• 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.

• 대한수의학회지
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• 제64권3호
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• pp.22.1-22.8
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• 2024

Differences between left and right-side joint range of motion may affect canine locomotive ability and movement. Passive range of motion (PROM) joint measurement provides the limits that a particular joint can move in its physiological planes of motion without influence of muscle activity. To compare left and right-side flexion and extension of the glenohumeral, humeroulnar/humeroradial, coxofemoral and femorotibial joints and for laterality PROM differences. Siberian Husky dogs were selected (n = 18), mixed gender, aged (1.4-11.8) years living and working together. Goniometry measured joint PROM, a validated, non-invasive method. Dogs were conscious and placed in standing position. Triplicate measures of joint flexion and extension were taken bilaterally of each dog for afore-mentioned joints. Median values of triplicate measures were computed. Paired t-tests compared laterality of joint PROM, gender, age (< 6 vs. ≥ 6 years) effects. Inferential symmetry indices [SI] were calculated. For all joints, there was no significant difference (p > 0.05) between left and right-side flexion and extension measures nor between genders. Age (< 6 vs. ≥ 6 years) had a significant effect on right hip flexion (p < 0.001); both left and right-side shoulder flexion (p < 0.001); elbow flexion (p = 0.001 and p < 0.001); hip extension (p = 0.02 and p < 0.001) respectively. The shoulder joint showed greatest PROM asymmetry (SI = 3.63%). Bilateral PROM measures are important to consider in joint movement and assessment. These results warrant further investigation with larger cohorts of defined age groups.

• 한국융합학회논문지
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• 제12권10호
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• pp.277-286
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• 2021

이 연구는 12주간 재활 운동프로그램이 어깨 불안정성을 가진 고등학교 야구선수들의 관절가동범위와 근력에 미치는 효과를 알아보기 위해 실시하였다. 어깨 불안정성이 있는 것으로 판명된 재활 운동군 12명과 정상 운동군 13명을 선정하였다. 12주간 재활운동 참가 전·후 내·외회전 관절가동범위는 공변량분석(ANCOVA)을 실시하였으며, 등속성 근력은 이원변량 분석(two-way ANOVA)을 실시하였으며, 통계적 유의수준은 p<.05로 설정 하였다. 관절가동범위는 불안정이 있는 우위측과 비-우위측 어깨의 경우 재활운동 전·후 내회전 ROM이 유의하게 증가했으며, Total ROM의 경우 불안정이 있는 우위측 어깨에서 재활운동 후 유의하게 증가했다. 등속성 근력의 경우 재활운동 후 내회전 근력이 각속도 180°/sec에서 유의하게 개선되었다. 본 연구 결과를 요약하면 12주간 재활운동 프로그램이 어깨 불안정성 환자의 ROM, 근력 개선에 효과적인 것으로 나타났다. 하지만 제한적 결과에 미루어 재활기간의 연장을 전제로 한 추가적 연구가 필요할 것으로 생각된다.

• Journal of Yeungnam Medical Science
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• 제38권1호
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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.

• 한국전문물리치료학회지
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• 제31권1호
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• pp.72-78
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• 2024

Background: Limitations of shoulder range of motion (ROM), particularly shoulder internal rotation (SIR), are commonly associated with musculoskeletal disorders in both the general population and athletes. The limitation can result in connective tissue lesions such as superior labrum tears and symptoms such as rotator cuff tears and shoulder impingement syndrome. Maintaining the center of rotation of the glenohumeral joint during SIR can be challenging due to the compensatory scapulothoracic movement and anterior displacement of the humeral head. Therefore, observing the path of the instantaneous center of rotation (PICR) using the olecranon as a marker during SIR may provide valuable insights into understanding the dynamics of the shoulder joint. Objects: The aim of the study was to compare the displacement of the olecranon to measure the rotation control of the humeral head during SIR in individuals with and without restricted SIR ROM. Methods: Twenty-four participants with and without restricted SIR ROM participated in this study. The displacement of olecranon was measured during the shoulder internal rotation control test (SIRCT) using a Kinovea (ver. 0.8.15, Kinovea), the 2-dimensional marker tracking analysis system. An independent t-test was used to compare the horizontal and vertical displacement of the olecranon marker between individuals with and without restricted SIR ROM. The statistical significance was set at p < 0.05. Results: Vertical displacement of the olecranon was significantly greater in the restricted SIR group than in the control group (p < 0.05). However, no significant difference was observed in the horizontal displacement of the olecranon (p > 0.05). Conclusion: The findings of this study indicated that individuals with restricted SIR ROM had significantly greater vertical displacement of the olecranon. The results suggest that the limitation of SIR ROM may lead to difficulty in rotation control of the humeral head.

• The Journal of Korean Physical Therapy
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• 제13권1호
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• pp.115-125
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• 2001

The purpose of this study was to determine the relationship between rotation of the humerus and the shoulder movement in the sagital, coronal, and diagonal planes. Thirty normal subjects(15 male. 15 female)were tested using Cybex NORMTM Testing & Rehabilitation System (CYBEX Division of LUMEX, Inc., Ronkinkoma, New York). The subjects performed active shoulder flexion, abduction and PNF patterns. The range of motion(ROM) of the glenohumeral joint was measured three times. In order to assure the statistical significance of the results. the independent t-test. and a pearson's correlation were applied of the .05 and .01 level of significant. The results of this study were as follow ;1. There were statistically significant differences between shoulder flexion with humerus medial rotation and shoulder flexion with humerus lateral rotation(p <.01). 2. There were statistically significant differences between shoulder abduction with humerus medial rotation and shoulder abduction with humerus lateral rotation(p <.01). 3. There were statistically significant differences between PNF pattern(flex-abd-ext rot) with humerus medial rotation and PNF pattern with humerus lateral rotation(p < .01).For effective rehabilitation of the shoulder, physical therapists must have correct knowledge of shoulder movements. Physical therapists should consider these results when the goal of treatment is to increase ROM of the shoulder.

• 한국운동역학회지
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• 제17권4호
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• pp.45-55
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• 2007

We investigated the biomechanics and characteristics of shoulder rotator muscles for professional woman volleyball players. The purpose of this study was to analyze the isokinetic peak torque and range of motion for shoulder joint rotation. We measured the strength and ROM of the internal rotation(IR) and external rotation(ER) of shoulders joint for nine professional woman Volleyball players and nine University students with Biodex and Simi-motion. 1. We measured peak torques for the shoulder joint rotator at angular velocities of 60/s and 180/s. It was found that the peak torques were significantly different between the two groups and also between the hands used. 2. At angular velocity of 60/s, IR/ER ratio of the shoulder joint was significantly different depending on the groups and the hands in use. There was a significant difference for 'Dominant side' at angular velocity of 180/s, but no significant difference for 'Non-dominant side' and the controls group. 3. Regarding the ROM of rotation of the shoulder joint group, IR was significantly different between the groups and the hands in use. 4. IR/ER ratio of the shoulder joint for Dominant side was quite different between the groups.

• 대한물리의학회지
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• 제13권2호
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• pp.11-19
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• 2018

PURPOSE: The aim of this study was to identify the effects of joint mobilization intervention combined with exercise on range of motion (ROM), pain intensity, and functional performance in adolescent baseball players with internal impingement syndrome of the shoulder. METHODS: The subjects were 30 adolescent baseball players diagnosed with internal impingement. Ten subjects were randomly assigned to each of 3 groups: Group 1 (exercise only), Group 2 (joint mobilization combined with exercise), and Group 3 (rest-only control group). Three weekly interventions were given for 4 weeks (the control group rested for 4 weeks). The main outcome measures were goniometer, visual analogue scale (VAS), and Korean Kerlan Jobe shoulder-elbow (K-KJOC) scores. The ROM (external and internal rotation), pain intensity (at the moment of throwing), and functional performance were compared among the groups. RESULTS: No significant difference was observed among the groups in the range of external rotation of the shoulder before and after the intervention, but the range of internal rotation was significantly increased in Group 2 compared to Groups 1 and 3. Pain intensity was significantly lower in Group 2 than in Group 1 and 3, and functional performance was significantly increased in Group 2 compared to Group 1 and 3. CONCLUSION: An intervention that combined joint mobilization with exercise was more effective than resting or exercise alone for rapid recovery from sports injury and improvement in athletic performance.

• 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.

• 대한정형도수물리치료학회지
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• 제2권1호
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• pp.39-49
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• 1996

The techniques of joint mobilization and traction are used to improve joint mobility or to decrease pain by restoring accessory movements to the shoulder joints and thus allowing full, nonrestriced, pain-free range of motion. In the glenohumeral joint, the humeral head would be the convex surface, while the glenoid fossa would be the concave surface. The medial end of the clavicle is concave anterioposteriorly and convex superioinferiorly, the articular surface of the sternum is reciprocally curved. The acromioclavicular joint is a plane synovial joint between a small convex facet on lateral end of the clavicle and a small concave facet on the acromion of the scapula. The relationship between the shape of articulating joint surface and the direction of gliding is defined by the convex-concave rule. If the concave joint surface is moving on a stationary convex surface, gliding occur in the same direction as the rolling motion. If the convex surface is moving on a stationary concave surface, gliding will occur in an opposite direction to rolling. Hypomobile shoulder joint are treated be using a gliding technique.