• 근관절건강학회지
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• 제6권2호
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• pp.278-294
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• 1999

The PACE (People nth Arthritis Can Exercise) is an exercise program developed by the Arthritis Foundation to improve muscle strength and joint flexibility for patients with arthritis. The purpose of this study was to explore the effects of PACE program on self-efficacy, pain, and joint function in the Korean immigrant elderly. The PACE program was held twice a week for 6 weeks for Korean immigrant elderly who had osteoarthritis. Twenty four subjects completed the program, who were recruited in two places : 10 elderly in a senior residential apartment, and 14 elderly in a senior center supported by Congregated Meal Program for Korean Elderly. Self-efficacy(Sherer et al., 1982), pain severity(by using Visual Analogue Scale), and number of painful joints were measured before and after the PACE program. To examine the joint flexibility and strengthening, the followings were measured : the extent of the upward arm reach in both sides(flexibility of shoulder), the ability to touch fingertips of the both hands in back pat and rub(flexibility of arm), the degree of range of motion(ROM) of both ankles in their dorsiflexion(flexibility of ankle) and plantarflexion with standing with toe(strengthening of ankle), and the degree of knee extension. Wilcoxon signed rank test was used for data analysis and the significance of the differences in the variables was examined to compare the data obtained before and after the PACE program. After the PACE, followings were found : 1. Self-efficacy was significantly increased. 2. Pain severity and number of painful Joints was significantly decreased. 3. The flexibility of both shoulders and arms were significantly improved, but the flexibility of knee was not changed. 4. The flexibility and strengthening of both ankle was significantly improved. In conclusion, PACE was clearly proved to be an effective exercise program to promote self-efficacy, to reduce pain, and to enhance joint function in the elderly with osteoarthritis. It is suggested that the PACE program should be recommended as one of the useful and appropriate nursing interventions for elderly with osteoarthritis.

• Clinics in Shoulder and Elbow
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• 제14권1호
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• pp.134-139
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• 2011

목적: 광범위한 Hill-Sachs 병변을 동반한 전방 견관절 불안정성에 대한 관절경 하 Remplissage 술기를 고찰하고 저자들의 경험을 소개하고자 한다. 대상 및 방법: 골관절염이 없고, 견관절 주위의 골절이 없으며, 10회 이상의 재발성 탈구를 경험하였던 환자들 중에, 30~40% 이상의 광범위한 Hill-Sachs 병변 및 관절와 골 결손이 20% 미만인 경우를 대상으로 관절경 하 Bankart 병변 복원술과 함께 Remplissage 술기를 시행하였다. 결과 및 결론: 광범위한 Hill-Sachs 병변이 동반된 전방 견관절 불안정성에 대한 Remplissage 술기는 견관절의 안정성 및 임상적, 기능적으로 양호한 결과를 보여줄 수 있을 것으로 생각된다.

• Clinics in Shoulder and Elbow
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• 제26권4호
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• pp.343-350
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• 2023

Background: Our purpose was to evaluate a custom reverse total shoulder arthroplasty glenoid baseplate for severe glenoid deficiency, emphasizing the challenges with this approach, including short-term clinical and radiographic outcomes and complications. Methods: This was a single-institution, retrospective series of 29 patients between January 2017 and December 2022 for whom a custom glenoid component was created for extensive glenoid bone loss. Patients were evaluated preoperatively and at intervals for up to 5 years. All received preoperative physical examinations, plain radiographs, and computed tomography (CT). Intra- and postoperative complications are reported. Results: Of 29 patients, delays resulted in only undergoing surgery, and in three of those, the implant did not match the glenoid. For those three, the time from CT scan to implantation averaged 7.6 months (range, 6.1-10.7 months), compared with 5.5 months (range, 2-8.6 months) for those whose implants fit. In patients with at least 2-year follow-up (n=9), no failures occurred. Significant improvements were observed in all patient-reported outcome measures in those nine patients (American Shoulder and Elbow Score, P<0.01; Simple Shoulder Test, P=0.02; Single Assessment Numeric Evaluation, P<0.01; Western Ontario Osteoarthritis of the Shoulder Index, P<0.01). Range of motion improved for forward flexion and abduction (P=0.03 for both) and internal rotation up the back (P=0.02). Pain and satisfaction also improved (P<0.01 for both). Conclusions: Prolonged time (>6 months) from CT scan to device implantation resulted in bone loss that rendered the implants unusable. Satisfactory short-term radiographic and clinical follow-up can be achieved with a well-fitting device. Level of evidence: III.

• 대한수의학회지
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• 제60권4호
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• pp.233-236
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• 2020

A five-year-old spayed female Labrador retriever presented with right forelimb lameness one day earlier. Radiographs and computed tomography of the right shoulder joint revealed conspicuous enthesophytes, bone cyst, and bone fragment at the intertubercular groove. Magnetic resonance imaging showed a loss of continuity of the biceps tendon and inhomogeneous hyperintense signal of the surrounding soft tissue and moderate synovial fluid on T2- and proton density-weighted images with contrast enhancement on the postcontrast T1-weighted images. The dog was diagnosed with tenosynovitis and biceps tendon rupture with osteoarthritis based on a comprehensive evaluation of the computed tomography and magnetic resonance imaging features.

• The Korean Journal of Pain
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• 제32권2호
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• pp.120-128
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• 2019

Background: We aimed to explore the American College of Rheumatology (ACR) 1990 and 2011 fibromyalgia (FM) classification criteria's items and the components of Fibromyalgia Impact Questionnaire (FIQ) to identify features best discriminating FM features. Finally, we developed a combined FM diagnostic (C-FM) model using the FM's key features. Methods: The means and frequency on tender points (TPs), ACR 2011 components and FIQ items were calculated in the FM and non-FM (osteoarthritis [OA] and non-OA) patients. Then, two-step multiple logistic regression analysis was performed to order these variables according to their maximal statistical contribution in predicting group membership. Partial correlations assessed their unique contribution, and two-group discriminant analysis provided a classification table. Using receiver operator characteristic analyses, we determined the sensitivity and specificity of the final model. Results: A total of 172 patients with FM, 75 with OA and 21 with periarthritis or regional pain syndromes were enrolled. Two steps multiple logistic regression analysis identified 8 key features of FM which accounted for 64.8% of variance associated with FM group membership: lateral epicondyle TP with variance percentages (36.9%), neck pain (14.5%), fatigue (4.7%), insomnia (3%), upper back pain (2.2%), shoulder pain (1.5%), gluteal TP (1.2%), and FIQ fatigue (0.9%). The C-FM model demonstrated a 91.4% correct classification rate, 91.9% for sensitivity and 91.7% for specificity. Conclusions: The C-FM model can accurately detect FM patients among other pain disorders. Re-inclusion of TPs along with saving of FM main symptoms in the C-FM model is a unique feature of this model.

• 근관절건강학회지
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• 제9권2호
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• pp.177-186
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• 2002

The purpose of this study was examine the effect of self-exercise on patients with chronic arthritis. This study was performed from 1999 to 2001 with 107 subjects. Pain, Fatigue, Flexibility and Health status were measured. Data were analysed by SPSSWIN 10. 0 Package program, frequency, independent t-test and One Way ANOVA. The results were as follows : Of the 107 patients who were sutdied, mean age was 62 years and most of common disease were osteoarthritis. 67.4%was doing self-exercise and self-exercise consisted of 17 types of exercise. Fatigue was statistically different by disease type, duration of disease, education respectively. And fatigue, left shoulder flexibility were significantly different by duration of disease. There weren't significant differences between patient with self-exercise and patient without self-exercise on pain fatigue, flexibility and halth status. These findings confirms that self-exercise do not effective in increasing health improvement for the patients with osteoarthritis. From results of this study indicate that patients with arthritis should have taken systematic exercise such as the self-help education program aquatic exercise program for arthritis patient.

• 근관절건강학회지
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• 제14권1호
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• pp.26-32
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• 2007

Purpose: The purpose of this study was to determine if osteoarthritis patients would benefit in terms of pain, fatigue, difficulty with physical activity, joint stiffness, and flexibility of the joints from a structured self-help program. Method: This self-help program was carried out 2-3 hours once a week for 6 weeks in 2005-2006, and evaluated in one group pretest-posttest pre-experimental design. The subjects of this study who were diagnosed osteoarthritis were recruited at two different Community Health Centers in Kangwon. The subjects who agreed with the purpose of this study and participated both pretest and post-test were 55 patients. Mean age is 63.48 (9.48) years, mean duration of disease is 7.95 (7.66) years. The self-help program was consisted of weekly health contract, exercise, health education, group discussion, group counseling, and recreation. At every meeting, researcher and trained public health nurse evaluated the program, and prepared the next program. The measurement tools were pain rating scale (0-10), fatigue rating scale (0-10), Korean WOMAC (Western Ontario and McMaster University Osteoarthritis) Index, ruler, and goniometer. Results: At the completion of 6 weeks of self-help program, the subjects reported significantly less pain and difficulty with physical activity and more flexibility in both shoulder and knee joints compared to pretest. Conclusion: The self-help program would be helpful on pain, physical activity, and joint flexibility for arthritis patients.

• Clinics in Shoulder and Elbow
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• 제26권2호
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• pp.117-125
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• 2023

Background: Preoperative traditional software planning (TSP) is a method used to assist surgeons with implant selection and glenoid guide-pin insertion in shoulder arthroplasty. Mixed reality (MR) is a new technology that uses digital holograms of the preoperative plan and guide-pin trajectory projected into the operative field. The purpose of this study was to compare TSP to MR in a simulated surgical environment involving insertion of guide-pins into models of severely deformed glenoids. Methods: Eight surgeons inserted guide-pins into eight randomized three-dimensional-printed severely eroded glenoid models in a simulated surgical environment using either TSP or MR. In total, 128 glenoid models were used and statistically compared. The outcomes compared between techniques included procedural time, difference in guide-pin start point, difference in version and inclination, and surgeon confidence via a confidence rating scale. Results: When comparing traditional preoperative software planning to MR visualization as techniques to assist surgeons in glenoid guide pin insertion, there were no statistically significant differences in terms of mean procedure time (P=0.634), glenoid start-point (TSP=2.2±0.2 mm, MR=2.1±0.1 mm; P=0.760), guide-pin orientation (P=0.586), or confidence rating score (P=0.850). Conclusions: The results demonstrate that there were no significant differences between traditional preoperative software planning and MR visualization for guide-pin placement into models of eroded glenoids. A perceived benefit of MR is the real-time intraoperative visibility of the surgical plan and the patient's anatomy; however, this did not translate into decreased procedural time or improved guide-pin position.

• 대한관절경학회지
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• 제4권1호
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• pp.49-53
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• 2000

목적 :. 만성 견관절 충돌증후군에 대한 수술적 치료로서 사용한 관절경적 전방 견봉 성형술의 치료 결과를 분석하고 임상적 효용성을 평가하고자 하였다. 대상 및 방법 : 1995년 7월부터 1997년 12월까지 만성 견관절 충돌증후군 환자 중 6개월 이상 보존적 치료에도 불구하고 증상이 호전되지 않아 관절경을 이용하여 전방 견봉 성형술을 시행한 26명의 환자, 27례의 견관절들을 대상으로 하였다. 심한 퇴행성 관절염 회전근 개 전층 파열 및 견관절 비출구 충돌증후군 (nonoutlet impingement) 등은 모두 연구 대상에서 제외하였다. 평균 추시 기간은 2년 3개월(범위, 1년 7개월-3년 11개월)이었다. 임상적인 결과 판정은 UCLA 견관절 평가지수를 이용하였다. 결과 : 27례 중 23례$(85.2\%)$에서 매우 우수 또는 우수한 결과를 보였으며, 4례$(14.8\%)$에서 양호의 결과를 나타내었다. 환자의 만족도는 27례 중 26례$(96.3\%)$에서 주관적인 만족을 나타내었고, 1례 $(3.7\%)$에서 불만족을 나타내었으며 이 경우 Parkinson 증후군과 경추 후종인대 골화증 및 제 5-6번 경추의 척추 협착증이 동반된 환자였다. 결론 : 관절경적 전방 견봉 성형술은 특히 술전 동통의 정도가 술후 현저히 개선되는 등 증상 완화에 우수한 결과를 예상할 수 있는 만성 견관절 충돌증후군의 효율적 치료법이지만, 견관절 및 그 주위의 병변이나 전신 질환 등이 동반될 경우 치료 결과에 영향을 미칠 수 있다.

• 대한물리의학회지
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• 제19권1호
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• pp.143-154
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• 2024

PURPOSE: The present study was conducted to improve the understanding of the Korean Standard Functional, Disability, and Health Classification (KCF) and its ease of use in the clinical domain of the musculoskeletal system by comparing, analyzing, and linking the KCF codes with items from patient-reported outcome measures (PROMs), which are currently mainly used to evaluate patients with neck, shoulder, waist, and knee pain. METHODS: The items of the most widely used PROMs, the Neck Disability Index (NDI), Disabilities of the Arm, Shoulder, and Hand (DASH) scores, Oswestry Disability Index (ODI), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the codes of the KCF were linked by two experts according to the linking rules. RESULTS: The concordance between the items of each of the PROMs and the KCF code linked by the two experts was NDI,86.4%86.4%, DASH 83.3%, ODI 92.0%, and WOMAC 80.7%. The NDI, DASH, and WOMAC indexes were found to comprise items corresponding to physical function, activity, and participation areas, and were linked to 22, 43, and 31 KCF codes, respectively. In addition to these two areas, the ODI included items related to environmental factors and was linked to 25 codes (duplicated codes are treated as one). CONCLUSION: This research can be used by adding the KCF code to the questions of the currently used evaluation tool. This coding can be easily applied and will contribute to the easy understanding of the KCF.