• Title/Summary/Keyword: moderate to severe shoulder pain

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Physical Therapy Program for Patients with Partial Rotator Cuff (Supraspinatus) Tears with Moderate to Severe Shoulder Pain : Comparison of the effects of eccentric training and concentric training (중등도 이상의 어깨통증을 동반한 근육둘레띠(가시위근) 부분파열 환자를 위한 물리치료 프로그램 : 편심성 훈련과 동심성 훈련의 효과 비교)

  • Yeon-Ki Choo
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.1
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    • pp.87-98
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    • 2023
  • Purpose : This study was to verify the effectiveness of eccentric training and to make clinical recommendations on detailed application methods by comparing the effects of changes in acromiohumeral distance (AHD), pain intensity, muscle strength, and functional performance after applying a 12-week eccentric training program (ET group) or concentric training program (CT group) for patients with partial rotator cuff (supraspinatus) tears with moderate to severe shoulder pain. Methods : A total of 29 subjects were assigned to either the "ET group (n=15)" or the "CT group (n=14)" through simple randomization and were measured in the same way at baseline before intervention, 4 weeks and 12 weeks after intervention. All subjects received a physical therapy program 12 sessions 3 times a week for the first 4 weeks, and physical therapy program, 12 sessions a week, from 4 weeks to 12 weeks, for a total 20 sessions. Ultrasound machine was used for AHD, visual analog scale (VAS) was used for pain intensity, electronic hand held dynamometer was used for muscle strength, Korean Constant shoulder score (K-CSS) used for functional performance. Results : AHD, pain intensity, and muscle strength did not show significant differences at 4 weeks, but improved numerically, and showed significant differences at 12 weeks (p<.05), showing superior results in the eccentric training group compared to the concentric training group. Functional performance showed significant changes at both 4 and 12 weeks (p<.05), and excellent results were also found in the eccentric training group. Conclusion : In patients with partial rotator cuff tears with moderate to severe shoulder pain, an eccentric training program increased acromiohumeral distance (AHD), reduced pain, and increased muscle strength. Therefore, it can be clinically presented as an intervention method that can quickly and effectively improve functional performance, which is the ultimate goal of physical therapy.

The profile of musculoskeletal pain and its associations with sleep quality and depression during the COVID-19 in Turkey

  • Karatel, Merve;Bulut, Zeynep Irem;Sari, Erkin Oguz;Pelin, Zerrin;Yakut, Yavuz
    • The Korean Journal of Pain
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    • v.35 no.1
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    • pp.78-85
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    • 2022
  • Background: The current pandemic has affected people's health multidimensionally. This study aims to investigate musculoskeletal pain, sleep quality, depression levels, and their relationships in individuals belonging to different age groups during COVID-19 in Turkey. Methods: A web-based self-administered survey that consisted of demographic questions, The Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and scores of musculoskeletal pain was sent to participants. Pearson correlation analysis was used for determining the statistical relationship between variables. Results: The study includes 1,778 participants. The highest percentage for mild, moderate, and severe pain was in the head (49.8%), back (15.5%), and head (11.5%), respectively. The PSQI-total had shown a weak correlation with pain levels in all body parts. The highest correlation for sleep quality and pain levels was between the PSQI-5 and lower back pain. There was a weak correlation between PSQI-2 and the BDI score, and a moderate correlation between the PSQI-1, PSQI-5, PSQI-7, PSQI-total, and BDI score. Pain in all body parts showed a weak correlation with depression level. Conclusions: This study showed that musculoskeletal pain was varied in body parts with different intensities according to age groups in Turkey during the pandemic. The most common pain was in the head, back, and lower back. Headache was found correlated with the parameters of sleep quality. Pain of the head, neck, back, lower back, and shoulder were correlated with sleep latency. Sleep quality was associated with depression and musculoskeletal pain, while musculoskeletal pain was correlated with depression.

A Clinical Study on Pruritus Due to Intrathecal Morphine (지주막하강에 투여한 Morphine으로 인한 소양감에 대한 임상적 고찰)

  • Jeong, Chan-Jong;Baik, Seong-Wan;Kim, Inn-Se;Chung, Kyoo-Sub
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.91-97
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    • 1988
  • Herein is a review of eigthy six surgical cases from March to August, 1986 which recieved tetracaine hydrochloride spinal anesthesia. In an attempt to relieve postoperative pain, 0.5 mg morphine sulfate was administrated into the lumbar subarachnoid space. Pruritus, a side effect of intraspinal morphine, was explored in detail. The results were as follows : 1) The incidence of pruritus was 67.4%, 65.5% in man and 71.0% in woman. 2) The time of onset of pruritus was between 30 and 120 minutes with an average of 79.1 minutes. 3) Pruritus primary occurred on the face(87.9%), especially on the nasal, perinasal and periocular areas. Other sites included the scalp, neck, chest, abdomen, shoulder, hip, thigh, flank, and whole body. 4) The severity of pruritus was classified as mild and moderate, but 4 cases(6.9%) were regarded as severe and were treated with naloxone. 5) The duration of pruritus was from 15 minutes to 19 hours with an average of 4.7 hours. 6) There was no significant difference in the prevention of pruritus between the group recieving diphenhydramine and the one which received normal saline.

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Debridement Arthroplasty for Post-Traumatic Stiff Elbow (후외상성 주관절 강직에서의 변연 관절 성형술)

  • Rhee Yong-Girl;Kim Hee-Seon;Chun Young-Soo;Cho Young-Lin
    • Clinics in Shoulder and Elbow
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    • v.1 no.2
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    • pp.242-249
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    • 1998
  • Stiffness of the elbow joint is relatively common after trauma, ectopic ossification, bum, postoperative scar, and etc. Mild flexion deformity can be reduced by use of active or passive motion exercise, dynamic sling, hinged distractor device, or turnbuckle orthosis. But these methods have disadvantages of difficulty in gaining acceptable range of motion only with stretching exercise, re-contracture after conservative managements and poor results that flexion contracture remained. The common described operative exposures for treatment of the stiff elbow are anterior, lateral, posterior, and medial approach. Through Anterior, lateral and medial approach each has not access to all compartments of the elbow. But, posterior approach has benefits that access to posterior, medial and lateral aspects of the elbow and as needed, fenestration to the olecranon fossa that produces a communication between the anterior and posterior compartments of the elbow are possible. From June 1991 through April 1997, 11 patients who had posttraumatic stiff elbow, were treated with debridement arthroplasty through the posterior approach. The purpose of this study are to introduce technique of the debridement arthroplasty and to evaluate final outcomes. With regarding to preoperative pain degree, mild degree matches to 3 cases, moderate to 3 cases, and severe to 2 cases. In preoperative motion, flexion was average 85° and extension was 30°. Postoperatively nine patients had got the complete relief of pain and two patients continued to have mild pain intermittentely. Postoperative flexion improved to 127° and extension to 2°, so that elbow flexion had improved by an average of 42° and elbow extension by 28°. On the objective scale all patients had good or excellent results and they all felt that they were improved by operation. Debridement arthroplasty is one of excellent procedures for the intractable stiff elbow if it is not unstable or it has not incongrous. But it need a meticulous operative technique and a well-programmed rehabilitation.

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Relation of the Degree of the Subacromial Bursitis with Acromial Shape and Pain in the Subacromial Impingement Syndrome (견봉하 충돌증후군에서 견봉하 점액낭의 염증 정도와 견봉의 모양 및 통증과의 연관성)

  • Lee, Kwan-Hee;Kim, Yong-Ju;Jeong, Hoon;Ha, Jong-Kyoung;Lee, Woo-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.34-38
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    • 2009
  • Purpose: To evaluate the association of subacromial bursa inflammation with acromial shape and shoulder pain in subacromial impingement syndrome. Materials and Methods: 24 cases with subacromial impingement syndrome were reviewed. Eighteen patines were males and six females(mean age: 58.3 yrs). During arthroscopic operation, the specimens were taken from subacromial bursa with arthroscopic knife($1{\times}1$ cm size). The shape of acromion were classified according to Bigliani grading system. The shoulder pain of patients was graded with visual analog scale (VAS). The grade of inflammation was classified to the pathological three grade system (mild, moderate, severe) by pathohistological 8 factors. Results: Of total 24 cases, 9 cases were the pathological grade I and 15 cases were grade II. None was grade III. In the 9 cases of pathological grade I, 6 cases were the radiologic grade II of acromial shape and 3 cases were grade III. In the 15 cases of pathological grade II, 5 cases were the radiologic grade II and 10 cases were grade III. The VAS was 7 point at pathological grade I and 8 point at grade II. As the statistical analysis, the pathological grade of subacromial bursa was associated with acromial shape (p<0.05), but not associated with pain of patient (p>0.05). Conclusion: Our study suggests that pathological grade of subacromial bursa inflammation was associated with acromial shape. But pathological grade of subacromial bursa inflammation was not associated with shoulder pain of patients.

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Work-Related Musculoskeletal Pain and Workload Evaluation of Physical Therapists: Focused on Neurological Injury Treatment of Adults (물리치료사의 작업관련 근골격계 통증과 부담작업 유해요인 평가: 성인 신경계 손상 치료를 중심으로)

  • Lee, Jung-Ho;Choi, Young-Chul;Kim, Jin-Sang
    • 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.

Surgical Treatment of Left Subclavian Aneurysm -A case report- (Subclavian artery 의 동맥류 -1예 수술 경험-)

  • Lee, Sung Haing;Lee, Sung Koo;Han, Sung Sae;Lee, Khil Rho;Kim, Song Myung
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.245-250
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    • 1976
  • A 33 year-old man was admitted with chief complaints of severe sharp pain on left upper interscapular region and motor weakness of left arm for 9 days. He had a history of blunt trauma over left shoulder about 3 years ago. Physical examination showed a ping pong ball sized mass which was located at the left supraclavicular area and was firm, fixed, and nonpulsatile. No bruit or murmur was obtained over the mass. Ipsilaterally, radial, ulnar, and brachial pulse were very weak and ptosis and anhidrosis were noticed. Neurologic examination revealed moderate or severe weakness of flexion and extension of left elbow, wrist and fingers, and anesthesia of the skin in left C8-T1 dermatome and hypalgesia in left C6-C7 dermatome. Retrograde aortography demonstrated complete obstruction of left subclavian artery. An exploratory operation was performed through the left 4th intercostal space. It was found that the mass was a left subclavian aneurysm of traumatic false type. Proximal and distal ligation of the aneurysm were applied and the sac was partially removed. The continuity of the subclavain artery was established by the use of a 6mm. Dacron graft from the root of the subclavian to the axillary artery. Postoperatively the patient was improved from the circulatory and neurologic disturbances.

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An Effect of Visual Acuity Protection by Natural Pigment (Anthocyanine) Extracted from Fermented Purple Sweet Potato (발효 자색고구마 추출 천연색소(anthocyanine)에 의한 시력보호 효과)

  • Seo, Eun-Sun;Ryu, Geun-Chang
    • Journal of Korean Ophthalmic Optics Society
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    • v.17 no.4
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    • pp.395-401
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    • 2012
  • Purpose: The purpose of this study was to research any effect on vision protecting or decreasing VDT syndrome of extracted anthocyanine from fermented purple sweet potato and blueberry. Methods: Subjects were aged 19-20 years old who do not have ophthalmic and systemic diseases and over -N4.00 D of refraction error. 40 mg of extracted anthocyanine from fermented purple sweet potato, from blueberry, and control group, placebo were dosed at separate try. After 2 hours later, subjects were directed perform visual display terminal (VDT) work for 2 hours. Objective refractive error was measured before dosing anthocyanine and after VDT work for 2 hours. Degree of head ache, eye pain and strain and subjective symptoms of neck, shoulder and waist was also examined through interviews by dividing its degree into severe, moderate, slight or none. Results: After 2 hours VDT work, vision protection effect in terms of refractive error for dominant eye was decreased by $0.031{\pm}0.21$ D in the group of extracted anthocyanine from fermented purple sweet potato, $0.006{\pm}0.32$ D in the group of extracted anthocyanine from blueberry. However, there was significantly myopic progression in the placebo group by $0.144{\pm}0.28$ D (t=2.27, p=0.03). Conclusions: It is considered that extracted anthocyanine from fermented purple sweet potato inhibits increase of refraction anomalies of dominant eye rather than non-dominant eye after VDT work.