• Journal of International Academy of Physical Therapy Research
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• v.6 no.1
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• pp.824-827
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• 2015

The purpose of this study was to investigate the effects of joint position on the distraction distance in patients with adhesive capsulitis of glenohumeral joint. The study was conducted upon 20 adults in their 40's with the findings of adhesive capsulitis of glenohumeral joint. These subjects were subdivided into 3 groups, which were a group with neutral position(n=7), second group with resting position(n=7) and third group with end-range position(n=6). After having the subject wearing sleeveless shirts exposing armpit and lying straight on the plinth, a physical therapist with OMT qualification pulled glenohumeral joint at the Grade III of Kaltenborn-Evjenth traction; and the distance between glenoid fossa and humeral head was measured with ultrasound. Following the application of traction, the group with resting position($.67{\pm}0.29$) exhibited the longest distance between humeral head and glenoid fossa, and it was followed by neutral position($.50{\pm}0.25$) and end-range position($.35{\pm}.21$) in this order. From the comparison of these groups, there was no significant difference in distraction distance between resting position and neutral position; and there was again no significant difference in distraction distance between end-range position and neutral position. However, there was a significant difference in distraction distance between end-range position and resting position(p<.05). Upon application of the Grade III of Kaltenborn-Evjenth traction, it was evident that the distance between humeral head and glenoid fossa can be varied depending on the location of the joint.

• Physical Therapy Korea
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• v.30 no.3
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• pp.237-244
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• 2023

Background: The external rotation (ER) exercise in performed at a 90° abduction of the shoulder joint is an effective to strengthen the infraspinatus. However, failure of the humeral head to control axial rotation during exercise can be increased the posterior deltoid over activity. Biofeedback training is an effective method of promoting motor learning and control it could look forward to activate the infraspinatus selectively by controlling the humeral head during exercise. Objects: The aim of this study was investigated that whether biofeedback for axial rotation was effective to activate selectively the infraspinatus during ER exercise. Methods: The 15 healthy males participated, and all subjects performed both ER exercise in a sitting position with shoulder abducted 90° under conditions with and without axial rotation biofeedback. Exercise was performed in a range of 90° ER, divided into three phases: concentric, isometric, and eccentric. The infraspinatus and posterior deltoid muscle activity were observed using surface electromyography. Results: Both infraspinatus activity (p < 0.01) and infraspinatus to posterior deltoid activity ratio (p = 0.01) were significantly higher with biofeedback however, posterior deltoid activity was significantly lower with biofeedback (p = 0.01). The infraspinatus muscle activity and muscle activity ratio were the highest in the isometric contraction type, and there were significant differences for all contraction types (p < 0.05). Whereas, the posterior deltoid activity was the lowest in the isometric contraction type, and showed a significant difference between isometric and other two contraction types (p < 0.05), but no significant different between concentric and eccentric contraction. Conclusion: Our results indicate that the axial rotation biofeedback during sitting ER exercise might be effective method to activating selective infraspinatus muscle and recommended to enhance the dynamic stability of the shoulder joint.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.80-83
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• 2011

Purpose: Traumatic posterior dislocation of the shoulder in a child is extremely rare, and posterior dislocation of the shoulder concomitant with ipsilateral humeral surgical neck fracture has not been reported in a child previously in Korea. Materials and Methods: The authors treated a 10-year-old with posterior dislocation of left shoulder and an ipsilateral humeral surgical neck fracture, that occurred during Taekwondo practice, by open reduction of the shoulder and pin fixation under general anesthesia. Results: A normal range of motion with complete union and good remodeling was achieved without redislocation or avascular necrosis of humeral head at 1 year after surgery. Conclusion: The authors report a successfully treated case of traumatic posterior dislocation of the shoulder with an ipsilateral humeral surgical neck fracture in child.

• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.125-129
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• 2016

Background: Superior migration of humeral head has been conventionally determined by measuring the acromiohumeral distance (AHD), We sought to devise a novel measurement system more reliably and accurately than AHD. We described a structural landmark called 'C-line'. In this study, we investigated the clinical usefulness of 'step-off of the C-line (SOC)' compared to that of AHD. Methods: The C-line formed from the medial margin of the proximal humeral head continuing up to the inferior margin of the articular glenoid and then to the lateral border of the scapula. The superior migration of the humeral head triggered by a rotator cuff tear introduces a discontinuity in this C-line. We measured the distance of this discontinuity. We enrolled 144 patients who underwent a rotator cuff repair. We selected 58 controls who didn't have any cuff lesions apparent on magnetic resonance imaging. Using radiographs derived from standardized true anteroposterior views of the shoulder, we measured the SOC and the AHD. We used t-tests for statistical analyses. Results: A rotator cuff tear was associated with an increase in SOC and a decrease in AHD. In control group, the mean SOC was $1.29{\pm}1.71mm$ and AHD was $9.71{\pm}2.65mm$. In cuff tear group, the mean SOC was $3.15{\pm}3.41mm$ and AHD was $8.28{\pm}1.76mm$. The mean SOCs of the patient group in relation to the mean SOC of the control group according to tear size, the SOCs of medium tear and lager groups showed statistically significant increase (p<0.05). Conclusions: The SOC may be a similarly effective to diagnose cuff tears of medium size and larger compared with AHD.

• The Korean Journal of Pain
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• v.34 no.4
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• pp.375-393
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• 2021

Percutaneous osteoplasty (POP) is defined as the injection of bone cement into various painful bony lesions, refractory to conventional therapy, as an extended technique of percutaneous vertebroplasty (PVP). POP can be applied to benign osteochondral lesions and malignant metastatic lesions throughout the whole skeleton, whereas PVP is restricted to the vertebral body. Common spinal metastases occur in the thoracic (70%), lumbosacral (20%), and cervical (10%) vertebrae, in order of frequency. Extraspinal metastases into the ribs, scapulae, sternum, and humeral head commonly originate from lung and breast cancers; extraspinal metastases into the pelvis and femoral head come from prostate, urinary bladder, colon, and uterine cervical cancers. Pain is aggravated in the dependent (or weight bearing) position, or during movement (or respiration). The tenderness and imaging diagnosis should match. The supposed mechanism of pain relief in POP is the augmentation of damaged bones, thermal and chemical ablation of the nociceptive nerves, and local inhibition of tumor invasion. Adjacent (facet) joint injections may be needed prior to POP (PVP). The length and thickness of the applied needle should be chosen according to the targeted bone. Bone cement is also selected by its osteoconduction, osteoinduction, and osteogenesis. Needle route should be chosen as a shortcut to reach the target bony lesions, without damage to the nerves and vessels. POP is a promising minimally invasive procedure for immediate pain relief. This review provides a technical survey for POPs in painful bony lesions.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2006.03a
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• pp.68-68
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• 2006

• Investigative Magnetic Resonance Imaging
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• v.23 no.3
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• pp.228-240
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• 2019

Purpose: The aim of this study is to evaluate the T2 value of the articular cartilage of the glenohumeral joint in rotator cuff disease displayed on 3.0T MRI and to apply it in clinical practice. Materials and Methods: This study involved sixty-two patients who underwent shoulder MRI containing T2 mapping. The mean T2 value was measured by placing a free hand ROI over the glenoid or humeral cartilage from the bone-cartilage interface to the articular surface on three consecutive, oblique coronal images. The drawn ROI was subsequently divided into superior and inferior segments. The assessed mean T2 values of the articular cartilage of the glenohumeral joint were compared and evaluated based on the degree of rotator cuff tear, the degree of fatty atrophy of the rotator cuff, and the acromiohumeral distance. Results: ICC values between two readers indicated moderate or good reproducibility. The mean T2 value for the articular cartilage of the glenoid and humeral head cartilage failed to show any significant difference based on the degree of rotator cuff tear. However, the mean T2 values of articular cartilage, based on fatty atrophy, tended to be higher in fatty atrophy 3 or fatty atrophy 4 groups while some subregions displayed significantly higher mean T2 values. There was no correlation between the acromiohumeral distance and the mean T2 values of the articular cartilage of the glenoid and humeral head. Conclusion: T2 mapping of the glenohumeral joint failed to show any significant difference in quantitative analysis of the degenerative change of the articular cartilage based on the degree of rotator cuff tear. However, it also offers quantitative information on the degenerative change of cartilage of the glenohumeral joint in patients with rotator cuff tear and severe fatty atrophy of the rotator cuff.

• Physical Therapy Korea
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• v.17 no.3
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• pp.1-10
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• 2010

The purpose of this study was to measure intra-rater and inter-rater reliability and range of motion for measurement of passive shoulder internal rotation range of motion and to compare anterior glide distance of humeral head in three methods. Fifty healthy subjects and fifty patients with shoulder musculoskeletal pain were recruited for this study. The subjects' passive shoulder internal rotation range of motion was measured by visual estimation, manual stabilization, and pressure biofeedback unit methods. In two trials, measurements were performed on each subject by two examiners. Intraclass correlation coefficient (ICC(3,1)) was used to determine the reliability of each measurement. The intra-rater reliability of the three methods was excellent (ICC=.77~.93) in both groups. The inter-rater reliability of the visual estimation method was poor (ICC=.20, .29), the manual scapular stabilization method was poor and fair (ICC=.09, .50), and the pressure biofeedback unit method was excellent (ICC .86, .75) in the experimental and control groups. In the experimental group, the difference of examined range of motion by each examiner was significant in the visual estimation method and manual scapular stabilization method, but there was an insignificant difference between the groups is the pressure biofeedback unit method. This result suggests that the intra-rater and inter-rater reliability of a pressure biofeedback unit was better than the other methods. The difference in distance of the anterior glide of humeral head was insignificant among all the methods. The pressure biofeedback unit method was the most reliable method, so it is proposed to be a new and reliable method to measure internal rotation range of motion.

• Clinics in Shoulder and Elbow
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• v.22 no.4
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• pp.216-219
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• 2019

Background: Progression of the tear size and erosion of the greater tuberosity (femoralization) in the supraspinatus tear makes it difficult to repair or increases the risk of a re-tear. This study examined the proximal articular surface and greater tuberosity of the humeral head in plain radiography. Methods: Two-hundred forty-seven cases, whose anteroposterior (AP) radiographs were taken correctly, were included from 288 cases, in whom the status of the supraspinatus had been confirmed by surgery. After downloading the plain AP radiograph as DICOM, the radius of the circle apposed at the superior half of the articular surface of the head, and the distance between the circle and the farthest point of the greater tuberosity ('height' of the greater tuberosity) were calculated using the software (TechHime, Korea). MRI checked the number of torn tendons and degree of muscular atrophy. Results: The following were encountered: 93 intact supraspinatus, 50 partial-thickness tears, and 104 full-thickness tears. In the analysis using the 93 intact cases, the average radius of the rotation center was 25.3 mm in male and 22.3 mm in female. The average height of the greater tuberosity from the circle with the same rotation center was 4.3 mm in male and 4.2 mm in female with no statistical significance. The correlation between the reparability of supraspinatus and height of the greater tuberosity, fatty infiltration, and muscular atrophy was confirmed. Conclusions: The height of the greater tuberosity from the circle with the same rotation center was 4.3 mm in male and 4.2 mm in female. This height was strongly correlated with muscular atrophy and fatty infiltration of the supraspinatus tendon.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.102-108
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• 2009

Purpose: The bone defects that are associated with shoulder anterior instability may be the causes of failure of arthroscopic surgery. For the treatment of traumatic shoulder instability, we tried to determine the arthroscopic techniques that can be used for the bone defect of the glenoid and the humeral head. The purpose of this study is to assess the surgical techniques for the arthroscopic reconstruction of the shoulder with anterior instability and bone defects. Materials and Methods: We analyzed the articles that have been recently published on anterior shoulder instability and we assessed the arthroscopic surgical techniques. We compared the articles and the methods of arthroscopic surgical techniques for treating bone defects of the anteroinferior glenoid and the posterolateral humeral head, which were considered as the causes of recurrence of shoulder instability. Results: There are the anteroinferior bone defects of the glenoid and Hill-Sachs lesions in the bone defects that appear in patients with anterior shoulder instability. These bone defects are currently the causes of failure of arthroscopic surgery. Conclusion: Open shoulder surgery may be the treatment of the choice for a shoulder with instability and significant bone defects of the glenoid and the humeral head. But efforts are being made to overcome the weaknesses of open surgery by the use of arthroscopy.