• Clinics in Shoulder and Elbow
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• 제9권1호
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• pp.89-95
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• 2006

Purpose: Arthroscopic repair of rotator cuff tears are many techniques that have been developed to improve the initial postoperative strength of the repair. There was a doubt that current arthroscopic cuff repairs using a single row of suture anchors reproduce insufficient area of the anatomic cuff insertion, and concerns about failure of fixation often lead surgeons to limit early motion. Newer technique of double-row repair in arthroscopic treatment may provide initial stronger fixation and more contact with bone at the repair site than single-row repair did. We studied the comparison between clinical outcomes of arthroscopic single- and double-row repair in cuff tears at 1year postoperatively. Materials and methods: We retrospectively analyzed 40 shoulders with single-row repair and 38 shoulders with double-row repair of full-thickness rotator cuff tears between May 2002 and October 2004. Out of total 78 shoulders, 42 (54%) were male patients and 36 (46%) were female patients and the mean age at surgery was 56 years. All patients were diagnosed by physical examination and MRI. At 1year' follow-up after operation, we evaluated with the ASES and the Constant scoring system, and measured muscle power of abduction, internal and external rotation of the affected shoulder then compared with each other. Results: Mean ASES scores and Constant scores in double-row repair group improved more than single-row repair group significantly at 1year postoperatively. Muscle power of abduction and internal rotation, especially abduction power, improved more significantly in double-row repair group than in single-row repair. Conclusion: Arthroscopic double-row repair for the full thickness rotator cuff tear may be a superior technique, which showed better clinical outcomes and restoration of muscle power compared with single-row repair at relatively short period of postoperative follow-up. Restoration of footprint close to normal anatomy by double-row repair seems to play an important role in the recovery of muscle strength.

• 구강회복응용과학지
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• 제26권2호
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• pp.169-178
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• 2010

연구목적 : 이 연구는 수직적 교합고경의 증가에 따른 사지 근력에 대한 영향을 관찰하고자 하였다. 연구재료 및 방법 : 평균 연령 21세의 10명의 남자를 선발하였다. 상악피개형의 교합장치를 제작하여 장치를 착용하지 않은 교두감합 (Intercuspal Position, ICP)시와 2mm, 3.5mm 그리고 5mm 수직적 교합고경을 증가시킨 위치에서 각각의 근력을 Cybex II dynamometer (Lumex Inc., Ronkonkoma, NY, USA)를 이용하여 측정하였다. 결과 : 측정한 14가지 동작 중 hip의 굴곡운동과 신전운동, forearm의 회외운동, shoulder의 내전운동, knee의 외전운동과 내전운동, ankle의 배측굴곡과 족측굴곡에서 교합장치의 장착시 근력의 유의한 증가를 보였다 (p<0.05). 결론 : 이 연구의 결과로 볼 때 수직적 교합고경을 증가시켰을 때 대부분의 동작에서 평균근력이 증가된다고 결론지을 수 있었다. 특히 3.5mm 수직적 교합고경을 증가시켰을 때 가장 높은 평균근력 증가율을 보였다.

• PNF and Movement
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• 제5권2호
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• pp.47-54
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• 2007

Purpose : The purpose of this study were to determine the effect of a Elastic Theraband Exercise Based of PNF L/E pattern on the gait of the chronic Hemiplegic Patients. Methods : We selected the 20 chronic Hemiplegic Patients not given treatment now and divided them into two groups of both 10 Elastic Theraband group and 10 Self Exercise. The first group went through a Elastic Theraband Exercise Based of PNF L/E pattern 30 minutes a day, 5 times a week, for 6 weeks. Exercise used to blue elastic band which 2 patterns of PNF by 1) hip extension - abduction - internal rotation with knee extension. 2) hip flexion - adduction - external rotation with knee flexion. The latter group experienced Self Exercise, 30 minutes a day, 5 times a week, for 6 weeks. Firstly, we measured the absolute improvement of gait velocity(m/s), cadence(steps/min) among walking characters. Secondly, we measured the functional walking ability such as Functional Ambulatory Category(FAC, score out of 5), Modified Motor Assesment Scale(MMAS, score out of 6). Data analysis was performed with using SPSS 12.0 win program. The descriptive analysis was used to obtain average and standard deviation. The independent t-test and the paired t-test were used to compare both the groups about pre and post training test. Treatment effects were established by pre and post assessment. Subjects tolerated the training well without side-effects. Therefore, the results of this study were as follows; Results : 1. There was a more significant improvement of Gait velocity(0.12m/s) Elastic Theraband group(p<.05). 2. There was a more significant improvement of cadence(9.40steps/min) Elastic Theraband group(p<.05). Conclusion : As we can see from above, the findings suggest that Elastic Theraband may be more effective than the Self Exercise for improving some gait parameters such as Gait velocity and Cadency. This conclusion also suggest that Elstic Theraband is more effective for the improvement of gait of chronic Hemiplegic Patients.

• 한국전문물리치료학회지
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• 제24권2호
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• pp.48-57
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• 2017

Background: Rounded shoulder posture (RSP), a postural abnormality, might cause shoulder pain and pathologic conditions. Although most previous research has investigated RSP focusing on the proximal structures of the shoulder, such as the scapula and pectoralis muscles, the relationship between RSP and anterior distal structures of the upper extremity, such as the biceps brachii muscle and elbow joint, is not clearly understood. Objects: This study aimed to investigate the correlations between RSP and the biceps brachii length, elbow joint angle (EJA), pectoralis minor length, general pectoralis major length, humeral head anterior translation (HHAT), glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HAD). Methods: Twelve subjects with RSP (6 male, 6 female) were recruited. All subjects fulfilled the RSP criteria indicated by a distance ${\geq}2.5cm$ from the posterior aspect of the acromion to the table in the supine position. The examiner measured each of the following parameters twice: RSP, biceps brachii length, EJA, pectoralis minor length, pectoralis major length, HHAT, glenohumeral IR, ER, and HAD. Pearson's correlation coefficient(r) was used to assess the correlation between RSP and all the variables. Results: There was a significant moderate positive correlation between RSP and biceps brachii length (r=.55, p=.032), moderate negative correlation between RSP and pectoralis minor length (r=-.62, p=.015), and moderate positive correlation between RSP and HHAT (r=.53, p=.038). Conclusion: The biceps brachii length, pectoralis minor length, and HHAT could be used to evaluate patients with RSP. Better understanding of the correlation between these factors and RSP could help in the development of effective methods to treat patients with this condition in clinical management.

• 한국운동역학회지
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• 제15권3호
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• pp.161-173
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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 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 LabVlEW 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 1. In three dimensional maximum linear velocity of racket head the X axis showed $11.41{\pm}5.27m/s$ at impact, not the Y axis(horizontal direction) and the z axis(vertical direction) maximum linear velocity of racket head did not show at impact but after impact this will resulted influence upon hitting ball It could be suggest that Y axis velocity of racket head influence on ball direction and z axis velocity influence on ball spin after impact. the stance distance between right foot and left foot was mean $74.2{\pm}11.2m$. 2. The three dimensional anatomical angular displacement of shoulder joint showed most important role in forehand stroke. and is followed by wrist joints, in addition the movement of elbow joints showed least to the stroke. The three dimensional anatomical angular displacement of racket increased flexion/abduction angle until the impact. after impact, The angular displacement of racket changed motion direction as extension/adduction. 3. The three dimensional anatomical angular displacement of trunk in flexion-extension showed extension all around the forehand stroke. The angular displacement of trunk in adduction-abduction showed abduction at the backswing top and adduction around impact. while there is no significant internal-external rotation 4. The three dimensional anatomical angular displacement of hip joint and knee joint increased extension angle after minimum of knee joint angle in the forehand stroke, The three dimensional anatomical angular displacement of ankle joint showed plantar flexion, internal rotation and eversion in forehand stroke. it could be suggest that the plantar pressure of open stance during forehand stroke would be distributed more largely to the fore foot. and lateral side.

• 한국운동역학회지
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• 제18권3호
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• pp.33-42
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• 2008

이 연구는 생횔체육 프로그램으로서의 태권에어로빅스 옆차기 동작의 운동학적 분석으로 대상자는 숙련자와 비숙련자 각 7명으로 하였다. 자료는 Qualisys사의 Proreflex MCU-240 카메라 7대를 샘플링 율(sampling rate), 100frames/sec로 촬영한 후 Qualisys System(SWEDEN)의 QTM(Motion Capture Software)으로 위치 좌표를 얻었으며 Visual3D를 사용하여 연구변인을 산출하였고, 두 집단간의 평균치 차이 검정은 SPSS 12.0K의 독립 t-test를 유의수준 p<.05로 실시하였다. 그 결과는 다음과 같다. 1. 구간별 소요시간은 전 구간에서 통계적으로 유의한 차이가 없었다. 2. 무릎 각도의 경우 제2 무릎최대굴곡순간(p=0.046, F=4.925)에서 통계적으로 유의한 차이가 있었다. 3. 무릎 각속도의 경우 제1 무릎최대굴곡순간(p=0.031, F=5.940)에서 통계적으로 유의한 차이가 있었다. 4. 힙의 굴곡/신전 각도는 제2 무릎최대굴곡순간(p=0.012, F=8.668)에서 통계적으로 유의한 차이가 있었다. 5. 힙의 외/내전 각속도는 무릎최소굴곡순간(p=0.019, F=7.324)에서 통계적으로 유의한 차이가 있었다. 6. 힙의 외/내측 회전각속도는 무릎최소굴곡순간(p=0.005, F=11.87)에서 통계적으로 유의한 차이가 있었다.

• PNF and Movement
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• 제10권2호
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• pp.9-16
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• 2012

본 연구는 43세 남성 환자의 관절가동술과 슬링을 이용한 유착성 관절낭염 환자의 치료사례를 조사하여 그 과정과 결과를 알아보고자 하였다. 어깨통증장애지수(shoulder pain and disability index) 측정과 어깨관절의 굽힘(flexion), 벌림(abduction), 바깥돌림(external rotation), 안쪽돌림(internal rotation)에 대한 관절가동범위를 측정하여 비교하였으며 견관절 주위에 비스테로이드 소염진통 주사 1회, 약물치료를 병행하며 주 3회 8주간 보존적인 물리치료인 온습포(hot pack)와 간섭파(ICT), 관절가동술, 그리고 슬링을 이용한 운동치료를 실시하였다. 결과는 관절가동술과 슬링운동치료의 적용이 유착성 관절낭염 환자의 통증을 줄이고 관절가동범위를 증진시키는데 효과가 있는 것으로 판단된다.

• 대한정형외과학회지
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• 제55권2호
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• pp.188-192
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• 2020

본 증례에서는 노인 환자에 발생한 견관절의 급성 외상성 전방 탈구에서 회전근개 파열과 동반되어 생긴 거대 Hill-Sachs 병변에 대한 치료법으로 상완 이두근 구를 통한 간접 정복과 동종 장골 삼중 피질골 이식을 시행하였다. 수술 후 6개월째, 회전근개의 치유 및 골유합을 확인하였다. 또한 American Shoulder and Elbow Surgeons (ASES) shoulder score 95점, 전방 능동 거상 155도, 외전 120도, 외전 90도에서 외회전 70도와 내회전 30도의 운동 범위로 만족스러운 임상결과를 보였다. 노인 환자에 발생한 견관절의 급성 외상성 전방 탈구에서 회전근개의 파열과 동반된 거대 Hill-Sachs 병변 대해 본 수술 방법을 고려해 볼 수 있을 것이다.

• Clinics in Shoulder and Elbow
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• 제26권3호
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• pp.245-251
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• 2023

Background: For anatomic total arthroscopic repair, cementless humeral fixation has recently gained popularity. However, few studies have compared clinical, radiographic, and patient-reported outcomes between cemented and press-fit humeral fixation, and none have performed follow-up for longer than 5 years. In this study, we compared long-term postoperative outcomes in patients receiving a cemented versus press-fit humeral stem anatomic arthroscopic repair. Methods: This study retrospectively analyzed 169 shoulders that required primary anatomic total shoulder arthroplasty (aTSA). Shoulders were stratified by humeral stem fixation technique: cementation or press-fit. Data were collected pre- and postoperatively. Primary outcome measures included range of motion, patient reported outcomes, and radiographic measures. Results: One hundred thirty-eight cemented humeral stems and 31 press-fit stems were included. Significant improvements in range of motion were seen in all aTSA patients with no significant differences between final cemented and press-fit stems (forward elevation: P=0.12, external rotation: P=0.60, and internal rotation: P=0.77). Patient reported outcome metrics also exhibited sustained improvement through final follow-up. However, at final follow-up, the press-fit stem cohort had significantly better overall scores when compared to the cemented cohort (visual analog score: P=0.04, American Shoulder and Elbow Surgeon Score: P<0.01, Simple Shoulder Test score: P=0.03). Humeral radiolucency was noted in two cemented implants and one press-fit implant. No significant differences in implant survival were observed between the two cohorts (P=0.75). Conclusions: In this series, we found that irrespective of humeral fixation technique, aTSA significantly improves shoulder function. However, within this cohort, press-fit stems provided significantly better outcomes than cemented stems in terms of patient reported outcome scores. Level of evidence: III.

• Archives of Plastic Surgery
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• 제38권6호
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• pp.894-898
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• 2011

Purpose: Coverage of full-thickness large flank defect is a challenging procedure for plastic surgeons. Some authors have reported external oblique turnover muscle flap with skin grafting, inferiorly based rectus abdominis musculocutaneous flap, and two independent pedicled perforator flaps for flank reconstruction. But these flaps can cover only certain portions of the flank and may not be helpful for larger or more lateral defects. We report a case of large flank defect after resection of extraskeletal Ewing's sarcoma which is successfully reconstructed with reverse latissimus dorsi myocutaneous flap. Methods: A 24-year-old male patient had $13.0{\times}7.0{\times}14.0$ cm sized Ewing's sarcoma on his right flank area. Department of chest surgery and general surgery operation team resected the mass with 5.0 cm safety margin. Tenth, eleventh and twelfth ribs, latissimus dorsi muscle, internal and external oblique muscles and peritoneum were partially resected. The peritoneal defect was repaired with double layer of Prolene mesh by general surgeons. $24{\times}25$ cm sized soft tissue defect was noted and the authors designed reverse latissimus dorsi myocutaneous flap with $21{\times}10$ cm sized skin island on right back area. To achieve sufficient arc of rotation, the cephalic border of the origin of latissimus dorsi muscle was divided, and during this procedure, ninth intercostal vessels were also divided. The thoracodorsal vessels were ligated for 15 minutes before divided to validate sufficient vascular supply of the flap by intercostal arteries. Results: Mild congestion was found on distal portion of the skin island on the next day of operation but improved in two days with conservative management. Stitches were removed in postoperative 3 weeks. The flap was totally viable. Conclusion: The authors reconstructed large soft tissue defect on right flank area successfully with reverse latissimus dorsi myocutaneous flap even though ninth intercostal vessel that partially nourishes the flap was divided. The reverse latissimus dorsi myocutaneous flap can be used for coverage of large soft tissue defects on flank area as well as lower back area.