• Clinics in Shoulder and Elbow
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• 제5권2호
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• pp.88-97
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• 2002

The purpose of this study was to compare the outcomes between arthroscopir repair and mini-open repair of medium and large rotator cuff tears in which arthroscopic repair was technically unsuccessful. We evaluated 76 patients of full-thickness rotator cuff tears, among them 42 patients had all-arthroscopic and 34 patients had mini-open salvage repairs. Patients who had acromioclavicular arthritis, subscapularis tear, or instability were excluded. There were 39 males and 37 females with mean age of 56 years (range,42 to 75 years). At a mean follow-up of 39 months (range, 24 to 64 months), the results of both groups were compared with regard to the UCLA and ASES shoulder rating scale s. Shoulder scores improved in all ratings in both groups (p > 0.05). Overall, sixty-six patients showed excellent or gr)of and ten patients showed fair or poor scores by the UCLA scale. Seventy-two patients satisfactorily returned to prior activity. Four showed unsatisfactory return. The range of motion, strength, and patient's satisfaction were improved postoperatively. There were no difference in shoulder scores, pain, and activity return between the arthroscopic and mini-open salvage groups (p > 0.05). However, Patients with larger size tear showed lower shoulder scores and less predictive recovery of the strength and function (p < 0.05). Postoperative pain was not different with respect to the size of the tear (p : 0.251). Arthroscopic repair of medium and large full-thickness rotator cuff tears had iln equal outcome to technically unsuccessful arthroscopic repairs, which were salvaged by conversion to a mini- open repair technique. Surgical outcome depended on the size of the tear, rather than the method of repair.

• Clinics in Shoulder and Elbow
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• 제11권2호
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• pp.131-136
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• 2008

목적: Parsonage-Turner syndrome은 어깨나 어깨 주위에 급작스럽게 발생하는 심한 동통과 연이어 나타나는 견관절 부위 근육 마비 증상을 주소로 하는 드문 질환이다. 이에 저자들이 경험한 환자군의 임상양상을 문헌 고찰과 함께 보고하고자 한다. 대상 및 방법: 2005년 12월부터 2008년 7월까지 Parsonage-Tuner syndrome으로 진단된 6명을 대상으로 의무 기록과 전화 설문을 통하여 자료를 수집하였다. 남자가 5명, 여자가 1명 이었다. 평균 나이는 43.3세(범위, 20~68세)였으며, 평균 추시 기간은 19.1개월(범위, 14~27개월)이었다. 결과: 견갑부의 극심한 통증은 발병 후 1일에서 3주간 지속되었고, 그 후 점차 감소하여 평균 3.3주(범위, 2~5주)이내 최소화 되었다. 통증 발생 후 평균 4주(범위, 2~7주)에 이환된 근육에 점진적인 근력 감소가 나타났으며, 추적 기간 동안 1명의 환자는 예전의 근력을 완전히 회복 하였고, 5명은 점차 회복 중이었다. 근전도 검사가 감별 진단에 가장 도움이 되었다. 결론: Parsonage-Turner syndrome은 비교적 양호한 예후를 갖는 질환으로, 이에 대한 숙지는 이 질환을 진단 및 치료하는데 도움이 될 것으로 생각한다.

• 한국철도학회:학술대회논문집
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• 한국철도학회 2009년도 춘계학술대회 논문집
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• pp.1613-1617
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• 2009

As demand regarding a recent energy-saving rises, the using ratio of the aluminum plate in manufacturing of a railroad vehicle has been increasing. The aluminum structure to be applied to a railroad vehicle is divided to single skin and double skin, and the main aluminum product is mainly Al 6005 extrude and Al 5083 rolled in domestic market. The Al 6005 alloy is applied heat treatment in order to improve the strength of material. Therefore there is the disadvantage that the strength of welding zone decreases compare with base material's if you apply to fusion welding like MIG(metal inert gas) welding. In this paper we tried to apply friction stir welding to solve these problems. In this study we investigated how tensile strength and fatigue strength were changed in case of changing the shoulder diameter of thread tool.

• 대한치과보철학회지
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• 제41권4호
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• pp.405-420
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• 2003

Purpose : The purpose of this study was to compare the fracture resistance of the IPS Empress ceramic crown with 1.0mm width rounded shoulder, which is usually recommended in all ceramic crown. and 0.5mm width chamfer finish lines on the maxillary central incisor. Material and method : After 15 metal dies were made for each group, the IPS Empress all ceramic crowns were fabricated and cemented with resin cement(Bistite resin cement, Tokuyama Soda Co. LTD., Japan) on the metal die. The cemented crowns were mounted on the positioning jig and the universal testing machine(Zwick Z020, Zwick Co. Germany)was used to measure the fracture strength with loading on the incisal edge. And also, three-dimensional finite element stress analysis was used to measure the stress distribution with the various types of the finish lines(1.0mm width rounded shoulder, 0.5mm width chamfer), the loading site(incisal edge, incisal $\frac{1}{3}$) and the type of loading(concentration loading, distribution loading). Results and conclusion : 1. In the fracture resistance experiment according to the finish line, the mean fracture strength of rounded shoulder(876N) and the mean fracture strength of chamfer(882N) did not skew any significant difference between each other(p>0.05). 2. The stress distribution of all ceramic crown in three dimensional finite element analysis showed concentration aspect at loading point and cervical area or labial surface. 3. In metal die, there were no differences in stress distribution between finish lines, but in natural teeth model, chamfer finish line showed higher stress than rounded shoulder finish line. 4. When force was loaded on the incisal edge the stress was concentrated on the incisal edge and the cervical area of labial surface. When force was loaded on the incisal $\frac{1}{3}$, the stress concentrated on the cervical area of labial surface and the cingulum area. 5. Generally, natural teeth model showed higher and various stress than the metal die.

• Clinics in Shoulder and Elbow
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• 제12권2호
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• pp.189-198
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• 2009

목적: 관절와 골 결손을 동반한 견관절 전방 불안정증에 대해 시행한 Latarjet 술식의 임상적 결과를 분석하고자 하였다. 대상 및 방법: 2006년 10월부터 2007년 5월까지 관절와의 현저한 골 결손을 동반한 재발성 전방 불안정증으로 Latarjet 술식을 시행 받은 14예를 대상으로 하였다. 추시 기간은 평균 15개월 (12~19개월), 평균 연령은 29.9세 (19~44세)였고, 남자가 13예였다. 우측이 8예, 좌측이 6예였으며, 우세수가 8예, 비우세수가 6예였다. 6예는 이전에 관절경적 뱅카르트 봉합술을 받은 후 재발하여 Latarjet 술식을 시행한 경우였다. 2예는 간질로 치료받는 환자였다. 결과: Rowe 점수는 수술 전 평균 51.8점에서 수술 후 평균 80.2점으로 향상되었고, 최우수 9예, 우수 4예, 양호 1예였다. Korean shoulder score for instability도 수술 전 평균 61.6점에서 수술 후 평균 82.1점으로 향상되었다. 능동적 전방 거상과 중립위 외회전 운동 범위는 수술후 건측과 비교하여 각각 8도와 16도 감소되었다. 전방 거상력과 중립위 외회전력은 수술 후 건측의 근력에 대해 각각 78.7%와 82.5%였다. 1예에서 간질 발작으로 재탈구가 발생하였고, 1예에서 일시적으로 한차례 아탈구가 있었다. 섬유성 골 유합이 2예, 전이된 오구 돌기의 흡수가 1예, 수술 중 나사에 의한 골 파괴가 1예, 수술 후 일시적 근피 신경 손상이 1예, 수술 후 견관절 강직이 1예 있었다. 결론: Latarjet 술식은 현저한 전방 관절와 골 결손을 동반한 견관절 전방 불안정증에서 수술 후 외회전 운동 범위의 감소를 유발할 수 있으나 관절 호의 길이를 연장시켜 견관절의 기능과 안정을 회복하는데 효과적인 방법이다. 오구 돌기 전이와 관련된 합병증이 많이 발생할 수 있어 이에 대한 주의가 요한다.

• 한국전문물리치료학회지
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• 제27권2호
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• pp.140-148
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• 2020

Background: Scapular winging (SW) could be caused by tightness or weakness of the periscapular muscles. Although data mining techniques are useful in classifying or predicting risk of musculoskeletal disorder, predictive models for risk of musculoskeletal disorder using the results of clinical test or quantitative data are scarce. Objects: This study aimed to (1) investigate the difference between young women with and without SW, (2) establish a predictive model for presence of SW, and (3) determine the cutoff value of each variable for predicting the risk of SW using the decision tree method. Methods: Fifty young female subjects participated in this study. To classify the presence of SW as the outcome variable, scapular protractor strength, elbow flexor strength, shoulder internal rotation, and whether the scapula is in the dominant or nondominant side were determined. Results: The classification tree selected scapular protractor strength, shoulder internal rotation range of motion, and whether the scapula is in the dominant or nondominant side as predictor variables. The classification tree model correctly classified 78.79% (p = 0.02) of the training data set. The accuracy obtained by the classification tree on the test data set was 82.35% (p = 0.04). Conclusion: The classification tree showed acceptable accuracy (82.35%) and high specificity (95.65%) but low sensitivity (54.55%). Based on the predictive model in this study, we suggested that 20% of body weight in scapular protractor strength is a meaningful cutoff value for presence of SW.

• 대한인간공학회지
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• 제25권2호
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• pp.11-22
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• 2006

The muscular-skeletal disorders(MSDs) that have become a major issue recently in Korean industrial safety area are mainly caused by manual material handling task. The objective of this study is to provide scientific data for the establishment of work safety standard for Korean workers through the experiments of lifting task under various conditions, in order to prevent the muscular-skeletal disorders in the industrial work site. Eight male college students were recruited as participants. Three different lifting frequencies(1, 3, 5 lifts/min) and three twisting angles(including the sagittal plane and two asymmetric angles; i.e., 0°, 45°, 90°) for symmetric and asymmetric tasks, respectively, with three lifting range from floor to knuckle height, knuckle to shoulder, floor to shoulder height for one hour's work shift using free style lifting technique were studied. The maximum acceptable weight of load(MAWL) was determined under the different task conditions, and the oxygen consumption, heart rate, and RPE were measured or recorded while subjects were lifting their MAWLs. The results showed that: (1) The MAWLs were significantly decreased as the task frequency and task angle increased.; (2) The heart rate, oxygen consumption, RPE significantly increased with an increase in lifting frequency although maximum acceptable weight of lift decreased.; (3) The highest heart rate and oxygen consumption was recorded at the lifting range of floor to shoulder, followed by floor to knuckle and knuckle to shoulder.; (4) The RPE value showed that subjects perceived more exertion at the high frequency rate of lifting task and lifting range of floor to shoulder height. (5) The modeling for MAWL using isometric strength, task angle and lifting frequency were developed. It is expected that use of the results provided in this study may prove helpful in reducing MMH hazards, especially from lifting tasks for Korean, and can be used as a basis for pre-employment screening.

• 한국전문물리치료학회지
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• 제7권2호
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• pp.88-95
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• 2000

Thirty normal adults were tested to measure the electrical activity of the anterior (AD), middle (MD), and posterior portion (PD) of the deltoid muscle and sternal portion of the pectoralis major muscle (PM) during the performance of four upper extremity PNF diagonal patterns with elbow flexion angle in $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$. The PNF patterns in which these muscles function optimally have been theoretically advanced by Kabat and further described by Knott and Voss. They theorize that the MD should be most active with shoulder flexion, abduction, and external rotation (D2F); the PD with shoulder extension, abduction, and internal rotation (D1E); the AD with shoulder flexion, adduction, and external rotation (D1F); and the PM with shoulder extension, adduction and internal rotation (D2E). The patterns were performed through range of motion, with an isometric contraction performed in the shortened range. When the EMG activity of AD, MD, PD and PM in its optimal patterns was measured, it does not have significant difference among fixed elbow flexion angle $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$ (p>.05). In addition, suggestions were made for study of patients who exhibit imbalance of muscle strength and have muscle weakness.

• The Journal of Korean Physical Therapy
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• 제30권3호
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• pp.84-89
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• 2018

Purpose: Therapeutic climbing has become very popular today, with it being reported as a new method for preventing and treating orthopedic trauma to the shoulder joint. However, objective studies on its effects on the musculoskeletal system are still lacking. The objective of the present study was to investigate the effects of wall inclination during therapeutic climbing on the muscle activity around the shoulder joint. Methods: In this study, the participants performed movements at three different inclination angles of $0^{\circ}$, $+15^{\circ}$, and $-15^{\circ}$. sEMG was performed to measure the activities of five different muscles around the shoulder joint (biceps brachii, serratus anterior, upper trapezius, middle trapezius, and lower trapezius muscles). Results: Biceps brachii muscle showed a significant increase at $-15^{\circ}$, as compared to $0^{\circ}$ (p<0.01), and the serratus anterior also showed a significant increase at $-15^{\circ}$, as compared to $0^{\circ}$ (p<0.05). Moreover, the middle and lower trapezius muscles also showed a significant increase at $-15^{\circ}$, as compared to $0^{\circ}$ (p<0.001). Compared to $0^{\circ}$, all muscles showed decreased values at $15^{\circ}$, but the differences were not statistically significant (p>0.05). Conclusion: Therapeutic climbing may be a new therapeutic approach that can increase muscle strength and coordination in the sensory nervous system, since it can be used as a tool that promotes active movement by altering wall inclination and causing the user to generate movements according to the existing situation.

• The Journal of Korean Physical Therapy
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• 제23권6호
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• pp.1-7
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• 2011

Purpose: The purpose of this study was to investigate the effect of movement training based on motor control theory on pain and average power of muscles in patients with shoulder impingement syndrome and to develop more effective training methods. Methods: We studied 35 patients with shoulder impingement syndrome. Patients were randomly assigned to an experimental group or a control group according to the intervention. The therapeutic modalities such as superficial heat, deep heat, and electronic stimulus, and motor control training with strengthening exercises were applied to the experimental group and therapeutic modalities only were applied to the control group. All interventions were done 3 times a week for 4 weeks. Before the intervention and again after the 4 weeks, we measured pain utilizing a visual analog scale. We measured average power using isokinetic equipment. Results: After application of the intervention, pain significantly decreased in both the experimental group and the control group. There was a significant difference between the extent of the decrease between experimental and control groups. After the intervention, the average power between the two groups were significant at an angle of $60^{\circ}$/sec and $180^{\circ}$/sec for external rotator and internal rotator muscles. They also showed significant improvement in all variables post-intervention compared to pre-intervention. Conclusion: This study indicates that there is an effect in giving appropriate motor control training to patients with shoulder impingement syndrome. It is assumed that there will be a need for more surveys on various variables for motor control training from now on.