• Clinics in Shoulder and Elbow
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• 제7권2호
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• pp.76-82
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• 2004

Purpose: In the traumatic anterior shoulder instability, the laxity of joint capsule and ligament is frequently demonstrated. Although a arthroscopic procedure to address anterior instability with joint capsular redundancy have generally provided good results, its recurrence rate is higher than open procedure. By reducing the capsular redundancy, thermal shrinkage is likely to improve the outcome of arthroscopic anterior stabilization. The objective of this study was to evaluate additional thermal capsular shrinkage as a treatment of joint capsular redundancy in anterior shoulder instability. Materials and Methods: From March 1999 to June 2000, 25 shoulders of 23 patients of recurrent anterior shoulder dislocation underwent arthroscopic Bankart repair with shrinkage procedure. The mean follow up was 29 months and average age at the time of operation was 26 years. Of these patients, 20 were male and 3 were female who had been experienced the average 8 times of dislocation before operation. Thermal shrinkage alone without Bankart repair was performed in two cases who did not have Bankart lesion. The clinical result was evaluated in according to Modified Rowe Score. Results: The Modified Rowe Score was improved from preoperative 35 points to postoperative 88 points. None of cases showed recurrence of dislocation. But, in two cases, temporary sensory hypesthesia of the axillary nerve was developed and in two cases of postoperative stiffness, arthroscopic capsular release and brisement were performed. Conclusion: Additional capsular shrinkage in arthroscopic technique to address recurrent anterior shoulder instability could treat effectively the capsular redundancy.

• 대한통합의학회지
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• 제11권1호
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• pp.121-130
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• 2023

Purpose : This study aimed to investigate the effect of blood flow restriction exercise on ankle muscle strength and balance ability to achieve maximum efficiency with the same exercise intensity and time. Methods : Twenty-six adults are randomly assigned to experimental group (n=13) and comparison group (n=13). The experimental group performed ankle joint strength exercises with blood flow restriction applied while the comparison group performed ankle joint strength exercises without blood flow restriction applied three times a week for four weeks. The digital muscle measurement, Y-balance test, and Cumberland ankle instability tool were used to evaluate the subject's muscle strength, dynamic balance, and ankle instability index before and after the intervention. Results : In within-group comparison muscle strength, all the two groups showed significant improvements post intervention (p<.05). In between-group comparison, there was significant difference in the change of dorsiflexion, eversion strength pre and post intervention (p<.05). but plantarflexion was no significant difference between pre and post intervention in the group comparison (p>.05). In within-group comparison dynamic balance, all the two groups showed significant improvements post intervention (p<.05). In between-group comparison, there was no significant difference in the change of Y-balance score pre and post intervention (p>.05). In within-group comparison ankle instability index, all the two groups showed significant improvements post intervention (p<.05). In between-group comparison, there was no significant difference in the change of CAIT score pre and post intervention (p>.05). Conclusion : The results of this study show that ankle joint strength exercise improved the strength and balance ability of those complaining of chronic ankle instability, and ankle joint strength exercise applied with blood flow restriction was more effective in dorsiflexion and eversion strength exercise than ankle joint strength exercise without blood flow restriction.

• 유통과학연구
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• 제14권6호
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• pp.107-118
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• 2016

Purpose - Over 90% of Domestic logistics industry is small enterprise and they are experiencing growth stagnation due to price-based competition structure rather than constructing logistics service of high added value. In order to get over this situation and pursue the development of logistics industry, strengthening its competitiveness, through inter-enterprise cooperative network build-up, would be a key alternative. Therefore, in this study, an index for measuring inter-enterprise cooperation level of Joint logistics business will be developed as a typical collaborative business model in logistics industry. Moreover, a strengthening competitiveness method suggests a developmental step and a key management index to mature in logistics industry. Research Design, Data, Methodology - This study is an index development research for measuring inter-enterprise cooperation level of logistics industry. Such a level was measured by performing a survey by targeting enterprises that participated in Joint logistics business. The targeting enterprises are typical cooperative models in logistics industry. Measurement items were developed which were based on the presented items in existing research. Question items were composed of selection type questions as answering Yes/No. They measures implementation status of corporate activity and detailed activity items measuring qualitative level. Total samples were based on 116 enterprise samples including 90 logistics enterprises and 26 shippers. In addition, by evaluating the importance for Joint logistics business recognition with personnel working level, the weight of measuring variable was extracted. This study has built an assessment tools (LPCI) on Joint logistics business cooperation level in a situation where there are no previous studies on joint logistics business, this study is meaningful for other studies. Results - As a result of analyzing LPCI presented in this study, the score of logistics enterprise was represented as 59.9 points based on full score of 100 points and that of shippers as 47.2 points and cooperation level among enterprises participated in Joint logistics business was revealed to be very low. In particular, as a result of measuring the importance between logistics enterprise and shippers, the difference by each measurement standard was represented among those enterprises. This difference is considered to be a key factor that cooperative operational conformity between logistics enterprises and shippers is represented to be low. Conclusions - As most joint logistics business, being promoted at present, is sharing facility and information with joint logistics business, it is hard to find such a joint logistics business in reality based on cooperative business model in main cooperation agents. Therefore, competitiveness of logistics industry could be strengthened by promoting joint logistics business based on their mutual cooperation among enterprises. In other words, it is to secure sustainable competitiveness of joint logistics business together with creation of new market by inter-enterprise cooperation based on integration of basic logistics business.

• 대한족부족관절학회지
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• 제16권1호
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• pp.38-46
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• 2012

Purpose: This study was performed retrospectively to evaluate clinical outcomes of distal metatarsal osteotomy using bio-compression screw as the joint preservation method for advanced hallux rigidus. Materials and Methods: Eleven cases were followed up for more than 1 year after distal metatarsal dorsal wedge osteotomy for advanced hallux rigidus. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) score and patient's satisfaction score. The range of motion, and the period to return to running exercise, tip-toeing gait, squatting, walking down the stairs were evaluated. As the radiographic evaluation, the interval of $1^{st}$ MTP (metatarsophalangeal) joint space and the period to union were measured. Results: The AOFAS hallux score had improved significantly from preoperative average 50.7 points to 87.6 points at the last follow-up (p=0.005). The subjective satisfaction score was average 90.6 points. There were no case of subsequent fusion or additional operation, and no complication associated with bio-compression screw. The period to return to running exercise, tip-toeing gait, squatting, walking down the stairs were average of 24.8 weeks, 20.4 weeks, 16.8 weeks, 18.5 weeks respectively. Dorsiflexion of $1^{st}$ MTP joint had improved significantly from preoperative average $17.5^{\circ}$ to $44^{\circ}$ (p<0.001). All cases achieved union of osteotomy site, and the period to union was average 10.4 weeks. The interval of $1^{st}$ MTP joint space had improved significantly from preoperative average 1.2 mm to 3.5 mm (p=0.014). Conclusion: Distal metatarsal osteotomy using bio-compression screw seems to be one of effective treatment methods for advanced hallux rigidus, because of restoration of the first MTP joint motion, and reliable pain relief, and needlessness of hardware removal.

• The Journal of Korean Physical Therapy
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• 제27권6호
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• pp.381-385
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• 2015

Purpose: This study was to identify the relationship between the game score and muscle strength in order to elucidate whether the obtained score for the dorsiflexor and plantar flexor muscles in the ankle joint using an EMG-based interactive game system can reflect muscle strength as measured conventionally. Methods: Forty adults were enrolled in the present study. They had no congenital deformities, and no neurological or orthopedic disorders in the 6 months prior to the start of the study. The Biodex were used to measure the isokinetic concentric maximal strength of the plantar flexor and dorsiflexor muscles in the ankle joint. EMG electrodes were attached to the tibialis anterior and gastrocnemius. Results: (1) There was a positive relationship between the obtained game score by the plantar flexor (sPF) and muscle strength of the plantar flexor (tPF) and dorsiflexor (tDF). In addition, the tPF affected the sPF, but the tDF did not. Thus, the higher the tPF, the higher the sPF. (2) There was no relationship between the obtained game score of dorsiflexor (sDF) and tPF or tDF. In addition, neither the tDF or tPF affected the sDF. Conclusion: The game score had a relationship with muscle strength, which is related to ankle instability and re-impairment. Thus we suggest that this game system can be used to predict the degree of weakness of muscle strength.

• Clinics in Shoulder and Elbow
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• 제20권2호
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• pp.95-99
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• 2017

Background: The purpose of this study was to investigate the clinical and radiological outcomes of locking plate fixation with fibular strut allograft to manage unstable osteoporotic proximal humerus fractures. Methods: We retrospectively reviewed 15 patients who underwent open reduction and locking plate fixation with fibular strut allograft for osteoporotic proximal humerus fracture between July 2011 and June 2015. For functional evaluation, we evaluated visual analogue scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) shoulder score, and active range of motion. For radiological evaluation, shoulder true anteroposterior (AP) and AP in $20^{\circ}$ external rotation, as well as the axillary view were taken at two weeks, six weeks, three months, six months, and one year. And the neck-shaft angle was measured on the AP view in $20^{\circ}$ external rotation view. Results: At the one-year follow-up, mean VAS pain score and all shoulder scores, including ASES score and UCLA shoulder score, exhibited satisfactory clinical outcomes. All patients obtained bone union between three and six months post-procedure. Moreover, the mean immediate postoperative neck-shaft angle was $138^{\circ}{\pm}4^{\circ}$, and at one-year follow-up, the neck shaft angle was $137^{\circ}{\pm}5^{\circ}$. There was no significant difference between the preoperative and postoperative values (p=0.105). Conclusions: For the unstable two-part and three-part osteoporotic proximal humerus fractures with medial calcar comminution, the use of fibular strut allograft with locking plate fixation was effective in maintaining the initial status of reduction and exhibiting the satisfactory functional and radiological outcomes.

• 근관절건강학회지
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• 제9권2호
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• pp.187-202
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• 2002

This study was aim to provide rheumatoid arthritis patients the basic data of development of nursing intervention to help psychosocial adaptation of rheumatoid arthritis patients as exploring the relationship among causal perception, coping pattern, psychosocial adaptation of rheumatoid arthritis. As the results of this study the mean score of causal perception of the subjects was 3.37. The score of the internal-unstable was the highest. which was followed by extra-stable, internal factor, internal-stable, external factor and external-unstable in order among the factor of causal perception. The mean score of coping pattern was 2.64. The type of coping patterns the score of the receptive coping was the highest, which was followed by wishful coping active coping and negative coping in order among the type of coping pattern. The mean score of psychosocial adaptation was 3.28. The subconcept of psychosocial adaptation the score for personal relationship was the highest, which was followed by role function and mental state in order among the psychosocial adaptation. The analysis of the relation among causal perception, coping pattern and psychosocial adaptation showed significant negative correlation between causal perception and psychosocial adaptation(r=-0.3219, P=0.002). The analysis of the relation between the type of coping pattern and psychosocial adaptation showed significant negative correlation between psychosocial adaptation and active coping(r=-0.3210, P=0.002), negative coping(r=-0.2296, P=0.032). Only causal perception(-.36) and period of illness(-.26) effected on the psychosocial adaptation were shown to the negative direction significantly. The psychosocial adaptation was explained the 17% by these two variables. Based on this study results the factor of causal perception and the type of coping pattern of rheumatoid arthritis were shown significant relations between psychosocial adaptation. We suggests that nurses in practice apply to assessing the factor of causal perception of individuals illness and the type of coping patterns when nursing interventions in rheumatoid arthritis patients.

• The Journal of Korean Physical Therapy
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• 제28권5호
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• pp.279-285
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• 2016

Purpose: This study was conducted to investigate the effects of joint mobilization and kinesio taping on pain, range of motion and knee function in patients with knee osteoarthritis. Methods: Thirty subjects were selected and divided into three groups: group 1 was treated with joint mobilization, group 2 was treated with kinesio taping and group 3 was treated with joint mobilization and kinesio taping. Joint mobilization was performed for 20 minutes three times a week for a period of 4 weeks, after which tape was applied for the same period of time and it was not exceeded 24 hours. Pain, range of motion and knee function were then assessed to identify the effectiveness. A visual analog scale (VAS) was used for pain assessment, while active and passive range of motion (AROM, PROM) were assessed using smart phones application, and knee injury and osteoarthritis outcome score (KOOS) was used to assess knee function. Results: After intervention, the joint mobilization group and kinesio taping group showed significant improvements in VAS, AROM, PROM and KOOS (Symptom, Pain, ADL, QOL), whereas no significant difference was found in sport/recreation. The joint mobilization with kinesio taping group showed significant improvements in all items, and a significant increase was found in AROM and PROM compared to the other two groups. Conclusion: We found that joint mobilization and kinesio taping effectively improved pain, range of motion and knee function in patients with knee osteoarthritis, but that application of joint mobilization with kinesio taping was most effective.

• 척추신경추나의학회지
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• 제8권2호
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• pp.113-121
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• 2013

Objectives : The objective of this study is to report the effect of Traditional Korean medical therapy and core exercise on osteoarthritis of knee joint by observing a clinical case study. Methods : Patient with a diagnosis of osteoarthritis of knee joint, was treated by acupuncture, herb medicine, physical theraphy and core exercise. Results : After treatment, Visual Analogue Scale(VAS), Korean version of the Western Ontario and McMaster Universities(KWOMAC), Pain Rating Score(PRS) were reduced from 5 to 2, from 25 to 16, from 55 to 27, and CENTAUR test results were improved. Conclusions : This study showed that Traditional Korean medical therapy and core exercise has meaningful effect on osteoarthritis of knee joint, and more researches should be followed.

• 대한정형외과 초음파학회지
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• 제5권1호
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• pp.9-14
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• 2012

목적: 유착성 관절낭염 환자에서 초음파를 이용한 관절와 상완 관절강 내 스테로이드 주사를 시행한 후 주사요법의 정확성이 임상적 결과에 미치는 영향을 평가하고자 하였다. 대상 및 방법: 임상적으로 유착성 관절낭염으로 진단받은 환자들 중 외상이 없고, 약물 치료 및 물리 치료를 받았으나 만족할 만한 호전을 보이지 않은 환자를 대상으로 하였다. 환자들은 총 33명으로 남자 15명, 여자 18명으로 평균 연령은 55.1세(42~72세)였다. 이를 대상으로 견봉 쇄골 접근법을 통해 스테로이드 칵테일 10 ml(triamcinolone 1 ml(40 mg/ml), lidocaine 4 ml(2%), normal saline 5 ml)와 조영제 5 ml ($Telebrix^{(R)}$, Guerbet, France)를 주입하였으며, 이후 바로 방사선 촬영을 시행하여 주사의 견관절 관절강 내 주입 여부를 확인하였다. 또한 조영제가 관절강내로 정확히 들어간 경우, 부분적으로 들어간 경우 그리고 조영제가 관절강 바깥으로 들어간 경우로 3군으로 분류하여 각각의 군에서 주사요법 전, 후 수동적 운동범위 및 VAS score를 이용한 통증 완화 정도를 분석하였다. 결과: 총 33례 중 25례(76%)에서 조영제가 정확히 관절강 내로 주입되었음을 확인하였다. 6례(18%)에서는 관절강에 부분적으로 조영제가 관찰되었고, 2례(6%)에서는 조영제가 관절강 바깥에서 관찰되었다. 조영제가 관절강내로 정확히 들어간 군은 시행 전 굴곡은 평균 111도(80~140도), 외회전은 48도(0~90도)였고, 시술 후 굴곡은 평균 134도(90~150도), 외회전은 70도(30~90도)로 호전되었다(p<0.01). 그리고 조영제가 관절강내로 부분적으로 들어간 군은 시행 전 굴곡은 평균 120도(90~150도), 외회전은 70도(10~90도)였고, 시술 후 굴곡은 평균 139(135~140도)도, 외회전은 78도(50~90도)로 호전된 결과가 관찰되었다(p<0.01). 조영제가 관절강 바깥으로 들어간 군은 환자수의 부족으로 통계적으로 의미를 갖지 않았다. 시술 전, 후 VAS 점수의 변화는 조영제가 관절강 내로 정확히 들어간 군은 7.1점(3~9점)에서 2.6점(0~5점)으로 호전되었고(p<0.01), 부분적으로 들어간 군은 7.5점(7~9점)에서 3.3점(2~4점)으로 호전되었고(p<0.01), 관절강 바깥으로 들어간 군은 7.5점에서 2점으로 호전되었다. 또한 당뇨 환자군과 비 당뇨 환자군을 비교한 결과 임상적 결과에 통계적으로 유의한 차이가 없이 모두 호전되었다. 결론: 유착성 관절낭염 환자에서 초음파 하에 견봉 쇄골 접근법을 통한 견관절 관절강 내 스테로이드 주사는 기존의 방법들보다 좋은 정확도(94%)를 보고하였으며, 이 중 관절강 바깥으로 새어나간 군과 새어나가지 않은 군 간에는 임상적으로 유의한 차이가 발견되지 않았다.