• 대한한의학방제학회지
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• 제18권2호
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• pp.259-265
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• 2010

Objectives : The purpose of this study is to report the improvement after Sweet BV herbal acupuncture therapy of shoulder impingement syndrome with Subacromial bursitis. Methods : We treated a patient having shoulder pain due to shoulder impingement syndrome with Sweet BV herbal acupuncture therapy. We checked visual analogue scale (VAS) score and range of movement (ROM). Results : We treated shoulder pain. Thereafter ROM improved and VAS score dropped to the level 3 points from 10 points at onset. Conclusions : This report shows Sweet BV herbal acupuncture therapy has effectiveness on shoulder impingement syndrome with Subacromial bursitis.

• 대한한방내과학회지
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• 제38권6호
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• pp.1060-1067
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• 2017

Objectives: This case study examined the effects of treatment with traditional Korean medicine on a central post-stroke pain patient, who had impingement syndrome of the right shoulder. Methods: The patient received traditional Korean medical treatments, including acupuncture, warm-needling, moxibustion, and cupping, throughout the treatment period, and extracorporeal shock-wave therapy and physical therapy for part of the treatment period. The effects of treatments were measured with a manual muscle test (MMT), numerical rating scale (NRS), range of motion (ROM), and gait staging index (self-invented). Results: The clinical symptoms of the patient were improved considerably after the complete treatment. Conclusions: Traditional Korean medicine may be effective for treatment of central post-stroke pain in patients with impingement syndrome.

• Clinics in Shoulder and Elbow
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• 제26권4호
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• pp.390-396
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• 2023

Background: The subacromial (SA) space is a commonly used injection site for treatment of impingement syndrome. For shoulder stiffness, glenohumeral (GH) injections are commonly performed. However, in cases of impingement syndrome with mild shoulder stiffness, the optimal site of steroid injection has yet to be identified. Methods: This prospective, randomized study compared the short-term outcomes of ultrasound-guided GH and SA steroid injections in patients who were diagnosed with impingement syndrome and mild stiffness. Each group comprised 24 patients who received either a GH or SA injection of 40 mg of triamcinolone. Range of motion and clinical scores were assessed before and 3, 7, and 13 weeks after the injection. Results: GH and SA injections significantly improved the range of motion and clinical scores after 13 weeks of follow-up. Notably, targeting the GH joint resulted in an earlier gain of forward elevation, external rotation, and internal rotation in 3 weeks (P<0.001, P=0.012, and P=0.002, respectively) and of internal rotation and a Constant-Murley score in 7 weeks (P<0.001 and P=0.046). Subsequent measurements were similar between the groups and showed a steady improvement in all ranges of motion and clinical scores. Conclusions: GH injections may be more favorable than SA injections for treatment of impingement syndrome with mild stiffness, especially in improving the range of motion in the early period. However, the procedures showed similar outcomes after 3 months. Level of evidence: I.

• 대한통합의학회지
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• 제8권1호
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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.

• Clinics in Shoulder and Elbow
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• 제13권1호
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• pp.53-57
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• 2010

목적: 1, 2단계 충돌 증후군과 회전근 개 파열이 있는 환자 사이의 근력 결핍 차이를 비교하였다. 대상 및 방법: 43명의 1, 2단계 충돌 증후군 환자 군 (1군)과 21명의 회전근 개 파열 환자 군 (2군)을 대상으로 하였다. 외회전, 내회전, 외전과 내전의 근력을 $60^{\circ}/sec$ 등속성 검사로 평가했다. 몸무게로 보정한 양측의 최대 우력, 총 일의 양, 평균 근력과 동측의 주동근과 길항근의 비율을 측정하였다. 결과: 양 군에서 몸무게로 보정한 최대 우력의 결핍은 외전에서 각각 $28.48{\pm}23.76%$ (1군), $29.12{\pm}32.81%$ (2군) (p=0.929), 내전에서 $7.20{\pm}13.98%$, $18.94{\pm}19.52%$ (p=0.021), 외회전에서 $16.88{\pm}13.76%$, $25.80{\pm}24.07%$ (p=0.221), 내회전에서 $14.15{\pm}25.67%$, $29.02{\pm}35.06%$ (p=0.059)로 측정되었다. 평균 근력과 총 일의 양에서 2군은 1군과 비교하여 내전력과 내회전력의 결핍이 유의하게 증가되었다. 결론: 2군에서 1군보다 더 큰 근력 결핍을 보였다. 1, 2단계 충돌 증후군 에서 3단계로 진행 시내회전과 내전 근력 결핍 변화가 더 크게 나타날 가능성이 있다.

• 한국전문물리치료학회지
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• 제27권1호
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• pp.38-44
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• 2020

Background: Posterior shoulder tightness, which is a problem mainly seen in patients with shoulder impingement syndrome, disrupts the scapulohumeral rhythm between the humerus and scapulae. Objects: The aim of this study was to compare the effects of joint mobilization and stretching on shoulder muscle activity and internal rotation range of motion (ROM) of the glenohumeral joint in patients with impingement syndrome with posterior shoulder tightness. Methods: The research subjects included 22 in-patients with impingement syndrome with posterior shoulder tightness. They were randomly divided into two groups: one group (12 patients) was treated with joint mobilization and the other group (10 patients) was treated with stretching for the posterior shoulder tightness. Each treatment was performed five times a week for two weeks, and there were 15 sessions for each treatment. The ROM of the internal rotation and muscle activities of shoulder joint were evaluated pretest and posttest in each group. Electromyography data were collected from the upper, middle, and lower trapezius and serratus anterior during shoulder abduction of 90°, 120°, and 150°. Results: Both the joint mobilization and stretching groups showed significant decreases in muscle activity in the upper, middle, and lower trapezius on the posttest (p < 0.05). There was a significant difference in serratus anterior at 150° (p < 0.05), but there was no significant difference between group in post-hoc analysis (p > 0.025). The internal rotation ROM was significantly increased in the stretching group compared to that in the joint mobilization group (p < 0.025). Conclusion: This study found that both joint mobilization and stretching for posterior shoulder tightness were effective in muscle activity during arm abduction, also in order to increase internal rotation ROM of shoulder joint, stretching was effective in patients with impingement syndrome with posterior tightness.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2007년도 제5차 연수강좌
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• pp.153-161
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• 2007

견관절의 ABER position에서 posterosuperior rotator cuff 가 posterior glenoid에 contact 하여 internal impingement가 일어나는 현상은 운동선수가 아닌 일반인에게도 발생하는 physiologic phenomenon이며 과도한 반복 동작으로 인하여 증상이 발현한다. Internal impingement는 증상이 모호할 뿐만 아니라 견관절 내 여러 병소가 함께 존재하기 때문에 각각의 pathology에 대한 자세하고 정확한 evaluation이 필수적이다. 아직 controversy가 있지만 internal impingement의 pathologic factors로서는 anterior capsular laxity (true anterior laxity), posteroinferior capsular tightness (pseudo anterior laxity)와 이로 인한 glenohumeral internal rotation deficit (GIRD), 그리고 SICK scapula syndrome (scapular dyskinesis) 등으로 요약할 수 있다. 진단은 주로 병력 청취와 신체 검사로 내려지며 ultrasonogram, MRA등으로 확진한다. Sleeper stretching exercise 등과 같은 보존적 치료에 반응이 좋지만 6개월간의 재활 치료에도 호전이 없다면 증상과 직접 관련된 주 병소(appropriate pathology)를 찾아 이에 대한 적절한 수술이 이루어져야 한다.

• 대한물리의학회지
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• 제16권3호
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• pp.45-53
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• 2021

PURPOSE: The current case study focuses on identifying the effects of the independent application of TECAR therapy and physiotherapeutic intervention using TECAR therapy on pain self-awareness and hip joint function in patients with hip impingement syndrome caused by nonstructural changes. Subjects: The research subject was a 34-year-old woman struggling with acute pain in her left hip, difficulty in actively moving the hip, and a problem in its overall function. METHODS: The subject's pain awareness and hip joint function were measured using a Visual Analog Scale (VAS) and passive range of motion (PROM), respectively. The experimental intervention was carried out in 24 sessions of 16 minutes each, three times a week, for eight weeks. RESULTS: The VAS score decreased to 0 cm on the post-test from 4.3 cm, 6.5 cm, and 7.2 cm in the pre-test at the rest, standing, and gait positions, respectively. The index of PROM measured hip joint flexion, extension, abduction, adduction, internal rotation, external rotation, and passive straight leg raise. The values increased to 122.5°, 24.5°, 78°, 33°, 65°, 42°, and 96.5° in the post-test compared to 88.5°, 15°, 39°, 21.5°, 23°, 22°, and 46.5° in the pre-test, respectively. CONCLUSION: TECAR therapy and physiotherapeutic intervention using TECAR can help reduce pain and enhance the hip joint function in patients with hip impingement syndrome.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2004년도 연수강좌
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• pp.253-268
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• 2004

• 대한관절경학회지
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• 제8권1호
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• pp.45-50
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• 2004

목적: 강직이 동반된 충돌 증후군으로 진단된 환자에서 수술적 가료를 시행하고 강직이 없는 충돌 증후군 환자의 치료 결과와의 차이를 알아보고자 한다. 대상 및 방법: 강직을 동반하지 않은 충돌 증후군 76 례와 강직을 동반한 충돌 증후군 환자군 24례를 대상으로 하였으며 수술은 강직이 없는 충돌 증후군은 견봉하 감압술 및 점액낭 부분 절제술을 시행하였으며, 강직이 있는 경우는 수동적 조작술을 추가하였다. 추시기간은 평균 32개월 이었다. 결과: 강직군이 비강직군에 비하여 술 전의 통증이 심하였으며, American Shoulder and Elbow Society의 기능 점수(ASES 점수)도 나빴다(p<0.05). 술 후 통증 및 ASES 기능 평가는 양군에서 모두 향상되었다(p<0.05). 양군의 술 후 결과를 비교할 때 통증과 ASES 점수는 양군간의 차이가 없었으나(p>0.05), 양호이상의 결과는 강직군에서 67%였으며, 비강직군에서80%이었다. 만족도는 강직군은 83%, 비강직군은 93%이었다. 당뇨병이 있었던 환자의 만족군는 강직군이 47%, 비강직군이 81%이었다. 강직군의 환자 7명중 4명(57%)이, 비강직군의 환자 11명중 9명(81%)이 수술에 만족하였다. 술 후 전방거상 및 90도 외전에서의 외회전, 내회전은 강직군과 비강직군에 차이가 없었다. 외회전은 강직군에서 적은 운동 범위를 보였다(p<0.05).결론: 강직을 동반한 충돌 증후군 환자군에서 견봉하 감압술과 수동적 조작술을 이용한 수술을 시행할 때 통증 감소 및 환자의 만족도, 외회전를 제외한 관절 운동 범위 증가는 강직이 없는 충돌 증후군 환자와 유사하게 기대할 수있다. 하지만 당뇨와 강직이 동반된 충돌 증후군은 술후 치료 결과가 기대에 못 미치므로 수술여부에 신중을 기하여야 한다.