• Korean Journal of Acupuncture
• /
• v.22 no.4
• /
• pp.29-41
• /
• 2005

Objectives : Although previous anatomic, physiological and biophysics studies have examined the acupuncture meridian system, much remains unclear and controversial. This study was undertaken to examine electrical potential aspects of the meridian system. Electric potential was measured at the well and sea acupoints on the twelve acupuncture meridians (AM), on forty patients half with loin lesions, and pain of loin and lower extremities(LL) and half with shoulder lesions, and aching of shoulder and arm(SA). The object was to determine to what extent electric potential is an important risk factor between LL and SA. Methods : At the left and the right side with each of twenty LL and twenty SA patients, physiograph was used to measure electric potentials of AM ten sessions. T-test was used to compare the mean of electric potential between the two different pain groups and multiple logistic regression was used to analyze the risk of the 24 electric potentials measured. Results and Conclusions : In the LL, the only electric potential that was statistically significantly greater than SA was the bladder meridian on the left side. On the contrary, electric potentials in SA, which includes the large intestine, pericardium, triple burner, spleen, stomach, kidney and gallbladder meridians, were statistically larger than those of LL at the same side. On the right side, the five kinds of electric potentials(lung, large intestine, small intestine, pericardium and gallbladder meridian) of LL were statistically larger than those of SA. On the triple burner, stomach and kidney meridians electric potentials of SA were larger than those in LL. After adjusting for 24 electric potentials, pain risk factors, and different illness categories, multiple stepwise selection logistic regression modeling, resulted in the final selection of a total of 13 statistically significant electric potentials. These were 7 electric potentials at left side - small intestine, triple burner, spleen, stomach, bladder, liver and gallbladder meridian, and 6 at rght side - lung, large intestine, heart, pericardium, kidney and bladder meridian.

• Clinics in Shoulder and Elbow
• /
• v.1 no.2
• /
• pp.160-166
• /
• 1998

The purpose of this study was to assess the results of arthroscopic subacromial decompression in patients with chronic impingement and to evaluate the results according to the rotator cuff pathology. We evaluated the clinical results of treatment for chronic impingement syndrome in 28 patients from Feb 1996 to Feb 1997. There were twenty men and eight women in age from 24 to 72 years (mean age 51) with dominant arm involvement in sixteen patients. Follow up evaluations averaged 15(range 12-24)months. The average duration of symptoms were 15(range 6­60)months. The final diagnoses which were based on the physical examination, plain radiographs and arthroscopic findings, were stage II impingement in 16 patients and stage ill impingement in 12 patients. We excluded the patients with acromioclavicular arthritis or glenohumeral instability in this study. All patients were managed non-operatively a minimum of six months. During the operation we performed contouring and smoothing the acromial undersurface and only resecting of the anterolateral band of the coracoacromial ligament. The clinical results were quantitated using UCLA shoulder rating score. Satisfactory results were obtained in 23(80%) patients. Unsatisfactory results were obtained in 5(18%) patients with posterior cuff tear. The average UCLA pain score showed significant improvement from 2.8(constant pain) to 7.2(present during heavy activities) at final follow up. The function and active forward flexion scores also increased from their preoperative value. There was no significant differences according to the surface and severity of tear and NeeI' stage (P>0.05). These results compared favorably with those reported following open acromioplasty. While arthroscopic subacromial decompression is a demanding technique with a learning curve, it is a reliable treatment for chronic impingement syndrome. A less aggressive approach to subacromial decompression and preserving the posteromedial band of the coracoacromialligament does not appear to compromise results.

• Clinics in Shoulder and Elbow
• /
• v.25 no.4
• /
• pp.274-281
• /
• 2022

Background: In the present study, the age- and sex-adjusted Constant score (CS) in a normal Indian population was calculated and any differences with other population cohorts assessed. Methods: The study participants were patients who visited the outpatient department for problems other than shoulder and healthy volunteers from the local population. Patients without shoulder pain/discomfort during activity were included in the study. Subjects with any problem that might affect shoulder function (e.g., cervical, thoracic spine, rib cage deformity, inflammatory arthritis) were excluded. Constant scoring of all participants was performed by trained senior residents under the supervision of the senior faculty. Shoulder range of movement and strength were measured following recommendations given by the research and Development Committee of the European Society for Shoulder and Elbow Surgery (2008). A fixed spring balance was used for strength measurement; one end was fixed on the floor and the other end tied with a strap to the wrist of the participant, arm in 90° abduction in scapular plane with palm facing down. Results: Among the 248 subjects (496 shoulders), the average age was 37 years (range, 18-78 years), 65.7% were males (326 shoulders) and 34.3% females (170 shoulders). The mean CS was 84.6±2.9 (males, 86.1±3.0; females, 81.8±2.9). CS decreased significantly after 50 years of age in males and 40 years of age in females (p<0.05). The mean CS was lower than in previous studies for both males and females. Heavy occupation workers had higher mean CS (p<0.05). A linear standardized equation was estimated for calculating the adjusted CS for any age. Conclusions: Mean CS and its change with age differed from previous studies among various population cohorts.

• The Korean Journal of Pain
• /
• v.4 no.2
• /
• pp.147-151
• /
• 1991

Cervical epidural steroid injection, although not as familiar to many anesthesiologists, can be useful in the management of patients with acute and chronic neck, shoulder and arm pain. My clinic personally contacted and interviewed thirty patients with cervical radiculopathy who received cervical epidural steroid injection. Twenty seven percent of the patients had a excellent response(greater than 75% improvement) and fifty percent of the patients had a good response (greater than 50% improvement) to an injection of steroid into the cervical epidural space. We have concluded that cervical epidural steroid injection was very effective in the management of cervical radiculopathy and represented a possible alternative to surgery. Many anesthesiologists should add to their armamentarium the use of such techniques in the management of cervical radiculopathy.

• Clinics in Shoulder and Elbow
• /
• v.5 no.1
• /
• pp.47-54
• /
• 2002

Purpose : We evaluated clinical result of arthroscopic and open Bankart repair in anterior shoulder instability to identify factors iuluencing operative result and prognosis. Materials & Methods . We reviewed 24 patients of anterior shoulder instability treated with arthroscopic Bankart repair in 16 cases and open Bankart repair in 8 cases. Average age was 26 years old and involved in dominant arm in 15 cases. Patients were suffered instability for 3.1 years before operation and mean follow-up was 2 year 9 months ( 1 you 9 months -4year 10 months). Results : Post operative pain was subsided in 2 weeks in arthroscopic surgery and 3 weeks in open surgery. The final range of motion after arthroscopic repair were flekion in 168" , external rotation in 54" , and internal rotation in 79, and after open repair 168" ,49" , and 78 respectively. In arthroscopic surgery,2 cases (13%) were redislocated, and 4 cases(25%) showed mild instability. In open case,1 case (11%) showed mild instability. According to function- al result by Rowe grading scale, satisfactory results were 12case (76%) in arthroscopic repair and 7 cases (88%) in open cases. Conclusions Both arthroscopic or open Bankart could get good results in the treatment of anterior instability of shoulder. In arthroscopic repair, perioperative morbidity was lower than open repair, but it needs careful rehabilitation program to prevent redislocation and to return to sports activity.

• Journal of Acupuncture Research
• /
• v.23 no.1
• /
• pp.165-177
• /
• 2006

Objectives : 1. Clinical trial for the efficacy evaluation of Korean acupuncture techniques in treating frozen shoulder. 2. Development of the standard clinical guidelines of the acupuncture treatment for the frozen shoulder. 3. Development of the new clinical protocol for the acupuncture treatments. 4. Verification of the hypothesis that treating at both the remote and the nearby acupoints according to the meridian theory is more effective than treating at only the nearby acupoints. Methods : 1. Research designed as Single blind, Randomized, Sham acupuncture controlled clinical Trial. 2. Assignment of 86 patients to one of three groups treated at nearby acupoints(group A), remote & nearby acupoints(group B), and sham points(group C) respectively. 3. Trial conducted at KIOM CRC of Dunsan oriental medical hospital, Daejeon Univ. 4. Estimation of the recovery rate of the frozen shoulder in subjects aged over 40. 5. Efficacy evaluation using VAS, SPADI, ROM and Improvement rate. Results : 1. There was no significant difference in VAS among the three groups. 2. Pain related scores in SPADI of the group B were significantly lower than those of the group A. 3. There was no significant difference in disability related scores of SPADI among the three groups. 4. External rotation of upper arm in the group B was significantly improved in comparison with that in the group C. 5. Abduction of upper arm in group A was improved with weak statistical significance in comparison with that in the group C. Conclusion : Acupuncture at both the remote and the nearby acupoints according to the meridian theory is effective to improve external rotation of frozen shoulder, and acupuncture at the nearby acupoints is effective to improve adduction of frozen shoulder. However it is not clear that acupuncture treatment at both the remote and the nearby acupoints according to the meridian theory is more effective than treating at only the nearby acupoints in the treatment of frozen shoulder. Since our study was a short term trial, a long term trial for a more precise evaluation of acupuncture treatment for frozen shoulder will be needed in the future.

• Clinics in Shoulder and Elbow
• /
• v.9 no.1
• /
• pp.119-123
• /
• 2006

Isolated avulsion of the lesser tuberosity of the humerus in adolescent is rare injury. The mechanism of injury is acute forced external rotation and with the arm in abduction which has been reported in children participating in sports such as football, hockey, volleyball, wrestling and skateboarding. The diagnosis is often delayed despite chronic pain and disability. Authors report the unique case of a skeletally immature adolescent Judo player who had an isolated avulsion of the lesser tuberosity of the humerus with the references.

• Journal of muscle and joint health
• /
• v.6 no.2
• /
• pp.278-294
• /
• 1999

The PACE (People nth Arthritis Can Exercise) is an exercise program developed by the Arthritis Foundation to improve muscle strength and joint flexibility for patients with arthritis. The purpose of this study was to explore the effects of PACE program on self-efficacy, pain, and joint function in the Korean immigrant elderly. The PACE program was held twice a week for 6 weeks for Korean immigrant elderly who had osteoarthritis. Twenty four subjects completed the program, who were recruited in two places : 10 elderly in a senior residential apartment, and 14 elderly in a senior center supported by Congregated Meal Program for Korean Elderly. Self-efficacy(Sherer et al., 1982), pain severity(by using Visual Analogue Scale), and number of painful joints were measured before and after the PACE program. To examine the joint flexibility and strengthening, the followings were measured : the extent of the upward arm reach in both sides(flexibility of shoulder), the ability to touch fingertips of the both hands in back pat and rub(flexibility of arm), the degree of range of motion(ROM) of both ankles in their dorsiflexion(flexibility of ankle) and plantarflexion with standing with toe(strengthening of ankle), and the degree of knee extension. Wilcoxon signed rank test was used for data analysis and the significance of the differences in the variables was examined to compare the data obtained before and after the PACE program. After the PACE, followings were found : 1. Self-efficacy was significantly increased. 2. Pain severity and number of painful Joints was significantly decreased. 3. The flexibility of both shoulders and arms were significantly improved, but the flexibility of knee was not changed. 4. The flexibility and strengthening of both ankle was significantly improved. In conclusion, PACE was clearly proved to be an effective exercise program to promote self-efficacy, to reduce pain, and to enhance joint function in the elderly with osteoarthritis. It is suggested that the PACE program should be recommended as one of the useful and appropriate nursing interventions for elderly with osteoarthritis.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.24 no.2
• /
• pp.51-58
• /
• 2018

Backdround: Using RUSI (Rehabilitation Ultra Sound Imiging) method, which showed high reliability in soft tissue measurements, we compared the muscle relax and contraction, sex, and physical characteristics of the activity of the multifidus muscle in patients with chronic low back pain and normal subjects. Methods: In this study, 16 patients (male: 8, female: 8) with chronic low back pain and 16 healthy adult (male: 8, female: 8) were participated. Subjects lied prone posture on the table with elbow flexed $90^{\circ}$ and shoulder abducted $120^{\circ}$ (starting position). Test was applied two types that muscle relax position and muscle contraction position. Muscle relax position is equal to starting position and muscle contraction position is that upper extremity lift up about 5cm from the table. We measured the thickness of the multifidus muscle in each position by ultrasound. Results: There was a statistically significant difference between the two groups in deviation of Both Side Difference of Activated resting-Arm Lifting Ratio according to posture change between the chronic low back pain patient group and the normal group. Conclusion: The result of this study support previous study showing that there is an imbalance in the activity of multifidus in patients with chronic low back pain.

• Clinics in Shoulder and Elbow
• /
• v.17 no.4
• /
• pp.175-180
• /
• 2014

Background: For Neer type IIB fracture of distal clavicle with coracoclavicular ligament injury, various surgical treatments have been used in literatures. However, there was no consensus on the optimal treatment. The aim of this study is to report the clinical and radiological results of open reduction and internal fixation of unstable distal clavicle fracture and suture augmentation of disrupted coracoclavicular ligament. Methods: A prospective study was performed in 23 patients with Neer type IIB distal clavicle fracture in Seoul Medical Center, Eulji Hospital, and National Medical Center. Firstly, suture anchors are inserted in the base of coracoid process and preliminary reduction was achieved by tie-off of three suture limbs around the clavicle. Then, the final fixation was completed with anatomical locking plate. Bony union and the distance between coracoclavicular ligaments were evaluated. Clinical results and complications including stiffness and secondary procedures were evaluated. Results: Bony union was achieved in all cases except one (22 of 23). At mean 14.9 months, no significant difference in the mean coracoclavicular distance was observed compared to uninjured shoulder ($8.2{\pm}7.9mm$ versus $7.3{\pm}3.4mm$, p=0.14). Pain visual analogue scale, American Shoulder and Elbow Surgeons score, Constant score, and Disabilities of the Arm, Shoulder and Hand score were 0.5, 83.4, 78.5, and 6.2, respectively. Revision surgery was performed in one case of nonunion. Four patients who complained of skin irritation underwent implant removal. Conclusions: In cases of an unstable distal clavicle fracture with coracoclavicular ligament disruption, satisfactory clinical results were obtained by locking plate fixation and coracoclavicular ligament suture augmentation concurrently.