• 대한통합의학회지
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• 제8권1호
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• pp.169-175
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• 2020

Purpose : This study was performed to comparison of distance change of subacromial space according to shoulder abduction angle in loaded and unloaded conditions. Methods : The subjects were 20 male college students, and the subacromial space was measured using an ultrasound diagnostic apparatus. The participants shoulder abduction was measured during each shoulder resting position and 45 ° abduction with loads of 1 kg, 2 kg, 3 kg. The collected data were analyzed by a paired t-test and repeated measure ANOVA with the SPSS (Ver. 22) program. Results : The subacromial space showed statistically significant decreased in 45 ° abduction than resting position (p<.001). All the subacromial space increased during the according to loads (1 kg, 2 kg, 3 kg) at the resting position but at 45 ° abduction showed statistically significant decreased as the load increases (p<.05). Also, subacromial space showed significant changes in the 2kg, 3kg compared with the 0kg loads. Conclusion : These results identified that shoulder abduction angle and load were related to subacromial space. When resting position, subacromial space is larger at loads than unload. As the load and shoulder abduction angle increase, subacromial space is reduced compared to resting.

• 대한물리의학회지
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• 제6권4호
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• pp.397-406
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• 2011

Purpose : Recently ultrasound images has been used to measure the subacromial space with a linear measurement of the acromiohumeral distance. The purpose of this study was to comparison of distance of subacromial space using ultrasonographic measurement on arm positions of shoulder injured patients. Methods : The subjects were 30 shoulder injured patients (19 males and 11 females). Ultrasonography was performed to measure subacromial space during each shoulder resting position, $45^{\circ}$ abduction, internal rotation with $45^{\circ}$ abduction and external rotation with $45^{\circ}$ abduction. Results : Subacromial space was a significantly difference between injured arm and normal arm at shoulder resting position. At $45^{\circ}$ abduction, subacromial space was narrowing significantly between injured arm and normal arm. At external rotation with $45^{\circ}$ abduction, subacromial space were wider in normal arm than in injured arm but it was not significantly. Intra-observer reliability for ultrasonography measurement of subacromial distance was excellent (.96~.99). Conclusion : These results identified that positions of injured shoulder was related to subacromion space.

• The Journal of Korean Physical Therapy
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• 제35권3호
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• pp.71-76
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• 2023

Purpose: This study investigated effect of the scapular retraction exercise on the subacromial and costoclavicular space using different thera-band intensities. Methods: Thirty-six healthy adults participated in this study, and the subjects were randomly divided into three groups (low, moderate, and high-intensity groups). The exercise was conducted twice a week for three weeks. The subacromial and costoclavicular space were measured before and after the intervention via ultrasonography. Data analysis was performed using the two-way Analysis of Variance with repeated measures and the paired t-test. Results: The effect of the scapular retraction exercise on the subacromial and costoclavicular space using a thera-band after a 60° shoulder abduction has significant difference in all groups (p<0.05). However, there was no significant difference between the groups, and the values in the groups before the exercise did not differ significantly from those after the exercise (p>0.05). Conclusion: Our results indicate that the scapular retraction exercise after a 60° shoulder abduction can be used to widen the subacromial and costoclavicular spaces.

• Clinics in Shoulder and Elbow
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• 제27권1호
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• pp.11-17
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• 2024

Background: Rotator cuff tears are often associated with synovitis, but the ability of noninvasive ultrasonography to predict the severity of synovitis remains unclear. We investigated whether ultrasound parameters, namely peak systolic velocity in the anterior humeral circumflex artery and Doppler activity in the glenohumeral joint and subacromial space, reflect synovitis severity. Methods: A total of 54 patients undergoing arthroscopic rotator cuff repair were selected. Doppler ultrasound was used to measure peak systolic velocity in the anterior humeral circumflex artery and Doppler activity in the glenohumeral joint and subacromial space, and these values were compared with the intraoperative synovitis score in univariate and multivariate analyses. Results: Univariate analyses revealed that tear size, peak systolic velocity in the anterior humeral circumflex artery, and Doppler activity in the glenohumeral joint were associated with synovitis in the glenohumeral joint (P=0.02, P<0.001, P=0.02, respectively). In the subacromial space, tear size, peak systolic velocity in the anterior humeral circumflex artery, and Doppler activity in the subacromial space were associated with synovitis severity (P=0.02, P<0.001, P=0.02, respectively). Multivariate analyses indicated that tear size and peak systolic velocity in the anterior humeral circumflex artery were independently associated with synovitis scores in both the glenohumeral joint and the subacromial space (all P<0.05). Conclusions: These findings demonstrate that tear size and peak systolic velocity in the anterior humeral circumflex artery, which can both be measured noninvasively, are useful indicators of synovitis severity.

• Journal of Acupuncture Research
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• 제38권3호
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• pp.242-244
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• 2021

LI15 is an important acupuncture point to treat shoulder pain. There are 4 needling methods for LI15 in the textbook; 1 method requires the insertion of the needle horizontally between the acromion and the great tuberosity of the humerus with the arm lowered for supraspinatus tendonitis. This method is also applicable for all conditions of rotator cuff disease, but it has not previously been described in detail. Providing X-ray scans and describing needle direction and depth of insertion will provide evidence for needling with the arm down as an effective stimulation of the subacromial space. Firstly, for this technique, with the arm raised, a concave point is located between the front edge of the acromion and the humerus, and the lower upper arm. Secondly, the acupuncture needle is inserted slightly posteriorly towards the supraspinous fossa, in the direction of the supraspinatus tendon and to a depth of 30-40 mm.

• 대한물리의학회지
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• 제17권1호
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• pp.49-61
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• 2022

PURPOSE: This study compared the effects of proprioceptive sensation, subacromial space, and dynamic function according to proprioceptive neuromuscular facilitation (PNF), static stretching (SS), and complex rotational stretching (CRS). METHODS: Thirty students without any musculoskeletal disease who volunteered to participate were included in this study. The following metrics were measured to evaluate the function and stability under the normal conditions, with the PNF, SS, and CRS: special test and flexion, extension, abduction, adduction, internal rotation, external rotation (shoulder range of motion) and reaching distance on the medial (ME), superolateral (SL), inferolateral (IL), and subacromial space and proprioceptive sensation were evaluated. All measures were analyzed using one-way ANOVA and repeated measures of ANOVA. RESULTS: A clear difference in adduction in the range of motion was observed in all groups (p < .05). Significant differences could not be identified in all values in the error test, except for Ab (p < .05). Significant differences in reach were noted in all directions of the SS and PNF in the Me, SL, and IL (p < .05). After the intervention, significant differences in the average values could be identified in all groups except for the SS group after rest (p < .05). After the intervention, there was a significant difference between the CRS and SS and PNF groups (p < .05). CONCLUSION: The application of CRS is as helpful as the existing SS and PNF for improving the joint range of motion improvement, shoulder balance, and subacromial space.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2008년도 제16차 학술대회
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• pp.172-172
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• 2008

Pigmented villonodular synovitis (PVNS) is a rare, benign, proliferating disease affecting the synovium of joints, bursae, and tendon sheaths. The knee is the most common site of involvement and accounts for up to 80% of cases. Involvement of the shoulder is extremely rare. Only 1 case of involvement of the subacromial space has been reported worldwide. We report a case of localized extra-articular PVNS of the subacromial space that was satisfactorily treated with marginal excision; the disease has not recurred during an 18-month follow-up period. The clinical manifestation, treatment, and prognosis of extra-articular PVNS are poorly understood, but if the lesion is left untreated, it can invade the surrounding soft tissue and joint. Therefore, we believe that early diagnosis and treatment are important for the satisfactory management of PVNS.

• Clinics in Shoulder and Elbow
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• 제10권2호
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• pp.232-235
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• 2007

다발성 미립체는 만성 류마토이드 관절염이나 만성 점액낭염의 합병증으로 드물게 발생하는 질환으로 어떤 기저 질환 없이도 발생할 수 있다. 활막 연골종증과 유사하기 때문에 수술 전 정확한 진단을 위해 단순 방사선과 자기 공명 영상 소견이 필요한 것으로 알려져 있다. 저자들은 우 견관절의 통증과 운동 제한을 주소로 내원한 37세 남자에서 견봉하 점액낭에 점액낭염을 동반한 다량의 미립체를 발견하고 관절경적으로 치료 후 좋은 결과를 얻었기에 문헌 고찰과 함께 보고하고자 한다.

• Clinics in Shoulder and Elbow
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• 제3권2호
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• pp.102-108
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• 2000

The aim of this study is to determine if intra-bursal morphine and Bupivacaine mixed infusion provided useful analgesia after subacromial arthroscopic operation. At the end of the subacromial arthroscopy, continuous intra-bursal infusion catheter was inserted. In a double-blind randomized trial, Sixty patients were allocated to one of two groups: placebo group(n=30) received continuous saline infusion. Study group received mixed 5㎖ of 0.5% Bupivacaine, 2㎎ of morphine and 0.05㎖ of 1/1000 epinephrine as bolus and mixed solution of 40㎖ of 0.5% Bupivacaine and 8㎎ of morphine as maintenance dose with continuous infusion pump(0.5㎖ hourly). In the placebo group, two patients were discontinued due to leakage and catheter coming out each. Intensity of pain was evaluated preoperatively and postoperatively for 3 days by 10 graded visual analogue scale. Night pain, pain on motion, sleep disturbance, lying on painful shoulder and amounts of intramuscular pain killer were recorded. Analgesic effect for pain was cleared at 1st and 2nd postoperative day and there was less sleep disturbance for 3 days postoperatively in study group. There was no difference in pain on motion postoperatively. In study group, less pain killers were used in the first 48 hours postoperatively. The continuous intra-bursal infusion decreased perception of pain at resting stage and reduced supplemental analgesic requirement for 2 days postoperatively.

• 대한정형도수물리치료학회지
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• 제13권1호
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• pp.67-72
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• 2007

Anatomy: The rotator cuff comprises four muscles-the subscapularis, the supraspinatus, the infraspinatus and the teres minor-and their musculotendinous attachments. The subscapularis muscle is innervated by the subscapular nerve and originates on the scapula. It inserts on the lesser tuberosity of the humerus. The supraspinatus and infraspinatus are both innervated by the suprascapular nerve, originate in the scapula and insert on the greater tuberosity. The teres minor is innervated by the axillary nerve, originates on the scapula and inserts on the greater tuberosity. The subacromial space lies underneath the acromion, the coracoid process, the acromioclavicular joint and the coracoacromial ligament. A bursa in the subacromial space provides lubrication for the rotator cuff. Etiology: The space between the undersurface of the acromion and the superior aspect of the humeral head is called the impingement interval. This space is normally narrow and is maximally narrow when the arm is abducted. Any condition that further narrows this space can cause impingement. Impingement can result from extrinsic compression or from loss of competency of the rotator cuff. Syndrome: Neer divided impingement syndrome into three stages. Stage I involves edema and/or hemorrhage. This stage generally occurs in patients less than 25 years of age and is frequently associated with an overuse injury. Generally, at this stage the syndrome is reversible. Stage II is more advanced and tends to occur in patients 25 to 40 years of age. The pathologic changes that are now evident show fibrosis as well as irreversible tendon changes. Stage III generally occurs in patients over 50 years of age and frequently involves a tendon rupture or tear. Stage III is largely a process of attrition and the culmination of fibrosis and tendinosis that have been present for many years. Treatment: In patients with stage I impingement, conservative treatment is often sufficient. Conservative treatment involves resting and stopping the offending activity. It may also involve prolonged physical therapy. Sport and job modifications may be beneficial. Nonsteroidal anti - inflammatory drugs(NSAIDS) and ice treatments can relieve pain. Ice packs applied for 20 minutes three times a day may help. A sling is never used, because adhesive capsulitis can result from immobilization.