• 대한물리의학회지
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• 제5권3호
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• pp.477-485
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• 2010

Purpose : The clinical scale to assess spasticity of muscle was wildly used the modified Ashworth scale (MAS). But reliability of the MAS has been controverted for ambiguity among the grades. The purpose of this study was to establish the inter-rater reliability of the modified MAS (MMAS) translated into Korean in stroke patients. Methods : Twenty-five patients (sixteen men and nine women) with hemiplegia (ten right and fifteen left) were measured by two raters who were physical therapist in the rehabilitation hospital. The raters assessed spasticity of shoulder adductor, elbow flexor, wrist flexor, hip adductor, knee extensor, and ankle plantar flexor in the same patients according to ratings criteria of the MAS and the MMAS. Results : For the inter-rater reliability of the MAS, two raters agreed on 57.3% and the Kappa values were moderate ($\kappa$=0.41) between two rater. The inter-rater reliability of the MAS was fair for the wrist flexor and the hip adductor and moderate for the other muscles. The intra-rater reliability was good for the shoulder adductor and the knee extensor and moderate for the other muscles. For the inter-rater reliability of the MMAS, two raters agreed on 84.7% and the Kappa values were good ($\kappa$=0.78) between two rater. The inter-rater reliability of the MMAS was moderate for the hip adductor, and good for the shoulder adductor and the wrist flexor, and very good for the other muscles. The intra-rater reliability was good for the wrist flexor and the hip adductor and very good for the other muscles. Conclusion : This study suggests that the MMAS translated into Korean is reliable test scale for the spasticity with stroke patients in the clinical field.

• Clinics in Shoulder and Elbow
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• 제9권2호
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• pp.176-180
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• 2006

Purpose: Although surgical arthroscopic repair of rotator cuff has become much more common as surgeons have developed proficient techniques, it is still technically difficult. The purpose of this study was to evaluate the clinical results and the usefulness of mini-open repair in large and massive size tears. Materials & Methods: From January 2000 to December 2004, sixteen patients were treated with mini-open repair. There were 10 male and 6 female patients with the average age of 62.5 years. The size of tear was massive in 4 cases and large in 12 cases. All tears were repaired with metal anchor sutures. The mean duration of follow-up period was 23 months. Postoperative results were evaluated based on American Shoulder and Elbow Society scoring system. Results: Five patients showed excellent results, five good, and two fair in large tears while one patient showed excellent result, one good, and two fair in massive tears. Poor outcome was not seen during the follow-up period. There was no significant relationship between the patient's age and the size of tear, and postoperative results. However, the relationship between the duration of symptomatic period in preoperation and postoperative results showed significant correlation. Conclusion: Mini-open repair combined with the preservation of deltoid and early rehabilitation is clinically useful in large and massive size rotator cuff tear patients treatment.

• 대한한의학회지
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• 제23권2호
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• pp.180-189
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• 2002

Background and Purpose : The hemiplegic upper extremity is affected in many stroke patients, and recovery is often poor. The purpose of this study was to assess the efficacy of electroacupuncture (EA) in enhancing the upper extremity motor and functional recovery of ischemic stroke patients. Subjects and Methods : Forty ischemic stroke patients (the upper extremity Fugl-Meyer motor scale (FM) score lower than 46, lesion location within middle cerebral artery territory) within 2 weeks of stroke onset were randomly allocated to either an EA group that received EA treatment or a control group that received only routine ward care. The EA was applied at Quchi-Shousanli (LI11-LI10), Waiguan-Hegu (TE5-LI4) points on the hemiparetic side six times per week for 4 weeks. The frequency of stimulation was 25-50Hz and the intensity was set at a level sufficient to induce muscle contraction. EA treatment was given for 30 minutes and all patients of both groups received standard rehabilitation program. Outcomes were assessed, in a blind manner, before treatment began and at 4 weeks after treatment, with the FM, the Motor Power score (MP) for shoulder/elbow, and the subsection of the Modified Barthel Index (MBI) for drinking/feeding/dressing upper body/grooming. Results : These 2 groups had comparable clinical characteristics, lesion location, lesion size, and pretreatment impairment scores. By the end of treatment, the EA group showed significantly more improvement than the control group in the subsection of the FM for shoulder/elbow/coordination (6.4 vs. 3.7; P=0.047) and the MP for shoulder/elbow (5.3 vs. 3.3; P=0.008). The subsection scores of the MBI for drinking/feeding/dressing upper body/grooming were not significantly different between two groups. No adverse effects due to treatment were found Conclusion : These results suggest that EA enhances the upper extremity motor recovery of acute stroke patients. However, this study failed to demonstrate any significant functional benefit related with upper extremity. Future study should be carried out in a larger sample size and use the functional outcome measure that is more specific and sensitive to the upper extremity.

• Clinics in Shoulder and Elbow
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• 제23권2호
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• pp.86-93
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• 2020

Background: Several systematic reviews have reported on the conservative treatment of full-thickness rotator cuff tears; however, clinical results of this treatment still remain determined. Methods: PubMed, Cochrane Library, PEDro, and CINAHL databases were systematically searched for randomized clinical trials and observational studies. Two independent researchers reviewed a total of 2,981 articles, 28 of which met the criteria for inclusion in the study. Clinical outcome measures included Constant score, visual analog scale score for pain, range of motion, and short-form 36 questionnaires. The meta-analysis used a linear mixed model weighted with the variance of the estimate. Results: The meta-analysis showed a significant improvement after surgery. Pain score is 26.2 mm (1 month) to 26.4 mm (3 months), and 24.8 mm (12 months) (P<0.05); active abduction: 153.2° (2 months), 159.0° (6 months), 168.1° (12 months) (P<0.05); Constant score: 67.8 points (2 months) to 77.2 points (12 months) (P<0.05); short-form 36 questionnaires "vitality" section: 57.0 points (6 months) to 70.0 points (12 months) (P<0.05). Conclusions: Our data confirmed the effectiveness of conservative treatment in patients with full-thickness rotator cuff tears 12 months post-intervention. The results suggest that conservative treatment for patients with full-thickness rotator cuff tears should be the first line of treatment before considering surgery.

• 대한물리치료과학회지
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• 제15권3호
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• pp.31-41
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• 2008

Purpose : The purpose of this study is to examine the muscle activity of shoulder stabilization according to change of supporting base interval between push-up bend and push-up plus position and is to prevent or treat a shoulder injury by the most effective exercise for rehabilitation. Methods : This study analyzed the muscle activity according to change of supporting base interval between push-up bend and push-up plus movement. The participants without neuromuscular disease were 25 students - 12 males and 13 females - all twenty or over and the surface electrode of EMG attached on pectoralis major, triceps long head, middle trapezius, lower trapezius, serratus anterior and latissimus dorsi. The process has practiced 3 sessions of supporting base interval - narrowing interval, two shoulder interval, broad interval - by push-up bend and push-up plus movement. Result : 1. The muscle activity of pectoralis major was significantly increased according to narrow interval of supporting base on push-up plus movement and was significant difference(p<.05). 2. The muscle activity of biceps was significantly increased according to narrow interval of supporting base on push-up bend movement(p<.05). 3. The muscle activity of middle or lower trapezius was a difference according to change of supporting base on push-up bend and push-up plus movement but was not significant difference. 4. The muscle activity of serratus anterior was significantly increased according to broad interval of supporting base on push-up bend movement(p<.05). 5. The muscle activity of latissimus dorsi was significantly increased according to broad interval of supporting base on push-up bend movement(p<.05). Conclusion : These results lead us to the conclusion that push-up bend exercise have the effect of muscle strength of biceps on narrowing interval, of serratus anterior or latissimus dorsi on broad interval and push-up plus exercise have the effect of muscle strength of pectoralis major on narrowing interval of support base.

• The Journal of Korean Physical Therapy
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• 제26권6호
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• pp.449-452
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• 2014

Purpose: The purpose of this study was to analyze the coordination between trunk flexion and lower limb extension contributing to vertical propulsion during sit-to-stand (STS) at different chair heights in the elderly. Methods: Ten elderly subjects were asked to stand up at their natural speed from different chair heights : (1) $90^{\circ}$ knee flexion; (2) $100^{\circ}$ knee flexion; (3) $110^{\circ}$ knee flexion; and (4) $120^{\circ}$ knee flexion. A standard chair without a backrest or armrests was used in this study. To remove inertial effects of upper limb movements, subjects were asked to stand up from a chair with their arms crossed at the chest. Mean of results of three trials were used in the analysis at different knee flexion angles. Distances moved by the shoulder for compensatory trunk movement was recorded by motion analysis and vertical force was recorded under foot using force plates. Distances moved by the shoulder and vertical ground reaction force measurements were analyzed using repeated ANOVA. Results: Distances moved by the shoulder significantly decreased with higher chair (p<0.05). Vertical forces were not significant difference on chair heights (p>0.05), but results of pairwise comparisons for vertical force revealed significant difference between $90^{\circ}$ knee flexion and $120^{\circ}$ knee flexion (p<0.05). Conclusion: Trunk movement is probably used as a compensatory mechanism at low chair heights to increase lift-off from sitting by the elderly.

• Clinics in Shoulder and Elbow
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• 제26권1호
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• pp.64-70
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• 2023

Background: This study aimed to analyze the efficacy of single-dose corticosteroid injection (CSI) administered at 6 weeks postoperative to treat stiffness following arthroscopic rotator cuff repair (ARCR). Methods: In this prospective, multicentric, case-control study, post-ARCR stiffness at 6 weeks was treated with either a single dose of intra-articular CSI (CSI group) or physical therapy with oral analgesics (non-CSI group). Pain intensity according to visual analog scale (VAS), functional outcome using the Constant Murley Shoulder Score, time to return to activities of daily living (ADLs), and retear rate were recorded at 6 weeks, 9 weeks, 12 weeks, 6 months, 12 months, and 18 months postoperatively in both groups. Results: A total of 149 patients (54.5%) in the CSI group and 124 patients (45.5%) in the non-CSI group were included in this study. Pain and function were significantly better in the CSI group at 9-week, 12-week, and 6-month (P<0.001) follow-up, whereas they were not significantly different when the groups were compared at 12- and 18-month follow-up. The mean duration to return to ADLs was significantly shorter (P<0.001) in the CSI group. The incidence of retears was not significantly different (P=0.36) between groups at the end of 18 months of follow-up. Conclusions: Single-dose intra-articular CSI administered at 6 weeks postoperative to treat post-ARCR stiffness significantly improved pain, function, and duration of return to ADLs without increasing the risk of retears compared to patients who did not receive intra-articular CSI. Level of evidence: III.

• 한방재활의학과학회지
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• 제28권3호
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• pp.119-124
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• 2018

Three cases of simple exanthematous eruption were suspected during Sumsu (Bufonis Venenum) pharmacopuncture (SP) topical anesthesia for acupotomy. Patients had skin rash with pruritus on both ankle, posterior neck, and left shoulder after 11, 12, and 7 times of SP treatment, respectively. There were no cases of systemic manifestations or changes in vital signs. As a result of using the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) causality assessment, all the cases were evaluated as 'unlikely'. However, the results of using the Korean algorithm for assessing the causality of drug adverse reactions version 2.0 were evaluated as 'possible'. This report is the first case report on adverse events suspected of occurring after SP treatment. Although the causal relationship between suspected intervention and the adverse event is not clear, there was a difficulty in completely excluding the possibility. Additional safety studies will be required to make SP more widely available.

• 한국전문물리치료학회지
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• 제17권2호
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• pp.10-16
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• 2010

This study was undertaken to develop the scapulometer, a measuring tool for scapular winging, and to determine the reliability of scapulometer. Thirty subjects with scapular winging greater than 2 cm participated in this study. Two examiners measured scapular winging using the scapulometer. Standardized measurement position of each subject was as follows: neutral position of shoulder and wrist, $90^{\circ}$ flexion of elbow, and cuff weight of 5% and 10% of body weight (BW) to neutral wrist. The interrater and intrarater reliability were calculated with an intraclass correlation coefficient (ICC) with 95% confidence interval (CI) and standard error of measurement (SEM) at 5% BW and 10% BW. The level of scapular winging was tested between 5% BW and 10% BW with a paired t-test. The interrater reliability was shown to be high at 5% BW (ICC(2,k)=.955, 95% CI=.900~.979, SEM=.07) and at 10% BW (ICC(2,k)=.968, 95% CI=.930~.985, SEM=.06). The intrarater reliability was shown to be high at 5% BW (ICC(2,k)=.921, 95% CI=.842~.961, SEM=.09) and at 10% BW (ICC(2,k)=.906, 95% CI=.813~.954, SEM=.10). The level of scapular winging was significantly different between 5% BW and 10% BW. Conclusively, it is demonstrated that the scapulometer is an objective and qualitative measurement tool for scapular winging.

• 대한물리의학회지
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• 제8권2호
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• pp.193-200
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• 2013

PURPOSE: The purpose of this study was to find out variations in body posture by using the baby carrier at the front side and back side. METHODS: Thirty two healthy and young female who will bring up infants and had no musculoskeletal disorders of neck, lumbar and low limb were recruited for this study. They were each marked about ears of tragus, cervical 7th, acromion anterior end, anterior superior iliac spine, posterior superior iliac spine, greater trochanter and lateral malleolus as landmarks to measure variations of body posture when they carry infants at the front side and back side. Landmarks were regarded as the creteria in order to measure NeckFlexion angle(NF), Foreward shoulder angle(FSA), Pelvic tilt(PT), Sway angle(SA), Head displacement(HD) and Scapular displacement(SD). Variations in body posture were measured from the neutral position to the front and back side by using Image J. RESULTS: There were significance level (p<.05) in NF, PT, SA, HD and SD except for FSA in two different side. CONCLUSION: The results of this study indicate that each of the using ways of baby carrier for baby care was influenced postural responses of young women. therefore, it could be considered to apply to women who have abnormal body posture in order to minimize musculoskeletal disorders.