• 제목/요약/키워드: repair and rehabilitation

검색결과 292건 처리시간 0.022초

Does physiotherapy after rotator cuff repair require supervision by a physical therapist?: a meta-analysis

  • Masaki Karasuyama;Masafumi Gotoh;Takuya Oike;Kenichi Nishie;Manaka Shibuya;Hidehiro Nakamura;Hiroki Ohzono;Junichi Kawakami
    • Clinics in Shoulder and Elbow
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    • 제26권3호
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    • pp.296-301
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    • 2023
  • Background: A supervised physiotherapy program (SPP) is a standard regimen after surgical rotator cuff repair (RCR); however, the effect of a home-based exercise program (HEP), as an alternative, on postoperative functional recovery remains unclear. Therefore, the purpose of this meta-analysis was to compare the functional effects of SPP and HEP after RCR. Methods: We searched electronic databases including Central, Medline, and Embase in April 2022. The primary outcomes included the Constant score, American Shoulder and Elbow Surgeons score, University of California Los Angeles shoulder score, and pain score. Secondary outcomes included range of motion, muscle strength, retear rate, and patient satisfaction rate. A meta-analysis using random-effects models was performed on the pooled results to determine the significance. Results: The initial database search yielded 848 records, five of which met our criteria. Variables at 3 months after surgery were successfully analyzed, including the Constant score (mean difference, -8.51 points; 95% confidence interval [CI], -32.72 to 15.69; P=0.49) and pain score (mean difference, 0.02 cm; 95% CI, -2.29 to 2.33; P=0.99). There were no significant differences between the SPP and HEP. Other variables were not analyzed owing to the lack of data. Conclusions: Our data showed no significant differences between SSP and HEP with regard to the Constant and pain scores at 3 months after RCR. These results suggest that HEP may be an alternative regimen after RCR. Level of evidence: I.

운동프로그램 중재가 돌림근띠 복원술 환자의 근 활성도에 미치는 영향 (Effects of Exercise Program Intervention on Muscle Activity in Rotator Cuff Repair Patient)

  • 강정일;문영준;박승규;이준희;양대중;최현;정대근;김용남;권혜민
    • The Journal of Korean Physical Therapy
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    • 제25권2호
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    • pp.56-63
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    • 2013
  • Purpose: This study was conducted in order to examine how an effective rehabilitation exercise program influences the activity of shoulder muscles, and to help the clinical application of a rehabilitation program, for prevention and relief of pain, adhesion, and joint stiffness of patients who undergo rotator cuff repair. Methods: Nine test subjects were placed randomly into each group for a total of 27 subjects and exercise program interventions according to the group were conducted for six weeks, after which maximum voluntary isometric contraction (%MVIC) value was re-measured for supraspinatus muscle, infraspinatus muscle, serratus anterior muscle, and middle deltoid muscle in all groups in order to compare changes in muscle activity before and after the experiment in order to perform comparative analysis of changes in muscle activity between groups, based on which four experimental hypotheses were confirmed. Results: Changes in muscle activity according to %MVIC showed a statistically significant difference (p<0.01) (p<0.001) in all muscles, except the middle deltoid muscle, and post-verification results showed that changes in muscle activity according to %MVIC were greater in test groups I and II, compared with the control group, for the supraspinatus muscle, infraspinatus muscle, and serratus anterior muscle. Conclusion: Therefore, rehabilitation through use of the methods described above should be applied efficiently in clinical settings and more research in development of much more efficient rehabilitation program interventions must be conducted.

당귀수산(當歸鬚散)이 대퇴골절 유발 생쥐에 미치는 영향 (Healing Effect of Danggwisu-san (Dangguixu-san) on Femur Fractured Mice)

  • 전동휘;오민석
    • 한방재활의학과학회지
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    • 제31권1호
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    • pp.1-16
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    • 2021
  • Objectives This study was designed to evaluate the effects of Danggwisu-san (Dangguixu-san, DG) on bone repair from femur fracture in mice. Methods Mice were randomly divided into 4 groups (normal, control, positive control and DG 300 mg/kg-treated group). In order to investigate the effects of DG on gene expressions in experimental animals with fracture, we measured the levels of bone morphogenetic protein-2 (BMP2), cyclooxygenase-2 (COX2), Sox9, collagen type II alpha 1 chain (Col2a1), runt-related transcription factor 2 (Runx2), osterix genes. After the cytotoxicity test, we analyzed the levels of expression of osteocalcin and Runx2, and tumor necrosis factor-α (TNF-α), a pro-inflammatory cytokine. The process of fusion in the fracture was also investigated by gross examination. Results Through in vivo BMP2, COX2 gene expression significantly decreased. Sox9 significantly increased. Col2a1, Runx2, osterix gene expression also increased as well, but there was no statistical significance. The degree of unilateral fracture fusion investigated by gross examination was significantly faster than those of the other groups. Through in vitro the level of TNF-α in macrophages was increased by DG in a dose-dependent mannerand and 250 and 500 ㎍/mL showed statistical significance. Osteocalcin and Runx2 genes expressions increased when DG was treated in osteoblasts. Conclusions DG promotes the healing of the fracture through the expression of bone repair-related genes and TNF-α production. This study may set the foundation for the clinical application of DG to the patients with bone fractures.

Regional nerve blocks for relieving postoperative pain in arthroscopic rotator cuff repair

  • Tae-Yeong Kim;Jung-Taek Hwang
    • Clinics in Shoulder and Elbow
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    • 제25권4호
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    • pp.339-346
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    • 2022
  • Rotator cuff tear is the most common cause of shoulder pain in middle-age and older people. Arthroscopic rotator cuff repair (ARCR) is the most common treatment method for rotator cuff tear. Early postoperative pain after ARCR is the primary concern for surgeons and patients and can affect postoperative rehabilitation, satisfaction, recovery, and hospital day. There are numerous methods for controlling postoperative pain including patient-controlled analgesia, opioid, interscalene block, and local anesthesia. Regional blocks including interscalene nerve block, suprascapular nerve block, and axillary nerve block have been successfully and commonly used. There is no difference between interscalene brachial plexus block (ISB) and suprascapular nerve block (SSNB) in pain control and opioid consumption. However, SSNB has fewer complications and can be more easily applied than ISB. Combination of axillary nerve block with SSNB has a stronger analgesic effect than SSNB alone. These regional blocks can be helpful for postoperative pain control within 48 hours after ARCR surgery.

Tibiotarsal and Ulnar Fracture Repair in a Great Horned Owl (Bubo virginianus)

  • Yoon, Hun-Young;Fox, Derek B.;Jeong, Soon-Wuk
    • 한국임상수의학회지
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    • 제25권3호
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    • pp.218-220
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    • 2008
  • A 1.4 kg adult great homed owl was presented to the University of Missouri-Columbia Veterinary Teaching Hospital after being found by the side of the highway. Physical examination revealed soft tissue injuries to the left wing and leg, and good body condition (body score 4/5). The radiographs revealed comminuted fracture of the diaphysis of the left tibiotarsus (severe) and ulna (mild). Closed reduction of the fracture was performed to the left tibiotarsus and ulna. System combining an intramedually (IM) Kirschner pin, IM Kirschner pin for external skeletal fixation, and polymethylmethacrylate was used for fracture repair. At 13 weeks, radiographs revealed that bridging callus was well formed over cortices of the fracture area. No physical, behavioral, or other assessable impairment was found during the rehabilitation period.

회전근개 파열의 수술적 치료 후 회전근개 초음파 소견 (Postoperative Ultrasound Findings of the Rotator Cuff Tendon after Arthroscopic Repair of a Rotator Cuff Tear)

  • 권동락
    • Clinical Pain
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    • 제19권2호
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    • pp.64-69
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    • 2020
  • Ultrasound (US) imaging is an efficient, easy to use, rapid, dynamic, noninvasive, with rare side-effects and inexpensive tool allowing for facilitated diagnosis and management of the painful shoulder. It also has advantages over other imaging modalities in the evaluation of the postoperative shoulder for rotator cuff integrity and correct anchor and suture placement, as well as rotator cuff analysis following repair surgery. Early postoperative tendons frequently had a hypo- echoic echo texture and the absence of a fibrillar pattern, which might be misinterpreted as recurrent tears. however, these features often normalized into tendons with an increased echo texture and the reappearance of a fibrillar pattern at 6 months. Based on these sequential findings, the US findings within 3 months after surgery should be interpreted with caution to accurately understand and monitor the repaired tendon status.

철근, 강판 및 CFRP를 적용한 R/C보의 보강효과 비교연구 (Comparative Study on the Strengthening Effect of R/C Beams with Rebar, Steel Plate of CFRP)

  • 심종성;황의승;최완철;배인환
    • 한국콘크리트학회:학술대회논문집
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    • 한국콘크리트학회 1996년도 봄 학술발표회 논문집
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    • pp.323-327
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    • 1996
  • Reinforced concrete(R/C) structures need repair and rehabilitation due to the deterioration such as a crack, spalling and disintergration. Numerous repair materials which are currently used in construction fields without any regulation are examined in terms of their serviceabilities and effectiveness. In this paper section of existing R/C beams are enlarged with repair materials, that is, epoxy, latex or premix. And then they are strengthened with rebar, steel poate of CFRP on the tension face. Structural behaviors of strengthened beams are investigated both statically and dynamically and they are compared with each. This paper summarizes the overall research plan.

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The Effects of Slab Size on Pavement Life Cycle Cost

  • Parsons, Timothy A.;Hall, Jim W.Jr
    • 한국도로학회논문집
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    • 제8권2호
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    • pp.49-54
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    • 2006
  • The purpose of this study was to determine the effect of expansion joint spacing (slab size) on the life cycle costs of owning Portland Cement Concrete (PCC) airfield pavements. Previous research has shown that slab size has a statistically significant impact on pavement performance. A probabilistic life cycle cost analysis was performed to determine if the effect of slab size on pavement performance would affect the total cost of ownership of PCC pavements. Data from 48 Pavement Condition Index (PCI) inspections of military and civilian airfields were used to develop probability-of-distress-by-condition curves, which were then used to develop probabilistic cost-of-repair-by-condition curves. A present worth life cycle cost analysis was then performed for various slab sizes, using construction costs, rehabilitation costs, and maintenance costs. Maintenance costs were determined by assuming a condition deterioration rate appropriate for each slab size and applying the cost-by-condition curves. The probabilistic cost-of-repair-by-condition curves indicated that smaller slabs are more expensive to repair on a unit cost basis. Life cycle cost analysis showed that larger slabs have a higher total cost of ownership than smaller slabs due to a faster rate of deterioration.

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관절경적 회전근 개 봉합술: 이열 봉합술 및 교량형 봉합술식 (Arthroscopic Rotator Cuff Repair: Double Rows & Suture Bridge Technique)

  • 신상진
    • Clinics in Shoulder and Elbow
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    • 제11권2호
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    • pp.82-89
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    • 2008
  • 이상적인 회전근 개 봉합술은 봉합 초기 높은 고정 강도로 봉합 부위 건-골간 간격 형성을 최소화시키며, 재활 과정 중 발생하는 반복적인 부하에도 견디는 기계적 강도를 나타내어 궁극적으로 건-골 조직의 생물학적 치유를 얻을 수 있는 방법이다. 현재 사용되는 회전근 개 봉합술 중 교량형 봉합술식은 회전근 개 부착 부위를 해부학적으로 복원할 수 있으며, 건-골간 압력 접촉 면적을 증가시키고, 방사형의 봉합 형태를 통하여 회전근 개 전체에 균등하게 압력을 분포함으로 부하를 분산시키며 생물학적 치유를 향상시킨다. 또한 건-골간 간격 형성을 최소화하며 전단 및 회전 응력에 저항력을 주어 정상과 동일한 해부학적 복원력으로 빠른 재활 운동을 가능하게 한다. 그러나 비록 교량형 봉합술식이 다른 술식에 비해 우수한 생역학적 특성을 나타내도 임상적으로 더 좋은 결과를 초래한다는 증거는 없으며, 이열 봉합술과는 비슷한 재파열율이 보고되고 있다. 회전근 개봉합술의 선택은 회전근 개 파열 크기, 파열 양상 및 건의 상태 등을 고려하여 적절하게 선택하여야 할 것으로 사료된다.