• Safety and Health at Work
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• v.1 no.2
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• pp.158-166
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• 2010

Objectives: This study aimed to find gender distinctions in terms of the sociology of the population; to determine work-related factors; to analyze gender differences in daily living, work, sports, and art performances; and to identify gender-related factors that limited performance of daily living and work activities. Methods: A questionnaire was designed that included disabilities of the arm, shoulder, and hand (DASH), accident history, disease history, work duration at current workplace, marital status, job satisfaction, job autonomy, and physical demands of the job. Out of 1,853 workers surveyed, 1,173 questionnaires (63.3%; 987 males, 186 females) included responses to DASH disability and DASH optional work and were judged acceptable for analysis. Results: Upper extremity functional limitation during work and daily living was higher for females than males. The limitations for males increased according to their household work time, accident history, work duration, job satisfaction, physical demand, and job autonomy. Meanwhile, female workers' upper extremity discomfort was influenced by their disease history, job satisfaction, and physical demands. In addition, the size of the company affected male workers' upper extremity function, while marriage and hobbies influenced that of female workers. Conclusion: This study addressed sociodemographic factors and work-related factors that affect each gender's upper extremity function during daily living and working activities. Each factor had a different influence. Further studies are needed to identify the effect that role changes, not being influenced by risks at work, have on musculoskeletal disorders.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.353-360
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• 2019

Purpose: In the treatment of Dupuytren's contracture, the aim of optical treatment is to lower the recurrence rate and reduce complications. This paper reports the results of subtotal fasciectomy in Dupuytren's contracture, extending the excision of palmar fascial structures from the diseased to normal appearing adjacent fascial structure. Materials and Methods: From 2007 to 2017, 45 patients with Dupuytren's contracture treated by subtotal fasciectomy were reviewed retrospectively. The mean follow-up period was 45.9 months. Ninety-two digits were involved (index: 2, middle: 10, ring: 44, little: 36). The predisposing factors and affected joint were reviewed and the preoperative and postoperative contracture was measured. For clinical results, quick disabilities of the arm, shoulder, and hand (quick DASH) were used. Complications, including wound or skin problems, nerve injuries, hematoma, and complex regional pain syndrome, were assessed. Results: Preoperative flexion contracture was 43.2° in the proximal interphalangeal joint and 32.9° in the metacarpophalangeal joint. In nine cases, patients had residual contracture of 9.7° (range, 5°-20°) on average and if the total number of cases were included, the mean residual contracture was 2.3° on average. The quick DASH score at the 12 months follow-up was 12.4. The overall complication rate was 26.6%. Conclusion: Subtotal fasciectomy can be a good surgical treatment option for Dupuytren's contracture with a low recurrence and low complication rate compared to other open procedures.

• 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.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.7-14
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• 2017

Purpose: To report the clinical results from surgical treatment for clavicle shaft fracture by percutaneous intramedullary fixation with Steinmann pins. Materials and Methods: Between January 2004 and June 2014, the medical records of 135 patients who underwent percutaneous intramedullary fixation with Steinmann pins were reviewed. The mean follow-up periods were 15 months. The functional results were evaluated with The Disabilities of the Arm, Shoulder and Hand (DASH) score and Constant score. The clinical results were evaluated with the shortened length of the clavicle, length of surgical wound, operation time and Kang's criteria. Results: The mean bone union period was 11.6 weeks (8-16 weeks). The mean DASH score was 11.8. The mean Constant score was 91.2. The mean shortened length of the clavicle was less than 20 mm. The mean length of surgical wound was 1.2 cm (0.7-1.5 cm). The mean operation time was 18 minutes (10-35 minutes). Using Kang's criteria, 131 out of 135 patients (97.0%) showed good results. Complications included were 3 pin migrations and 2 non-unions. Conclusion: Percutaneous intramedullary fixation with Steinmann pins showed good results for treating clavicle shaft fracture.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.6
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• pp.2862-2868
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• 2013

The purpose of this study was to investigate the relationship between neck pain and upper limb disability in patients with non-specific neck pain (n=132) recruited from physiotherapy departments in the Korea. Baseline neck pain/disability was measured using the Northwick Park Neck Pain Questionnaire (NPQ) and upper limb disability was measured using the Disabilities of Arm, Shoulder, Hand questionnaire (DASH). A range of baseline psychosocial variables were measured as potential confounding variables. Pairwise analysis revealed a positive correlation between NPQ score and DASH score (Pearsons' r=0.628, p<0.05). This study provides preliminary evidence that patients with severe neck pain/disability also report severe upper limb disability. The presence of severe neck pain or low pain self efficacy and high fear-avoidence beliefs questionnaire should clinicians towards a careful examination of upper limb function in patients presenting with neck pain. Our data suggest the upper limb disability may need to be addressed as part of the neck management process.

• Clinics in Shoulder and Elbow
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• v.26 no.2
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• pp.140-147
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• 2023

Background: The management of acromioclavicular (AC) joint dislocation remains controversial. Recently, anatomic coracoclavicular (CC) fixation with a double clavicular tunnel and three flip-buttons has shown promising results. This study aimed to evaluate functional and radiological outcomes in patients with high-grade AC joint dislocation treated with anatomic CC fixation using double clavicular tunnels and three flip-buttons. Methods: A retrospective, unicentric study was performed. The study included patients with high-grade AC joint dislocation who underwent surgery with anatomic CC fixation using double clavicular tunnels and three flip-buttons. Demographic data were obtained from medical records. A functional evaluation using subjective shoulder value (SSV), visual analog scale (VAS), and disabilities of the arm, shoulder, and hand (DASH) questionnaires was performed, and an evaluation of preoperative and postoperative comparative Zanca view images was performed. Factors associated with functional outcomes and radiological AC reduction were analyzed. Results: A total of 83 patients completed follow-up and were included in the analysis. The mean SSV, VAS, and DASH scores were 92.8, 0.8, and 6.4, respectively. Patients who had complications experienced significantly worse functional outcomes (DASH: P=0.037). Suboptimal final AC reduction was observed in nine patients (11.1%), and significantly more frequently in patients older than 40 years (P=0.031) and in surgeries performed more than 7 days after injury (P=0.034). There were two reoperations (2.4%). Conclusions: Anatomic CC fixation with a double clavicular tunnel and three flip-buttons leads to good functional outcomes, low complication rates, and high rates of optimal AC reduction.

• The Journal of Korean Physical Therapy
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• v.28 no.2
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• pp.142-148
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• 2016

Purpose: The aim of this pilot study was to determine the effect of soft tissue technique (STT) in Axillary Web Syndrome (AWS) following sentinel Lymph Node Biopsy in breast cancer patients by examining the upper extremity function, range of motion, and pain. Methods: Nineteen patients with breast cancer-related AWS were evaluated. STT was performed on the symptom area for treatment of AWS symptoms. We evaluated AWS symptoms and pain intensity using a visual analogue scale (VAS), and functional disability using the Korean version of the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire, glenohumeral joint (GHJ) flexion and abduction range of motion (ROM) with or without elbow extension. Results: Visual analyses of the data suggest a modest effect of STT in improving GHJ flexion, abduction ROM with or without elbow extension, DASH for upper extremity function, and Pain. The statistically significant improvement in baseline observed for pain, DASH, and ROM data made it impossible to assess the effects of STT on those outcomes. There were no adverse events. Conclusions: STT may be an effective and safe treatment option for AWS patients recovering from breast cancer treatment; however, further research is needed.

• The Korean Journal of Pain
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• v.35 no.3
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• pp.280-290
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• 2022

Background: This study aimed to determine the impact of complex decongestive therapy applications on upper extremity function in breast cancer patients who developed adhesive capsulitis after lymphedema. Methods: Thirty patients who developed adhesive capsulitis due to lymphedema were divided into two groups as study (n = 15) and control (n = 15) groups. Both groups received 20 minutes of exercise five days a week for three weeks using a Biodex isokinetic dynamometer, as well as a hot pack and TENS (Transcutaneous Electrical Nerve Stimulation) treatment to the shoulder joint. The study group received 45 minutes of intensive decongestive therapy along with the adhesive capsulitis treatment. The visual analogue scale was used to assess pain, circumference, and volumetric measurements were used to assess edema, and the Arm, Shoulder, and Hand Problems Questionnaire (DASH: Disabilities of the Arm, Shoulder, and Hand) was used to assess upper extremity functionality. The shoulder range of motion was evaluated. Results: Both groups had improvements in pain (P < 0.001), shoulder joint range of motion (P < 0.001), and upper extremity functionality (P < 0.001) after the treatment. There was a significant decrease in circumference and volumetric measurements in the study group (P < 0.001). However, no differences were seen in measurements in the control group. Conclusions: The results showed that complex decongestive therapy was beneficial in reducing lymphedema in breast cancer patients who acquired adhesive capsulitis due to lymphedema. Consequently, the authors believe that supplementing conventional physiotherapy with complex decongestive therapy will benefit patients.

• Clinics in Shoulder and Elbow
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• v.24 no.2
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• pp.80-87
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• 2021

Background: Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR. Methods: Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups. Results: Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (p<001). Comparisons between the two groups were not significantly different, except for SF-36 "general health perception" (p<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema. Conclusions: CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.4
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• pp.19-28
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• 2021

Purpose : The purpose of this study was to apply manual lymphatic drainage (MLD) and high-frequency diathermy (HFD) to patients with axillary web syndrome (AWS), one of the side effects of breast cancer surgery, and to treat upper extremity pain, volume, function of the upper extremity, (joint range of motion; ROM, disabilities of the arm, shoulder and hand; DASH) and quality of life before and after treatment. It is to determine the effect of treatment by checking the level change. Methods : This study is a case series. A total of 5 patients diagnosed with AWS after breast cancer surgery voluntarily participated in this study. The intervention program consisted of stretching, MLD and HFD. It was conducted 3 times a week for 30 minutes for 4 weeks. In order to compare the effects of pain (numeric pain rating scale; NPRS), volume, upper limb function (ROM, DASH) and quality of life (the European organization for research and treatment of cancer quality of life questionnaire-breast, EORTC QLQ-BR23) evaluations were compared before and after 4 weeks of intervention. All measured variables were analyzed and expressed as mean, standard deviation and percentage. Results : The shoulder NPRS level of the subjects in all case groups decreased, the volume decreased and the shoulder flexion, abduction ROM increased. It showed improvement in DASH and quality of life, QLQ-BR23. Conclusion : After breast cancer surgery, we confirmed the possibility that MLD and HFD treatments could be effective in improving pain, decreasing volume, increasing upper extremity function, and quality of life for patients who have difficulties with AWS. The possibility has been confirmed, and additional research is needed by increasing the number of participants in the experiment in the future.