• Journal of International Academy of Physical Therapy Research
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• v.11 no.2
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• pp.2071-2076
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• 2020

Background: Based on the understanding of the muscle activation relationship between the infraspinatus and posterior deltoid muscles to according to the angle of motion during external rotation on glenohumeral joint, effective shoulder joint strengthening exercise for the prevention and rehabilitation of shoulder injury due to muscle strength imbalance can be performed by achieving the ideal muscle activity ratio during exercise. Objectives: To compare and analyze the muscle activation changes and activity ratio of the infraspinatus and posterior deltoid muscles according to the glenohumeral external rotation angle. Design: Quasi-randomized trial. Methods: The study included 48 healthy male and female adults who provided informed consent for participation in the study. All the subjects performed isometric glenohumeral external rotation by setting the angle of motion to 30°, 45°, and 60° using a 5 kg resistance weight pulley. On surface electromyography, the differences in muscle activation and activity ratio between the infraspinatus and posterior deltoid muscles were investigated. Results: A significant difference in muscle activation was found in the comparison between the infraspinatus and posterior deltoid muscles according to the glenohumeral external rotation angle (P<.05). The muscle activation levels of the infraspinatus and posterior deltoid muscles were highest at the external rotation angles of 30° and 60°, respectively. The muscle activity ratio between the infraspinatus and posterior deltoid muscles also showed a significant difference (P<.05) and was highest at the shoulder external rotation angle of 30°. Conclusion: The findings of this study suggest that muscle activity is the highest at the shoulder external rotation angle of 30° in healthy individuals.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.236-239
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• 2009

Purpose: We wanted to evalulate the clinical results of pectoris major tendon transfer for a neglected winged scapula that was caused by paralysis of the serratus anterior due to injury to the long thoracic nerve. Materials and Methods: A patient had neglected winged scapula that followed an arthroscopic operation for multi-directional instability of the shoulder joint, which was caused by traumatic dislocation. The patient was treated with pectoralis major tendon transfer using the modified Eden-Lange procedure. The range of a motion was improved from forward flexion $90^{\circ}$ and external rotation $70^{\circ}$ to $170^{\circ}$ and $150^{\circ}$ respectively. Results and Conclusion: There were no complications or recurrence and the patient's psychological satisfaction was also high. If the shoulder girdle muscles are intact, except for the serratus anterior, then pectoralis tendon transfer is a satisfactory method that can provide normal scapulo-thoracic motion.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.67-75
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• 2014

There are several kinds of regional nerve blockades, such as interscalene brachial plexus block, C5 root block, suprascapular nerve block, and axillary nerve block, which can be applied for anesthesia and postoperative pain control after shoulder surgeries. These regional nerve blockades have shown good results, but high failure rate and serious complications, such as phrenic nerve palsy, pneumothorax, and nerve injury, still remain. Ultrasound-guided intervention can increase the success rate of nerve blockades and reduce complications. We described the method of ultrasound-guided intervention for the regional nerve blockades around shoulder.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.1
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• pp.45-52
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• 2019

Background: Scapular dyskinesis is one of the risk factors for upper extremity injury in patients with chronic stroke. Taping can used as an adjunctive treatment for this. The aim of this study was to investigate the effects of rigid tape in conjunction with elastic tape and elastic tape only on shoulder pain, proprioceptor, and function of chronic stroke patients with scapular dyskinesis. Methods: Participants were randomly assigned to elastic tape (ET) group (n=10) and both tape (BT) group (n=10). Both ET and BT groups performed therapeutic exercise on the upper extremity with taping applied for 4 weeks. Therapeutic exercise was performed 30min/day, 5 times/week. Clinical outcome measures used Numerical pain rating scale with a faces pain scale for pain, angle at shoulder join position sense (JPS) for proprioceptor, and Fugl-meyer assessment upper extremity for function. Results: Clinical outcomes were measured at initial baseline, after 4weeks. There were statistically significant differences in pain, JPS, and function after 4 weeks in both groups (p<.05). There was no significant difference in pain and JPS between the groups, and There was a statistically significant difference in function in the BT group compared to the ET group (p<.05). Conclusions: This results suggest that accurate clinical assessment and appropriate taping can improve proprioceptor and function of the upper extremity in patients with chronic stroke.

• Clinics in Shoulder and Elbow
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• v.24 no.4
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• pp.202-208
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• 2021

Background: We aimed to assess the effect of plate hook bending in treatment of acromioclavicular (AC) dislocation by analyzing clinical and radiological results according to the angle of the plate hook (APH). Methods: This was a retrospective, observational, case-control study including 76 patients with acute AC joint dislocation that were divided into two groups according to treatment with bent or unbent plate hook. The visual analog scale (VAS), the American Shoulder and Elbow Surgeons (ASES) shoulder score, and range of motion (ROM) were evaluated as clinical outcomes. Comparative coracoclavicular distance (CCD) was measured to evaluate radiological outcomes. Results: While the VAS and ASES of the bending group at 4 months after surgery were significantly higher (p=0.021 and p=0.019), the VAS and ASES of the bending group at other periods and ROM of the bending group showed no significant difference. The initial CCD decreased from 183.2%±25.4% to 114.3%±18.9% at the final follow-up in the bending group and decreased from 188.2%±34.4% to 119.1%±16.7% in the non-bending group, with no statistical difference (p=0.613). The changes between the initial and post-metal removal CCD were 60.2%±11.2% and 57.3%±10.4%, respectively, with no statistical difference (p=0.241). The non-bending group showed greater subacromial osteolysis (odds ratio, 3.87). Pearson's coefficients for the correlation between APH and VAS at 4 months after surgery and for that between APH and ASES at 4 months after surgery were 0.74 and -0.63 (p=0.027 and p=0.032), respectively. Conclusions: The APH was associated with improved postoperative pain and clinical outcomes before implant removal and with reduced complications; therefore, plate hook bending is more useful clinically during plate implantation.

• Clinics in Shoulder and Elbow
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• v.26 no.2
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• pp.140-147
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• 2023

Background: The management of acromioclavicular (AC) joint dislocation remains controversial. Recently, anatomic coracoclavicular (CC) fixation with a double clavicular tunnel and three flip-buttons has shown promising results. This study aimed to evaluate functional and radiological outcomes in patients with high-grade AC joint dislocation treated with anatomic CC fixation using double clavicular tunnels and three flip-buttons. Methods: A retrospective, unicentric study was performed. The study included patients with high-grade AC joint dislocation who underwent surgery with anatomic CC fixation using double clavicular tunnels and three flip-buttons. Demographic data were obtained from medical records. A functional evaluation using subjective shoulder value (SSV), visual analog scale (VAS), and disabilities of the arm, shoulder, and hand (DASH) questionnaires was performed, and an evaluation of preoperative and postoperative comparative Zanca view images was performed. Factors associated with functional outcomes and radiological AC reduction were analyzed. Results: A total of 83 patients completed follow-up and were included in the analysis. The mean SSV, VAS, and DASH scores were 92.8, 0.8, and 6.4, respectively. Patients who had complications experienced significantly worse functional outcomes (DASH: P=0.037). Suboptimal final AC reduction was observed in nine patients (11.1%), and significantly more frequently in patients older than 40 years (P=0.031) and in surgeries performed more than 7 days after injury (P=0.034). There were two reoperations (2.4%). Conclusions: Anatomic CC fixation with a double clavicular tunnel and three flip-buttons leads to good functional outcomes, low complication rates, and high rates of optimal AC reduction.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.11
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• pp.7439-7446
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• 2015

The purpose of this study was to find the risk factors of injury by FMS and to investigate the effects of 12-weeks' combined training program on body imbalance, physical fitness, muscle strength and FMS score in woman rugby players of the national team. Fourteen subjects were woman rugby national players to participate in the 17th Incheon Asian Games. These players tested FMS and performed 12 weeks' (May~Aug, 2014) combined training program (4days, 120min${\geq}$). Statistical evaluation was undertaken using paired t-test (pre vs. post). The results of this study were as follows; Frist, the score of FMS test on Deep Squat, Hurdle Step, Active Straight Leg Raise, and Trunk Stability Push up were significantly increased after 12 weeks' combined training program (p<.05), and also Inline Lunge (p<.01) and Rotary Stability (p<.001) were significantly increased. However, Shoulder Mobility was not significantly increased(p=.104) although the tendency of increased was FMS score. Second, the sum of the entire item was significantly increased after combined training(p<.001). These results suggest that 12-weeks' combined training program has effect of improving FMS score and low-injury risk in woman rugby national players. Therefore, we consider that FMS have effect on prevention of athletic injury and improvement of athletic performance in woman rugby national players.

• Journal of Korea Entertainment Industry Association
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• v.14 no.3
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• pp.431-442
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• 2020

This study examined the effect of the theratainment swiss ball exercise on the upper limb function, pain, and daily activities of a patient with axillary nerve injury. The research duration was from November 5^th, 2019 to February 25^th, 2020. The research subject was a 23-year-old female patient living in the metropolitan city of G in South Korea, and the A-B-A' type of single-subject experimental research design was used. In this study, repeated training was provided to the patient in the form of exercises employing different directions and gradually increased weights. The training increased the structural stability and mobility of the shoulder and was effective for pain relief as it strengthened shoulder function. The training helped the subject improve her posture change adaptability and reaction ability in different environments and ultimately enabled her to increase and maximize her performance of independent daily activities. This study thus demonstrated the positive effect of the Swiss ball exercise on the upper limb function, pain and disability, daily activities of a patient with axillary nerve injury and confirmed the potential of the exercise as an intervention method. Continued investigation to develop and test the effect of the Swiss ball exercise will be required for it to be used professionally as a therapeutic approach by occupational therapists in treating a variety of patients.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.1
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• pp.46-49
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• 2012

Diagnoses of the acromial fractures are frequently delayed because most acromial fractures are non-displaced or minimally displaced patterns and the frequency are low. We report a case that a non-displaced acromial fracture of 74 years old male hit by the falling pipes could be diagnosed by the ultrasonography. For this case who had a pain, swelling, and the limitation of active elevation of the left shoulder after direct injury, the evaluation about the rotator cuff and the biceps long head tendon was required but the early diagnosis of the non-displaced acromial fracture was done by the easier ultrasonography before the additional studies. The ultrasonography has the advantage over the computed tomography in the aspect of evaluating the injury of the tendons of the shoulder joint.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.92-98
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• 2007

Introduction: The treatment of proximal humeral fracture is traditionally determined by Neer's classification system. The severely displaced three-part or four-part fracture is an indication for primary hemiarthroplasty. The current authors report the clinical results of 10 patients who received hemiarthroplasty for proximal comminuted fractures. The minimum follow-up period was 12 months. Materials and Methods: The current authors studied 10 patients who, between July 1999 and March 2005, each received hemiarthroplasty for a proximal humeral fracture of one shoulder. According to Neer's classification system, 5 of the patients had three-part fractures, and 5 of the patients had 4-part fractures. The mean interval between trauma and hemiarthroplasty was 6.1 days. The mean age of the 6 female and 4 male patients was 67.4 years(range: 56 to 76). Shoulder function was evaluated using the Constant score, the Simple Shoulder Test, and the modified UCLA score. Results: The mean Constant score was 51.4(range: 34 to 60). The mean modified SST score was 7.8 out of 12 tasks. Excluding the one patient who had also sustained an axillary artery rupture and a brachial plexus injury after the initial trauma, the mean Constant score for the remaining 9 patients was 53.5(range: 44 to 60), and the mean SST score was 7.2 tasks. The modified UCLA score averages for pain, function, and active forward flexion and strength were, respectively, 8.2($6{\sim}10$), 6.6($2{\sim}8$), and 6.9($4{\sim}8$). The total UCLA score was an average of 21.7($12{\sim}26$). Patients' the modified UCLA ratings were as follows: Excellent: 3, Good: 6, and Poor: 1. The patient with the poor outcome was the one who had also sustained the neurovascular injury. Patient's subjective satisfaction rating were as follows: Excellent: 2, Good: 7, and Poor: 1. Conclusion: Based on short term follow-up results, this study indicates that hemiarthroplasty is the treatment of choice for proximal humeral fractures on which it would be difficult to perform open reduction and internal fixation. Hemiarthroplasty is a useful treatment modality to prevent shoulder stiffness and to allow daily living tasks in elderly patients. However, restoration of muscle power and range of joint motion were not recovered satisfactorily.