• Biomaterials and Biomechanics in Bioengineering
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• v.3 no.2
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• pp.115-127
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• 2016

Shoulder pain, injury and discomfort are public health and economic issues world-wide. The function of these joints and the stresses developed during their movement is a major concern to the orthopedic surgeon to study precisely the injury mechanisms and thereby analyze the post-operative progress of the injury. Shoulder is one of the most critical joints in the human anatomy with maximum degrees of freedom. It mainly consists of the clavicle, scapula and humerus; the articulations linking them; and the muscles that move them. In order to understand the behavior of individual muscle during abduction arm movement, an attempt has been made to analyze the stresses developed in the shoulder muscles during abduction arm movement during the full range of motion by using the 3D FEM model. 3D scanning (ATOS III scanner) is used for the 3D shoulder joint cad model generation in CATIA V5. Muscles are added and then exported to the ANSYS APDL solver for stress analysis. Sensitivity Analysis is done for stress and strain behavior amongst different shoulder muscles; deltoid, supraspinatus, teres minor, infraspinatus, and subscapularies during adduction arm movement. During the individual deltoid muscle analysis, the von Mises stresses induced in deltoid muscle was maximum (4.2175 MPa) and in group muscle analysis it was (2.4127MPa) compared to other individual four rotor cuff muscles. The study confirmed that deltoid muscle is more sensitive muscle for the abduction arm movement during individual and group muscle analysis. The present work provides in depth information to the researchers and orthopedicians for the better understanding about the shoulder mechanism and the most stressed muscle during the abduction arm movement at different ROM. So during rehabilitation, the orthopedicians should focus on strengthening the deltoid muscles at earliest.

• Journal of Korean Physical Therapy Science
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• v.8 no.1
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• pp.859-867
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• 2001

The purpose of this single subject care study was to evaluate the effectiveness of a functional electrical stimulation(FES) treatment program designed to prevent glenohumeral pint stretching and subsequent subluxation and shoulder pain in hemiplegic patients. The subject was a 43-year-old male who had left side hemiparesis with shoulder pain and subluxation on affected side. He received conventional physical therapy and additional FES therapy where two flaccid shoulder muscles, supraspinatus and posterior deltoid. were induced to contract repetitively up to 20 minutes for 2 weeks. As a result. the patient showed improvements in hemiplegic arm function, reduction in subluxation(as indicated by Jig test) and range of motion(SLROM). But it was difficult to generalize. We concluded that the FES program was effective in reducing the severity of shoulder subluxation and pain. Further study must be evaluated its statistical significance.

• The Korean Journal of Pain
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• v.21 no.1
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• pp.57-61
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• 2008

Background: Shoulder joint injection is currently performed under fluoroscopic or computed tomography scan guidance. We performed this study to determine if an ultrasound guided shoulder joint injection through rotator cuff interval would have clinical usefulness. Methods: A total of 17 volunteers [12 women, 5 men; mean age 28 yr (23-32 yr)] received shoulder joint injection under multilinear ultrasound (5-10 MHz). Volunteers were positioned supinely on a table with their arm in a neutral position. The anterior shoulder region of the patient was sterilized using povidone iodine. A 24 gauge needle was introduced and directly visualized in real time as it passed obliquely from the skin surface to the inferior space of the biceps tendon. If there was little or no resistance to the injection, a contrast media (omnipaque) was injected and checked fluoroscopically. Results: Ultrasound guided shoulder joint injection through rotator cuff interval was successful in all cases. The average time taken for the procedure was $27.5{\pm}16.5sec$. The vertical distance from skin to the inferior space of the biceps tendon was $1.6{\pm}0.4cm$ and the distance of needle from the skin to the inferior space of biceps tendon was $2.8{\pm}0.6cm$. The procedure was well tolerated by all volunteers. Conclusions: Ultrasound guided shoulder joint injection through rotator cuff interval is an effective, rapid, and easy-to-perform injection technique. Ultrasound guided injection enables exact needle placement and avoids the use of both ionizing radiation and iodinated contrast material.

• PNF and Movement
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• v.12 no.3
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• pp.189-199
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• 2014

Purpose: The objective of this case report is to examine the impact of physical therapy using the proprioceptive neuromuscular facilitation (PNF) concept for a patient with shoulder impingement syndrome. Methods: The patient is a 35-year-old female who has felt pain in the right shoulder for one month. The physical examination evaluated sensory integration, pain, joint integration and mobility, posture, reflex integration, range of motion, muscular strength, analysis of movement, and shoulder function. Comprehensive physical therapy was given to the patient, including stretching, mobilization, strengthening, posture correction, coordination improvement, daily activities, and sports exercises. The therapy was given 5 times a week for the first 5 weeks, then 3 times a week for the next 5 weeks. In all, the intervention lasted for 10 weeks. Results: The patient's senses, posture, and muscular strength all improved to a normal level. The degree of pain fell from 3/10 to 0/10 for activities taking place below shoulder height, and from 8/10 to 1/10 for activities above the head. Additionally, joint integration, motility, range of motion, and movements also improved. The disabilities of the arm, shoulder and hand (DASH) for functional evaluation improved from 27.5 to 10.3. Conclusion: Physical therapy using the PNF concept is effective in improving the body structure, function, activity, and participation of patients with motor disorders of the shoulder impingement syndrome.

• PNF and Movement
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• v.16 no.2
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• pp.169-178
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• 2018

Purpose: This study aimed to investigate the effect of angular joint mobilization (AJM) on the shoulder pain, range of motion, and functional improvement in a patient with shoulder adhesive capsulitis. Methods: The patient diagnosed with right shoulder adhesive capsulitis by an orthopedic surgeon was a 60-year-old male, right hand/arm dominant, with a height of 175 cm and weight of 75 kg. The patient received 12 sessions of AJM once or twice per week for eight weeks. AJM was applied for 5 min each of flexion, abduction, external rotation, internal rotation, for a total of 20 min per session. The visual analog scale, the goniometer, and the Oxford shoulder score were used to measure pain, range of motion, and shoulder pain & disability index, respectively. Results: After all the treatments, the pain decreased from 6 to 2 points. The range of motion increased in flexion by $54.3^{\circ}$ from $125^{\circ}$ to $179.3^{\circ}$, abduction by $38^{\circ}$ from $140^{\circ}$ to $178^{\circ}$, external rotation by $54.4^{\circ}$ from $30.3^{\circ}$ to $84.7^{\circ}$, and internal rotation by $25^{\circ}$ from $45^{\circ}$ to $70^{\circ}$. The shoulder disability index decreased from 33 points to 17 points. Conclusion: This study found that AJM has a positive effect on the improvement of shoulder pain, range of motion, and function in a patient with shoulder adhesive capsulitis. Further studies on AJM are needed in the future.

• Journal of Acupuncture Research
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• v.22 no.1
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• pp.177-190
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• 2005

Objective : This study intends to identify the effects of the Doin Gigong Exercise on the shoulder-arm pain in Women. Methods : The study was performed with nonequivalent control group pretest-posttest design. A total of 45 subjects were divided into 25 persons in experimental groups and 20 persons in contrastive group by convenience sampling. The data were collected by using questionnaires and measured values from June, 2004, to August, 2004. Results : The results of the study are as follows: 1. The homogeneity testing revealed that most study variables were equally distributed between experimental and control groups. 2. The first hypothesis: The experimental group who performed the Doin Gigong Exercise and who decreased on the subjective symptom scale was supported(t=10.245, p=.000). 3. The scond hypothesis : The experimental group who received Doin Gigong Exercise and who decreased on the subjective pain(VAS) was supported(t=6.816, p=.000). 4. The third hypothesis: The experimental group who received Doin Gigong Exercise and who decreased on the muscular stiffness measured techniques(UNIQUE) was supported (t=7.114, p.000). Conclusions : Based on the results described above, it is considered that the Doin Gigon Exercise is clearly effective in all an values of the 5 measured. Therefore, the Doin Gigong Exercise can be thought of as effective nursing intervention for the reduction of shoulder-arm pain in women.

• Clinics in Shoulder and Elbow
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• v.7 no.1
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• pp.10-13
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• 2004

Superior labrum anterior to posterior (SLAP) lesions of the shoulder has recently been a popular issue to shoulder surgeons. Now we are correlating many shoulder symptoms to this SLAP lesion. A 45 year-old female patient injured her shoulder when her arm sleeve was entrapped in moving automobile door. A forceful pull of the arm in external and abduction position was suspected. She complained continuous shoulder pain with limited range of motion for 2 months. Magnetic resonance image showed possible SLAP lesion but no definite diagnosis were made prior to the operation. Arthroscopic evaluation revealed SLAP type Ⅱ lesion with concomitant avulsion of the superior glenoid cartilage. In addition anterior labrocapsular tear was seen from 7 to 9 o'clock of anterior glenoid. The SLAP lesion and the anterior capsulolabral lesion were repaired properly to the glenoid. We report a case of glenoid-cartilage avulsion type of SLAP Ⅱwith anterior labrocapsular lesion.

• Physical Therapy Rehabilitation Science
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• v.6 no.4
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• pp.208-213
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• 2017

Objective: Despite reliable evidence of abnormal scapular motions increases, there is not yet sufficient evidence of abnormal humeral translations. This study aims to analyze the motion of the humeral head toward the scapula when the shoulder is actively abducted using the C-arm. Design: A case report. Methods: The participant was a healthy man without any limitation and pain during shoulder movement. The participant's shoulder was abducted; this movement in the frontal plane was measured using a C-arm (anterior-posterior view) and was analyzed with computer-aided design. The starting posture was $15^{\circ}$, and as the participant abducted his shoulder measurements were taken and analyzed at $30^{\circ}$, $60^{\circ}$, $90^{\circ}$, $120^{\circ}$, $150^{\circ}$, and ending at $165^{\circ}$. A line was drawn perpendicularly to the line connecting the humeral head axis to the glenoid, and another line was drawn perpendiculary to the line connecting the scapular axis to the glenoid. The distance between the two lines measured is defined as the e value. Results: At the starting posture ($15^{\circ}$), the central axis of the humeral head was located 1.92 mm inferior to the central axis of the scapula. The humeral head was superiorly translated from the starting posture to $120^{\circ}$, and then, showed an inferior translation to the ending posture ($165^{\circ}$). Conclusions: The results of this study showed that the humeral head moved upward from the starting posture ($15^{\circ}$) up to $120^{\circ}$ indicating, superior translation, and it moved downward when the posture was past $120^{\circ}$, indicating inferior translation.

• Journal of Korean Academy of Nursing
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• v.45 no.3
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• pp.378-387
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• 2015

Purpose: Acute myocardial infarction (AMI) leads to death if the patient does not receive emergency treatment. Thus it is very important to recognize the symptoms in the early stage. The purpose of this study was to identify clusters of symptoms that represent AMI in Koreans. Methods: The study used a retrospective, descriptive design with secondary data analysis. Data were abstracted from 725 medical records of AMI patients admitted from June 1, 2006 to August 15, 2014 at a university hospital. Results: Analysis of the AMI symptoms revealed five symptom clusters; Cluster 1 (n=140): middle chest pain (100%), shortness of breath, and cold sweating, Cluster 2 (n=256): substernal pain (100%), cold sweating, and shortness of breath, Cluster 3 (n=47): substernal pain (95.7%), left arm pain, shortness of breath, cold sweating, left shoulder pain, right arm pain, and the lower neck pain, Cluster 4 (n=212): shortness of breath (28.3%), left chest pain, and upper abdominal pain, and Cluster 5 (n=70): cold sweating (100%), left chest pain, shortness of breath, left shoulder pain, and upper abdominal pain. Length of hospital stay and mortality rate were significantly different according to symptom clusters (F=2.52, p =.040; F=3.62, p =.006, respectively). Conclusion: Symptom clusters of AMI from this study can be used for AMI patients in order to recognize their symptoms at an early stage. The study findings should be considered when developing educational prevention programs for Koreans with AMI.

• Clinics in Shoulder and Elbow
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• v.24 no.2
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• pp.55-65
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• 2021

Background: Although ultrasound-guided needle decompression (US-GND) can treat calcific tendinitis of the shoulder effectively, repeat procedures might be required for unresolved symptoms. We evaluated the overall clinical outcomes of US-GND with subacromial steroid injection and the final results and factors predisposing toward repeat procedures. Methods: Ninety-eight patients who underwent US-GND for calcific tendinitis of the supraspinatus/infraspinatus were analyzed between March 2017 and December 2018. The clinical outcomes (pain visual analog scale, functional visual analog scale [FVAS], and American Shoulder and Elbow Surgeons [ASES] score) and final subjective satisfaction were compared between groups A (single US-GND) and B (repeat US-GND). The factors predisposing toward repeated US-GNDs were analyzed. Results: We found that 59.3% (58/98) of patient ASES scores were ≥80, and 73.5% of patients (72/98) were satisfied with the outcome. Group B (n=14) demonstrated a significantly higher rate of dominant-arm involvement compared to group A (78.6% vs. 48.8%, p=0.046). However, initial calcification size, shape, number, density, subscapularis involvement, lavage, and procedure time did not differ significantly between the groups. Group B showed poorer final FVAS (7 [interquartile range, 6-8] vs. 8 [interquartile range, 7-9], p=0.036) and subjective satisfaction compared to group A (satisfied: 5 [35.7%] vs. 67 [79.8%], p<0.001]. Conclusions: US-GND with subacromial steroid injection is a viable treatment option for calcific tendinitis of the shoulder. Dominant-arm involvement was the only independent factor for repeated US-GND. Final outcome of repeated US-GND for unimproved patients was promising; however, these outcomes were poor compared to those of the patients who improved after the first procedure.