• PNF and Movement
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• 제19권1호
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• pp.19-29
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• 2021

Purpose: This study aimed to compare the effects of a four-week scapular stabilization exercise program using the PNF technique on scapular symmetry and range of flexion motion (ROM), pain, function, and quality of life (QOL) in post-mastectomy women with breast cancer. Methods: This study included 20 women divided into an experimental group (n = 10) and a control group (n = 10). All patients performed complex decongestive physiotherapy for 40 min daily, five times per week for four weeks. The experimental group performed the extra scapular stabilizing exercise program using the PNF technique for 50 min daily, five times per week for four weeks. Scapular symmetry, shoulder flexion ROM, pain and function, and QOL were subsequently assessed. For ROM measurement, the range of shoulder flexion was measured using a clinometer smart phone application; the pain of the shoulder was measured using the visual analogue scale (VAS); the scapular position was measured using a lateral scapular slide test (LSST); the level of pain and functional activity was measured using the Shoulder Pain and Disability Index (SPADI); and the QOL was measured using Functional Assessment of Cancer Therapy-Breast. Results: There were significant differences in shoulder flexion ROM, VAS, SPADI, and LSST 0˚ and 45˚ when the experimental group was compared with the control group (p < 0.05). After the intervention, there was an improved within-group change in the ROM, SPADI, LSST, and QOL in both the experimental and control groups. Conclusion: These findings suggest that a scapular stabilization exercise program using the PNF technique may be used as a possible treatment option for post-mastectomy women with breast cancer that aims to improve scapular position, shoulder ROM and function, and QOL.

• 한국융합학회논문지
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• 제12권11호
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• pp.135-142
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• 2021

본 연구는 스마트폰을 장시간 사용으로 VDT증후군(Visual Display Terminal Syndrome)을 가진 20대 성인들을 대상으로 체외충격파 치료(ESWT)를 통해 목-어깨의 근육의 복합적 통증지수에 미치는 영향을 알아보고자 한다. VDT증후군으로 목-어깨통증을 가지고 있는 대상자 20명을 무작위로 분류해서 실험군 10명과 대조군 10명으로 나눠서 실험에 참여하였다. 실험대상자들은 4주간, 주 5일간 실시하였다. 실험군은 1회 5 Hz, 2.0 bar의 강도로 체외충격파치료를 2000회씩 실시하였고, 대조군은 1회 30분간 자가신장운동을 실시하였다. 실험대상자들은 실험전과 실험후에 VAS와 PPT로 목-어깨통증을 측정하여 비교하였다. 자료분석은 SPSS win 18.0으로 실험전과 실험후에 실험군과 대조군의 결과값을 분석하기 위해 독립비교를 실시하였다. 실험 후 실험군이 목-어깨근육의 VAS, PPT에서 많이 감소하였다. 하지만 대조군은 큰 차이가 없었다. 이런 결과를 통해 체외충격파 치료는 치료전보다 치료후에 통증감소가 나타났지만 자가신장운동은 치료후 통증감소의 차이가 없었다. 앞으로도 VDT증후군의 원인으로 목-어깨통증을 감소시킬 수 있는 다양한 치료법으로 이용될 것으로 사료된다.

• Clinics in Shoulder and Elbow
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• 제12권1호
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• pp.27-32
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• 2009

목적: 견관절 전방 불안정성에서 관절경 술식을 이용한 전하방 관절낭 상방전위 및 중첩술과 부가적인 하방 관절낭 중첩술과의 추시 결과를 비교하고자 한다. 재료 및 방법: 2005년 3월부터 2007년 8월까지 견관절의 전방 불안정성을 보인 환자중에서 전하방 관절낭 중첩술을 시행하고 하방 관절낭 중첩술을 추가로 시행하지 않은 42예(1군)와 부가적인 하방 관절낭 중첩술을 시행한 33예(2군)를 대상으로 하였다. 평균 나이는 1군이 22.5(17~31)세, 2군이 21.8(16~30)세였으며, 평균 추시 기간은 1군이 23.5(12~45)개월, 2군이 20.1 (12-49)개월이었다. 술 전과 술 후 6개월, 1년, 최종 추시에서 운동 범위와 Rowe점수를 측정하였고 합병증의 빈도를 비교하였다. 결과: Rowe score는 1군에서는 술 전 평균 20.6 에서 술 후 최종 추시에서 86.8 로, 2군에서는 술 전 평균 20.5 에서 술 후 최종 추시에서 94.1 로 개선되었다. 견관절 전방 불안정성에서 관절경 하 재건술은 모든 군에서 좋은 결과를 보였지만 1군에서보다 2군에서 더 좋은 결과를 보였고(p<0.05), 합병증의 비교에서 2군이 합병증이 더 적었다(p<0.05). 결론: 전하방 관절낭 중첩술과 부가적으로 시행된 하방 관절낭 중첩술은 재발성 견관절 전방 탈구의 합병증의 빈도를 낮추고 결과를 호전시킬 수 있는 술식으로 생각된다.

• 대한약침학회지
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• 제16권2호
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• pp.23-27
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• 2013

Objective: This research was performed to investigate the efficacy of complex rehabilitation combined with pharmacopuncture treatment for the children with neuromotor system diseases. Methods: Fifty (50) patients aged from 5 to 15 yr old were compared. Twenty (20) patients received conventional treatments and complex rehabilitation as a control group, and fifty (50) patients received complex rehabilitation with pharmacopuncture. At their first visits, the patients had checkups and neurological scales, and after 10 days of pharmacopuncture treatments and 55 days of rehabilitation, they also took neurological scales. We studied the pre and post effects of the treatment group. Results: The number of patients with ankle joint disorder and contracture, knee joint contracture, steppage, horsey hoof, shoulder weakness and contracture, radio-carpal joint disorder and contracture, arm hypotrophia, arm atrophia, leg hypotrophia and total atrophia decreased after treatments. Conclusion: This study showed the efficacy of pharmacopuncture combined with complex rehabilitation for the treatment of neuromotor system diseases.

• 대한영상의학회지
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• 제81권1호
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• pp.2-20
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• 2020

MRI 영상은 관절 내 질환의 평가에 중요한 검사기법이며, 관절 MRI 영상의 해석을 위해선 견고한 해부학적 지식이 바탕이 되어야 한다. 관절의 해부학 분야에서는, 새로운 구조물이 발견되기도 하며, 과거에 보고되었으나 기능을 알지 못하던 구조물이 새롭게 주목을 받기도 한다. 본 종설에서는 최근 십여 년간 활발하게 연구되어온 견관절 회전근개 케이블(rotator cable) 및 상관절막(superior capsule), 슬관절의 후외측(posterolateral corner) 및 전외측 인대 복합(anterolateral ligament complex), 발목관절의 원위부 경비골 인대결합(distal tibiofibular syndesmosis) 등의 최근 연구 결과를 소개하고, 이를 MRI 영상을 통해 확인해 보았다.

• 한국전문물리치료학회지
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• 제30권1호
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• pp.23-31
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• 2023

Background: Several factors contribute to shoulder pain, including abnormal neck posture, repeated use of the upper limbs, work involving raising the upper limbs above the head, and the effects of vibration. However, previous study has reported that constant vibration exposure could impact improvement of the stability on joints related with muscle recruitment and activation. For this difference reason, we need to verify for the complex study of relationship with repetitive upper limb movements, poor head posture, and constant vibration exposure. Objects: Our study was made to investigate the influence of vibration exposure on the shoulder muscle activity during forward-head and over-head tasks with isometric shoulder flexion. Methods: In a total of 22 healthy subjects, surface electromyography (EMG) data were collected from shoulder muscles (upper/lower trapezius, serratus anterior, and lumbar erector spinae) on tasks (neutral-head task [NHT], forward-head task [FHT], and over-head task [OHT]) with and without vibration exposure. Results: In all tasks, the EMG data of the upper trapezius and serratus anterior significantly increased with vibration exposure (p < 0.05). Furthermore, the EMG data of the lumbar erector spinae significantly increased with vibration exposure in the NHT and FHT (p < 0.05). Conclusion: We suggest that continuous vibration exposure during the use of hand-held tools in the tasks could be associated with harmful effects in the workplace. Lastly, we clinically need to examine the guidelines regarding the optimal posture and vibration exposure.

• 한방재활의학과학회지
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• 제33권3호
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• pp.115-127
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• 2023

Objectives Through this study, we investigated the effects of Korean medicine treatments on range of motion recovery and pain reduction in patients with Frozen shoulder. Methods In this study, the medical records of 26 patients diagnosed with frozen shoulder were retrospectively observed and analyzed through the IBM SPSS Statistics 25 program. We used range of motion to observe the patient's motion recovery and numeric rating scale to evaluate pain reduction. Results The shoulder range of motion increased statistically significantly from 160.0 (123.5~170.0) to 170.0 (160.0~180.0) (flexion), 115.0 (90.0~135.0) to 167.5 (130.0~178.8) (abduction), 40.8±22.1 to 58.3±16.0 (external rotation) (p<0.001). The average of numeric rating scale reduced statistically significantly from 6.7±2.0 to 3.2±1.4 (p<0.001). Depending on the period, the range of motion increased statistically significantly when visited within 3 months, also the pain score decreased 7.0 (5.4~8.0) to 3.0 (1.8~3.6) statistically significantly when visited within 3 months. In the treatment intervention, the increase in the range of motion and the decrease in pain were statistically significant, especially when the bee venom acupuncture and chuna manaul therapy were used together. Conclusions Korean medicine treatments was effective in improving the range of motion and reducing pain in frozen shoulders. In particular, when treated within 3 months of onset and when bee venom acupuncture and chuna manual therapy were used together, it was effective in recovering the range of motion and reducing pain.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2009년도 제17차 학술대회
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• pp.74-74
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• 2009

The purpose of this study was to estimate force of muscles that constituted the rotator cuff during elevation motion in scapula plane, using a skeletal muscle model and quantitatively evaluate rotator cuff function in vivo. A healthy volunteer was measured with an open MR and CT system at elevation positions in scapula plane (MR: $30^{\circ}$, $60^{\circ}$, $90^{\circ}$, $120^{\circ}$, $150^{\circ}$, CT: $0^{\circ}$). After reconstruction three-dimensional MRI-based and CT-based bone surface models, matched each models with registration technique. Then supraspinatus, infraspinatus, subscapularis, teres minor, deltoid (anterior, middle, posterior portions) represented as plural lines. These lines were proportional to physiologic cross-sectional area (PCSA) and defined straight line to bind origin and insertion. Force of supraspinatus became greatest at $59^{\circ}$ of elevation. Subsequently force of deltoid middle portion became greatest at $89^{\circ}$ of elevation. Infraspinatus and subscapularis were active at the meantime. In addition, supraspinatus was active during elevation. These results resembled clinical finding and were proved force couples that contribute to mobility and stability of shoulder complex.

• Clinics in Shoulder and Elbow
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• 제25권2호
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• pp.163-169
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• 2022

Distal humerus fractures (DHFs) are challenging to treat due to the locally complex osseous and soft tissue anatomy. Adequate exposure of the articular surface of the distal humerus is crucial when performing an anatomical reconstruction of the elbow. Even though "triceps-on" approaches are gaining popularity, one of the most commonly used surgical treatments for DHF is olecranon osteotomy. The incidence of complications related to this approach is unclear. This review was performed to assess the type and frequency of complications that occur with the olecranon osteotomy approach in the treatment of DHF. A literature search was conducted in the PubMed/Medline, Embase, and Cochrane Library digital databases up to February 2020. Only English articles describing complications of olecranon osteotomy in the treatment of DHF were included. Data on patient and surgical characteristics and complications were extracted. Statistical analysis was performed using SPSS. A total of 41 articles describing 1,700 osteotomies were included, and a total of 447 complications were reported. Of these 447 complications, wound infections occurred in 4.2% of osteotomies, of which 1.4% were deep infections and 2.8% were superficial. Problems related with union occurred in 3.7% of osteotomies, 2% of which represented non-union and 1.7% delayed union. The high risk of complications in olecranon osteotomy must be considered in the decision to perform this procedure in the treatment of DHF.

• Clinics in Shoulder and Elbow
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• 제24권3호
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• pp.183-188
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• 2021

We report a case of a 69-year-old right-dominant man who had an open Monteggia-like lesion of the right elbow (Gustilo-Andersen IIIA) with severe proximal ulna bone loss associated with an ipsilateral ulnar shaft fracture due to a motorcycle accident. The patient underwent two-stage surgery. Wound debridement and bridging external fixation were performed at first. Three months later, a frozen massive osteochondral ulnar allograft was implanted and fixed with a locking compression plate. A superficial wound infection appeared 5 weeks after the second surgery. Superficial wound debridement, negative pressure therapy, and antibiotics were administered for 3 months, achieving infection healing. At 3 years post-surgery, the elbow range of motion was satisfactory with a Disabilities of the Arm, Shoulder and Hand (DASH) score of 16.7. Radiographs and computed tomography scans showed good allograft-bone integration without allograft reabsorption or hardware loosening. Although not complication-free, massive ulna osteochondral allograft implantation can be considered a valid option in cases of open Monteggia-like lesions associated with ulnar shaft fracture and severe bone loss in active patients, whenever osteosynthesis or joint replacement is not a proper solution. This type of bone stock restoration allows for future surgery, if needed.