• 제목/요약/키워드: SHOULDER

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Partial-thickness rotator cuff tears: a review of current literature on evaluation and management

  • Ramesh Radhakrishnan;Joshua Goh;Andrew Hwee Chye Tan
    • Clinics in Shoulder and Elbow
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    • 제27권1호
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    • pp.79-87
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    • 2024
  • Rotator cuff disease is a common cause of shoulder pain for which partial-thickness rotator cuff tears occupy a significant proportion. Such tears are often difficult to diagnose and manage in the general clinic setting. A review of the available literature from well-known databases was performed in this study to provide a concise overview of partial-thickness rotator cuff tears to aid physicians in their understanding and management.

Can Suboccipital Release Followed by Cranio-Cervical Flexion Exercise Improve Shoulder Range of Motion, Pain, and Muscle Activity of Scapular Upward Rotators in Subjects With Forward Head Posture?

  • Kim, Bo-been;Lee, Ji-hyun;Jeong, Hyo-jung;Cynn, Heon-seock
    • 한국전문물리치료학회지
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    • 제23권2호
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    • pp.57-66
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    • 2016
  • Background: For the treatment of forward head posture (FHP) and forward shoulder posture, methods for strengthening scapular retractors and deep cervical flexors and stretching pectoralis and upper cervical extensors are generally used. No study has yet assessed whether suboccipital release (SR) followed by cranio-cervical flexion exercise (CCFE) (SR-CCFE) will result in a positive change in the shoulders and neck, showing a "downstream" effect. Objects: The purpose of this study was to investigate the immediate effects of SR-CCFE on craniovertebral angle (CVA), shoulder abduction range of motion (ROM), shoulder pain, and muscle activities of upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction in subjects with FHP. Methods: In total, 19 subjects (7 males, 12 females) with FHP were recruited. The subject performed the fifth phase of CCFE immediately after receiving SR. CVA, shoulder abduction ROM, shoulder pain, muscle activities of UT, LT, and SA, and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction were measured immediately after SR-CCFE. A paired t-test and Wilcoxon signed-rank test were used to determine the significance of differences in scores between pre- and post-intervention in the same group. Results: The CVA (p<.001) and shoulder abduction ROM (p<.001) were increased significantly post-versus pre-intervention. Shoulder pain was decreased significantly (p<.001), and LT (p<.05) and SA (p<.05) muscle activities were increased significantly post- versus pre-intervention. The LT/UT muscle activity ratio was increased significantly post- versus pre-intervention (p<.05). However, there was no significant change in UT muscle activity and SA/UT muscle activity ratio between pre- and post-intervention (p>.05). Conclusion: SR-CCFE was an effective intervention to improve FHP and induce downstream effect from the neck to the trunk and shoulders in subjects with FHP.

특발성 및 속발성 동결견에 대한 한방복합치료 성과의 후향적 분석 (Analysis of Treatment Outcomes for Idiopathic and Secondary Frozen Shoulder with Traditional Korean Medicine : A Retrospective Study)

  • 이주현;석경환;류수형;이수연;김홍국;유덕우;구본혁;김민정;박연철;서병관;백용현
    • Journal of Acupuncture Research
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    • 제32권4호
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    • pp.177-186
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    • 2015
  • Objectives : This study was performed to analyze treatment outcomes of idiopathic and secondary frozen shoulder patients with clinical characteristics, as well as percentage of pain reduction, and to find out relevant factors for pain reduction in the frozen shoulders of each patient group. Methods : Data were collected from outpatients who visited the Acupuncture and Moxibustion department and treated with traditional Korean Medical treatments at a Korean Medicine Hospital from June 12, 2006 to June 30, 2015. Patients were divided into two groups; idiopathic and secondary frozen shoulder, based on imaging and medical records. Clinical characteristics (demographic characteristics, disease characteristics, treatment characteristics) and percentage pain reduction were collected. Percentage pain reduction was compared between two groups and relevant factors for pain reduction were analyzed. Results : 78 outpatients'medical records were reviewed. There was no significant difference of clinical characteristics between idiopathic and secondary frozen shoulder patients. In percentage pain reduction, there was no significant difference between the two groups. In the idiopathic frozen shoulder group, patients who had a short duration from the onset had a tendency for less pain (p<0.05). In the secondary frozen shoulder group, patients taking herbal medicine experienced significantly less pain (p<0.05). Conclusions : We could find no significant difference in percentage pain reduction with traditional Korean medicine between idiopathic and secondary frozen shoulder. Duration from the onset could be relevant in percentage pain reduction in idiopathic frozen shoulder, and taking herbal medicine could be relevant in the percentage pain reduction in secondary frozen shoulder.

Dynamic Electromyography Analysis of Shoulder Muscles for One-handed Manual Material Handling

  • Mo, Seung-Min;Jung, Myung-Chul
    • 대한인간공학회지
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    • 제34권4호
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    • pp.313-326
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    • 2015
  • Objective: The objective of this research is to quantitatively analyze muscle activities of arm and shoulder, according to direction in various types of one-handed manual material handling, based on surface electromyography. Background: Workers in industrial sites frequently carry out one-handed manual material handling using arm and shoulder muscles. Therefore, chronic load and accumulated fatigue occur to arm and shoulder muscles, which becomes a main cause of upper arm and shoulder musculoskeletal disorders. The shoulder muscles have widely range of motion, and complex interactions take place among various muscles including rotator cuff muscles. In this regard, research on interactions among should muscles, according to such various dynamic motions, is required. Method: Ten male subjects in their 20s participated in this research. This research considered upward, downward, leftward, rightward, forward and backward directions and fourteen muscles around arm and shoulder (biceps brachii and trapezius, etc.) as independent variables. The mean muscle activity was set as the dependent variable. This research extracted $4^{th}{\sim}7^{th}$ repetition signals according to ten times of repetitive muscle contraction, and analyzed the muscle activity concerned using the envelope detection technique. Results: The mean muscle activity of upward direction was analyzed highly statistically significant. The reason is that the effect of gravity works to arm and shoulder muscles. Also, it is conjectured that deformation of coracoacromial ligament was caused, and its contact pressure increased, due mainly to the shoulder flexion, and therefore load was analyzed high. Muscle activity was analyzed significantly low, according to concentric ballistic motion used in the concentric contraction phase by storing elastic energy in the eccentric contraction phase with a motion to bring the weight to the front of subject's body as to downward, leftward and backward directions. Because, elbow joint's flexion-extension motions mainly occurred, biceps brachii was analyzed high muscle activity as the prime mover. Conclusion: The information on the quantitative load of muscles can be applied to ergonomic work design for one-handed manual material handling to minimize muscle load. Application: This research has effectively identified muscle activity according to dynamic contraction by applying an envelope detection technique. The results can be used for ergonomic work design to minimize muscle load during the one-handed manual material handling, according to each direction. The research results are expected to be used for musculoskeletal disorder prevention and physiotherapy in the rehabilitation medical field, based on the muscle load of arm and shoulder in various directions.

8주간의 어깨 강화 운동이 요양보호사들의 어깨 근력에 미치는 영향 (The Effect of an 8-week Shoulder Strengthening Exercise on Shoulder Muscle Strength of Caregivers)

  • 신재욱;이승민;정대윤;김동인;박재성;이병수;송세희;박이대;김문정;김노용;이광훈;김재용
    • PNF and Movement
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    • 제16권1호
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    • pp.43-50
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    • 2018
  • Purpose: This study examined the effects of a shoulder-strengthening exercise on muscle strength of shoulder flexors and extensors of caregivers. Methods: The study consisted of 19 caregivers (2 males and 17 females) employed by Medical Center B. All the participants took part in an 8-week shoulder muscle strengthening exercise, based on previous studies. In the first week, the subjects took part in a stretching exercise enhance the range of motion. In the second week, they participated in an exercise aimed at improving shoulder blade stability. From the third to seventh weeks, a resistance exercise of different intensities was applied in a phased manner. Finally, in the eight week, the subjects took part in plyometric exercise. Peak torque, average power, and total work of shoulder flexors and extensors in both sides were measured before and after the exercise at an angular speed of 120deg/sec using an isokinetic device. Wilcoxon's singed-ranks test was conducted to analyze differences in muscle strength before and after the intervention. Results: After the exercise, there was a significant improvement in peak torque and average power of flexors of the right arm. After the exercise, peak torque, total work, and average power showed a significant improvement in the flexors of the left arm (p<0.05). However, there was no statistically significant difference in extensor muscle strength in either arm after the exercise. Conclusion: Shoulder flexors of caregivers are utilized frequently in the workplace. Implementation of extensor-strengthening exercises, in addition to flexor-strengthening exercises, can contribute to reducing the incidence rate of shoulder injuries among caregivers.

In-Ceram 전부도재관의 shoulder 폭경에 따른 변연적합도 (Marginal fit of In-Ceram crown according to shoulder width)

  • 천승근;이청희;조광헌
    • 구강회복응용과학지
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    • 제16권2호
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    • pp.105-112
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    • 2000
  • 본 연구는 치아형성시 shoulder 폭경이 변연 적합도에 미치는 영향을 평가하기 위해 시행하였다. 지대치의 치경부쪽의 shoulder 폭경을 0.6 mm, 0.9 mm, 1.2 mm로 나누어 각각 9개씩, 총 27개의 모형을 제작하여 통법에 따라 In-Ceram 전부 도재관을 제작한 후 시멘트 접착하고 근심, 원심, 협, 설측 중앙 부위를 200배 확대하여 변연 적합도의 측정한 후 각 군과, 측정부위에 따른 변연 적합도 비교해 본 결과 다음과 같은 결론을 얻었다. 1. shoulder 폭경이 0.6 mm인 경우 $81.28{\mu}m$, 0.9 mm인 경우는 $70.78{\mu}m$, 1.2mm 인 경우는 $67.75{\mu}m$의 변연간극을 보였다. 2. shoulder 폭경이 0.6 mm인 경우가 0.9 mm, 1.2 mm인 경우보다 변연간극이 유의한 차이를 크게 나탔났으며(p<0.05), 0.9 mm인 경우와 1.2 mm인 경우는 유의한 차이가 없었다(p>0.05). 3. In-Ceram 시편의 변연부에서 근심측, 원심측, 순측, 설측의 측정위치에 따른 변연적합도의 비교시 유의한 차이가 없었다(p>0.05).

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견관절 전방 통증 환자에서 초음파 유도하 견쇄관절 소염약침요법 병행 치료의 효과: 후향적 연구 (The Effectiveness of Ultrasound-Guided Soyeom Pharmacopuncture Therapy at Acromioclavicular Joint of Shoulder in Patients with Anterior Shoulder Pain: A Retrospective Study)

  • 김상우;전동휘;김병준;박정욱;오민석
    • 한방재활의학과학회지
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    • 제31권3호
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    • pp.95-104
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    • 2021
  • Objectives The purpose of this study was to observe effectiveness of ultrasound-guided Soyeom pharmacopuncture therapy at acromioclavicular joint of shoulder in patients with anterior shoulder pain. Methods We analyzed medical records of 9 patients hospitalized with anterior shoulder pain who had admitted to Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University from March 1, 2021 to June 13, 2021. 9 patients were treated the treatment of Soyeom pharmacopuncture therapy on acromioclavicular joint under ultrasonic guidance with Korean medicine treatment (such as herbal medicine, acupuncture, moxabustion, etc). The study was conducted as a retrospective observation study which analyze the patient's medical records. We used numeric rating scale (NRS) to evaluate pain reduction and the shoulder range of motion (ROM) to evaluate function improvement twice (before pharmacopuncture treatment and 5 days later treatment). Statistical analysis was performed using the IBM SPSS Statistics version 25 program (IBM Co., Armonk, NY, USA). Results The average of numeric rating scale reduced statistically significantly from 5.56±1.13 to 3.11±1.36 (p=0.004). The average of shoulder flexion ROM increased statistically significantly from 166.67±8.17° to 175.00±8.37° (p<0.05). And the average of shoulder abduction ROM increased statistically significantly from 158.57±20.35° to 172.86±12.53° (p<0.05). Both NRS and shouler ROM showed statistically significantly improve after treatment. Conclusions This study shows ultrasound-guided Soyeom pharmacopuncture therapy at acromioclavicular joint of shoulder has a meaningful clinical effect on the improving shoulder pain and ROM especially on flexion and abduction.

The Clinical Results of Conservative Treatment of Frozen Shoulder Using Continuous Passive Motion

  • Chung, Hoe-Jeong;Kim, Doo-Sup;Yoon, Yeo-Seung;Lee, Dong-Woo;Hong, Kyung-Jin
    • Clinics in Shoulder and Elbow
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    • 제18권4호
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    • pp.217-220
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    • 2015
  • Background: The purpose of this study is to administer conservative treatment in 30 patients diagnosed with idiopathic frozen shoulder, following the suggested frozen shoulder rehabilitation program and to assess the clinical outcome using a prospective study. Methods: Thirty patients diagnosed with idiopathic frozen shoulder, treated with steroid hormone injection on the articular joint with an intra-articular steroid (triamcinolone 40 mg+lidocaine 4 ml) injection and started on stepwise shoulder extension exercise were chosen. The subjects were divided into two groups of 15 people each with one group undergoing rehabilitation with continuous passive motion (CPM) and the other group without it. Follow-ups were done before rehabilitation and at 4-week intervals with the 24th being the final week. At every follow-up, passive range of motion (ROM) was measured and surveys on pain and clinical score were administered. Results: In the last follow-up, both groups showed statistically significant improvements in all evaluation criteria. However, no statistical difference in all values of the ROM and Constant score evaluation criteria was observed between the groups. Only in the last follow-up, group 1 had a visual analog scale (VAS) score of $2.4{\pm}2.1$ points, which was lower, with statistical significance, than the VAS score of group 2, which was $4.4{\pm}3.1$ points (p<0.001). Conclusions: Study using CPM in treatment of frozen shoulder has been inadequate, meaning that there is still room for improvement and need for more study on setting a more specific protocol and guidelines for this procedure.