• Title/Summary/Keyword: stiffness of joint

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Does Single Blind Anterior Glenohumeral Steroid Injection Performed by Short Experienced Clinicians Could Provide Clinical Efficacy in Patients with Frozen Shoulder?

  • Hong, Jin Ho;Ryu, Ho Young;Park, Yong Bok;Jeon, Sang Jun;Park, Won Ha;Yoo, Jae Chul
    • Clinics in Shoulder and Elbow
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    • v.17 no.3
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    • pp.102-106
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    • 2014
  • Background: The purpose of this study was to evaluate the effect of single blinded anterior intra-articular corticosteroid injection to the glenohumeral joint performed by short experienced clinicians in frozen state adhesive capsulitis patients. Methods: From March to June of 2013, among the patients who visited the shoulder outpatient clinic due to shoulder pain for 5-6 months and those patient diagnosed as frozen state adhesive capsulitis was selected. The diagnosis were based on base, first the global limitation of range of motion, defined as forward elevation <100, external rotation at side <10, internal rotation less than buttock, and abduction <70. Second, the patients had additional radiologic evaluations showing no major pathologies for such stiffness. Clinical outcome, were performed with pain visual analog scale (PVAS) and functional visual analog scale (FVAS), American Shoulder and Elbow Surgeons Shoulder score (ASES), preinjection and postinjection after 2-4 weeks. Finally 82-patients were enrolled. Mean age of the patients was 55.1 years and mean follow-up duration was 25.17 days. Results: The mean preinjection PVAS was 6.91 and postinjection was 3.11, there was 3.8 decreases from preinjection status (p < 0.001). The mean FVAS score showed 4.26 at preinjection and 6.63 afterwards (p < 0.001). The ASES score showed 27.89 increases after injection (p < 0.001). There were 64-patients (78.04%) who reported more than 3 points of decrease of PVAS, who could be judged as effective treatment. Conclusions: Single anterior glenohumeral steroid injection by short experienced clinicians to the patients with frozen state adhesive capsulitis has shown relatively high efficacy in clinical result evaluated by means of PVAS.

Coracoclavicular Ligament Suture Augmentation with Anatomical Locking Plate Fixation for Distal Clavicle Fracture

  • Lim, Tae Kang;Shon, Min Soo;Ryu, Hyung Gon;Seo, Jae Sung;Park, Jae Hyun;Ko, Young;Koh, Kyoung-Hwan
    • Clinics in Shoulder and Elbow
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    • v.17 no.4
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    • pp.175-180
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    • 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.

Effects of Exercise Program Intervention on Muscle Activity in Rotator Cuff Repair Patient (운동프로그램 중재가 돌림근띠 복원술 환자의 근 활성도에 미치는 영향)

  • Kang, Jeong-Il;Moon, Young-Jun;Park, Seung-Kyu;Lee, Joon-Hee;Yang, Dae-Jung;Choi, Hyun;Jeong, Dae-Keun;Kim, Yong-Nam;Kwon, Hye-Min
    • The Journal of Korean Physical Therapy
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    • v.25 no.2
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    • pp.56-63
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    • 2013
  • Purpose: This study was conducted in order to examine how an effective rehabilitation exercise program influences the activity of shoulder muscles, and to help the clinical application of a rehabilitation program, for prevention and relief of pain, adhesion, and joint stiffness of patients who undergo rotator cuff repair. Methods: Nine test subjects were placed randomly into each group for a total of 27 subjects and exercise program interventions according to the group were conducted for six weeks, after which maximum voluntary isometric contraction (%MVIC) value was re-measured for supraspinatus muscle, infraspinatus muscle, serratus anterior muscle, and middle deltoid muscle in all groups in order to compare changes in muscle activity before and after the experiment in order to perform comparative analysis of changes in muscle activity between groups, based on which four experimental hypotheses were confirmed. Results: Changes in muscle activity according to %MVIC showed a statistically significant difference (p<0.01) (p<0.001) in all muscles, except the middle deltoid muscle, and post-verification results showed that changes in muscle activity according to %MVIC were greater in test groups I and II, compared with the control group, for the supraspinatus muscle, infraspinatus muscle, and serratus anterior muscle. Conclusion: Therefore, rehabilitation through use of the methods described above should be applied efficiently in clinical settings and more research in development of much more efficient rehabilitation program interventions must be conducted.

Seismic behavior of steel reinforced concrete (SRC) joints with new-type section steel under cyclic loading

  • Wang, Qiuwei;Shi, Qingxuan;Tian, Hehe
    • Steel and Composite Structures
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    • v.19 no.6
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    • pp.1561-1580
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    • 2015
  • No significant improvement has been observed on the seismic performance of the ordinary steel reinforced concrete (SRC) columns compared with the reinforced concrete (RC) columns mainly because I, H or core cross-shaped steel cannot provide sufficient confinement for core concrete. Two improved SRC columns by constructing with new-type section steel were put forward on this background: a cross-shaped steel whose flanges are in contact with concrete cover by extending the geometry of webs, and a rotated cross-shaped steel whose webs coincide with diagonal line of the column's section. The advantages of new-type SRC columns have been proved theoretically and experimentally, while construction measures and seismic behavior remain unclear when the new-type columns are joined onto SRC beams. Seismic behavior of SRC joints with new-type section steel were experimentally investigated by testing 5 specimens subjected to low reversed cyclic loading, mainly including the failure patterns, hysteretic loops, skeleton curves, energy dissipation capacity, strength and stiffness degradation and ductility. Effects of steel shape, load angel and construction measures on seismic behavior of joints were also analyzed. The test results indicate that the new-type joints display shear failure pattern under seismic loading, and steel and concrete of core region could bear larger load and tend to be stable although the specimens are close to failure. The hysteretic curves of new-type joints are plumper whose equivalent viscous damping coefficients and ductility factors are over 0.38 and 3.2 respectively, and this illustrates the energy dissipation capacity and deformation ability of new-type SRC joints are better than that of ordinary ones with shear failure. Bearing capacity and ductility of new-type joints are superior when the diagonal cross-shaped steel is contained and beams are orthogonal to columns, and the two construction measures proposed have little effect on the seismic behavior of joints.

Effects of Dan-jun Breathing Exercise Program Experienced by Women in Midlife (단전호흡 운동프로그램에 참여한 중년여성의 운동효과에 대한 경험)

  • Hyun Kyung-Sun;Kang Hyum-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.9 no.2
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    • pp.180-189
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    • 2002
  • Purpose : This study focused on affirming of the effects of Dan-jun breathing exercise experienced by women in midlife. Method: The data were collected via direct interview from 20 participants, who participated in a Dan-Jun exercise program during three months. Collected data were analyzed by content analysis. Result : 1. As for the health problems of women in midlife before the Dan-jun exercise program, 93 items were extracted in the content analysis These items were categorized into 59 attributes and 15 higher attributes. 1) Of the 59 attributes of health problems, shoulder pain (30%) was the most dominant. 2) The 15 higher attributes consisted for the physical domain of, weakness, pain, joint stiffness, sexual problem, sleep disorder, gastro-intestinal disorder. menstrual irregularity. circulatory disorder, respiratory disorder. constipation, urinary incontinence, and for the psychological domain, anger, emptiness, depression, and anxiety. 2. As for the effects experienced by women in midlife after the Dan-jun exercise program, 169 items were extracted in the content analysis. These items were categorized into 85 attributes and 14 higher attributes. 1) Of 85 attributes, lightening of physical condition (55%) was the most dominant. 2) The higher attributes consisted in physical domain of, recovery of vigor, pain relief, menstrual regularity and improvements in flexibility. sexual problem, sleep disorder, gastro-intestinal disorder, circulatory disorder constipation, respiratory disorder and urinary incontinence, and for the psychological domain, relaxation, cultured mind and self-confidence. Conclusions : Dan-jun breathing exercise program for three months showed positive effects on physical and psychological health in women in midlife. In this context, it can be also considered as a significant nursing intervention for maintenance and promotion of the health of these women.

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Behaviour and design of bolted endplate joints between composite walls and steel beams

  • Li, Dongxu;Uy, Brian;Mo, Jun;Thai, Huu-Tai
    • Steel and Composite Structures
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    • v.44 no.1
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    • pp.33-47
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    • 2022
  • This paper presents a finite element model for predicting the monotonic behaviour of bolted endplate joints connecting steel-concrete composite walls and steel beams. The demountable Hollo-bolts are utilised to facilitate the quick installation and dismantling for replacement and reuse. In the developed model, material and geometric nonlinearities were included. The accuracy of the developed model was assessed by comparing the numerical results with previous experimental tests on hollow/composite column-to-steel beam joints that incorporated endplates and Hollo-bolts. In particular, the Hollo-bolts were modelled with the expanded sleeves involved, and different material properties of the Hollo-bolt shank and sleeves were considered based on the information provided by the manufacture. The developed models, therefore, can be applied in the present study to simulate the wall-to-beam joints with similar structural components and characteristics. Based on the validated model, the authors herein compared the behaviour of wall-to-beam joints of two commonly utilised composite walling systems (Case 1: flat steel plates with headed studs; Case 2: lipped channel section with partition plates). Considering the ease of manufacturing, onsite erection and the pertinent costs, composite walling system with flat steel plates and conventional headed studs (Case 1) was the focus of present study. Specifically, additional headed studs were pre-welded inside the front wall plates to enhance the joint performance. On this basis, a series of parametric studies were conducted to assess the influences of five design parameters on the behaviour of bolted endplate wall-to-beam joints. The initial stiffness, plastic moment capacity, as well as the rotational capacity of the composite wall-to-beam joints based on the numerical analysis were further compared with the current design provision.

Effects on Mechanical Properties, Joint Range of Motion, and Grip Strength of Forearm Muscles Depending on Wrapping Direction of the Floss Band

  • Ki Bum Jung;Seohui Kim;Yongwoo Lee
    • Physical Therapy Rehabilitation Science
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    • v.13 no.1
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    • pp.95-105
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    • 2024
  • Objective: The purpose was to investigate changes in mechanical properties, range of motion, and grip strength of the forearm muscle in 13 students depending on the wrapping direction of the floss band. Design: A single-blind, crossover study Methods: Subjects were randomly assigned to the wrapping direction of the flossing band and then performed a concentric exercise of the wrist flexors using a Flex-Bar. Intervention A applied the flossing band in a right spiral direction, Intervention B applied the flossing band in a left spiral direction, and Intervention C performed the exercise alone. All subjects used their dominant right hand, and pre- and post-assessments were conducted between interventions. To analyze differences in changes between groups pre- and post-, all results were subjected to one-way ANOVA, followed by Scheffe's test as a post-hoc analysis. The paired samples t-test was used to analyze the difference between pre- and post-change within groups. Results: First, in the mechanical properties of the Flexor carpi ulnaris (FCU) muscle, interventions A and B significantly improved muscle tone and stiffness than intervention C (p<0.05), and intervention A showed a significant decrease in decrement (muscle elasticity) than intervention B (p<0.05). Second, interventions A and B showed significant improvement in grip strength than intervention C (p<0.05). Conclusions: The right spiral direction of the flossing band tended to increase the elasticity of the muscles compared to the left spiral direction. Therefore, in future studies, it is necessary to choose the direction of the flossing band to increase the elasticity of the muscles.

The Treatment of Tibial Shaft Fractures by Interlocking Nailing (Interlocking Nail을 사용한 경골간부 골절의 치료)

  • Lee, Jae-Chang;Lee, Jae-Sung;Ahn, Myun-Whan;Kim, Sae-Dong;Ihn, Joo-Chul
    • Journal of Yeungnam Medical Science
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    • v.5 no.1
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    • pp.61-67
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    • 1988
  • The treatment of tibial shaft fracture has become one of the most controversial subjects in orthopedic surgery. Comminuted, segmental and rotationally unstable fractures or bone defect at fracture site have problems of the fixation. The interlocking nail solve these problems. We have experienced 8 cases of the tibial shaft fractures treated with interlocking nail from 1986 to 1988. Authors analysed these cases and our own clinical study. The results were as follows. 1. The average bone union rate was about 15 weeks. 2. The interval between operation and crutch walking was 4:3 weeks. 3. The merits of this operation were the short hospitalization and early adaptation of social activity. 4. The advantage is be able to do early ambulation without following muscular atrophy or joint stiffness. 5. The results were assessed on clinical examination and radiographic appearance by Hamza et al. An excellent results were 7 cases and good result was 1 case.

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Acupotomy for Scapulohumeral Periarthritis

  • Guo, Chang Qing;Ma, Shi Ning;Fu, Xin Yi;Wang, Quan Gui;Lee, Mira
    • Journal of Acupuncture Research
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    • v.37 no.4
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    • pp.254-258
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    • 2020
  • Background: Scapulohumeral periarthritis causes pain and stiffness, and limits movement but it is a treatable condition. This was a clinical study of acupotomy treatment for scapulohumeral periarthritis. Methods: There were 80 patients randomly assigned to the traditional Chinese Medicine group (acupotomy) and the Western medicine group (naproxen), with 40 cases in each group. All patients had adjunct physiotherapy exercises for 14 days. Patients received acupotomy treatment 3 times for 14 days (Day 0, 7 and 14) or naproxen (0.22 g capsule; a non-steroidal anti-inflammatory drug) 3 times a day, for 14 days. The visual analogue scale (VAS) scores, range of motion (ROM) values, and the Melle scale, together with the therapeutic standard of diseases and syndromes in traditional Chinese Medicine were used for diagnosis and evaluation. Results: There were significant differences in the VAS scores, ROM, Melle scores, cure rate and total effective rate in the group which took naproxen and the acupotomy group, before and after treatment (p < 0.01). There were significant differences in the changes in VAS, ROM and Melle scores between the 2 groups (p < 0.01), and the acupotomy group was better than the naproxen group. Conclusion: Traditional Chinese Medicine and Western medicine can improve functional activity and reduce the level of pain experienced by patients suffering from scapulohumeral periarthritis. However, improvement of functional activity of the shoulder joint following acupotomy treatment was more obvious than the use of a non-steroidal anti-inflammatory drug, and the cure rate, and total effective rate of acupotomy was better.

Domestic and Foreign Research Trend on the Pediatric Chuna Treatment (소아 추나에 대한 국내·외 연구 동향)

  • Lee, Jin Hwa;Han, Jae Kyung;Kim, Yun Hee
    • The Journal of Pediatrics of Korean Medicine
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    • v.29 no.4
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    • pp.67-76
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    • 2015
  • Objectives The purpose of this review is to investigate the domestic and foreign studies of pediatric Chuna treatment and propose the directions of future studies and clinical applications. Methods We searched for the study at RISS, KISS, DBPIA, Pubmed, CNKI by keywords, '추나', 'Osteopathic', 'Chiropractic', 'Manipulation', '推拿', '導引', '按摩', After 2010. Results 1. Selected 3 domestic studies were categorized as 1 survey study and 2 case reports. Selected 41 foreign studies from Pubmed were categorized as 15 systemic reviews, 8 survey studies, 12 case reports and 6 control studies. Selected 82 foreign studies from CNKI were categorized as 10 systemic reviews, 22 case reports and 50 control studies. 2. 2 clinical domestic studies researched on idiopathic Scoliosis. The foreign clinical studies from Pubmed are 18 cases, and those studies were categorized into Premature baby care (3), Infant colic (2), ADHD (2), Congenital talipes equinovarus (1), Somatic dysfuntion (1), Nonsynostotic occipital plagiocephaly (1), Conversion disorder (1), Lower back pain (1), Chronic bilateral dorsal foot pain and stiffness (1), plantar fasciitis (1), Migraine headaches (1), Cyclic vomiting syndrome (1), Acute otitis media (1) and Cerebral palsy (1). The other 72 foreign clinical studies were from CNKI, and they studied 39 different diseases. Systematically, they studied about digestive diseases (25), respiratory diseases (20), fever (6), musculoskeletal diseases (5), nervous system diseases (5), dermatology diseases (2) and other disease states. The Chuna treatment was used in variety of studies. 3. 2 clinical domestic studies adopted techniques of Osteopathy Chuna. The foreign clinical studies from Pubmed adopted techniques of Osteopathic manipulation (10) and Chiropractic manipulation (8). The other foreign clinical studies from CNKI adopted techniques of Acupressure (69), Abdominal manipulation (23), Spinal manipulation (21), Thoracic manipulation (11), Traction manipulation (2), Muscular manipulation (2), Squeezing Sha manipulation (1), Spine correction (1), Joint manipulation (1) and Fascia manipulation (1). Conclusions In addition to musculoskeletal disorders, variety of pediatric diseases could be treated with Chuna treatment instead of acupuncture.