• Clinics in Shoulder and Elbow
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• v.22 no.4
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• pp.195-202
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• 2019

Background: This study investigates the effects of neuromuscular electrical stimulation (NMES) in preventing deltoid atrophy during the first 12 weeks after arthroscopic rotator cuff repair. Methods: Eighteen patients undergoing arthroscopic repair of a medium-sized rotator cuff tear by a single surgeon, were randomized into two groups: NMES and transcutaneous electrical nerve stimulation (TENS). Each group used the respective device for 6 weeks after surgery. Pain was measured at baseline, 6, and 12 weeks postoperatively, using the visual analogue scale (VAS); range of motion (ROM), abduction strength and functional scores were measured at baseline and 12 weeks postoperatively. Deltoid thickness and cross-sectional areas were measured using magnetic resonance imaging at 12 weeks postoperatively. Results: At 12 weeks post-surgery, no statistically significant difference was observed between the NMES and TENS groups in the pain VAS, the Disabilities of the Arm, Shoulder and Hand score, ROM, and abduction strength. Postoperative decrease in the thickness of the anterior, middle, and posterior deltoid, at the level just below the coracoid, was -2.5%, -0.7%, and -6.8%, respectively, in the NMES group, and -14.0%, -2.6%, and -8.2%, respectively, in the TENS group (p=0.016, p=0.677, and p=0.791, respectively). At the level of the inferior glenoid tubercle, postoperative decrease in area of the deltoid was -5.4% in the NMES group and -14.0% in the TENS group, which was significantly different (p=0.045). Conclusions: NMES has the potential for reducing deltoid atrophy after arthroscopic rotator cuff repair, suggesting that NMES might help minimize postoperative atrophy after various shoulder surgeries.

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

• Physical Therapy Rehabilitation Science
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• v.10 no.2
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• pp.112-115
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• 2021

Objective: This study was conducted to apply skin mobilization to patients with Axillary web syndrome following breast cancer resection and to see the resulting changes in pain and joint range of motion. Design: Single case study,pre-post comparison. Methods: The subject was a female patient in her 40s who performed a mastectomy after being diagnosed with breast cancer, and then complained of uncomfortable pain from the shoulder joint to the axilla and limited range of motion. To implement a skin mobilization, the palms were adhered to the inner half of the arm, the arms were raised to a pain-free extent, and skin mobilization was performed. The skin was pulled in the direction of axilla and kept for 5 seconds 10 times for a total of 2 sets. Immediate changes in range of motion and pain were identified. Results: Following skin mobilization, there was an immediate increase in range of motion (pre 116°, post 140°) and a decrease in pain (NRS pre 5, post 2). And also uncomfortable pain, which is hard to define in words, also seems to have improved. Conclusions: Skin mobilization, which considers skin mobility for patients with Axillary web syndrome, can be considered for improving range of motion and restoring function in patients with pain due to fibrous bands around veins and lymphatic vessels, and is recommended as a new intervention method not used as a conventional treatment.

• Clinics in Shoulder and Elbow
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• v.21 no.1
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• pp.42-47
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• 2018

A 25-year-old woman presented to the emergency room with a painful and swollen right forearm. She had just sustained an injury from an accident during which her arm was tightly wound by a rope as she was lowering a net from a fishing boat. Before being released, her arm was rigidly trapped in the rope for approximately ten minutes. Radiographs revealed anterior dislocation of the radial head that was accompanied by plastic deformation of the proximal ulna, manifested as a reversal of the proximal dorsal angulation of the ulna (PUDA); suggested a Monteggia equivalent fracture. With the patient under general anesthesia, we reduced the radial head by posterior compression at $90^{\circ}$ of elbow flexion and at neutral rotation of the forearm. However, the reduction was easily lost and the elbow re-dislocated with even slight supination or extension of the arm. After the osteotomy of the ulnar deformity to restore the PUDA to normal, the reduction remained stable even with manipulation of the arm. We found that the patient could exercise a full range of motion without pain at the 3-month follow-up, and neither residual instability nor degenerative changes were observed at the final 3-year follow-up.

• Journal of muscle and joint health
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• v.6 no.2
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• pp.278-294
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• 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
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• v.24 no.2
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• pp.51-58
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• 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.

• Journal of Acupuncture Research
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• v.23 no.1
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• pp.165-177
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• 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
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• v.9 no.1
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• pp.119-123
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• 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.

• 대한근관절건강학회:학술대회논문집
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• 2001.04a
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• pp.179-190
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• 2001

The purpose of this study was to explore the effects of GEAP on pain, joint function, activities of daily living(ADL) and fatigue in chronic arthritis patients. The GEAP was held twice a week for 6 weeks for chronic arthritis patients at one university hospital in Seoul, Korea. Thirty four subjects completed the program, who were recruited at four times from September, 1999 to September, 2000. The effect of GEAP were evaluated as follows: Pain severity and number of painful joints ADL, fatigue were measured before and after the GEAP. In order 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, and the grip strength. Paired t-test and Wilcoxon signed rank test were used for data analysis and the significance of the differences in the variables was examined to compare the data obtained before and after the GEAP. After the GEAP, followings were found: 1. Pain severity and number of painful joints was significantly decreased. 2. The flexibility of both shoulders and arms, knee, both ankle were significantly improved. 3. The strengthening of both arms was significantly improved, but the strengthening of ankle was not changed. 4. ADL was significantly increased. 5. Fatigue was significantly decreased. In conclusion, GEAP used in this study was clearly proved to be an effective exercise program to reduce pain and fatigue, to enhance joint function and ADL in people with chronic arthritis. It is suggested that the GEAP should be recommended as one of the useful and appropriate nursing interventions for chronic arthritis patients.

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