• Physical Therapy Korea
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• v.21 no.1
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• pp.1-12
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• 2014

The purpose of this study were to determine the intra-rater and inter-rater reliability of shoulder passive range of motion measurement using the "Clinometer + bubble level", a smartphone application and to compare with the intra-rater and inter-rater reliability of measurement using a goniometer. Twenty six patients with stroke were recruited for this study. Two raters measured the passive range of motion of four types of shoulder movements (forward flexion; FF, abduction; ABD, external rotation at $90^{\circ}$ abduction; ER90 and internal rotation at $90^{\circ}$ abduction; IR90) using a goniometer and a smartphone to determine within-day inter-rater reliability. A retest session was performed thirty minutes later to determine within-day intra-rater reliability. The reliability was assessed using intraclass correlation coefficients (ICC) and the standard error of measurement (SEM). The ICC (2,1) for the inter-rater reliabilities of the goniometer and smartphone were good in FF and ABD [ICC (2,1)=.75~.87] and excellent in ER90 [ICC (2,1)=.90~.95]. The intra-rater reliabilities for the goniometer and smartphone were good or more than good, with an ICC (3,1) value >.75, the exception was IR90 measured by rater 2 on the smartphone. These results suggest that smartphone could be used as an alternative method tool for measurement of passive shoulder range of motion in patients with stroke.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.1
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• pp.85-94
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• 2020

PURPOSE: This study examined the effects of the meridian muscle release technique on the pain and functional movement of patients with myofascial pain syndrome (MPS) of the shoulder joint. METHODS: The subjects of this study included 45 patients with MPS of the shoulder joint. The subjects were divided randomly into the following groups; the meridian muscle release technique group (n=15), the Graston technique group (n=15), and the control group (n=15). Both the meridian muscle release group and the Graston technique group received conventional therapy for 35 minutes initially and were then treated using the meridian muscle releases technique and Graston technique for 10 minutes, respectively. The control group received only conventional therapy for 35 minutes. All three groups underwent treatments three times a week for four weeks. Each subject was evaluated randomly using the VAS, PPT, SPADI and ROM both before and after treatment. RESULTS: The Graston technique group showed a significantly more substantial increase in functional movement (p<.05) than the meridian muscle release technique and control groups. The meridian muscle release technique group had significantly less pain (p<.05) compared to the Graston technique and control groups. CONCLUSION: These findings suggest that the meridian muscle release technique can be useful for decreasing pain and increasing the functional movement of patients with MPS of the shoulder joint.

• The Journal of the Korea Contents Association
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• v.16 no.10
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• pp.711-718
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• 2016

The aim of this study was to investigate the effects of dual-task training on balance and upper extremity function with chronic stroke. For seventeen persons with chronic stroke, we executed dual-task training for 4 weeks, five times per week, and 30 minutes each time. Before and after the dual-task training, the patients were tested with Berg Balance Scale(BBS) and BTS FreeEMG 300(BTS FreeEMG 300, BTS, Italy). After the dual-task training, the subjects showed significant changes in the score of BBS(p<.05). And, the subjects' shoulder and elbow movement had negative values of change after the intervention, indicating that there was a positive change. The results of this study show that dual-task training for persons with chronic stroke is a useful therapeutic approach by enhancing the their quality of life through improving balance and upper extremity function.

• The Korean Journal of Pain
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• v.22 no.3
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• pp.224-228
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• 2009

Background: Shoulder arthroscopic surgery is frequently associated with severe postoperative pain, which can be difficult to manage without the use of high-dose opioids. Although an interscalene brachial plexus block (ISBPB) can be used to provide anesthesia for shoulder arthroscopic surgery, its effect using low-dose mepivacaine on postoperative pain management has not been reported. We hypothesized that ISBPB using a low-dose mepivacaine can provide effective postoperative analgesia for shoulder arthroscopic surgery without the need for high-dose opioids and act as a significant motor or sensory block. Methods: This study examined a total of 40 patients, who underwent shoulder arthroscopic surgery, and received ISBPB with 10 ml of normal saline (group NS; n = 20) or 10 ml of 1% mepivacaine with epinephrine 1:200,000 (group MC; n = 20). The block was performed preoperatively. The postoperative pain score, opioid consumption, and side effect were recorded. Results: The visual analog scale scores were significantly lower in group MC than in group NS at 120 minutes after shoulder arthroscopic surgery ($1.9{\pm}1.0$ versus $4.0{\pm}1.4$). Group MC showed significantly lower fentanyl consumption after shoulder arthroscoic surgery than group NS ($27{\pm}32.6$ versus $79{\pm}18.9{\mu}g$). The degree of motor and sensory block after surgery was minimal. Conclusions: ISBPB using low-dose mepivacaine reduced the level of postoperative pain and fentanyl consumption without significant side effects. ISBPB using low-dose mepivacaine is a useful analgesic technique for shoulder arthroscopic surgery.

• Journal of Korean Physical Therapy Science
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• v.20 no.1
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• pp.43-49
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• 2013

Background and purpose : The shoulder joints permit the greatest mobility of any joint area carries out the important function of stabilization for hand use. Research has now shown that grip strength has proven to be a reliable indicator for quality of life at an older age. The purpose of this study was to investigate the effects of testing posture and shoulder position on grip strength for repetitive gripping task. Methods : Forty(20male, 20female) college adult volunteers with no known shoulder dysfunction participated subject in two testing posture(sitting and standing) and three positions with shoulder flexion: (1) shoulder $0^{\circ}$ flexion (2) shoulder $90^{\circ}$ flexion (3) shoulder $180^{\circ}$ flexion. The paired t-test was used to determine any significant difference in grip strength between the testing posture and shoulder position. Results : The higher grip strength gained in the sitting with the shoulder $180^{\circ}$ flexion and the higher grip strength gained in the standing with the shoulder $180^{\circ}$ flexion. The second experiment showed that the grip strength was significant for sitting, standing position of shoulder $0^{\circ}$ flexion( p<0.05). Grip strength goes up as increase height and weight. Conclusion : These findings demonstrate that the theory does not fit with, because of the influence of gravity, a measure from the shoulder joint is the most high, $0^{\circ}$. And sitting posture and stance in the grip of a difference when compared SIT $0^{\circ}$ and standing position $0^{\circ}$ significant difference in indicated but, $90^{\circ}$ and $180^{\circ}$ in the sitting position and stance in the grip of the difference was not significant difference. To demonstrate the universality of this study's results, future studies should have a larger and more subject as well as a more even distribution of male and female subject. Therefore future research is needed to refine the definition and identify optimal methods of measuring this grip strength.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.7
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• pp.3132-3139
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• 2012

The purpose of this study was to evaluate whether extracorporeal shock wave (ESWT) is an effective treatment for rotator cuff tendinitis. Study subjects included 32 patients (16 in the experimental group and 16 in the control group). The patients were evaluated by assessing pain and function using visual analog scale (VAS), pressure pain threshold (PPT), Constant and Murley Scale (CMS), and simple shoulder test (SST). The results of this study indicated that ESWT after the subjects in the experimental group experienced significant changes in pain, range of motion, muscle strength, and function when compared to the control group. These results indicate that ESWT could be considered as an effective and efficient treatment for rotator cuff tendinitis.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.1
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• pp.17-25
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• 2016

Purpose: This study was aimed to determine the effects of thoracic spine thrust manipulation on muscle activities of the scapular upward rotators and middle deltoid, active range of motion (AROM), shoulder pain, and rounded shoulder posture in young adults with rounded shoulder. Methods: The subjects were 30 young adults (14 males, 16 females) with rounded shoulder. Thirty subjects were randomly assigned to an experimental (manipulation) and control (placebo) groups of fifteen subjects respectively. The manipulation group received the manipulation (high velocity, low amplitude), which was performed by a physical therapist with the subject in the supine position and with the arms crossed over the chest and hands passed over the shoulders. For the sham group, the same procedure was performed, with the exception that the high-velocity thrust was not applied. Measurements were taken before and after the intervention. Muscle activity of upper and lower trapezius, serratus anterior, middle deltoid was measured using surface electromyography. Visual analog scale (VAS) was used for shoulder pain. Goniometry was used for shoulder abduction active range of motion (AROM). Straight edge was used for supine rounded shoulder posture (RSP) distance. Results: The muscle activity of the upper trapezius, lower trapezius and middle deltoid muscle increased significantly after the intervention (p<.05). However, no significant difference was observed in serratus anterior muscle (p>.05). The VAS was significantly decreased and AROM significantly increased after the intervention (p<.05). The distance of RSP were not significant (p>.05). The control group showed no differences before and after the intervention (p>.05). Conclusion: The results of this study suggest that thoracic spine thrust manipulation can be an effective component of treatment plan to improve pain and function.

• Journal of The Korean Society of Integrative Medicine
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• v.4 no.3
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• pp.1-15
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• 2016

Purpose : The purpose of this study was to evaluate the difference of early muscle strengthening exercise(starting at 1 week) on pain, function and sleep quality for rotator cuff partial tear patients. Method : Experimental group 15 people, control group 15 people, was a total of 30 people. Group-specific arbitration method, was applied to early muscle strengthening exercise (experimental group) and general movement treatment(Starting at 6 week) (control group). Both groups were subjected to 40 minutes of basic physical therapy interventions four times a week over an six-week intervention period. In this study, Pain, function and sleep quality measured by VAS, PPT and ROM, CMS, SST and PSQI. Result : 1. The VAS and PPT in the experimental group and control group before and after treatment were significant difference(p<.01). Comparison between the two groups in the change in motion before and after treatment also showed a statistically significant(p<.01). 2. Comparison functional Assessment of the shoulder ROM, CMS and SST in the experimental group and control group before and after treatment were significant difference(p<.01). ROM was not significant differences between the groups but CMS and SST were significant differences between the groups. 3. PSQI in the experimental group and control group before and after treatment were significant difference(p<.01). Comparison between the two groups in the change in motion before and after treatment also showed a statistically significant(p<.01). Conclusion : Therefore, early muscle strengthening exercise is useful to improve the shoulder function and pain for rotator cuff tear patients.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.1
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• pp.101-111
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• 2020

Purpose : The purpose of this study was to identify the comparison of the effects of manual therapy combined with exercise on range of motion (ROM), muscle strength, and functional performance in adolescent baseball players with internal impingement syndrome of the shoulder. Methods : The subjects were 30 patients diagnosed with impingement syndrome of the shoulder. Thirty subjects are randomly assigned to each 3 different groups; Group 1. (exercise group), Group 2. (exercise+mobilization; EMOB group), Group 3. (exercise+mobilization with movement; EMWM group). The interventions were performed three times a week for 4 weeks. The main outcome measures were goniometer, Biodex dynamometer, and Korean Kerlan Jobe shoulder-elbow (K-KJOC) scores. The ROM (external and internal rotation), muscle strength (external and internal rotation: 60 °/sec., 180 °/sec.), and functional performance were compared among the groups. Results : No significant difference was observed among the groups in the range of external rotation of the shoulder before and after the intervention, but the range of internal and total rotation was significantly increased in Group 2, 3 compared to Groups 1. Muscle strength of external and internal rotation (60 °/sec., 180 °/sec.) was not significantly different among Group 1, 2, 3, and functional performance was significantly increased in Group 2, 3 compared to Group 1. However, there was no significant difference between Group 2 and Group 3 in all measurements. Conclusion : An intervention with manual therapy such as EMOB and EMWM was more effective than exercise alone for rapid recovery from shoulder injury and improvement in functional performance. However, further efforts are needed to identify effects of specific interventions with manual therapy.

• The Korean Journal of Pain
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• v.10 no.2
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• pp.166-169
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• 1997

Background: We have noted a high incidence of vasovagal episodes associated with use of interscalene block(ISB) for shoulder arthroscopy in the sitting position. The purpose of this retrospective study is to alert the possibility of potentially dangerous vasovagal events, describe the characteristics of this problem, and propose therapeutic devices. Methods: Results 62 patients who underwent shoulder arthroscopy in the sitting position with ISB were retrospectively analyzed. Group 1, 10 patients experienced vasovagal events characterized by sudden hypotension and bradycardia. Remaining 52 patients, Group 2, did not experience these symptoms. All patient charts were reviewed for age, sex, side of surgery, premedication, preoperative fluid and intraoperative medications. Perioperative hemodynamic changes were also compared between the two groups. Results: Vasovagal events experienced in 16% of patients(10/62) and occurred $39{\pm}18$ min after sitting position and $22{\pm}18$ min after start of operation. Number of patients who receiving anticholinergics for premedication were significantly lower in Group 1 than Group 2(2/10 vs. 28/52, p<0.05). Conclusions: Bezold-parish reflex is a potential mechanism for sudden hypotension and bradycardia which can occur during shoulder arthroscopy in sitting position. Therefore anticholinergic pretreatment and meticulous monitoring during operation are recommended to prevent B-J reflex.