• The Korean Journal of Pain
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• v.29 no.3
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• pp.179-184
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• 2016

Background: Recently, ultrasound has been commonly used. Ultrasound-guided interscalene brachial plexus block (IBPB) by posterior approach is more commonly used because anterior approach has been reported to have the risk of phrenic nerve injury. However, posterior approach also has the risk of causing nerve injury because there are risks of encountering dorsal scapular nerve (DSN) and long thoracic nerve (LTN). Therefore, the aim of this study was to evaluate the risk of encountering DSN and LTN during ultrasound-guided IBPB by posterior approach. Methods: A total of 70 patients who were scheduled for shoulder surgery were enrolled in this study. After deciding insertion site with ultrasound, awake ultrasound-guided IBPB with nerve stimulator by posterior approach was performed. Incidence of muscle twitches (rhomboids, levator scapulae, and serratus anterior muscles) and current intensity immediately before muscle twitches disappeared were recorded. Results: Of the total 70 cases, DSN was encountered in 44 cases (62.8%) and LTN was encountered in 15 cases (21.4%). Both nerves were encountered in 10 cases (14.3%). Neither was encountered in 21 cases (30.4%). The average current measured immediately before the disappearance of muscle twitches was 0.44 mA and 0.50 mA at DSN and LTN, respectively. Conclusions: Physicians should be cautious on the risk of injury related to the anatomical structures of nerves, including DSN and LTN, during ultrasound-guided IBPB by posterior approach. Nerve stimulator could be another option for a safer intervention. Moreover, if there is a motor response, it is recommended to select another way to secure better safety.

• The Journal of Internal Korean Medicine
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• v.41 no.2
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• pp.122-131
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• 2020

Background: This study aimed to determine the effects of complex Korean medicine treatments on a patient suffering from tetraplegia caused by spinal cord injury. Case Summary: A 64-year-old female patient diagnosed with tetraplegia was treated using acupuncture, electroacupuncture, pharmacopuncture, knee joint motion style treatment (MST), and herbal medicine. Clinical symptoms were measured using the numeric rating scale (NRS) and manual muscle test (MMT). After 67 days of treatment, the NRS score for lower back pain and knee pain decreased from 7 to 3. For the shoulder joint the MMT grade improved from 3+/4+(Rt./Lt.) to 4/5-; in the hip joint, it improved from 3-/3+ to 4/4+. No side effects were observed from the treatments used in this case report. Conclusion: The complex Korean Medicine treatments appeared to be effective in recovering muscle strength and reducing pain in patients with tetraplegia caused by spinal cord injury.

• 재활복지
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• v.21 no.4
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• pp.59-75
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• 2017

The purpose of this study was to analyze sports injuries in athletes with disabilities during the 2015 National Games in Korea. We conducted a survey to assess sport injuries in 171 male athletes with disabilities who participated in this study. The shoulder was most frequently injured, followed by the fingers and low back. Contusions were the most common type of injury, and were usually caused by collisions with teammates or contact with equipment. Injuries often occur during enthusiastic play in both competition and practice sessions. Injured athletes are emergently treated with medicated spray and patch application by the head coach. Warm-up and cool-down exercises are recommended to prevent injury, and physical therapy is effective after an injury occurs. Based on these findings, an injury prevention training program and athletic trainers should be provided for athletes with disabilities to ensure appropriate care and rehabilitation.

• Journal of Biomedical Engineering Research
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• v.43 no.4
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• pp.241-250
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• 2022

It is known that chronic pain and injury of upper limb joint tissue in manual wheelchair users is usually caused by muscle imbalance, and the propulsion speed is reported to increase this muscle imbalance. In this study, kinematic variables, electromyography, and ultrasonographic images of the upper limb were measured and analyzed at two different propulsion speeds to provide a quantitative basis for the risk of upper extremity joint injury. Eleven patients with spinal cord injury for the experimental group (G_E) and 27 healthy adults for the control group (G_C) participated in this study. Joint angles and electromyography were measured while subjects performed self-selected comfortable and fast-speed wheelchair propulsion. Ultrasound images were recorded before and after each propulsion task to measure the acromiohumeral distance (AHD). The range of motion of the shoulder (14.35 deg in G_E; 20.24 deg in G_C) and elbow (5.25 deg in G_E; 2.57 deg in G_C) joints were significantly decreased (p<0.001). Muscle activation levels of the anterior deltoid, posterior deltoid, biceps brachii, and triceps brachii increased at fast propulsion. Specifically, triceps brachii showed a significant increase in muscle activation at fast propulsion. AHD decreased at fast propulsion. Moreover, the AHD of G_E was already narrowed by about 60% compared to the G_C from the pre-tests. Increased load on wheelchair propulsion, such as fast propulsion, is considered to cause upper limb joint impingement and soft tissue injury due to overuse of the extensor muscles in a narrow joint space. It is expected that the results of this study can be a quantitative and objective basis for training and rehabilitation for manual wheelchair users to prevent joint pain and damage.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.78-83
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• 2007

Purpose: This study reports the clinical results of the tenodesis of long head of the Biceps brachii tendon with bioabsorbable interference screw by minimal open procedure. Materials and Methods: Ten cases of 10 patients (7 male, 3 female) were included in this study. The average age was 45.8 years old and the average period from the symptom onset to operation was 13.7 months. Average preoperative ASES score was 38.5. The causes of injury was; sports activities in 4 patients, unknown in 4 patients, industrial accident in 1 patient and traffic accident in 1 patient. The average follow up period was 12.1 months. Tenodesis with bioabsorbable interference screw by minimal open precedure was performed in all cases. Results: The ASES score improved to 87.5 at last follow up period and 6 cases had full range of motion of the shoulder. 4 cases had mild limited range of motion of the shoulder without any problem in normal daily activity. Conclusion: It was assumed that tenodesis of long head of the biceps brachii tendon with bioabsorbable interference screw by minimal open precedure was one of the good methods with good clinical results.

• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.8-13
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• 1999

The results of the operative treatment of the Grade III acromioclavicular joint injury is defined by the durability of the reduced joint and free of exertional pain. Several surgical techniques have been applied to reduce and stabilize the joints effectively. Resection of clavicular lateral end and subacromial decompression also could be applied to prevent post-operative arthritic change. Biomechanical studies reveals the role of clavicular elevation and rotation to achieve more than 90 degrees of elevation. It also serves as a attachment site of deltoid and trapezius muscle. The stability and mobility of the both acromioclavicular and coracoclavicular joint are important to get full functional recovery. We modified the methods of coracoacromial ligament transfer described by Weaver-Dunn and by Shoji et a!. to pre­vent pullout of the transferred ligament and to get more improved functional results. Main technical point was harvesting full thickness bone block and fix it through the key-hole to reduce pull out angle.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.141-145
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• 2010

Purpose: Understanding elbow biomechanics is necessary to understand the pathophysiologic mechanism of elbow injury and to provide a scientific basis for clinical practice. This article provides a summary of key concepts that are relevant to understanding common elbow injuries and their management. Materials and Methods: The biomechanics of the elbow joint can be divided into kinematics, stability and force transmission through the elbow joint. Active and passive stabilizers include bony articular geometry; soft tissues provide joint stability, compression force and motion. Results and Conclusion: Knowledge of elbow biomechanics will help (i) advance surgical procedures and trauma management, (ii) develop new elbow prostheses and (iii) stimulate future research.

• Journal of Institute of Control, Robotics and Systems
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• v.11 no.1
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• pp.41-49
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• 2005

Electromyogram (EMG) signal generated by voluntary contraction of muscles is often used in rehabilitation devices because of its distinct output characteristics compared to other bio-signals. This paper proposes a novel EMG-based human-computer interface for electric-powered wheelchair users with motor disabilities by C4 or C5 spine cord injury. User's commands to control the electric-powered wheelchair are represented by shoulder elevation motions, which are recognized by comparing EMG signals acquired from the levator scapulae muscles with a preset double threshold value. The interface commands for controlling the electric-powered wheelchair consist of combinations of left-, right- and both-shoulders elevation motions. To achieve a real-time interface, we implement an EMG processing hardware composed of analog amplifiers, filters, a mean absolute value circuit and a high-speed microprocessor. The experimental results using an implemented real-time hardware and an electric-powered wheelchair showed that the EMG-based human-computer interface is feasible for the users with severe motor disabilities.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.1
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• pp.71-76
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• 2016

Background: The objective of this research is to provide base line data on Korea Baseball rehabilitation treatment by presenting the distribution of upper extremity surgeries according the surgical sites of Korean professional baseball players. Methods: The targets of this research are 561 players from nine Korean baseball clubs. The number of players that have undergone surgery was investigated. In other words, the frequency of shoulder joint surgeries, elbow joint surgeries, and wrist and hand surgeries per each baseball club was investigated. Results: The number of the players who have had surgeries was 151, but among the players, there were some who have had repeated surgeries for which the total number of surgery experience was 162. The result showed that elbow joint surgeries were the most frequently enacted, followed by shoulder joint surgeries, and wrist and hand surgeries. From the nine clubs, Samsung was the club with the highest frequency of surgeries. Conclusions: This research shows that Korean professional baseball players need special training centers with systematic rehabilitation programs. Another conclusion suggests that urgent need for rehabilitation program of upper arm which particularly focused on elbow joint is existing. On the basis of this research, we expect more studies on the specific rehabilitation programs which is categorized by injury areas.

• Clinics in Shoulder and Elbow
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• v.6 no.1
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• pp.37-43
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• 2003

Purpose: To evaluate the results in patients who received total elbow replacement for posttraumatic destroyed or unreduced elbow joint. Materials and Methods: Six patients with posttraumatic destroyed, or unreduced elbow joint, who were nearly impossible to move actively and had pain and grossly unstable joint, were followed up average 42 months. 3 cases were soft tissue injuries and bone defects which were caused by severe comminuted fracture, 1 was a nonunion with comminuted fracture, and 2 were unreduced elbow joint. Total elbow replacement was performed average 10 months after the injury. All the cases were used by semiconstrained prosthesis, and the results were estimated by Mayo elbow perfomance score. Results: Pain was decreased in all the cases postoperatively. Average ranges of motion were improved with active extension 20° and flexion 120°. Mayo elbow performance scores were pain 42.5 points, range of motion 17.5 points, stability 8.3 points, function 19.2 points and totally 87.5 points, and final results were 3 excellent and 3 good. Loosening of prosthesis was not found in all the cases by final follow-up radiograph. Conclusicon: Semiconstrained TER can be used as a effective treatment improving pain and active ranges of motion caused by posttraumatic destroyed or unreduced elbow joint, however, long term follow-up is needed because early loosening of TER can be occurred due to severe bone defects.