• Anatomy and Cell Biology
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• v.56 no.3
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• pp.322-327
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• 2023

The aim of this study was to elucidate the intramuscular arborization of the teres minor muslce for effective botulinum neurotoxin injection. Twelve specimens from 6 adult Korean cadavers (3 males and 3 females, age ranging from 66 to 78 years) were used in the study. The reference line between the 2/3 point of the axillary border of the scapula (0/5), where the muscle originates ant the insertion point of the greater tubercle of the humerus (5/5). The most intramuscular neural distribution was located on 1/5-3/5 of the muscle. The tendinous portion was observed in the 3/5-5/5. The result suggests the botulinum neurotoxin should be delivered in the 1/5-3/5 area of the teres minor muscle.

• The Journal of Korean Physical Therapy
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• v.30 no.4
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• pp.117-122
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• 2018

Purpose: The objective of this study was to examine the effect of vibration exercises generated from an $XCO^{(R)}$ trainer on supraspinatus, infraspinatus, teres minor, and deltoid muscle thickness. Methods: Thirty subjects were evenly divided into two groups. Muscle thickness was measured by a sonogram prior to the study, and at three and six weeks after the intervention. Changes in muscle thickness were analyzed using a repeated measure analysis of variance (ANOVA). The significance level for the statistical test was set at ${\alpha}=0.05$. Results: A statistically significant differences in timing, interactions between timing and the groups, and between-group changes were demonstrated for supraspinatus muscle thickness (p<0.05). A similar finding was reported for infraspinatus, teres minor, and deltoid muscles with regard to the interactions between timing and the groups (p<0.05), although the between-group change did not reach statistical significance (p>0.05). Conclusion: Significant changes were observed in the thickness of the supraspinatus, infraspinatus, teres minor, and deltoid muscles, owing to the use of vibration exercises generated from an $XCO^{(R)}$ trainer. These findings can be used as a foundation for future studies on rehabilitation training.

• Clinics in Shoulder and Elbow
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• v.18 no.3
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• pp.138-143
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• 2015

Background: To evaluate the effect of preoperative fatty degeneration of deltoid and teres minor muscles on the clinical outcome in patient with reverse total shoulder arthroplasty (RTSA). Methods: Nineteen patients with RTSA were enrolled. The mean follow-up period was 16.1 months. The fatty degeneration of three distinct parts in each deltoid and the teres minor muscle was measured using a preoperative magnetic resonance imaging. Postoperatively, the muscle strengths for forward elevation (FE), abduction (Abd), and external rotation (ER) were measured using a myometer at the last follow-up. The parameters for clinical outcome were Constant Score (CS) and Korean Shoulder Score (KSS). Results: The number of cases was 10 in group 1 and 9 in group 2. The strength of FE and Abd were significantly higher in group 1 (p<0.001 and p<0.001, respectively), and the strength of ER was not different significantly between two groups (p=0.065). For the clinical outcome, both CS and KSS were higher in group 1 (p=0.002 and p=0.002, respectively). The number of patients in group A was 11, and group B was 8. Although there was not a significant difference in terms of FE and Abd between group A and B (p=0.091, p=0.238), ER was significantly higher in group A (p=0.012). We did not find a significant difference in the clinical scores (CS, p=0.177 and KSS, p=0.238). Conclusions: These findings suggest the importance of a preoperative evaluation of the fatty degeneration of deltoid and teres minor muscles for predicting postoperative strength and clinical outcome.

• Investigative Magnetic Resonance Imaging
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• v.25 no.1
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• pp.1-9
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• 2021

The aim of this study was to provide a new assessment of rotator cuff muscle activity. Eight male subjects (24.7 ± 3.2 years old,171.2 ± 9.8 cm tall, and weighing 63.8 ± 11.9 kg) performed the study exercises. The subjects performed 10 sets of the exercise while fixing the elbow at 90 degrees flexure and lying supine on a bed. One exercise set consisted of the subject performing external shoulder rotation 50 times using training equipment. Two imaging protocols were employed: (a) true fast imaging with steady precession (TrueFISP) at an acquisition time of 12 seconds and (b) multi-shot spin-echo echo-planar imaging (MSSE-EPI) at an acquisition time of 30 seconds for one echo. The main method of assessing rotator cuff muscle activity was functional T2 mapping using ultrafast imaging (fast-acquired muscle functional MRI [fast-mfMRI]). Fast-mfMRI enabled real-time imaging for the identification and evaluation of the degree of muscle activity induced by the exercise. Regions of interest were set at several places in the musculus subscapularis (sub), musculus supraspinatus (sup), musculus teres minor (ter), and deltoid muscle (del). We used the MR signal of the images and transverse relaxation time (T2) for comparison. Most of the TrueFISP signal was not changed by exercise and there was no significant difference from the resting values. Only the T2 in the musculus teres minor was increased after one set and the change were seen on the T2 images. Additionally, except for those after one and two sets, the changes in T2 were significant compared to those at rest (P < 0.01). We also demonstrated identify and visualize the extent to which muscles involved in muscle activity by exercise. In addition, we showed that muscle activity in a region such as a shoulder, which is susceptible to B0 inhomogeneity, could be easily detected using this technique.

• Clinics in Shoulder and Elbow
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• v.19 no.4
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• pp.241-244
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• 2016

Calcific tendinitis of the shoulder joint is common disease causing acute pain, mainly involving the supraspinatus or infraspinatus muscle, and less frequently the teres minor or subscapularis muscle. This study reports on the satisfactory arthroscopic removal of calcium deposits as well as infraspinatus and supraspinatus muscle repair without relapse via minimal incision using suture anchors. This was a case of atypically extensive calcific tendinitis involving the infraspinatus muscle, with a bursal side partial rupture of the supraspinatus muscle in a 61-year-old female whose chief complaint was chronic pain of the right shoulder exacerbated by limited movement.

• The Korean Journal of Pain
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• v.4 no.2
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• pp.168-178
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• 1991

It has been generally known that shoulder pains are attributed to the degenerative changes around the shoulder joint. However, many patients who complain of pain or limited range of motion of the shoulder have no definite pathology on X-ray or laboratory examinations. I examined 134 patients with shoulder pain and found the fact that compression of the axillary nerve, which leads to contraction of the deltold muscle or teres minor muscle, resulted in pain and limited range of motion in many cases. Accordingly, relieving the compression of the axillary nerve by laser stimulation or local anesthetic infiltration on the identified trigger point, anti-inflammatory medication, muscle relaxant together with ordinary physical therapy was found to be very effective in the treatment of shoulder pain.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.13 no.1
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• pp.67-72
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• 2007

Anatomy: The rotator cuff comprises four muscles-the subscapularis, the supraspinatus, the infraspinatus and the teres minor-and their musculotendinous attachments. The subscapularis muscle is innervated by the subscapular nerve and originates on the scapula. It inserts on the lesser tuberosity of the humerus. The supraspinatus and infraspinatus are both innervated by the suprascapular nerve, originate in the scapula and insert on the greater tuberosity. The teres minor is innervated by the axillary nerve, originates on the scapula and inserts on the greater tuberosity. The subacromial space lies underneath the acromion, the coracoid process, the acromioclavicular joint and the coracoacromial ligament. A bursa in the subacromial space provides lubrication for the rotator cuff. Etiology: The space between the undersurface of the acromion and the superior aspect of the humeral head is called the impingement interval. This space is normally narrow and is maximally narrow when the arm is abducted. Any condition that further narrows this space can cause impingement. Impingement can result from extrinsic compression or from loss of competency of the rotator cuff. Syndrome: Neer divided impingement syndrome into three stages. Stage I involves edema and/or hemorrhage. This stage generally occurs in patients less than 25 years of age and is frequently associated with an overuse injury. Generally, at this stage the syndrome is reversible. Stage II is more advanced and tends to occur in patients 25 to 40 years of age. The pathologic changes that are now evident show fibrosis as well as irreversible tendon changes. Stage III generally occurs in patients over 50 years of age and frequently involves a tendon rupture or tear. Stage III is largely a process of attrition and the culmination of fibrosis and tendinosis that have been present for many years. Treatment: In patients with stage I impingement, conservative treatment is often sufficient. Conservative treatment involves resting and stopping the offending activity. It may also involve prolonged physical therapy. Sport and job modifications may be beneficial. Nonsteroidal anti - inflammatory drugs(NSAIDS) and ice treatments can relieve pain. Ice packs applied for 20 minutes three times a day may help. A sling is never used, because adhesive capsulitis can result from immobilization.

• The Journal of Korean Medicine
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• v.36 no.4
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• pp.1-7
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• 2015

Objectives: The aim of this study was to observe the effect of Embedding therapy on frozen shoulder. Methods: 57 patients with frozen shoulder were treated with Embedding therapy. It was performed once a day, once per a week. 15~20 Embedding thread were used in one time Embedding therapy. The total number of Embedding therapy was 10. Trapezius muscle including the Gyeonjeong ($GB_{21}$), Deltoid muscle including the Nosu ($SI_{10}$), Supraspinatus muscle including the Byeongpung ($SI_{12}$), Infraspinatus muscle including the Cheonjong ($SI_{11}$) and gokwon($SI_{13}$), Lavator scapular muscle including the Gyeonjunsu ($SI_{15}$), Rhomboides major muscle including the Pungmun ($BL_{12}$), Rhomboides minor muscle including the Daejeo ($BL_{11}$) and Teres major muscle including the Gyeonjeong ($SI_{19}$). VAS scale, SPADI scale and ROM were compared between before and after treatment to evaluate the effect of Embedding therapy. Results: VAS scale decreased significantly (p=0.003). SPADI Scale decreased significantly (pain (p=0.006), disability(p=0.005)). ROM angle range increased significantly(flexion (p=0.005), extension(p=0.005), abduction(p=0.003), adduction(p=0.003), external rotation (p=0.005), internalrotation(p=0.005)). 29.8% patients were very much satisfied, 62.0% patients were satisfied and 8.0% patients were answered so so about Embedding therapy. Conclusion: The Embedding therapy could be effective to improve symptoms of frozen shoulder.

• Biomaterials and Biomechanics in Bioengineering
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• v.3 no.2
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• pp.115-127
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• 2016

Shoulder pain, injury and discomfort are public health and economic issues world-wide. The function of these joints and the stresses developed during their movement is a major concern to the orthopedic surgeon to study precisely the injury mechanisms and thereby analyze the post-operative progress of the injury. Shoulder is one of the most critical joints in the human anatomy with maximum degrees of freedom. It mainly consists of the clavicle, scapula and humerus; the articulations linking them; and the muscles that move them. In order to understand the behavior of individual muscle during abduction arm movement, an attempt has been made to analyze the stresses developed in the shoulder muscles during abduction arm movement during the full range of motion by using the 3D FEM model. 3D scanning (ATOS III scanner) is used for the 3D shoulder joint cad model generation in CATIA V5. Muscles are added and then exported to the ANSYS APDL solver for stress analysis. Sensitivity Analysis is done for stress and strain behavior amongst different shoulder muscles; deltoid, supraspinatus, teres minor, infraspinatus, and subscapularies during adduction arm movement. During the individual deltoid muscle analysis, the von Mises stresses induced in deltoid muscle was maximum (4.2175 MPa) and in group muscle analysis it was (2.4127MPa) compared to other individual four rotor cuff muscles. The study confirmed that deltoid muscle is more sensitive muscle for the abduction arm movement during individual and group muscle analysis. The present work provides in depth information to the researchers and orthopedicians for the better understanding about the shoulder mechanism and the most stressed muscle during the abduction arm movement at different ROM. So during rehabilitation, the orthopedicians should focus on strengthening the deltoid muscles at earliest.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.74-74
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• 2009

The purpose of this study was to estimate force of muscles that constituted the rotator cuff during elevation motion in scapula plane, using a skeletal muscle model and quantitatively evaluate rotator cuff function in vivo. A healthy volunteer was measured with an open MR and CT system at elevation positions in scapula plane (MR: $30^{\circ}$, $60^{\circ}$, $90^{\circ}$, $120^{\circ}$, $150^{\circ}$, CT: $0^{\circ}$). After reconstruction three-dimensional MRI-based and CT-based bone surface models, matched each models with registration technique. Then supraspinatus, infraspinatus, subscapularis, teres minor, deltoid (anterior, middle, posterior portions) represented as plural lines. These lines were proportional to physiologic cross-sectional area (PCSA) and defined straight line to bind origin and insertion. Force of supraspinatus became greatest at $59^{\circ}$ of elevation. Subsequently force of deltoid middle portion became greatest at $89^{\circ}$ of elevation. Infraspinatus and subscapularis were active at the meantime. In addition, supraspinatus was active during elevation. These results resembled clinical finding and were proved force couples that contribute to mobility and stability of shoulder complex.