• Clinics in Shoulder and Elbow
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• v.24 no.2
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• pp.55-65
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• 2021

Background: Although ultrasound-guided needle decompression (US-GND) can treat calcific tendinitis of the shoulder effectively, repeat procedures might be required for unresolved symptoms. We evaluated the overall clinical outcomes of US-GND with subacromial steroid injection and the final results and factors predisposing toward repeat procedures. Methods: Ninety-eight patients who underwent US-GND for calcific tendinitis of the supraspinatus/infraspinatus were analyzed between March 2017 and December 2018. The clinical outcomes (pain visual analog scale, functional visual analog scale [FVAS], and American Shoulder and Elbow Surgeons [ASES] score) and final subjective satisfaction were compared between groups A (single US-GND) and B (repeat US-GND). The factors predisposing toward repeated US-GNDs were analyzed. Results: We found that 59.3% (58/98) of patient ASES scores were ≥80, and 73.5% of patients (72/98) were satisfied with the outcome. Group B (n=14) demonstrated a significantly higher rate of dominant-arm involvement compared to group A (78.6% vs. 48.8%, p=0.046). However, initial calcification size, shape, number, density, subscapularis involvement, lavage, and procedure time did not differ significantly between the groups. Group B showed poorer final FVAS (7 [interquartile range, 6-8] vs. 8 [interquartile range, 7-9], p=0.036) and subjective satisfaction compared to group A (satisfied: 5 [35.7%] vs. 67 [79.8%], p<0.001]. Conclusions: US-GND with subacromial steroid injection is a viable treatment option for calcific tendinitis of the shoulder. Dominant-arm involvement was the only independent factor for repeated US-GND. Final outcome of repeated US-GND for unimproved patients was promising; however, these outcomes were poor compared to those of the patients who improved after the first procedure.

• Journal of Acupuncture Research
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• v.24 no.6
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• pp.89-96
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• 2007

Objectives : To observe the effect of acupuncture treatment in chronic shoulder pain patients. Methods : 36 voluntary patients were randomly assigned to an acupuncture treatment group(E Group, n=18) and a control group(C Group, n=18). The E Group patients received acupuncture treatment on $LI_{15}$, $TE_{14}$, $GB_{21}$ and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for four weeks. The C Group patients received no treatment. All patients in both groups were instructed to practise self exercise in their daily lives. Evaluations were made at baseline and after four weeks of study. The Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI) and the patient's subjective pain was measured by Visual Analogue Scale(VAS). The obtained data was analyzed. Results : The E Group showed significant(p<0.05) improvement in CSA, SPADI and VAS after four weeks of treatment. The C Group showed significant(p<0.05) improvement in CSA, but the change of SPADI and VAS was insignificant(p>0.05). CSA and SPADI of E Group significantly(p<0.05) improved compared to the C Group, but the difference of VAS change in the two groups was insignificant(p>0.05). Conclusions : Four weeks of acupuncture treatment significantly improved CSA, SPADI and VAS. The improvement of CSA and SPADI was significant(p<0.05) compared to untreated patients.

• Journal of muscle and joint health
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• v.8 no.1
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• pp.27-50
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• 2001

Rheumatoid arthritis is a chronic systemic autoimmune disease. Although the joints are the major loci of the disease activity, fatigue is a common extraarticular symptom that exists in all gradations of rheumatoid arthritis. Fatigue is defined as a subjective sense of generalized tiredness or exhaustion and has multiple dimensions. Therefore fatigue is a common and frequent problem for those with rheumatoid arthritis. In fact, 88-100% of individuals with rheumatoid arthritis experience fatigue. Especially the degree of fatigue is higher in women than men with rheumatoid arthritis. Despite the importance of fatigue among the patients with rheumatoid arthritis, the mechanism that leads to fatigue in rheumatoid arthritis is not completely understood. This study was intended to test and validate a model to predict fatigue in women with rheumatoid arthritis. Especially it was intended to identify the direct and indirect effects of the variables of pain, disability, depression, sleep disturbance, morning stiffness, and symptom duration to fatigue. Data were collected by questionnaires including Multidimensional Assesment of Fatigue(Tack, 1991), numeric scale of pain, graphic scale of joints, Ritchie Articular Index, Korean Health Assessment Questionnaire(Bae, et al., 1998), Inventory of Function Status(Tulman, et al., 1991), Center for Epidemiologic Studies-Depression, and Korean Sleep Scale(Oh, et al 1998). The sample consisted of 345 women with a mean duration of rheumatoid arthritis for 10.06 years and a mean age of 49.64 years. SPSS win and Win LISREL were used for the data analysis. Structural equation modeling revealed the overall fit of the model. Pain predicted fatigue directly and indirectly through disability, depression, and sleep disturbance. Disability, sleep disturbance predicted fatigue only directly, while depression only indirectly through disability and sleep disturbance. Also morning stiffness and symptom duration predicted fatigue through disability and depression. All predictors accounted for 65% of the variance of fatigue. Depression, pain, and disability predicted sleep disturbance. Depression had reciprocal relationship with disability and they both were predicted by pain directly and indirectly. In summary, pain, depression, disability, sleep disturbance, morning stiffness, and symptom duration contributed to the fatigue of patients with rheumatoid arthritis. The best predictor of fatigue was pain. This finding indicates that the modification of pain, depression, disability, sleep disturbance, morning stiffness could be nursing intervention for relief or prevention of fatigue.

• Journal of Korean Medicine Rehabilitation
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• v.33 no.3
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• pp.135-148
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• 2023

Objectives To investigate the effectiveness of acupuncture in the treatment of post-disaster musculoskeletal pain by reviewing relevant clinical studies. Methods A systematic search was conducted across 10 electronic databases to identify relevant clinical studies on acupuncture treatment for post-disaster musculoskeletal pain until May 2023. The methodological quality was evaluated using the Cochrane Risk of Bias 2 and Risk of Bias Assessment tool for non-randomized studies tools. Results Six articles were analyzed, including two randomized controlled trials (RCTs), two before-after studies, one qualitative research, and one case series. Overall, acupuncture therapy showed some improvement in pain scale among musculoskeletal pain survivors. However, no significant improvement was observed in the Short-Form McGill Pain Questionnaire (SF-MPQ-2). Subgroup analysis of participants who completed at least four acupuncture sessions revealed a significant effect on the SFMPQ-2. Additionally, a significant improvement in 36-Item Short Form Survey (SF36P) was observed after 6 months of treatment, but the 2-month treatment period did not show statistically significant effects on SF-36P improvement. The evaluation of the methodological quality of the RCTs identified some concerns of bias. Conclusions The results suggest that acupuncture is effective in alleviating post-disaster musculoskeletal pain. However, considering the limited number of selected studies and the inclusion of subjective evaluation measures, caution should be exercised in interpreting the results. Further large-scale follow-up studies are needed to determine the optimal frequency and duration of acupuncture treatment. Well-designed controlled trials should be conducted to provide more robust evidence regarding the effectiveness of acupuncture for post-disaster musculoskeletal pain.

• Journal of Oral Medicine and Pain
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• v.30 no.4
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• pp.383-389
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• 2005

Xerostomia is defined as a subjective complaint of dry mouth that may be perceived when there is insufficient mucosal wetting. However, the diagnosis and treatment of xerostomia is not that simple because of the fact that the subjective awareness of dry mouth is not always correlated with a diminution in the flow of saliva and there is always a difference between individuals in salivary flow rates needed for normal oral function. In the present study, the aim was to develop a questionnaire to evaluate the dry mouth symptoms and to analyze its reliability and usability as a diagnostic and analytic tool for xerostomia. The questionnaire which consists of 6 Visual Analogue Scale(VAS) type questions to evaluate the subjective oral dryness and 4 questions to evaluate behavior to avoid oral dryness was developed and administered twice with 1 week's interval to the healthy 88 young adults without dry mouth symptoms(44 males and 44 females; mean age was $25.6{\pm}3.1$ years in male and $24.3{\pm}2.1$ years in female). The results were as follows. 1 The intraclass correlation coefficients of 6 questions to evaluate the subjective oral dryness were as significantly high as 0.767 for the degree of oral dryness at other times of the day, 0.850 for the amount of saliva in the mouth, and 0.791 for the degree of effect on daily life due to oral dryness and as high as 0.563 for the degree of oral dryness at night or on awakening, 0.674 for the degree of oral dryness during eating, and 0.641 for the degree of difficulty in swallowing foods. 2. Cronbach's alpha value of 6 questions was 0.982. It can be concluded that the series of questions to evaluate the subjective oral dryness has high internal consistency. 3. Cohen's kappa values of 4 questions to evaluate behavior to relieve oral dryness were as significantly high as 0.850 for the frequency of keeping a glass of water at the bedside and as high as 0.506 the frequency of awakening during sleeping due to oral dryness, 0.419 for the frequency of sipping liquids to aid in eating dry foods, and 0.407 for the frequency of using a candy or chewing gum due to oral dryness. From the results, it can be concluded that the questionnaire consisting of 6 VAS type questions to evaluate the subjective oral dryness and 4 questions to evaluate behavior to relieve oral dryness has reliability of good to excellent level, and that the series of 6 VAS type questions has significantly high internal consistency to evaluate the subjective oral dryness.

• Journal of Oral Medicine and Pain
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• v.38 no.4
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• pp.339-356
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• 2013

This study was designed to evaluate the sex differences in the pain control effect by morphine injection to masticatory muscle pain patients. Patients with masticatory muscle pain visited the Department of Oral Medicine, Kyung Hee University Dental Hospital were recruited to this study and diagnosed by RDC/TMD. Experimental group were divided into four group each from male (n=20) and female (n=20); saline injection group (n=5), lidocaine injection group (n=5), morphine 1.5 mg injection group (n=5) and morphine 3 mg injection group (n=5). Evaluation list was the subjective pain evaluation(visual analogue scale, Mc Gill pain questionnaire, pain drawing) and the objective pain evaluation(pressure pain threshold, pressure pain tolerance) and evaluation time was injection before, after 1 hour, 24 hour, 48 hour and then it was analyzed statistically. The results were as follows : 1. The male and female were significantly different statistically morphine 3 mg group in visual analogue scale evaluation. (male: p<0.05, female: p<0.05) 2. The male and female were more significantly different statistically morphine 3 mg group than morphine 1.5 mg group in McGill pain questionnaire evaluation. (male: p<0.001, female: p<0.01) 3. The male were significantly different statistically morphine 3 mg group in pain drawing evaluation and pressure pain threshold evaluation. (PD: p<0.001, PPT: p<0.05) Therefore, it was revealed that the morphine 3 mg injection for masticatory muscle pain was effective to pain control male patients and more effect than female patients in the objective pain evaluation.

• Journal of Oral Medicine and Pain
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• v.18 no.2
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• pp.29-41
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• 1993

A prevalence study was carried out on 847 CMD patients who had visited the Department of Oral Medicine in Pusan National University from 1990 to 1993. To obtain the same type of information, all subjects were interviewed and examined clinically using a standardized examination form, The ratio of women to men was about 3:1 and all subjects were divided into acute and chronic groups on the basis of 6 months of duration. Diagnostic groups consisted of muscle disorder, joint disorder and muscle-joint disorder. As related to gender, duration and diagnosis subjective and objective symptoms in CMD were studied. The obtained results were as follows : 1. Muscle-joint disorder had the highest percent, followed by muscle disorder and joint disorder. 2. The most common reasons for CMD treatment were pain, joint noise and limited opening, while headache and neckache were relatively often reported as associated symptoms and dizziness, ringing in the ears also reported as secondary CNS excitatory effects. 3. Pain was more ofter seen in women, acute group and muscle-related disorder groups (p<0.05, p<0.01). Noise was significantly frequent in chronic group and joint-related groups (p<0.01). 4. Analysis of contributing factors presented that macrotrauma was found frequently in men (p<0.05), and that muscle-related groups were more related to stress than joint disorder grop (p<0.05). 5. Hard end feel was seen significantly often in joint-related disorder group (p<0.05). On the other hand, soft end feel was frequent in muscle disorder. 6. Reciprocal clicks and crepitation increased with chronicity. Subjects with joint-related disorder groups significantly often reported all kinds of noises (p<0.01). 7. Tender muscles and joints were more often reported in women and chronic group. Whereas muscle-related disorder groups revealed significantly more tender muscles (p<0.01). joint-related disorder groups presented significantly more tender joints (p<0.01).

• Journal of Acupuncture Research
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• v.30 no.5
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• pp.65-76
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• 2013

Objectives : This study was designed to find out the differences of the acupuncture sensation by body parts. Methods : Sixty-three subjects got acupuncture at five acupoints which represent five different body parts ; head($GV_{20}$), abdomen($ST_{25}$), back($BL_{24}$), upper extremity($LU_9$), lower extremity($GB_{40}$). All subjests were asked to complete questionnaire rating the intensity of 13 kinds of acupuncture sensation(acupuncture sensation scale, ASS). We compared the subjective acupuncture sensation between the body parts. Results : Intensity of acupuncture sensation of $GV_{20}$ was significantly lower than $LU_9$(p=0.001) and $GB_{40}$(p=0.000). Sum of acupuncture sensation of $GV_{20}$ was also significantly lower than $BL_{24}$(p=0.011), $LU_9$(p=0.004) and $GB_{40}$(p=0.033). Among the 13 types of acupuncture sensation scale, tingling and aching were well sensed at $GV_{20}$ and $ST_{25}$, aching, tingling and sharp pain were well sensed at $LU_9$, $GB_{40}$, dull pain, deep pressure and heaviness were well sensed at $BL_{24}$. Conclusions : Head showed significantly lower intensity of acupuncture sensation than upper extremity and lower extremity. Among the acupuncture sensation scales, tingling and aching were well sensed at head and abdomen, aching, tingling and sharp pain were well sensed at upper extremity and lower extremity, dull pain, deep pressure and heaviness were well sensed at back.

• The Journal of Advanced Prosthodontics
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• v.6 no.5
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• pp.395-405
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• 2014

PURPOSE. This study aims to investigate the degree of subjective pain and the satisfaction of patients who have undergone an implant treatment using a computer-guided template. MATERIALS AND METHODS. A survey was conducted for 135 patients who have undergone implant surgery with and without the use of the computerguided template during the period of 2012 and 2013 in university hospitals, dental hospitals and dental clinics that practiced implant surgery using the computer-guided template. Likert scale and VAS score were used in the survey questions, and the independent t-test and One-Way ANOVA were performed (${\alpha}=.05$). RESULTS. The route that the subjects were introduced to the computer-guided implant surgery using a surgical template was mostly advices by dentists, and the most common reason for which they chose to undergo such surgery was that it was accurate and safe. Most of them gave an answer that they were willing to recommend it to others. The patients who have undergone the computer-guided implant surgery felt less pain during the operation and showed higher satisfaction than those who have undergone conventional implant surgery. Among the patients who have undergone computer-guided implant surgery, those who also had prior experience of surgery without a computer-guided template expressed higher satisfaction with the former (P<.05). CONCLUSION. In this study, it could be seen that the patients who have undergone computer-guided implant surgery employing a surgical template felt less pain and had higher satisfaction than those with the conventional one, and the dentist's description could provide the confidence about the safety of surgery.

• Physical Therapy Korea
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• v.19 no.2
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• pp.69-79
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• 2012

Importance of the work-related musculoskeletal disorders (WMSDs) has been increasing in the hospital industry such as health care industry and financial industry. This study investigated in order to identify the factors like general, occupational and ergonomically characteristics of the subjects related to musculoskeletal disorders (MSDs) of physical therapists (PTs). Ergonomic tools of rapid upper limb assessment (RULA) were used for evaluation workload of the tasks. Prevalence of MSDs were 13 PTs (26.0%) for neck, 31 PTs (62.0%) for shoulder, 9 PTs (18.0%) for arm/elbow, 27 PTs (54.0%) for hand/wrist, 28 PTs (56.0%) for back, 14 PTs (28.0%) for leg/foot. The analysis of the rate of the pain intensity showed that 53.5% subjects experience moderate pain and 14.0% subjects experience severe pain. Factors which were general characteristics, for example, height, ergonomically characteristics such as 'Posture Score A' were related musculoskeletal subjective symptoms in logistic analysis (p<.05). Among physical therapists, action level of RULA were action level 2 (6.0%), action level 3 (52.0%), action level 4 (42.0%). Physical therapists were estimated one of the highest risk factor in this study. This study suggested that the need of preventive education and program for PTs (physical therapists). Comprehensive and systematic management plans should be established to include both ergonomic and sociopsychological aspects.