• Korean Journal of Applied Biomechanics
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• v.15 no.4
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• pp.105-115
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• 2005

Recently among several tennis techniques forehand stroke has been greatly changed in the aspect of spin, grip and stance. The most fundamental factor among the three factors is the stance which consists of open, square and closed stance. The purpose of this study was to investigate the relations between the segments of the body, the three dimensional anatomical angle according to open, close, and square stance patterns during forehand stroke in tennis. For the movement analysis three dimensional cinematographical method(APAS) was used and for the calculation of the kinematic variables a self developed program was used with the LabVIEW 6.1 graphical programming(Johnson, 1999) program. By using Eular's equations the three dimensional anatomical Cardan angles of the joint and racket head angle were defined. In conclusion, the first hypothesis, "In three dimensional maximum linear velocity of racket head would be significant difference among the stance patterns during forehand stroke in tennis" was rejected. The second hypothesis, "In three dimensional anatomical angular displacement of trunk would be significant difference among the stance patterns during forehand stroke in tennis" was rejected and the result showed that the internal-external rotation showed most important role among the three dimensional anatomical angular displacement of trunk The third hypothesis, "In three dimensional anatomical angular displacement of upperlimb would be significant difference among the stance patterns during forehand stroke in tennis" was rejected and the result showed that The three dimensional anatomical angular displacement of shoulder joint showed most important role in forehand stroke. Flexion-extension and internal-external rotation the open stance showed the largest angular displacement and is follwed by square stance and closed stance. The fourth hypothesis, "In three dimensional anatomical angular velocity of upperlimb would be significant difference among the stance patterns during forehand stroke in tennis" was rejected and the result showed that X-axis angular velocity and Z-axis angular velocity the square stance showed the largest angular velocity of the trunk and X-axis angular velocity and Y-axis angular velocity the closed stance showed the largest angular velocity of the shoulder joint.

• Physical Therapy Korea
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• v.27 no.1
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• pp.19-29
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• 2020

Background: Stretch-oriented home exercise programs are often used as treatments for patients with adhesive capsulitis; however, there is lack of research on home exercise programs to strengthen rotator cuffs. Objects: The aim of this study is to investigate the effect of home exercise programs for rotator cuff strengthening on pain, range of motion (ROM), disability level, and quality of life in patients with adhesive capsulitis. Methods: Twenty-two patients with adhesive capsulitis volunteered to participate in this study. The subjects were randomly divided into an experimental group (n = 11) and control group (n = 11). For the experimental group, manual therapy and home exercise programs for rotator cuff strengthening were applied for 6 weeks; for the control group, only manual therapy was applied for 6 weeks. Shoulder pain (quadruple visual analogue scale, QVAS), ROM, disability (shoulder pain and disability index-Korean version, SPADI), and quality of life (world health organization quality of life scale-Korean version, WHOQOL-BREF) were evaluated at baseline, after 3 weeks, and after 6 weeks of intervention. The changes in the measurement variables were analyzed by using repeated measure analysis of variance. Results: Significant differences were observed between the experimental group and control group in the QVAS; SPADI-pain scores; SPADI-disability scores; SPADI-total scores; flexion, abduction, internal and external rotation ROM of the glenohumeral joint; and WHOQOL-BREF total, overall, physical health, and psychological scores. All groups displayed statistically significant improvements as observed in the QVAS, SPADI, flexion, abduction, external and internal rotation ROM of the glenohumeral joint, and WHOQOL-BREF. Conclusion: Home exercise programs for rotator cuff strengthening had a positive impact on shoulder pain, shoulder ROM, disability level, and quality of life in patients with adhesive capsulitis. Therefore, we propose the use of home exercise programs for rotator cuff strengthening in the exercise rehabilitation of patients with adhesive capsulitis.

• Journal of the Ergonomics Society of Korea
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• v.28 no.3
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• pp.125-134
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• 2009

The muscle strengths in various postures are used in our daily life with or without our recognition. Also, many works are still performed with strengths, although mechanization and automation have been fairly accomplished at the industry site. Since the late seventies, various body measurements have been conducted periodically in Korea, however, muscle strengths have not been measured actively. For this reason, the muscle strength data have been hardly accumulated. The aims of this study are to learn more about the physical strength of young-aged Koreans and to provide basic information for designing equipments, tools and facilities in the work site and daily life. The muscle strengths that are related to shoulder and upper limbs joints, which are used frequently, are measured in this study. Eighteen muscle strengths, from seven different movements such as elbow flexion, elbow extension, shoulder abduction(seated), shoulder adduction(seated), shoulder rotation(internal and external), lifting a tray, and turning a key(inward and outward) were measured. For every movement, the muscle strengths for both hands were measured. In each measurement, five seconds averaged value and peak value were collected. Comparing the average value, the strength of shoulder adduction was the strongest for male and female, while strength of turning a key inward with left hand was the weakest for male and female. Strengths of preferred hand in elbow extension, shoulder abduction, shoulder external rotation, lifting a tray, and turning a key were stronger than those of non-preferred hand for both male and female. Rohrer's index considerably had an effect on muscle strength. The results of this study can provide some basic information not only in designing the equipment and facilities in work site or daily life, but also in selection, training and management of workers.

• Korean Journal of Applied Biomechanics
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• v.23 no.2
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• pp.109-116
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• 2013

The purpose of this study was to provide fundamental information for the enhancement of performance through kinematic analysis of cornering according to the radius of curve course in short track speed skating. To perform this study, six skaters: three narrow radius players(N, body mass: $56.0{\pm}7.2$ kg, height: $163.7{\pm}5.1$ cm, age: $21.3{\pm}1.5$ yrs) and three wide radius players(W, body mass: $61.0{\pm}9.5$ kg, height: $169.0{\pm}4.4$ cm, age: $20.0{\pm}1.7$ yrs). Three-dimensional motion analysis was performed on the section from the forth block starting to show the change of radius to the sixth block using eight infrared cameras(sampling frequency of 100 Hz for N and W players). The time of push-off was greater for N than for W(p<.05) while the radius of center of mass was greater for W than for N(p<.05). The flexion and extension of knee and hip joint were greater for N than for W(p<.05). The external rotation of left knee joint was greater for N than for W(p<.05). Based on the findings, a small radius by increasing the range of the flexion and extension of knee and hip joint with greater external rotation of left knee joint would be related to more efficient run at curve. It is expected that these results will be useful in developing a training program for enhancing performance of short track speed skating athletes.

• Korean Journal of Applied Biomechanics
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• v.28 no.2
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• pp.143-149
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• 2018

Objective: This study aimed to investigate the influence of landing foot orientations on biomechanics of knee joint in order to identify vulnerable positions to non-contact knee injuries during single-legged landing. Method: Seventeen men (age: $20.5{\pm}1.1 years$, height: $175.2{\pm}6.4cm$, weight: $68.8{\pm}5.8kg$) performed single-leg drop landings repeatedly with three different landing foot orientations. They were defined as toe-in (TI) $30^{\circ}$ adduction, neutral (N, neutral), and toe-out (TO) $30^{\circ}$ abduction positions. Results: The downward phase time of TI was significantly shorter than those of N and TO. The flexion and valgus angle of N was greater than those of TI and TO at the moment of foot contact. At the instance of maximum knee flexion, N showed the largest flexion angle, and TO position had the largest varus and external rotation angles. Regarding ground reaction force (GRF) at the moment of foot contact, TO showed the forward GRF, while others showed the backward GRF. TI indicated significantly larger mediolateral GRF than others. As for the maximum knee joint force and joint moment, the main effect of different foot positions was not significant. Conclusion: TI and TO might be vulnerable positions to knee injuries because both conditions might induce combined loadings to knee joint. TI had the highest mediolateral GRF with a shortest foot contact time, and TO had induced a large external rotation angle during downward phase and the peak forward GRF at the moment of foot contact. Conclusively, N is the preferred landing foot orientation to prevent non-contact knee injuries.

• Korean Journal of Applied Biomechanics
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• v.31 no.3
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• pp.155-161
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• 2021

Objective: There is a lack of studies using the 3D-2D image registration techniques on the mechanism of a shoulder injury for ice hockey players. This study aimed to analyze in vivo 3D glenohumeral joint arthrokinematics in collegiate ice hockey athletes and compare shoulder scaption with or without a hockey stick using the 3D-2D image registration technique. Method: We recruited 12 male elite ice hockey players (age, 19.88 ± 0.65 years). For arthrokinematic analysis of the common shoulder abduction movements of the injury pathogenesis of ice hockey players, participants abducted their dominant arm along the scapular plane and then grabbed a stick using the same motion under C-arm fluoroscopy with 16 frames per second. Computed tomography (CT) scans of the shoulder complex were obtained with a 0.6-mm slice pitch. Data from the humerus translation distances, scapula upward rotation, anterior-posterior tilt, internal to external rotation angles, and scapulohumeral rhythm (SHR) ratio on glenohumeral (GH) joint kinematics were outputted using a MATLAB customized code. Results: The humeral translation in the stick hand compared to the bare hand moved more anterior and more superior until the abduction angle reached 40°. When the GH joint in the stick hand was at the maximal abduction of the scapula, the scapula was externally rotated 2~5° relative to 0°. The SHR ratio relative to the abduction along the scapular plane at 40° indicated a statistically significant difference between the two groups (p < 0.05). Conclusion: With arm loading with the stick, the humeral and scapular kinematics showed a significant correlation in the initial section of the SHR. Although these correlations might be difficult in clinical settings, ice hockey athletes can lead to the movement difference of the scapulohumeral joints with inherent instability.

• Archives of Plastic Surgery
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• v.51 no.1
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• pp.52-61
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• 2024

Background Although prepectoral implant-based breast reconstruction has recently gained popularity, dual-plane reconstruction is still a better option for patients with poor-quality mastectomy skin flaps. However, shoulder morbidity is aggravated by subpectoral reconstruction, especially in irradiated patients. This study aimed to demonstrate shoulder exercise improvement in subpectoral reconstruction by delayed prepectoral conversion with an acellular dermal matrix (ADM) inlay graft technique at the time of expander-to-implant exchange after irradiation. Methods Patients with breast cancer treated for expander-to-implant exchange after subpectoral expander insertion and subsequent radiotherapy between January 2021 and June 2022 were enrolled. An ADM inlay graft was inserted between the pectoralis major muscle and the previously inserted ADM. The ADM was sutured partially overlapping the pectoralis muscle from the medial side with the transition part, to the muscle border at the lateral side. Perioperative shoulder joint active range-of-motion (ROM) for forward flexion, abduction, and external rotation was also evaluated. Results A total of 35 patients were enrolled in the study. Active shoulder ROM significantly improved from 163 degrees preoperatively to 176 degrees postoperatively in forward flexion, 153 to 175 degrees in abduction, and 69 to 84 degrees in external rotation. There was no difference in patient satisfaction regarding the final outcome between the conventional prepectoral reconstruction group and the study group. Conclusion Shoulder exercises in irradiated patients who underwent subpectoral reconstruction were improved by delayed prepectoral conversion using an ADM inlay graft. It is recommended that subpectoral reconstruction not be ruled out due to concerns regarding muscle contracture and shoulder morbidity in radiation-planned patients with poor mastectomy skin flaps.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.1
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• pp.9-14
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• 2012

Purpose: The purpose of the study was to evaluate the accuracy and clinical outcome of ultrasound-guided glenohumeral joint steroid injection on adhesive capsulitis. Materials and Methods: Patients who were diagnosed as adhesive capsulitis by MRI and physical examination and did not improve their symptom with physical therapy and NSAIDS treatment more than 6 months were included in the study. Patients who showed any other shoulder pathology or history if trauma were excluded from the study. 33 patients including 15 males and 18 females were enrolled in the study, the average age being 55.1 (age 42~72). Cocktail of steroid, lidocaine, saline and contrast medium injected inside shoulder glenohumeral joint using novel approach (which we called acromioclavicular approach) under ultrasound guidance. Clinical outcome was measured through passive range of motion and VAS scoring system. Results: Based on radiographic findings, cases were classified according to the leakage of contrast medium; perfect confinement of contrast-medium inside the capsule, partial leakage of the medium and contrast-medium found at outside the joint. Total 25 cases (76%) out of 33 cases showed perfect confinement of contrast-medium inside the glenohumeral joint. Partial leakage was observed in 6 cases (18%), and contrast medium was observed outside of the glenohumeral joint in 2 cases (6%). Perfect-confinement group showed $111^{\circ}$($80{\sim}140^{\circ}$) of forward flexion and $48^{\circ}$($0{\sim}90^{\circ}$) of external rotation before injection, and improved to $134^{\circ}$($90{\sim}150^{\circ}$) of forward flexion and $70^{\circ}$($30{\sim}90^{\circ}$) of external rotation after injection (p<0.01). Partial leakage showed $120^{\circ}$($90{\sim}150^{\circ}$) of forward flexion and $70^{\circ}$($10{\sim}90^{\circ}$) of external rotation before injection, and improved to $139^{\circ}$($135{\sim}140^{\circ}$) of forward flexion and $78^{\circ}$($50{\sim}90^{\circ}$) of external rotation after injection (p<0.01). VAS score improved from 7.1 (score 3~9) to 2.6 (score 0~5) (p<0.01) in perfect confinement group, from 7.5 (score 7~9) to 3.3 (score 2~4) (p<0.01) in partial leakage group. Two group showed no significant difference. Conclusion: Accuracy of Acromioclavicular approach was 94% which is better than any other methods published so far. Partial leakage of the injection material did not show inferior result compared to perfect injection.

• Journal of Korean Orthopaedic Sports Medicine
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• v.12 no.1
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• pp.29-36
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• 2013

Purpose: Proprioceptive function has been known to be important to shoulder stability. However, the function in rotator cuff tear patients is rarely investigated. The purpose of current study is to report the proprioceptive function in rotator cuff tear patients and to analyze the proprioceptive function regarding the tear size and the presence of subscapularis tear. Materials and Methods: Between 2011 and 2012, total 76 patients (male 28 and female 48) were recruited and average age was 61.7 years old (range, 38~76). Preoperatively, joint position senses in internal and external rotation were measured for proprioceptive function testing by method of active re-positioning technique. The absolute difference from set point was measured. Proprioceptive function was further analyzed according to tear size of rotator cuff, the presence of subscapularis tear, visual analogue scale of pain, shoulder functional score (American society of elbow and shoulder score), and ranges of motion in shoulder. Results: The absolute difference for external rotation was $4.9^{\circ}{\pm}2.9^{\circ}$, in normal joint and $4.9^{\circ}{\pm}3.0^{\circ}$for involved joint in rotator cuff tear patients. This difference was not significant statistically (p=0.87). The absolute difference for internal rotation was $4.0^{\circ}{\pm}2.7^{\circ}$in normal joint whereas $4.8^{\circ}{\pm}3.7^{\circ}$ for involved joint showing statistically significant difference (p=0.043). There was some trend that the proprioceptive function of internal rotation was more impaired in the bigger tear size group (more than medium tear) compared to the smaller tear size group (partial thickness and small tear, 5.0 vs. 4.0, p=0.061). The impairment of internal rotation proprioception was also accentuated in patients with subscapularis tear (4.8 vs. 4.0, p=0.065). The proprioceptive function of internal rotation was decreased when the pain visual analogue scale was increased (5.2 vs. 4.0 p=0.04), shoulder functional score was decreased (6.1 vs. 4.2, p=0.005), or range of motion in shoulder joint was restricted (5.3 vs. 3.7, p=0.041). Conclusion: The deficit of proprioceptive function was observed in rotator cuff tear patients. Proprioception for internal rotation was impaired in patients with the bigger tear size and subscapularis tear. Pain, shoulder function score, and range of motion were also shown to be related with the deficit in proprioceptive function.

• Journal of Haehwa Medicine
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• v.21 no.1
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• pp.135-141
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• 2012

Objectives : This study was conducted to understand 4 groups in tentatively named "muscle coordinative manipulation" by Korean medicine. Methods : We researched some articles on meridian-muscle theory and muscle's action that are classified into 4 groups in muscle coordinative manipulation. Results : The outcome of examining the hypothesis is as follows: 1. The 1st hypothesis : 'Elevated shoulder' group mainly consists of muscles that are involved with shoulder elevation, abduction and external rotation. 'Lowered shoulder' group is mainly composed of muscles that acts of shoulder depression, adduction and internal rotation. 'Elevated pelvis' & 'Lowered pelvis' groups didn't show significant features by the movement of the hips. 2. The 2nd hypothesis : Most of muscles in 'elevated & lowered shoulder' groups are classified into 'hand taiyang' meridian-muscle. Most of muscles in 'elevated pelvis' group are included in 'foot jueyin' meridian-muscle. Most of muscles in 'lowered pelvis' group are classified into 'foot taiyang & foot yangming' meridian-muscle. Conclusions : There is no significant classification in muscles that comprise 4 groups in muscle coordinative manipulation when it comes to meridian-muscle theory and muscle function. More studies on chain reaction of muscle and subsequent analysis in Korean medicine are needed.