• Clinics in Shoulder and Elbow
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• 제7권2호
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• pp.70-75
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• 2004

Purpose: To evaluate the results of arthroscopic repair of traumatic anterior shoulder instability with glenoid bone defect. Materials and Methods: Nineteen patients who had underwent arthroscopic repair for the shoulder with traumatic anterior instability and glenoid bone defect were retrospectively reviewed. Mean age was 24.6 years(range, 20 to 39) and mean follow-up was 23 months(range, 19 to 55). No glenoid bone defect was greater than 7mm in length and 20% of the glenoid. The results were evaluated according to stability, range of motion and function. Results: All patients obtained excellent-good results according to Rowe scoring system. Two patients(10.5%) had instability. The mean loss of external rotation was 15 degrees (range, 0 to 25). Functionally, 17 patients could participate in preinjured work or sports to the same level with or without mild discomfort. The remained 2 patients who had 25 degree loss of external rotation could not play sports. Conclusion: Though arthroscopic repair is a good treatment for traumatic anterior shoulder instability with small glenoid bone defect, it is possible to cause loss of external rotation

• 대한임상전기생리학회지
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• 제2권1호
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• pp.71-82
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• 2004

To compare the effectiveness of the hemisling, bobath sling, extension-type sling, and the newly designed Modified Triangular Bobath Sling with Distal Support on a hemiplegic shoulder subluxation. Fourteen hemiplegic patients with shoulder subluxation were evaluated by a simple X-ray with and without the slings and the vertical and horizontal distances on the plain AP views were measurement. The newly designed arm sling was compared in terms of the effects of correction with distal support attached with shoulder saddle sling. The arm sling designed for this study was developed for the purpose of maintaining patients hands in a functional position and performing ROM exercise of the shoulder easily, and prevention or correction to shoulder subluxation. The mean values of the vertical and horizontal distance were compared to determine if there was significant difference of function between the new sling and the conventional slings. The new sling provided the patients with good vertical correction of the subluxation(p<0.05) but did not increase the horizontal distance significantly. These results support the effectiveness of a new sling to decrease subluxation in hemiplegia. Further study on the long term effects or complication of the new sling is recommended.

• The Journal of Korean Physical Therapy
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• 제24권2호
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• pp.151-156
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• 2012

Purpose: The purpose of this study was to investigate the adverse effects of sensorimotor function at the shoulder joint according to long-term cane usage in stroke patients without apraxic behavior, in terms of the presence of shoulder joint pain, accuracy of tracking task, proprioceptive joint position sense, and nine-hole pegboard. Methods: Nineteen stroke patients with long-term cane usage (cane usage group) and nineteen stroke patients without cane usage (non-cane usage group) were recruited. All subjects were tested in pain presence, a tracking task for visuomotor function, joint reposition, and nine-hole pegboard in the shoulder joint regarding the non-affected side. Results: In the accuracy index for tracking task and the nine-hole pegboard test, significant differences were observed between the cane usage group and the non-cane usage group. However, although a higher emergence of shoulder pain and a lower accuracy for joint reposition sense were detected in the cane usage group in comparison to the non-cane usage group, there were no significant differences between the two groups. Conclusion: Our findings suggest that long-term cane usage could induce to decrease in delicate movement and coordination in the non-affected upper arm in stroke patients. In addition, they could experience high frequency of shoulder pain and poor joint reposition sense. Therefore, careful evaluation and observation will be required concerning stroke patients with long-term cane usage.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2009년도 제17차 학술대회
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• pp.43-43
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• 2009

Glenohumeral ligaments play an important role in stabilizing the shoulder. However, it is impossible to know how they function in vivo during shoulder motion. To help elucidate this stabilizing role, we conducted in vivo three-dimensional kinematics of the normal shoulder joint using a markerless bone-registration technique. Magnetic resonance images of 14 shoulder joints of 7 healthy volunteers were acquired for 7 isometric abduction positions between $0^{\circ}$ and $180^{\circ}$. We then calculated three-dimensional shortest paths between the origin and insertion of each ligament based on anatomical study in each abduction position. At $0^{\circ}$ of abduction, the posterior band of the coracohumeral ligament displayed the maximum length. At $30^{\circ}$ of abduction, the superior glenohumeral ligament displayed the maximum length. At $60^{\circ}$ of abduction, the anterior band of the coracohumeral ligament and the middle glenohumeral ligament displayed the maximum length. At $120^{\circ}$ of abduction, the anterior band of the inferior glenohumeral ligament displayed the maximum length. We think that the maximum length of these results is an important influence on the function of the soft tissue stabilizer.

• Clinics in Shoulder and Elbow
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• 제25권2호
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• pp.101-105
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• 2022

Background: Rotator cuff tears cause pathologies of the long head of the biceps tendon (LHBT). One of the surgical treatments for such a tear is LHBT tenodesis to the humerus. This study aims to compare simultaneous rotator cuff repair and LHBT tenodesis with or without detachment of the proximal end of the LHBT (PELHBT) from its site of adhesion to the glenoid. Methods: This retrospective study involved patients affected by LHBT pathology with rotator cuff tear. The patients were divided into two groups, with or without PELHBT detachment from the glenoid. Therapeutic outcomes were investigated by evaluation of patient satisfaction, pain based on visual analog scale, shoulder function based on Constant score and simple shoulder test, and biceps muscle strength based on the manual muscle testing grading system before surgery, at 6 months, and at the final visit after surgery. Results: Groups 1 and 2 comprised 23 and 26 patients, respectively, who showed no significant differences in demographic characteristics (p>0.05). Shoulder function, biceps muscle strength, pain, and satisfaction rate improved over time (p<0.05) but were not significantly different between the two groups (p>0.05). No post-surgical complication was found in either group. Conclusions: There was no difference in final outcomes of tenodesis with or without detachment of the PELHBT from the supraglenoid tubercle. Such tendon detachment is not necessary.

• Clinics in Shoulder and Elbow
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• 제25권2호
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• pp.106-111
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• 2022

Background: The use of telemedicine for postoperative visits is increasing, especially in rural areas. Few studies have investigated its use for arthroscopic shoulder patients. This study aims to evaluate patient satisfaction with telemedicine for postoperative clinic visits following arthroscopic shoulder procedures in a rural setting. Methods: Patients were prospectively enrolled using the following exclusion criteria: <18 years, open procedures, and non-compliance follow-up at 6 weeks postoperatively. All patients completed a 13-question satisfaction survey, while telemedicine patients completed an additional, separate seven-question survey. Patients who switched groups completed a four-question prompt to determine the reasons for switching. Differences between groups were evaluated by either Student t-test or Mann-Whitney U-test. Results: The study enrolled 32 patients, with five patients following up by telemedicine and 27 in person. Age and distance from clinic were similar between patients who were assigned to the telemedicine group, completed the telemedicine visit, and opted for in-person visits (all p>0.05). Patient satisfaction did not vary significantly based on care by the surgeon, concerns being addressed, thoroughness of visit, overall clinical assessment at a prior visit, and improvements in pain and physical function (all p>0.05). Among patients who opted out of telemedicine visits, the most common reason was a preference to meet in-person but these patients agreed that telemedicine visits are a good idea. Conclusions: Regardless of type of follow-up, individuals reported similar levels of satisfaction with treatment during the visit and improvements in pain and physical function.

• PNF and Movement
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• 제20권2호
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• pp.223-233
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• 2022

Purpose: The study aimed to determine the effect of extra thoracic mobilization exercises on shoulder pain and function in patients who had undergone rotator cuff repair. Methods: Following the recording of baseline measurements, 20 subjects who had undergone rotator cuff repair were randomized into two groups: the experimental group (n = 10), which did thoracic mobilization exercises, and the control group (n = 10), which received traditional physical therapy. Each group participated in the intervention five times per week for two weeks. The pain (using the visual analogue scales [VAS]), the flexion and abduction range of motion (ROM), and the shoulder pain and disability index (SPADI) scores of both groups were recorded pre- and post-intervention. Paired t-tests were used to determine whether post-intervention scores were significantly different from pre-intervention scores, and independent t-tests were used to analyze differences in the dependent variables between the two groups. Results: After the two-week intervention, both groups experienced significantly decreased VAS and SPADI scores (p < 0.05) and significantly increased flexion and abduction ROM (p < 0.05). The experimental group that undertook the thoracic mobilization exercises showed greater improvements in pain, flexion and abduction ROM, and the SPADI than the control group (p < 0.05). Conclusion: These results suggest that thoracic mobilization exercises reduce shoulder pain and disability and enhance function in patients who have undergone rotator cuff repair.

• Physical Therapy Rehabilitation Science
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• 제11권4호
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• pp.464-470
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• 2022

Objective: Axillary web syndrome (AWS) is a condition comprising fibrous band-like cords that appear in the axilla of patients after axillary lymph node dissection (ALND) during breast cancer surgery and result in pain and reduced mobility. The cords appearing with AWS are hardened veins or lymphatic vessels. Manual therapy and stretching are recommended for pain control and mobility improvement. Therefore, this study investigated the effect of cytoskeletal manual therapy (CMT), which is a new soft tissue mobilization technique. Design: A case report Methods: A 41-year-old woman with AWS after breast cancer surgery and ALND visited a physical therapy clinic because of shoulder pain, decreased function, and decreased mobility. The cords were palpable and pain occurred 2 weeks after surgery. CMT was performed three times per week for a total of 6 weeks. Her pain intensity, range of motion (ROM), and shoulder function were measured. Results: Measurements were performed after 2 weeks and 6 weeks of CMT and evaluated using the numeric pain rating scale (NPRS). Her pain intensity largely decreased after 2 weeks (4-point score reduction) and after 6 weeks (5-point score reduction) of CMT. After CMT, her full ROM was restored and her shoulder function was improved (7-point score reduction). Conclusions: CMT is effective for pain control, mobility improvement, and functional improvement of patients with AWS.

• 대한산업공학회지
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• 제25권1호
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• pp.56-66
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• 1999

Shoulder joint is the most movable joint in human body with, at least, three degrees of freedom, since there are at least three bones and five joints involved in shoulder movement. Due to the complexity of the shoulder joint and the lack of appropriate anatomical data, modeling of the shoulder joint has been known to be extremely difficult. In many biomechanical models being used, shoulder joint is considered as a fixed point and it is also assumed that the shoulder joint does not noticeably move during the shoulder movement. However, such an assumption is not valid in real applications and causes inaccuracy, especially, in the area of workspace evaluation. The reachable area generated by a human becomes somewhat different from that of current models for those models fail to appropriately reflect the movement of shoulder joint's center of rotation. In this study, the location of the shoulder joint's center of rotation was obtained in relation to the location of humerus, on which a new model for reach envelope generation was developed for workspace evaluation. From the experiments conducted for three subjects, the initial location of the center of rotation was determined for each subject and subsequent changes in the instantaneous center of rotation were drawn as a function of flexion and abduction of the shoulder. Based on the regression analysis, the study suggested a new method for the generation of reach envelope. Comparisons were also made among real reach envelopes obtained from the experiment, the ones from the model, and the ones from the new method suggested in the study. As a result, the prediction errors incurred from the new method were significantly reduced when compared to the ones from the current approach.

• Clinics in Shoulder and Elbow
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• 제20권1호
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• pp.18-23
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• 2017

Background: To assess the incidence of venous thromboembolism (VTE) following shoulder surgery and to evaluate the role of postoperative duplex ultrasonography. Methods: The study comprised a total of 224 patients who underwent shoulder surgery, including 180 shoulder arthroscopic surgeries, 28 shoulder arthroplasties, and 16 plate fixations for proximal humerus fracture between January 2014 and December 2014. The mean age of patients was 59.0 years, and there were 81 men and 143 women. Clinical data, including body mass index, blood tests, metabolic work-up for liver and renal function, previous, and present medical history, were evaluated. Duplex ultrasonography in the operative arm was performed on 2 to 4 days after surgery. Results: The overall incidence of VTE following shoulder surgery was 0.45% (1/224). One patient with open reduction and plate fixation for proximal humerus fracture had asymptomatic deep vein thrombosis that showed complete remission after anticoagulant medication during a 2-month period. Four patients had asymptomatic superficial cephalic vein thrombosis and complete remission without any treatment. There was no case of pulmonary embolism. Conclusions: The incidence of VTE following shoulder surgery was extremely low in Asians. Duplex ultrasonography may be not considered a routine follow-up of shoulder surgery and can be selectively performed in high-risk or symptomatic patients for VTE.