. In the range of the glenoid apex, the ratios of the distribution of triangles with a Constant anterior and posterior area of the glenoid were measured. The location of glenoid apex was confirmed as the percentage of the position with respect to the upper part of the glenoid with the center of the part, analyzed the angle between the glenoid anterior surface and glenoid axis was measured. Results: The angle between the glenoid anterior surface and glenoid axis was $19.80^{\circ}{\pm}3.88^{\circ}$. The location of the glenoid apex is $60.36%{\pm}9.31%$, with the upper end of the glenoid as the reference. The range of the glenoid apex was $21.16%{\pm}4.98%$. When the height of the glenoid becomes smaller, the range of the glenoid apex tends to become larger (p=0.001) and the range of the glenoid apex becomes wider (p=0.001) as the glenoid width narrows. Conclusions: We believe the anatomical measurements of the glenoid will be helpful for a more accurate insertion in glenoid component. It is thought that more accurate insertion is possible if we can set other anatomical measurements using computed tomography imaging of the glenoid which can develop into the study of other anatomical measurements.

• Journal of Gynecologic Oncology
• /
• 제29권6호
• /
• pp.92.1-92.9
• /
• 2018

Objective: To evaluate the effectiveness of the pulmonary recruitment maneuver (PRM) at the end of the operation to decrease laparoscopy-induced abdominal or shoulder pain after gynecological oncologic surgery. Methods: In total, 113 women undergoing laparoscopic surgery for malignant or premalignant gynecological lesions were assigned randomly to two groups: the PRM group (the patient was placed in the Trendelenburg position ($30^{\circ}$) and the PRM, consisting of two manual pulmonary inflations to a maximum pressure of $40cmH_2O$) (n=54) and the control group (n=52). Postoperative shoulder and abdominal pain was assessed 12, 24, and 48 hours later using a visual analog scale (0-10). In addition, the incidence of post-discharge nausea and vomiting was recorded until 48 hours after discharge. Results: Postoperative shoulder pain at 12 and 24 hours was significantly less severe in the PRM group ($2.2{\pm}0.5$ and $2.0{\pm}0.4$) than in the control group ($4.0{\pm}0.5$ and $3.9{\pm}0.4$; both p<0.001). The PRM significantly reduced the severity of upper abdominal pain at 12 and 24 h compared with the control group ($3.1{\pm}0.4$ and $2.9{\pm}0.4$ vs. $2.9{\pm}0.5$ and $4.9{\pm}0.5$; both p<0.001). The analgesic requirement during the postoperative period was similar in the two groups (control group, 78.8%; PRM group, 75.9%; p=0.719). Conclusion: The PRM effectively and safely reduced postoperative shoulder and upper abdominal pain levels in patients undergoing laparoscopic gynecological oncologic surgery. Trial registry at ClinicalTrials.gov, NCT01940042.

• 한국전문물리치료학회지
• /
• 제30권3호
• /
• pp.237-244
• /
• 2023

Background: The external rotation (ER) exercise in performed at a 90° abduction of the shoulder joint is an effective to strengthen the infraspinatus. However, failure of the humeral head to control axial rotation during exercise can be increased the posterior deltoid over activity. Biofeedback training is an effective method of promoting motor learning and control it could look forward to activate the infraspinatus selectively by controlling the humeral head during exercise. Objects: The aim of this study was investigated that whether biofeedback for axial rotation was effective to activate selectively the infraspinatus during ER exercise. Methods: The 15 healthy males participated, and all subjects performed both ER exercise in a sitting position with shoulder abducted 90° under conditions with and without axial rotation biofeedback. Exercise was performed in a range of 90° ER, divided into three phases: concentric, isometric, and eccentric. The infraspinatus and posterior deltoid muscle activity were observed using surface electromyography. Results: Both infraspinatus activity (p < 0.01) and infraspinatus to posterior deltoid activity ratio (p = 0.01) were significantly higher with biofeedback however, posterior deltoid activity was significantly lower with biofeedback (p = 0.01). The infraspinatus muscle activity and muscle activity ratio were the highest in the isometric contraction type, and there were significant differences for all contraction types (p < 0.05). Whereas, the posterior deltoid activity was the lowest in the isometric contraction type, and showed a significant difference between isometric and other two contraction types (p < 0.05), but no significant different between concentric and eccentric contraction. Conclusion: Our results indicate that the axial rotation biofeedback during sitting ER exercise might be effective method to activating selective infraspinatus muscle and recommended to enhance the dynamic stability of the shoulder joint.

• 제어로봇시스템학회:학술대회논문집
• /
• 제어로봇시스템학회 1990년도 한국자동제어학술회의논문집(국제학술편); KOEX, Seoul; 26-27 Oct. 1990
• /
• pp.896-901
• /
• 1990

A simulation analysis is presented for the position control of a single-link flexible manipulator whose end-effector is subjected to an impulsive force. Arm is rotated by a d.c. servomotor at the shoulder so that the end point stays precisely at its initial position even if the end effector is thumped with the impulsive loading. A gap sensor is used to measure the tip displacement. The control torque based on the PD control law is applied to the motor through the driver circuit. The control strategy is tested by means of computer simulation for the one-link flexible-arm prototype in the authers' laboratory at Tohoku Univ.

• The Journal of Korean Physical Therapy
• /
• 제26권3호
• /
• pp.140-146
• /
• 2014

Purpose: Differences in scapular kinematics and muscle activity appear in the forward head and rounded shoulder posture (FHRSP). Thus, the aim of this study was to investigate the following effects according to different postures on scapular kinematics and muscle activity around scapular region in individuals with and without FHRSP during overhead reaching task. Methods: Thirty pain-free subjects with/without FHRSP participated in this study. All subjects were positioned into three positions: habitual head posture (HHP), self-perceived ideal head posture (SIHP) and therapist-perceived neutral head posture (TNHP). Muscle activities of upper trapezius (UT), lower trapezius (LT) and serratus anterior (SA) were measured during overhead reaching task. Results: Muscle activity of trapezius muscle (UT and LT) during HHP was significantly higher than SIHP and TNHP in FHRSP group (p<0.05), but there was no difference between SIHP and TNHP. SA also significantly increased muscle activity in HHP more than SIHP and TNHP in FHRSP group (p<0.05), but there was no significant difference between SIHP and TNHP. In Non-FHRSP group, although there was a tendency of different muscle activities among three postures, it was not statistically significant. Conclusion: This result demonstrates that muscle activity associated with overhead reaching task is increased in HHP which affects the scapular kinematics and SIHP contributes changed scapular kinematics and proper recruitment of muscle activity in FHRSP similarly to TNHP.

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2008년도 제16차 학술대회
• /
• pp.84-84
• /
• 2008

최근 견관절 질환의 상당수가 관절경 수술로 이루어지고 있다. 좌체위(beath chair position)를 이용한 관절경 수술은 시술 중 관헐적 방법으로의 전환이 용이하고 공간에 대한 orientation을 쉽게 잡을 수 있어 선호되고 있다. 또한 관절경 수술 시 시야 확보를 위해 epinephrine을 혼합한 세척액이 통상적으로 사용되고 있다. 관절경 수술 시 심부 정맥 혈전증(deep vein thrombosis), 가스 색전증, 세척액에 사용하는 epinephrine에 의한 심실성 빈맥 등과 같은 치명적인 부작용이 가끔 보고되어 있다. 관절경하 견관절 수술 도중 심실 빈맥의 발생은 매우 드문 경우이며 이에 대한 보고도 거의 없는 상태이다. 저자들은 2주의 기간 동안 좌체위로 관절경하 견관절 수술을 하는 도중 갑작스럽게 발생한 심실 빈맥 2예를 경험하였기에 원인 및 치료 과정을 보고하고자 한다. 좌체위로 인한 뇌혈류 저하, 가스 색전증 등의 증세는 없었다. 관절경술 도중 세척액에 투입된 소량의 epinephrine이 동시에 체내로 급속히 유입되어 심실 빈맥이 왔으리라 추정하고 있으며, 실험을 통해 이를 증명하고자 하였다.

• 한국운동역학회지
• /
• 제13권3호
• /
• pp.311-325
• /
• 2003

A relation between the movement range of arms and arising moment has been studied to find out efficient movement range to minimize impact concerning arm landing in sports aerobics. Four male athletes who won top three in national-level sports aerobics competition were chosen for the experiment. They were allowed to jump in between two force platform so that the right hand and the right leg could land onto the front and rear force platform, respectively. The sampling frequency was 200 Hz. The main conclusions based on the analysis of the angle and joint moment parameters of wrist, elbow, and shoulder are as follows: 1. The wrist moment was small when its angle was small, indicating that the dorsi-flexion of the wrist joint offered a positive influence to reduce wrist moment. 2. The elbow angle increased as wrist angle decreased and vice versa. This means that the movement range of the wrist joint affects that of the elbow joint. The darsi-flexion of the wrist is the position to absorb the impact of the elbow effectively rather than to absorb the impact of the wrist itself. The impact is absorbed by the flexion of wrist joint rather than the wrist. 3. The degree of moment transfer of the shoulder joint, having absorbed the impact from the elbow and elbow joint, became dependent on the efficiency of the fore-joints impact absorption.

• 한국운동역학회지
• /
• 제20권3호
• /
• pp.311-318
• /
• 2010

This study examined the double piked dismount among the landing techniques of parallel bars based on three-dimensional motion analysis. Four male national gymnasts were the subjects. This study was performed to provide quantitative data highlighting players strengths and weaknesses to enable more stable landing technique. The variables analyzed were the position and velocity of center of gravity(CG) and angles of shoulder joints, hip joints, and trunk. The results are as follows: S1 secured the height of flight with fast vertical rise. After the easy spin in the air, he conducted a stable landing maintaining a proper hip joints angle. S2, S3, and S4, however, began the backward somersault already before leaving the bars, so they moved backward greatly making it more difficult to achieve a higher flight path. As a result, they couldn't control the velocity of their backward movement at landing. For a stable landing, they have to maintain the negative shoulder angle when rising, minimize both antero-posterioror side-to-side movements by doing a strong tap using hip joints, to secure the height of flight before the somersault. Results also show that at the descent, they should conduct rapid spinning by increasing their shoulder and hip joints to the maximum while controlling their velocity.