• Title/Summary/Keyword: Shoulder rehabilitation

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Effects of glenohumeral corticosteroid injection on stiffness following arthroscopic rotator cuff repair: a prospective, multicentric, case-control study with 18-month follow-up

  • Amyn M. Rajani;Urvil A Shah;Anmol RS Mittal;Sheetal Gupta;Rajesh Garg;Alisha A. Rajani;Gautam Shetty;Meenakshi Punamiya;Richa Singhal
    • Clinics in Shoulder and Elbow
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    • v.26 no.1
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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.

Three Adverse Events Reports of Simple Exanthematous Eruption after Sumsu (Bufonis Venenum) Pharmacopuncture Topical Treatment (섬수약침 국소시술 이후 발생한 단순 피부 발진: 3 이상사례 보고)

  • Yoon, Sang-Hoon;Jo, Hee-Geun;Song, Min-Yeong;Seo, Hyung-Sik
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.3
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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.

Reliability of Scapular Winging Measurement Using a Scapulometer (익상견갑의 평가를 위한 "Scapulometer"의 신뢰도 연구)

  • Weon, Jong-Hyuek;Choi, Houng-Sik;Kwon, Hyuk-Cheol
    • Physical Therapy Korea
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    • v.17 no.2
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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.

The effects of body posture by using Baby Carrier in different ways (아기띠 착용 방법이 신체정렬에 미치는 영향)

  • Kim, Kyoung;Yun, Ki Hyun
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.2
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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.

Relationship between Exercise Stress, Tension, Exercise Habits and Sports Injuries of Professional Golf Players (프로 골프 선수의 운동 스트레스, 긴장도, 운동 습관과 스포츠 손상과의 관계)

  • Seo, Dong-Ick;Choi, Byung-Sun;Seo, Kyung-Mook
    • Journal of Korean Physical Therapy Science
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    • v.19 no.4
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    • pp.17-25
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    • 2012
  • Purpose : The purpose of this study is to know sports injury aspects and relationship between exercise stress, tension, exercise habits and sports injuries. Methods : We surveyed 42 professional golf players who attended Korea Tour during the second half of the year 2010 and have sports injuries with self - assessment questionnaires. Results : According to the types, they had myalgia, tendonitis, ligament sprain in the order. According to the body parts, they had injuries in right thoracic, left cervical, left shoulder region in the order. As a result of the analysis of the sports injury frequency according to the exercise stress and tension, there were no significant differences between the high and low level group. But result of injury regions showed high tension level group showed more damages in right thoracic region (p<0.05). Exercise habits appear subjects had lots of training time, however, they used to skip the muscular strengthening exercise during the on season, but had no significant difference between sports injury frequencies and exercise habit. Conclusion : For the improvement of the athletic performance and prevention of the sports injury, warming-up, cooling-down and muscular strengthening exercise program developments are needed.

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Effect of Blood Flow on Carotid and Vertebral Artery During Forward Shift on Head: Case Study (머리의 전방 이동이 경동맥과 추골동맥 혈류량의 변화에 미치는 영향: 사례연구)

  • Ko, Do-hoon;Kim, Han-il;Kim, Myung-joon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.21 no.1
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    • pp.43-47
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    • 2015
  • Background: The purpose of this study was to identify the effects of the blood flow on carotid and vertebral artery during the forward shift on head. Methods: A 20-year female healthy subject participated in this study. This study was set up the forward shift on head at the 3cm and 6cm in a shoulder midline (acromion). Measurement method were using duplex ultrasound with colour doppler imaging for the blood flow on carotid and vertebral artery. Results: Carotid artery was increased the blood flow and vertebral artery was decreased the blood flow during forward shift on head. Conclusions: These findings suggest that carotid and vertebral artery changes to the blood flow during forward shift on head. Therefore, we should be consider that hemodynamic factor when apply to the therapeutic exercise for patients of forward head posture.

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Treatment Approach of Instable Scapular by Proprioceptive Neuromuscular Facilitation (고유수용성 신경근 촉진법에 의한 견갑골 불안정 치료 접근)

  • Bae, Sung-Soo;Kim, Sang-Soo;Kim, Soo-Min;Kim, Mi-Hyun;Kim, Sik-Hyun
    • PNF and Movement
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    • v.4 no.1
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    • pp.1-7
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    • 2006
  • Objective : The purpose of this study was conducted to find scapular movement instability related with shoulder complex and provide strengthening the scapular muscles with proprioceptive neuromuscular facilitation(PNF). Methods : This is a literature study with books and articles, seminar note and book for PNF international course. Results : The scapular serve as the platform for humeral motions. The scapulothoracic articulation is stabilized and controlled, in part, by the scapular muscles. Therefore, if scapular muscle function is altered, then dysfunctional scapulothoracic kinematics may result. Strengthening exercise for scapular muscles are a common part of rehabilitation programs designed for patients with scapular instability. Conclusion : Treatment of the scapular instability is provided. It is that treatment with combination of isotonic, stabilize reversal on different patient's positions.

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Injury and inflammation detection by the application of microcurrent through the skin

  • Hui, Timothy;Petrofsky, Jerrold
    • Physical Therapy Rehabilitation Science
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    • v.2 no.1
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    • pp.31-38
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    • 2013
  • Objective: To determine the efficacy and reliability of measuring direct current microcurrent applied through the skin to determine injury in the underlying tissues. Design: Case control study. Methods: First, microcurrent was measured as decreased blood flow induced hypoxia in healthy subjects. Next, reliability was assessed by measuring over ten days with set variations in pressure and distance between the electrodes. Finally, measurements over sprained ankle were compared to measurements over comparable uninjured areas on the same injured subject. Results: For the blood flow test phase, microcurrent significantly decreased an average of 17% after 5 minutes (p<0.05), remained decreased for 30 seconds, and returned to non-occlusive levels after 2 minutes of normal circulation. The results indicate that the microcurrent decrease was not due to blood flow, and most likely from hypoxic cellular damage. For the reliability phase, the coefficients of variation averaged 10.3% for the shoulder, 14.8% for the low back, and 29.1% for the knee. Changing distance 2.5 cm between the electrodes resulted in insignificant changes. Changes in pressure had some significant effect after an increase in force of 2.6 N, affirming the need for consistent pressure for measurement. For the injury test phase, a significant 69% decrease occurred comparing injured areas to the same area on the uninjured side, and a significant 74% occurred comparing injured and non-injured areas on the same limb. Conclusions: Microcurrent through the skin shows promise as an objective method of assessing a soft tissue injury by detecting damage likely due to hypoxia.

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Musculoskeletal Model for Assessing Firefighters' Internal Forces and Occupational Musculoskeletal Disorders During Self-Contained Breathing Apparatus Carriage

  • Wang, Shitan;Wang, Yunyi
    • Safety and Health at Work
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    • v.13 no.3
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    • pp.315-325
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    • 2022
  • Background: Firefighters are required to carry self-contained breathing apparatus (SCBA), which increases the risk of musculoskeletal disorders. This study assessed the newly recruited firefighters' internal forces and potential musculoskeletal disorders when carrying SCBA. The effects of SCBA strap lengths were also evaluated. Methods: Kinematic parameters of twelve male subjects running in a control condition with no SCBA equipped and three varying-strapped SCBAs were measured using 3D inertial motion capture. Subsequently, motion data and predicted ground reaction force were inputted for subject-specific musculoskeletal modeling to estimate joint and muscle forces. Results: The knee was exposed to the highest internal force when carrying SCBA, followed by the rectus femoris and hip, while the shoulder had the lowest force compared to the no-SCBA condition. Our model also revealed that adjusting SCBA straps length was an efficient strategy to influence the force that occurred at the lumbar spine, hip, and knee regions. Grey relation analysis indicated that the deviation of the center of mass, step length, and knee flexion-extension angle could be used as the predictor of musculoskeletal disorders. Conclusion: The finding suggested that the training of the newly recruits focuses on the coordinated movement of muscle and joints in the lower limb. The strap lengths around 98-105 cm were also recommended. The findings are expected to provide injury interventions to enhance the occupational health and safety of the newly recruited firefighters.

Delayed Postoperative Paravertebral Abscess in a Patient with Cervical Spinal Cord Injury Accompanied by Ankylosing Spondylitis (강직성 척수염이 있는 경수 손상 환자에서 발생한 지연성 척추주위 농양)

  • Lee, Geon Jae;Lee, Jang Woo
    • Clinical Pain
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    • v.20 no.2
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    • pp.145-149
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    • 2021
  • Ankylosing spondylitis (AS) is a chronic inflammatory disease presenting progressive spinal stiffness and sacroiliitis. Cervical spine fracture combined with AS should be treated with operation, but it is closely related with increased rates of surgical site infection, which are associated with an elevated erythrocyte sedimentation rate and elevated C-reactive protein. We report a case of delayed postoperative infection appeared in cervical paravertebral space, which was masked by laboratory findings and clinical characteristics represented in this rheumatic disease. A 53-year-old man who had medical history of AS got operation after cervical spine fracture. During hospitalization, he experienced aching pain originating from left posterior neck to shoulder, which was revealed out to be delayed postoperative infection, diagnostically obscured by elevated values of inflammatory markers. This case emphasizes detailed evaluation considering symptoms and comorbidity of the patient should be performed to apply proper management.