• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.18 no.1
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• pp.83-86
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• 2012

Background: The research examined the effect of a scapular stabilizing exercise on shoulder pain, active range of motion (AROM) and changes in the position of the shoulder blade of patients with frozen shoulder. Methods: General physical therapy and a scapular stabilizing exercise were applied to a 53-year-old female patient with frozen shoulder three times a week for four weeks. Before and after the therapy, measurements were made on the visual analog scale (VAS) and of the AROM, and a lateral scapular slide test was conducted. Results: Following the therapy, VAS fell from 7 to 3. Before therapy, flexion, abduction, internal rotation, and external rotation recorded $133^{\circ}$, $102^{\circ}$, $45^{\circ}$, and $53^{\circ}$ respectively; after the therapy they increased to $150^{\circ}$, $123^{\circ}$, $55^{\circ}$, and $65^{\circ}$ respectively. The lateral scapular slide test showed sliding distances before therapy of 8.5cm at $0^{\circ}$, 9.2cm at $45^{\circ}$, and 11.3cm at $90^{\circ}$; after therapy, the distances decreased to 6.8 cm at $0^{\circ}$, 8.2 cm at $45^{\circ}$, and 9cm at $90^{\circ}$. Conclusion: The scapular stabilizing exercise was effective in alleviating shoulder pain, increasing AROM, and reducing changes in the position of the shoulder blade of frozen shoulder patients.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.2
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• pp.153-163
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• 2019

Purpose : This study was to identify the effects of Mobilization with Movement combined with exercise (EMWM) on acromio-humeral distance (AHD), range of motion (ROM), pain intensity, and functional performance in patients with impingement syndrome of the shoulder. Methods : The subjects were 40 patients diagnosed with impingement syndrome of the shoulder. Twenty subjects are randomly assigned to each 2 different groups; Group 1. (exercise group), Group 2. (EMWM group). Three weekly interventions were given for 4 weeks. The main outcome measures were ultrasound, goniometer, visual analogue scale (VAS), and Korean Constant shoulder score (K-CSS). The ultrasound (AHD), ROM (flexion, abduction), pain intensity (for shoulder flexion) and functional performance (K-CSS) were compared between the groups. Results : The AHD was significantly increased in Group 2 compared to Groups 1. No significant difference was observed between the groups in the range of abduction of the shoulder, but the range of flexion was significantly increased in Group 2 compared to Groups 1. Pain intensity was significantly lower in Group 2 than in Group 1, and functional performance was significantly increased in Group 2 compared to Group 1. Conclusion : An intervention that combined mobilization with movement with exercise was more effective than exercise alone for rapid recovery from shoulder injury and improvement in functional performance.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.115-118
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• 2004

Purpose: The purpose of this study is to measure the internal and external rotation of shoulder and compare with normal volunteer and patients diagnosed as SLAP lesion. Materials and Methods: Thirty-eight cases (group 1) who had SLAP lesions at shoulder arthroscopy and fourty young volunteers(group 2) were analyzed retrogradely with medical record, intra-operative arthroscopic photo & video for SLAP lesions and the ROM of shoulder Under the interscalene anesthesia, the range of motion of internal rotation and external rotation were measured on flxed scapula and 90 degree abduction of shoulder, and the same method for group 2. We analyzed the results with two sample T-test and Wisconsin signed ranks test. Results: There was a significant difference between group 1 and group 2 for the ROM of shoulder. (IR; p<0.001,ER; p<0.001).For the group 1, internal and external rotation with the arm abducted 90 averaged 50 and 64 degrees and for the group 2, internal and external rotation averaged 77 and 90 degrees with significant difference(IR; p<0.001,ER; p<0.001).Conclusion: The range of motion of shoulder, especially internal and external rotation significantly decreased in SLAP lesions. Our results suggest that a limited rotational motion of shoulder closely related with SLAP lesion.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.883-892
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• 2021

Background: This case study suggests the potential usefulness of Korean medicine treatment with herbal medicines for shoulder pain and improving the quality of life of patients with frozen shoulder. Case Summary: A patient had shoulder pain and decreased daily living function due to frozen shoulder. Korean medicine treatments, including herbal medicine; acupuncture at points TE14, HT1, BL11, SI10, and LI15; and pharma-acupuncture containing Sinbaro, were applied for 31 days. The Numeric Rating Scale scores for shoulder pain decreased from 7 to 4, and the Shoulder Pain and Disability Index scores decreased from 71.54 to 66.15, with an increase in range of motion from 30° flexion, 60° abduction, and 10° external rotation to around the normal range of motion. Conclusion: Korean medicine treatment can be considered an effective conservative management option for pain and decreased daily living function in patients with frozen shoulder.

• Clinics in Shoulder and Elbow
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• v.22 no.3
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• pp.128-134
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• 2019

Background: Patients with rotator cuff tears are usually afflicted with shoulder pain and disability. However, it is unclear which factors are related to shoulder pain in patients with rotator cuff tears. This study was therefore undertaken to determine the factors correlated with shoulder pain in patients with painful rotator cuff tears, but without any history of trauma. Methods: We evaluated a cohort of 745 patients with painful rotator cuff tears having no trauma history, and analyzed the relationship between pain and multiple factors including demographic data, tear characteristics, and passive range of motion. Pain was analyzed with a questionnaire concerning the visual analogue scale (VAS) for pain. Tear characteristics were determined by evaluating tear size, muscle atrophy, number of torn tendons, and presence of arthritis. Multivariate linear regression analysis and chi-squared test were applied to evaluate the relationship between the VAS for pain and variable factors. Results: Shoulder pain was associated with young age (p=0.01), male sex (p=0.01) and the presence of diabetes mellitus (p<0.001). Measurements of rotator cuff tear characteristics including tear size (p=0.53), muscle atrophy (p=0.16) and the number of torn tendons (p=0.34) did not correlate with shoulder pain. Symptom duration (p=0.60) and range of motion (p>0.05) also showed no correlation with VAS for pain. Conclusions: Young age, male sex and the presence of diabetes mellitus correlated positively with preoperative shoulder pain in patients with painful rotator cuff tears without a trauma history. Combined treatment of pain management and risk factor correction could be helpful to control preoperative shoulder pain.

• Clinics in Shoulder and Elbow
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• v.24 no.4
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• pp.215-223
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• 2021

Background: The objective of this study was to compare the efficacy of platelet-rich plasma (PRP) injection with an institution-based physical therapy (PT) program for adhesive capsulitis (AC) of the shoulder in patients with diabetes mellitus (DM). Methods: A total of seventy diabetic patients with AC of the shoulder for <6 months were assigned to two groups: PRP group and PT group. In the PRP group, 35 patients were administered a single shot of PRP (4 mL) into the glenohumeral joint. In the PT group, 35 patients were given institution-based PT that included 10 30-minute sessions of planned PT over a 2-week period. After the interventions, all patients were prospectively followed for 12 weeks. Intensity of shoulder pain, function, and range of motion were assessed at baseline and then at 3, 6, and 12 weeks. Results: Thirty-three patients in the PRP group and 32 in the PT group completed the 12-week study. At 12 weeks, patients who received PRP injections showed greater improvement in shoulder pain (p<0.001) than those recruited to the PT group. In the range of motion and shoulder function activities, patients in the PRP group showed significant improvement compared with the institution-based PT group (p<0.001). No significant complications were reported from any groups. Conclusions: In a diabetic population, PRP injections significantly improved shoulder pain and function compared with an institution-based PT program for shoulder AC. Additionally, it is a safe and well-tolerated method for AC management for diabetic patients.

• Physical Therapy Korea
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• v.23 no.3
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• pp.68-75
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• 2016

Background: Shoulder horizontal adduction (HA) is performed in many activities of daily living. The limited range of motion (LROM) of HA is affected by the tightness of the posterior deltoid, infraspinatus, teres major, and posterior capsule of glenohumeral joint. The LROM of shoulder HA contributes to excessive scapular abduction. Objects: The aim of this study is to compare the scapular abduction distance and three-dimensional displacement of the scapula during shoulder horizontal adduction between subjects with and without the LROM of shoulder HA. Methods: 24 subjects (12 people in LROM group and 12 people in normal ROM group) participated. Subjects with less than $115^{\circ}$ of HA ROM were included in LROM group. Shoulder HA was performed 3 times for measuring scapular abduction distance and three-dimensional displacement of the scapula. Tape measure was used for measuring scapular abduction distance. Scapular abduction distance was normalized by dividing the scapular size. Polhemus Liberty was used for measuring the three-dimensional displacement of the scapula. Results: Normalized scapular abduction distance was significantly greater in LROM group than normal ROM group (p<.001). Three-dimensional displacement of the scapula during shoulder HA was greater in LROM group than normal ROM group (p<.05). Conclusion: LROM group had a greater scapular abduction and three-dimensional displacement of the scapula during shoulder HA compared to normal ROM group.

• Clinics in Shoulder and Elbow
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• v.18 no.4
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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.

• Journal of the Korea Convergence Society
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• v.12 no.10
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• pp.277-286
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• 2021

This study investigated the effect of a 12-week rehabilitation program on the range of motion (ROM) and muscle strength of high school baseball players with shoulder instability. We allocated 12 players with shoulder instability to the rehabilitation group and 13 players without shoulder instability to the normal exercise group. Covariate analysis (ANCOVA) was performed to assess the ROM of the internal (IR) and external (ER) rotational joints before and after participating in the 12 weeks of rehabilitation, and two-way ANOVA was performed to assess isokinetic muscle strength. The statistical significance level was set at p<.05. The IR ROM of the dominant (D) shoulder with instability and non-dominant (ND) shoulder was significantly increased before and after the rehabilitation program. The total ROM of the D shoulder with instability significantly increased after rehabilitation. IR isokinetic strength significantly improved at an angular velocity of 180°/s after rehabilitation. These results indicate that the rehabilitation program used in this study could be effective in improving ROM and muscle strength in patients with shoulder instability. However, due to the limited results, additional research on the premise of extending the rehabilitation period is necessary.

• Journal of Yeungnam Medical Science
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• v.38 no.1
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• pp.19-26
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• 2021

Adhesive capsulitis of the shoulder joint is a common disease characterized by pain at the insertional area of the deltoid muscle and decreased range of motion. The pathophysiological process involves fibrous inflammation of the capsule and intraarticular adhesion of synovial folds leading to capsular thickening and contracture. Regarding the multidirectional limitation of motion, a limitation in external rotation is especially prominent, which is related to not only global fibrosis but also to a localized tightness of the anterior capsule. Ultrasound and magnetic resonance imaging studies can be applied to rule out other structural lesions in the diagnosis of adhesive capsulitis. Hydraulic distension of the shoulder joint capsule provides pain relief and an immediate improvement in range of motion by directly expanding the capsule along with the infusion of steroids. However, the optimal technique for hydraulic distension is still a matter of controversy, with regards to the infusion volume and rupture of the capsule. By monitoring the real-time pressure-volume profile during hydraulic distension, the largest possible fluid volume can be infused without rupturing the capsule. The improvement in clinical outcomes is shown to be greater in capsule-preserved hydraulic distension than in capsule-ruptured distension. Moreover, repeated distension is possible, which provides additional clinical improvement. Capsule-preserved hydraulic distension with maximal volume is suggested to be an efficacious treatment option for persistent adhesive capsulitis.