• Clinical Pain
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• v.18 no.1
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• pp.44-47
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• 2019

Lying on the side while falling asleep deeply after drinking or taking a sleeping pill can cause compressive neuropathy. We report a 70-year-old male patient of medial cord of left brachial plexus injury (BPI) after deep sleep. The mechanism of the injury might be compression and stretching of brachial plexus. The electrodiagnostic study was performed and the medial cord lesion of BPI was suggested. The ultrasonography image of compression site revealed the nerve swelling of medial cord of brachial plexus and median nerve at the mid-arm level. Pharmacologic treatment including oral prednisolone and exercise training were prescribed. On 6 months after initial visit, neurologic symptom and pain were improved but mild sequelae was remained.

• The Journal of Korean Physical Therapy
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• v.21 no.4
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• pp.1-7
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• 2009

Purpose: Cervical pain is caused mainly by a static position, lasting work, bad habits and stress, and is accompanied by pain in the upper trapezius. Traditionally, heat and traction, exercise, mobilization, manipulation have been used to treat cervical pain. This study examined the effect of stretching and manipulation (high-velocity low-amplitude: HVLA) on the pain and ROM in women with chronic cervical and upper shoulder pain. Methods: Fifty-two women diagnosed with chronic cervical and upper shoulder pain were enrolled in this study. Among them, 26 patients (experiment group) were managed by passive stretching and manipulation, and another 26 patients (control group) were treated with physical therapy intervention (hat pack: HP, transcutaneous electrical nerve stimulation: TENS, ultra sound: US). Each group made use of a Visual Analogue Scale (VAS) and the highly reliable (flextion: 0.92, extention: 0.99) cervical range of motion (CROM) to compare the possible changes in pain and ROM in the two groups after treatment. Results: In the experimental group, the pain decreased and the ROM has increased in all directions. In the control group, the pain decreased but the ROM was not changed in all directions. Conclusion: According to the results, passive stretching and manipulation is effective for increasing the ROM and decreasing the level of pain. Moreover, physical therapy intervention (HP, TENS, US) is effective for immediately decreasing the pain but has little effect on the ROM.

• Journal of Korean Neurosurgical Society
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• v.54 no.3
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• pp.268-271
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• 2013

Occipital neuralgia is a rare pain syndrome characterized by periodic lancinating pain involving the occipital nerve complex. We present a unique case of entrapment of the greater occipital nerve (GON) within the semispinalis capitis, which was thought to be the cause of occipital neuralgia. A 66-year-old woman with refractory left occipital neuralgia revealed an abnormally low-loop of the left posterior inferior cerebellar artery on the magnetic resonance imaging, suggesting possible vascular compression of the upper cervical roots. During exploration, however, the GON was found to be entrapped at the perforation site of the semispinalis capitis. There was no other compression of the GON or of C1 and C2 dorsal roots in their intracranial course. Postoperatively, the patient experienced almost complete relief of typical neuralgic pain. Although occipital neuralgia has been reported to occur by stretching of the GON by inferior oblique muscle or C1-C2 arthrosis, peripheral compression in the transmuscular course of the GON in the semispinalis capitis as a cause of refractory occipital neuralgia has not been reported and this should be considered when assessing surgical options for refractory occipital neuralgia.

• Journal of Trauma and Injury
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• v.27 no.3
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• pp.79-83
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• 2014

The brachial plexus is a network of nerves that provides movement and feeling to the shoulder, arm and hand. The majority of acute brachial plexus injuries occur when the plexus is stretched violently or torn. This happens as result of the shoulder being pressed down forcefully while the head is pushed up and away from that shoulder. Such injuries frequently result from automobile or motor-cycle accidents or from falls and usually affect one side. Nerve injuries vary in severity from a mild stretching of the nerve to a tearing of the nerve root away from the spinal cord. We experienced a 50-year-old woman with weakness in both upper extremities after an attempted hanging. A consecutive workup revealed bilateral brachial plexus injuries. Six months after the incident, she had fully recovered. This is a very rare case of bilateral brachial plexus injuries after an attempted hanging.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.17 no.1
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• pp.1-8
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• 2011

Background: The purpose of this study was to determine the effects of massage, stretching exercise, and scapular stabilization exercise in patients with upper trapezius myofascial pain syndrome (MPS). Methods: Twenty-three female patients with upper trapezius MPS were randomly allocated to three groups: massage, stretching exercise, and scapular stability exercise groups. Therapeutic intervention for all groups included general therapy such as hot pack, transcutaneous electrical nerve stimulation and ultrasound. Patients in the massage group (n=8), stretching group (n=7), and stabilization exercise group (n=8) received their respective therapy program after general therapy for 15 minutes. Therapeutic intervention for each group was performed three times per week for six weeks. All groups were tested four times: prior to the test, at three weeks, at six weeks, and at nine weeks. Results: Pain levels decreased significantly in the stretching and stabilization exercise groups over time (p<.05). The rate of change in pain level was significantly different among all groups (p<.01), and the stability exercise group experienced the lowest pain level. Pressure-pain level increased significantly in the stabilization exercise group over time (p<.05). The rate of change in pressure-pain level was significantly different among all groups (p<.01), and the stability exercise group had the highest pressure-pain level. The level of upper-extremity stability increased significantly in the stability exercise group over time (p<.05). The rate of change in the upper-extremity stabilization level was significantly different among all groups (p<.01), and the stability exercise group had the highest upper-extremity stability level. Conclusions: Scapular stabilization exercises proved to be the most effective therapy for MPS patients.

• Journal of Korean Neurosurgical Society
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• v.48 no.2
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• pp.115-118
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• 2010

Objective : Cerebral aneurysms which cause oculomotor nerve [cranial nerve (CN) III] palsy, are frequently found with a daughter sac of the aneurysm dome. We assumed that CN III might be compressed by the daughter sac and it would be more helpful not to fill the daughter sac with coils than vice versa during endosaccular embolization for recovering from CN III palsy, because it may give a greater chance for the daughter sac to shrink by itself later. We reviewed the initial results of our experiences of such cases. Methods : Among 9 aneurysms accompanied by CN III palsy, 7 (6 unruptured, 1 ruptured) showed a daughter sac. We tried to fill the main dome completely and spare the daughter sac from coil filling to increase the possibility of decompression. We evaluated the short-term effectiveness of this concept using medical records and angiograms. Results : After initial embolization, all of CN III palsy caused by unruptured aneurysms (6/6) resolved completely after various periods (3-90 days) of time. No adverse effects were noted during and after the procedures except for one case of harmless coil stretching during coil filling using double microcatheter. Conclusion : During the coil embolization of the cerebral aneurysm causing CN III palsy, sparing the daughter sac from coil packing while tightly packing the main dome, can be helpful in increasing the effectiveness of decompression. However, a long-term follow-up will be required.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.193-197
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• 1998

Frozen shoulder is known as a self-limited disease. But, its long duration and pain nature can make the patients debilitative. And most patients cannot tolerate a chronically painful extremity and are concerned about the possibility of developing permanent dysfunction. In painful phase of frozen shoulder, some aggressive mordalties as like trigger point injection or suprascapular nerve block can beneficial to: reduce discomfort and pain. In order to document clinical results, we evaluated the results of 134 frozen shoulders treated with trigger point injection and/or suprascapular nerve block at Kyungpook National University Hospital, from January 1995 to April 1997. The treatment group was divided into 3 modalities: 17 cases in trigger point injection(TPI), 39 cases in suprascapular nerve block(SSB), and 78 cases in both methods. The supportive treatment including oral medication, heat and stretching exercise was also applied. The average age at the time of diagnosis was 57 years old and average follow-up time was 18 months. The results were as follows: Average time of significant improvement in pain was 9 days. Eighty-eight percent (119 cases) was improved in pain and range of motion after injecllion treatments; 82%(14/17) with TPI, 85%(33/39) with SSB, and 92%(72/78) with both. Early improvement of paih within 1 week was 72% in the treatment-responsive group, in which TPI group has 100% response(14/14) and sse has 94% response(31/33)

• Journal of the Korean Society of Physical Medicine
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• v.6 no.4
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• pp.369-379
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• 2011

Purpose : The purpose of this study is to compare the initial effect of nerve mobilization (NM), static stretching (SS), and contract-relax (CR) techniques to find the best method in improving hamstring flexibility and gait function in patients with hemiplegia. Methods : Eleven patients with hemiplegia were included in this study. Passive knee extension (PKE) range of motion and the sit and reach (SR) test were used to measure hamstring flexibility, while timed up and go (TUG) and the 10m walking (10MW) test were used to measure the subject's gait. Measurements on each test were assessed prior to the experiment, immediately following the experiment, and 30 minutes after the experiment. Analysis of the results utilized a repeated measures analysis of variance to examine hamstring flexibility and the difference in walking ability. Results : The results suggest significant increases in NM, SS, and CR techniques as they relate to hamstring flexibility (p<.05) following (both immediate and 30 minutes post experiment) PKE range of motion and the SR test, but post-hoc showed no significant difference between the three techniques (p>.05). Additionally, the results suggest significant increases in NM, SS, and CR techniques as they relate to gait function (p<.05) following the TUG test, but found no significant difference in the 10MW test (p>.05). Post-hoc analysis between the three techniques suggests that only the NM technique significantly changed gait function. The time of TUG and 10MW test showed no significant difference between the three techniques before an experiment, just after an experiment, and 30 minutes following the experiment according to the measurement points in time (p>.05). Conclusion : This study suggests NM, SS, and CR techniques immediately improve hamstring length and flexibility while improving gait function in patients with hemiplegia.

• Clinics in Shoulder and Elbow
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• v.5 no.2
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• pp.63-68
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• 2002

Volleyball has become one of the world's most popular participatory sports in recent years. There are many dynamic skills and movements needed to play the game. As a result, many acute and overuse injuries to the shoulder may occur. This article addresses the common injuries and rehabilitation recommendations for the shoulder injuries in the volleyball players. The glenohumeral instability, primary or secondary impingement, internal impingement, labral injuries, and suprascapular nerve lesions are common problems in volleyball players. A basic knowledge of the biomechanics and volleyball maneuvers (blocking, serving, and spiking) can help in the development of appropriate trainging and reha- bilitation protocols. Special emphasis must be placed on the knowledge of muscular patterns involved in serving and spiking, because they typically require a strenuous unilateral action of the dominant shoulder. It is therefore impera- tive to include adequate stretching and muscular training programme for the prevention, as well as for therapy, of shoulder pain in volleyball players.

• The Journal of Korean Physical Therapy
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• v.14 no.3
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• pp.345-354
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• 2002

A Study of Clinical Application of the Connective Tissue Massage General massage is termed kneading and rubbing. It will bring the effect of blood volume and cardiovascular reaction. Connective tissue massage is a diagnostic and treatment method. But the general massage has not diagnostic aspect. Connective tissue massage techniques are stimulating and stretching the LCT, mast cell, collagenous fiber, fascia, skin, muscle and nerve tissue. Diagnostic aspects of connective tissue massage are visible investigation, manual investigation, and stroking on the reflex zone. CTM do stroking with 3, 4th finger tips on the whole body for the treatment.