• Title/Summary/Keyword: Shoulder rehabilitation

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Pain Recovery Pattern According to the Integrity after an Arthroscopic Rotator Cuff Repair (관절경하 회전근 개 봉합술 후 파열 정도에 따른 통증 회복 양상)

  • Kim, Ju-O;Sim, Sang-Don;Noh, Kyung-Hwan;Shon, Suk-June;Kim, Sul-Jun;Yang, Yun-Hyeok
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.155-160
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    • 2009
  • Purpose: The purpose of this study was to evaluate the pain recovery pattern according to the integrity and to analyze the factors affecting the progress and level of pain postoperatively. Materials and Methods: We examined 153 patients, who were treated with arthroscopic rotator cuff repair. 101 rotator cuff tears were full-thickness tear and 52 were partial tear. The mean follow up duration was 20 months (12~30 months). We evaluated the visual analogue scale, range of motion, ASES (American Shoulder and Elbow Surgeons), and UCLA (University of California at Los Angeles) scores preoperatively and postoperatively. We analyzed the pain recovery pattern between partial and full thickness tear using Student T-test and the factors affecting the progress and level of postoperative pain using multiple regression analysis. Results: The change patterns of visual analogue scale after arthroscpoic repair were similar regardless of the tear integrity. The VAS showed a continuous decreasing pattern, but increased at first 3 weeks postoperatively and at 7 weeks postoperatively, and then, decreased thereafter. The average VAS was ${\leqq}2$ points by postoperative 3 months. The factor affecting the pain score at 3 months was related to the preoperative limitation in forward flexion ($r^2=0.377$, p=0.021). Conclusion: There was no differences of the pain recovery pattern according to the integrity, and the factor affecting the progress of postoperative pain was preoperative angle of forward elevation. So, the appropriate preoperative rehabilitation protocol that can improve motions of the shoulder joint would help to improve the level of postoperative pain and functional recovery.

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The Analysis of Conservative Treatment in Midshaft Fractures of Clavicle (쇄골 간부 골절의 보존적 치료 분석)

  • Cha, Seung-Do;Chung, Soo-Tai;Kim, Yong-Hoon;Park, Sang-Jun
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.27-33
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    • 2010
  • Purpose: Most clavicular fractures can be healed by conservative treatment, although there are many factors that influence healing. The aim of the present study was to analyze factors that influence (i) bone union of midshaft fractures of the clavicle treated conservatively and (ii) bone functioning, after union. The long-term goal was to determine which treatments are adequate. Materials and Methods: We evaluated factors that have an effect on bone union and bone function after union. We evaluated age, fracture site, comminution, displacement, shortening and other factors. Among 523 clavicular midshaft fractures that presented between January 2004 and Jun 2009 at our Department of Orthopaedic Surgery, we identified 270 who had conservative treatment and 173 patients who had surgical treatment. Results: The period required for bone union increased with the degree of displacement. For the group below 12 years of age, and the group without comminution, it took half the time to achieve bone union compared with the other groups. Displacement mostly occurred within 2 weeks after conservative treatment. Conclusion: In patients with a comminuted clavicular midshaft fracture, we might, because of expected delays in bone union, delay the start of rehabilitation until patients are more than 13 years old. Because the degree of displacement may be increased within 2 weeks during conservative treatment, we can think about surgical treatments.

What are Valuable Positive Signs of Supraspinatus Test for Diagnosis of Torn Rotator Cuff? - Comparison of Pain and Weakness in "Empty Can Test" and "Full Can Test" - (회전근 개 파열의 진단을 위한 극상근 검사에서 유용한 양성 징후는 무엇인가? - "Empty can test"와 full can test"에서 통증과 근력 약화의 비교 -)

  • Shin, Hun-Kyu;Kim, Eu-Gene;Jeong, Hwa-Jae;Kim, Jong-Min;Choi, Jae-Yol;Lee, Yong-Taek
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.27-32
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    • 2007
  • Purpose: To investigate the validity of positive signs of supraspinatus test. Materials and Methods: The empty can test and full can test were performed on 200 shoulders which were diagnosed with magnetic resonance imaging or surgical findings as full thickness tear, partial thickness tear and no tear. Presence of pain, weakness, pain or weakness, and both pain and weakness were recorded as positive signs separately. The two tests with positive signs were compared and analyzed. Results: Pain and weakness were severity-dependent, and the empty-can test had a higher incidence of pain. The sensitivities of the two supraspinatus tests in all positive signs were higher when including partial-thickness tears in the tear group; however, their specificities were higher when excluding partial-thickness tears. The sensitivities of an empty-can test in 'pain', 'pain or weakness', 'both pain and weakness' were higher than those of the full-can test, otherwise, the specificity of the full-can test for 'pain' and 'pain or weakness' were higher. Concordance rate between 'pain or weakness' and 'pain' was the highest in all categorization. Conclusion: Both empty can and full can test were valuable for detecting torn rotator cuff.

A Study on Job Stress and Working Environment of Female Occupational Therapist (여성 작업치료사의 직무 스트레스와 근무 환경에 관한 연구)

  • Lee, Jae-Hong;Song, Ye-Won;Cha, Tae-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.2
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    • pp.484-492
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    • 2017
  • This study assessed female occupational therapist job stress and musculoskeletal pain, and examines the problems caused by sexual harassment, family, and marriage policy. The results provide information to improve work environments, reduce job stress, yield data needed for sexual harassment prevention education, examine women occupational therapists' economic activities, and broadly improve the quality of life through participation. The study subjects were currently employed female occupational therapists. Initially 200 subjects were recruited, of whom 185 returned the study questionnaire. Questions addressing job stress included, 'There are times when one feels that the salary is worth less than the job effort', 'Feel tired due to work.', 'That it is time to pay attention to other therapy.', answered positively in that order. Musculoskeletal pain in the wrist and hand (90%), shoulder (86%), neck (69.7%) and waist (68.6%) were the order of the wrist and hand (63%), shoulder (62.2%) and waist (51.9%) pain resulted in interference with daily life. Verbal harassment was reported by 71.4% and 48.6% reported physical and visual harassment. The most common topics in workplace relations were 'Must choose whether to focus on the individual or work (61.1%).', 'Need for understanding and someone who can share their feelings (54.6%).', and 'Colleagues are willing to listen to my story (73%)'.

The Effectiveness of Prolotherapy Postoperative Rotator Cuff Tear (회전근 개 봉합 수술 후 증식 요법의 유용성)

  • Moon, Young Lae;You, Jae Won;An, Ki Yong;Cho, Sung Won
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.1
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    • pp.21-25
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    • 2010
  • Purpose: To evaluate efficacy of ultrasound guided prolotherapy in patients with persistant symptoms after rotator cuff repair. Materials and Methods: Between January and December of 2008, 90 patients who had persistant pain and shoulder adhesion 4 weeks after rotator cuff repair were treated with ultrasound guided prolotherapy. The mean age was 55.2 years. Visual analogue scale (VAS) and range of motion (ROM) before and after the procedure, complications related to the procedure were analyzed. Results: The average VAS score at 4 weeks follow up decreased to $2.5{\pm}2.304$ from $6.3{\pm}1.25$ before prolotherapy and forward flexion range at 4 weeks follow up increased to $143{\pm}26.63$ from $106{\pm}21.64.$ Four weeks after the ultrasound guided prolotherapy, 74 cases(82%) reported of improved pain and ROM, 13 cases(14%) reported of improvement after 2~5 days of the procedure and 3 cases(4%) had no improved in pain and ROM. No complications were encountered. Conclusion: The authors believe that ultrasound guided prolotherapy in repaired rotator cuff tear patients theoretically increased possibilities of healing and with relieving the pain of the patients results in increased possibility of rehabilitation effect.

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Arthroscopic Treatment of Acute Acromioclavicular Dislocation using $TightRope^{(R)}$ ($TightRope^{(R)}$를 이용한 관절경적 급성 견봉쇄골 관절 탈구의 치료)

  • Kim, In-Bo;Shon, Myung-Hwan;Kim, Moon-Chan;Kim, Dong-Jun
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.13-18
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    • 2011
  • Purpose: The purpose of this study is to evaluate the radiologic and clinical results of the arthroscopic coracoclavicular fixation of the acute acromioclavicular dislocation using $TightRope^{(R)}$ (Arthrex, Inc, Naples, FL). Materials and Methods: We performed the arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ in twenty patients with the Rockwood type III or V acute acromioclavicular dislocation between February, 2009, and February, 2010. Mean follow-up was 13.4(range 8~22) months. Radiologic results were evaluated by comparing the distances between the clavicle and the coracoid process with those in the contralateral sides using the acromioclavicular stress radiographs. Clinical results were made according to the KSS(Korean Shoulder Scoring System), and the cosmetic satisfaction of the patient was assessed. Results: Radiologically, 18 cases showed excellent, 1 case showed good and 1 case showed fair results. Clinically, KSS was mean 98.5 (range 92~100) points and all cases revealed satisfactory cosmetic results. Because one case complained of skin tenderness and discomfort of palpation, we closed the knot with surrounding muscle & fascia. Then local wound infection occurred, so we treated it by incision and drainage under local anesthesia and antibiotic therapy for 2 weeks. Conclusion: Arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ for treating the Rockwood type III or V acute acromioclavicular dislocation showed satisfactory radiologic and clinical results. It seems to be a good treatment method that has little postoperative complication, provides an early rehabilitation and an excellent cosmetic result, and does not require secondary operation for removal of metal implant.

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Linked (Semi-constrained) Total Elbow Arthroplasty (연결형(반구속형) 주관절 인공 관절 치환술)

  • Jung, Hong Jun;Jeon, In-Ho;Chun, Jae-Myeung;Lee, Tae Kyoon
    • Clinics in Shoulder and Elbow
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    • v.16 no.2
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    • pp.170-177
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    • 2013
  • Total elbow arthroplasty is still in its infancy compared with other arthroplasties, such as knee or hip arthroplasties. Implant design has been evolving with clinical experiences; however, there are only limited data on the long-term clinical outcome of elbow arthroplasty in the literature. The design of total elbow prostheses can be divided into three categories: linked (constrained or semi-constrained), unlinked (unconstrained), and convertible types. The choice between an unlinked (unconstrained) implant and a linked (semi-constrained) implant depends on joint stability and adequacy of the bone stock. Linked elbow arthroplasty has provided high patient satisfaction, and pain relief thanks to proper patient selection, advancement of implant design, improvement in cement techniques, meticulous surgical technique, and appropriate postoperative rehabilitation. Concerns remain about the use of this implant in young or high-demand patients. This article focuses on the linked (semi-constrained) prostheses, which provides an overview of the current state of linked total elbow arthroplasty.

Effect of Increase in Occlusal Vertical Dimension on Appendage Muscle Strength (수직적 교합고경의 증가가 사지 근력에 미치는 영향에 관한 연구)

  • Ahn, Su-Jin;Lee, Richard Sung-Bok;Lee, Suk-Won
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.2
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    • pp.169-178
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    • 2010
  • Objective. This study was conducted to observe the effect on appendage muscle strength according to increase in occlusal vertical dimension. Materials and methods. Ten males with a mean age of 21 were selected. The tested occlusal splints were made at the position of increased occlusal vertical dimension of 2mm,3.5mm and 5mm from the intercuspal position. Before and after wearing occlusal splints, the appendage muscle strength were tested by Cybex II dynamometer (Lumex Inc., Ronkonkoma, NY, USA). Results. Statistical analysis using the paired t-test revealed significant differences for flexion and extension of the hip, pronation of the forearm, internal rotation of the shoulder, external and internal rotation of the knee, and dorsiflexion and plantarflexion of the ankle (p<0.05). Conclusions. As the result of this study, we conclude that when occlusal vertical dimension was increased, most of mean muscular strength values were increased. Especially at the position of 3.5mm increased vertical dimension displayed the highest mean muscular strength value than other positions.

The Effect of Human Appendage Muscle Strength on Increase in Vertical Dimension from Intercuspal Position of Mandible (교두감합위로부터 출발한 수직교합고경의 단계적 증가가 사지 근력에 미치는 영향에 관한 연구)

  • Hong, Dong-Hee;Lee, Sung-Bok;Choi, Dae-Kyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.19 no.3
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    • pp.169-183
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    • 2003
  • According to our recent investigation that the increase in the occlusal vertical dimension made the appendage muscle strength got higher, the occlusal appliances were made by increasing the occlusal vertical dimension "from the centric relation" position of the mandible. In this experiment, the authors tried to study the change in the appendage muscle strength due to increase in occlusal vertical dimension from intercuspal position(ICP) of mandible with the same subjects and manner as the former experiment. For this study, ten male athletes in a mean age of 23 year who were joined the former study were selected. All the subjects had a complete or almost complete set of natural teeth and reported no subjective symptoms of temporomandibular disorders. Upper and lower casts were mounted on the semi-adjustable articulator at the intercuspal position and a point was marked on the attached gingival area between the right canine and the right 1st. premolar in each upper and lower cast. From the points, the occlusal vertical dimension was increased by 2mm, 3.5mm and 5mm, and then each 10 maxillary type occlusal splint at each 3-increased position were fabricated with heat curing clear acrylic resin. Including the intercuspal position, the 3 kinds of occlusal splints were placed on the subjects individually, and then isokinetic muscle strength on 7 parts of the human appendage which are shoulder, knee, ankle, wrist, forearm, elbow and hip was measured with the CYBEX 6000 SYSTEM (Lumex, NewYork, USA). The results were as follows: The highest mean value in muscular strength was shown at the position of 2mm-increased vertical dimension. The muscle strength during internal/external rotation of shoulder and knee, plantarflexion of ankle, flexion of elbow, and flexion and extension of hip at the increased occlusal vertical dimension position were significantly higher than them at the intercuspal position (p<0.05). Only in view of the increase in the appendage muscle strength, regardless of the way of making the occlusal splints by elevating the occlusal vertical dimension from the centric relation position or intercuspal position, the occlusal splints had an effect on the increase of isokinetic muscle strength at the occlusal vertical dimension which increased within the proper range on the habitual arc of closure.

Analysis of trunk angle and muscle activation during chest compression in 119 EMTs (가슴압박시 구급대원의 체간 각도와 근활성도 분석)

  • Shin, Dong-Min;Lee, Chang-Sub;Kim, Seung-Yong;Kim, Chang-Kook;Hong, Eun-Jeong;Lee, Young-Chul;Choi, Ga-Ram;Kim, Gyoung-Yong;Jang, Mun-Sun;Kim, Jeong-Hee;Han, Boong-Ki;Lee, Jong-Kun;Tak, Yang-Ju
    • The Korean Journal of Emergency Medical Services
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    • v.18 no.3
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    • pp.7-18
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    • 2014
  • Purpose: We aimed to investigate trunk angle and muscle activation of the extremity and back to evaluate the effect of chest compression on work-related musculoskeletal disorders in 119 emergency medical technicians (EMTs). Methods: Eighteen 119 EMTs performed 2-minute chest compression without interruption on a cardiopulmonary resuscitation manikin, during which we measured changes in the trunk and shoulder joint angles, muscle activation (triceps brachii, biceps brachii, erector spinae, gluteus maximus, pectoralis major, rectus abdominis, and rectus femoris) and chest compression accuracy. Results: The decrease in trunk angle by trunk muscle activation was the highest in event 2, the major direction of chest compression. Both shoulder joint angles had no significant difference. Muscle activation of the triceps brachii (p < .01), biceps brachii (p < .05), rectus abdominis (p < .05) and rectus femoris (p < .01) significantly increased during the compression phase compared with the decompression phase, with the rectus femoris showing an increase of 19%. Muscle activation of the erector spinae significantly increased in the decompression phase compared with the compression phase (p < .01). Conclusion: 119 EMTs mainly use the triceps brachii, biceps brachii and pectoralis major muscles during chest compression.