• Clinics in Shoulder and Elbow
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• 제20권2호
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• pp.77-83
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• 2017

Background: Although there have been multiple reports on surgical outcomes of superior labral anterior to posterior (SLAP) lesions in overhead athletes, only a few reports exist in the literature about the results of nonoperative treatment in elite (collegiate or professional) overhead athletes. To determine the clinical outcomes of nonoperative treatment of SLAP lesions in elite overhead athletes. Methods: Between January 2006 and December 2011, 69 patients were selected. Initial arthroscopic SLAP repair was performed in 19 patients and of the 50 patients who underwent nonsurgical treatment, such as range of motion gain and periscapular muscle strengthening, 14 patients were converted to surgical treatment; 5 patients were lost to follow-up. Medical records of 31 elite overhead athletes who underwent nonsurgical treatment were retrospectively reviewed. Four clinical outcome measures were used: visual analogue scale (VAS) for pain, VAS for satisfaction, American Shoulder and Elbow Surgeons (ASES) score, and subjective feeling of recovery. Results: The average follow-up period was 35.9 months (range, 24-62 months). The VAS for pain decreased from 6.5 to 2.2 (p<0.01) and VAS for satisfaction was 7.6. The ASES score increased from 54.1 to 85.9 (p<0.01). The overall average value of subjective feeling of recovery was 72%. Twenty-three out of 31 elite athletes (74.2%) returned to play after rehabilitation; these 23 athletes performed at the same or higher levels after rehabilitation. Conclusions: Nonsurgical treatment in elite overhead athletes with SLAP lesion should be considered as a treatment option.

• 대한한방내과학회지
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• 제42권5호
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• pp.767-776
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• 2021

Objective: This study examined a case in which insomnia and pain due to herniated intervertebral disks were improved by treatment with an oriental herbal and the administration of Uhwangchungsim-won. Case Summary: Three patients with insomnia diagnosed with herniated intervertebral disks were treated with a series of Korean medical therapies, including the herbal medication Uhwangchungsim-won, acupuncture, herbal acupuncture, and physical therapy. We used the Numerical Rating Scale (NRS) to measure subjective sleep states and the European Quality of Life Five Dimensions (EQ-5d) Scale to evaluate the therapeutic effect. Following treatment, subjective sleep states and the overall scores for pain had improved. Conclusion: The results indicate that Korean medical therapies with Uhwangchungsim-won have beneficial effects on insomnia for patients with herniated intervertebral disks.

• Clinics in Shoulder and Elbow
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• 제24권2호
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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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• 제24권6호
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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.

• 근관절건강학회지
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• 제8권1호
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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.

• 한방재활의학과학회지
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• 제33권3호
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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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• 제30권4호
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• pp.383-389
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• 2005

구강건조증은 입안이 마르는 느낌의 주관적 증상을 의미하는 것으로 타액분비의 감소에 따른 불충분한 구강점막의 습윤도에 의해 발생할 수 있다. 그러나 구강건조증의 정도는 실제 측정된 객관적인 타액분비율과 상관관계를 보이지 않는 경우도 있어 그 진단과 치료에 어려움을 야기한다. 본 연구에서는 이러한 구강건조증의 진단과 평가를 위해 구강건조증 환자의 문제 해결을 위한 설문지를 개발하고 설문지의 문항들이 갖는 신뢰도를 분석하여 향후 구강건조증의 연구 및 진단 도구로서의 활용가능성을 알아보고자 하였다. 이를 위하여 구강건조감의 정도를 Visual Analogue Scale(VAS) 척도로 답하는 6 가지 문항과 구강건조감에 따른 행동을 파악하기 위한 4 가지 문항을 개발하고 문항들이 갖는 신뢰도를 평가하기 위하여 구강건조증의 증상을 호소하지 않는 건강한 성인 남녀 88 명(남자 44 명, 평균 $25.6{\pm}3.1$세, 여자 44 명, 평균 $24.3{\pm}2.1$세)을 대상으로 2 회에 걸쳐 질문에 답하도록 하여 다음과 같은 결과를 얻었다. 1. 구강건조감의 정도를 묻는 6 가지 문항의 급내상관계수(intraclass correlation coefficient; ICC) 값은 낮 시간의 구강건조감의 정도(Dry-day)가 0.767, 입안에 침이 적다고 느끼는 정도(Am-sal)가 0.850, 구강건조감으로 인한 일상 생활의 불편감 정도(Eff-life)가 0.791로 매우 높은 신뢰도를 나타내었고, 밤 또는 아침 기상시의 구강건조감의 정도(Dry-PM)가 0.563, 식사시의 구강건조감의 정도(Dry-eat)가 0.674, 음식물을 삼키기 힘든 정도(Dif-swal)가 0.641로 높은 급내상관계수 값을 나타내었다. 2. 6 개의 문항들의 내적 일치도를 평가하는 크론바흐의 알파(Cronbach's alpha) 값은 0.928로 매우 높게 나타났다. 3. 구강건조감에 따른 행동을 파악하기 위한 4 가지 문항들의 코헨의 카파(Cohen's kappa) 값은 잠자리 옆에 물을 준비하게 되는 빈도($H_2O$-bed)는 0.850으로 매우 높은 신뢰도를 나타내었고, 입이 말라 잠을 깨는 빈도(Night-awake)가 0.506, 마른 음식 섭취시에 물을 마시게 되는 빈도(Sip-liq)가 0.419, 껌이나 사탕을 먹게 되는 빈도(Gum-candy)가 0.407로 높은 신뢰도를 나타내었다. 이러한 결과로부터 VAS 척도로 답변하는 주관적 구강건조감의 정도를 묻는 6 가지 질문과 주어진 보기를 선택하여 답변하는 구강건조증에 따른 행동을 묻는 4 가지 질문으로 구성된 설문은 중등도 이상의 신뢰도를 가지고 있고 VAS 척도로 답변하는 6 가지 질문은 매우 높은 내적 일치도를 가지고 있음을 알 수 있었다.

• Journal of Oral Medicine and Pain
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• 제38권4호
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• pp.339-356
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• 2013

이 연구에서는 말초 opioid 수용체를 이용한 저작근 통증 조절 시 성별 효과의 차이를 확인하고자 RDC/TMD로 진단된 지원자 남성 20명, 여성 20명을 saline 주사군, lidocaine 주사군, morphine 1.5 mg 주사군, morphine 3 mg 주사군 각각 5명씩 배정하였다. 통증부위에 주사 전, 주사 후 1시간, 24시간, 48시간에 각각 주관적인 통증 평가인 시각유추척도평가, 맥길통증설문지 평가, 통증부위표시평가 그리고 객관적인 통증 평가인 압력통증역치평가와 압력통증한계평가를 실시하였다. 검사 후 평가된 자료를 통계 처리하여 다음과 같은 결과를 얻었다. 1. 시각유추척도평가에서는 남녀 모두가 morphine 3 mg군에서 통계학적으로 유의성 있는 효과가 있었다. (male: p<0.05, female: p<0.05) 2. 맥길통증설문지 평가에서는 남녀 모두가 morphine 1.5 mg군 보다 morphine 3 mg군에서 더 통계학적으로 유의성 있는 효과가 있었다. (male: p<0.001, female: p<0.01) 3. 통증부위표시평가와 압력통증역치평가에서는 남성이 morphine 3 mg군에서 통계학적으로 유의성 있는 효과가 있었다. (PD: p<0.001, PPT: p<0.05) 이상의 연구 결과로 저작근 통증을 조절하기 위해서 morphine 3 mg을 통증부위에 주사한 경우 객관적인 통증 평가에서 여성 환자보다 남성 환자에게 더 효과가 있다는 것을 알 수 있었으며, 앞으로 시간에 따른 그리고 용량에 따른 남녀 치료효과의 차이에 관한 연구가 더 필요 할 것으로 생각된다.

• Journal of Oral Medicine and Pain
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• 제18권2호
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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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• 제30권5호
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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.