• Clinics in Shoulder and Elbow
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• 제25권2호
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• pp.101-105
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• 2022

Background: Rotator cuff tears cause pathologies of the long head of the biceps tendon (LHBT). One of the surgical treatments for such a tear is LHBT tenodesis to the humerus. This study aims to compare simultaneous rotator cuff repair and LHBT tenodesis with or without detachment of the proximal end of the LHBT (PELHBT) from its site of adhesion to the glenoid. Methods: This retrospective study involved patients affected by LHBT pathology with rotator cuff tear. The patients were divided into two groups, with or without PELHBT detachment from the glenoid. Therapeutic outcomes were investigated by evaluation of patient satisfaction, pain based on visual analog scale, shoulder function based on Constant score and simple shoulder test, and biceps muscle strength based on the manual muscle testing grading system before surgery, at 6 months, and at the final visit after surgery. Results: Groups 1 and 2 comprised 23 and 26 patients, respectively, who showed no significant differences in demographic characteristics (p>0.05). Shoulder function, biceps muscle strength, pain, and satisfaction rate improved over time (p<0.05) but were not significantly different between the two groups (p>0.05). No post-surgical complication was found in either group. Conclusions: There was no difference in final outcomes of tenodesis with or without detachment of the PELHBT from the supraglenoid tubercle. Such tendon detachment is not necessary.

• Clinics in Shoulder and Elbow
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• 제18권3호
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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.

• 대한물리치료과학회지
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• 제9권1호
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• pp.61-68
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• 2002

The purpose of this dissertation was to analyze the effect of trunk extension strengthening exercise on muscle performance of the upper limb in adolescent baseball player. The twenty people were studied : experimental group(10), comparative group(10). The experimental group has done trunk extension strengthening exercise for 8 weeks. The study analyzes isometric maximal strength of shoulder internal rotation. shoulder external rotation, elbow flexion, elbow extension, forearm pronation, forearm supination and ball speed. All of subjects were tested for 3 times ; pre, mid, post. The results were as follows; 1. Maximal isometric strength of upper limb, during trunk extension strengthening exercise in experimental group, shoulder internal rotation and external rotation showed it has slightly increased and comparative group showed it has no change, but not significant elbow flexion and extension significantly(p<0.05) increased after exercise either for 4 or 8 weeks compared with that of control group. Forearm pronation showed not significantly changed in both group, but significantly different between group either for 4 or 8 weeks. Forearm supination, significantly((p<0.05) increased after 8 weeks in experimental group. 2. Ball speed showed slightly increased but not significantly in experimental group. These results it may expect improvement of upper limb muscle performance of upper limb in adolescent baseball player. However, in case of shoulder a point of view of bunk extension strengthening exercise of this study hasn't a significant influence. More experimental studies are needs, hereafter which will use more experimental subjects and various methods of exercise and new application of treatment term to define significant change.

• Clinics in Shoulder and Elbow
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• 제2권2호
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• pp.143-150
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• 1999

Purpose: The purpose of this study is to describe the characteristic clinical findings and treatment of suprascapular nerve entrapment by ganglion and to evaluate its results. Materials and Methods: Seven paitents with suprascapular nerve entrapment were evaluated on an average 13 months(range, six months to three years two months) after surgical excision and decompression. There were six males and one female. The mean age at operation was 31 years(range, 23 to 40 years), Suprascapular nerve entrapment were caused by compression of ganglion cyst in suprascapular notch or spinoglenoid notch in all cases. All patients complained of pain located over posterolateral area of the shoulder. Two patients had atrophy of both the supraspinatus and infraspinatus muscles, In four patients, only the infraspinatus muscle was involved. Muscle strength on both forward flexion and external rotation was decreased in two patients. In four patients, only external rotation was decreased. All patients underwent open excision of ganglion cyst and decompression. Results: The most dramatic effect of operation was prompt disappearance of pain in all patients. The average visual analog scale had improved from 7.2 to 0.6 point at the latest follow-up evaluation. An atrophy of the supraspinatus or infraspinatus muscle partially disappeared in four of six patients and muscle strength of forward flexion or abduction improved in all of six patients. The overall result was excellent for five patients and good for two. Conclusion: Surpascapular nerve entrapment by ganglionic cyst had clinically unique symptoms and signs on physical examination. Surgical excision is effective for symptomatic and functional outcomes. We believe that early intervention can be one of treatment modality before an irreversible damage occurs if the ganglion is large enough to compress suprascapular nerve, and to develop severe pain and muscular atrophy.

• 대한물리의학회지
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• 제10권3호
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• pp.101-108
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• 2015

PURPOSE: This study researched the effects of the changes of elbow joint angle and of arm position in PNF pattern on muscle activation of the contralateral shoulder muscles while performing PNF pattern exercise. METHODS: The research subjects were 16 male physical therapists who had no neuromuscular or neurological disorders. To measure the muscle activation of the contralateral shoulder muscles, EMG electrodes were attached to the muscle valley of the middle and posterior areas of the deltoid and triceps muscles of the arm. Muscle activation while performing the ulnar thrust PNF pattern exercise was measured with the elbow joint positioned at angles of $30^{\circ}$, $45^{\circ}$, and $60^{\circ}$. Resistance points were at the initial, middle, and end ranges of PNF pattern exercise. RESULTS: Muscle activation of the middle and posterior portions of the deltoid muscle increased significantly according to the changes of elbow joint angle. In each resistance point the middle range was significantly higher than at other points. A significant difference on muscle activation was demonstrated throughout each range depending on the type of muscle. Muscle activation of the middle and posterior portions of the deltoid muscle was higher than muscle activation of the triceps. CONCLUSION: The results of this study demonstrate that the PNF pattern exercising method used in this study is a selective exercising method focusing on the deltoid muscle over the triceps muscle. In order to increase the muscle strength to the maximum level, it is necessary to provide the maximum level of resistance in the middle range of the elbow joint.

• Clinics in Shoulder and Elbow
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• 제22권4호
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• pp.195-202
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• 2019

Background: This study investigates the effects of neuromuscular electrical stimulation (NMES) in preventing deltoid atrophy during the first 12 weeks after arthroscopic rotator cuff repair. Methods: Eighteen patients undergoing arthroscopic repair of a medium-sized rotator cuff tear by a single surgeon, were randomized into two groups: NMES and transcutaneous electrical nerve stimulation (TENS). Each group used the respective device for 6 weeks after surgery. Pain was measured at baseline, 6, and 12 weeks postoperatively, using the visual analogue scale (VAS); range of motion (ROM), abduction strength and functional scores were measured at baseline and 12 weeks postoperatively. Deltoid thickness and cross-sectional areas were measured using magnetic resonance imaging at 12 weeks postoperatively. Results: At 12 weeks post-surgery, no statistically significant difference was observed between the NMES and TENS groups in the pain VAS, the Disabilities of the Arm, Shoulder and Hand score, ROM, and abduction strength. Postoperative decrease in the thickness of the anterior, middle, and posterior deltoid, at the level just below the coracoid, was -2.5%, -0.7%, and -6.8%, respectively, in the NMES group, and -14.0%, -2.6%, and -8.2%, respectively, in the TENS group (p=0.016, p=0.677, and p=0.791, respectively). At the level of the inferior glenoid tubercle, postoperative decrease in area of the deltoid was -5.4% in the NMES group and -14.0% in the TENS group, which was significantly different (p=0.045). Conclusions: NMES has the potential for reducing deltoid atrophy after arthroscopic rotator cuff repair, suggesting that NMES might help minimize postoperative atrophy after various shoulder surgeries.

• 대한통합의학회지
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• 제11권3호
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• pp.171-183
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• 2023

Purpose : This study sought to investigate research trends regarding joint mobilization type among patients with shoulder joint diseases. Methods : A scoping review was conducted according to the five steps outlined by Arskey and O'Malley and PRISMA-ScR. We searched six domestic databases (ScienceOn, DBpia, Riss, Kmbase, Kiss, KCI) and three international databases (CINAHL, Pubmed, Cochrane central) between 2013 and June 2023. The keyword terms used were 'joint mobilization', 'Kaltenborn', 'Maitland', 'Mulligan', and 'shoulder joint'. Results : There were a total of 44 studies that investigated the topic, and these were divided into quantitative analysis and topic analysis. In terms of publication year, the number of studies within the last five years has increased more than compared to the previous five years, with most of them being randomized clinical trials. In shoulder joint diseases, it was found that the majority of joint movement studies focused on adhesive joint cystitis and shoulder collision syndrome. The Mulligan concept was the most commonly studied type of joint motion. The dependent variables used included pain, joint function (disability), and muscle function. The visual analog scale was the most commonly used for the pain variable, followed by the numeric rating scale. For joint function and disability variables, range of motion was the most commonly used, followed by shoulder pain and disability index, and disabilities of the arm, shoulder, and hand. For muscle function, variables such as muscle tone, strength, and activity were used. Conclusion : We believe that findings of this scoping review can serve as valuable mapping data for joint mobilization research on shoulder joint diseases. Further studies including systematic reviews and meta-analyses based on these results are recommended.

• 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.

• Physical Therapy Rehabilitation Science
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• 제8권2호
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• pp.79-85
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• 2019

Objective: The purpose of this study was to investigate the relationship between physical features, strength, function, and upper extremity musculoskeletal pain during rehabilitation of manual wheelchair users with spinal cord injuries. Design: Cross-sectional study. Methods: The degree and frequency of upper extremity musculoskeletal pain were measured in persons with spinal cord injuries using manual wheelchairs with the use of questionnaires. The pain scores of the hand, wrist, and shoulder joints were calculated by multiplying the seriousness and frequency of pain. We collected data on the manual muscle test, Spinal Cord Independent Measure-III, and the Body Mass Index. Statistical analysis was performed by descriptive analysis and Pearson's correlation analysis. Results: A total of 47 patients participated in this study and the neurological level of the injuries ranged from C2 to S5. Pain in the shoulder joints was the most common in persons with tetraplegia and paraplegia. Pain was experienced as mild to moderate, and occurred one or more times a week. Of the 32 persons with paraplegia, the most common area of complaint was the shoulder. Of the 15 persons with paraplegia, the shoulder joints were the most common site of pain. The independence levels of the persons with spinal cord injuries were highly correlated to muscle strength levels (p<0.05). Conclusions: This study investigated upper extremity musculoskeletal pain during rehabilitation of manual wheelchair users with spinal cord injuries and the relationship between physical features, strength, and function. In most persons with spinal cord injuries, pain and frequency of shoulder joints were high and pain levels were also related to functional levels.

• 근관절건강학회지
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• 제18권1호
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• pp.93-102
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• 2011

Purpose: The purpose of this study was to identify the effects of the BeHaS exercise program, developed by Jong Im Kim (2006), consisting of exercise, education and cognitive support on muscle strength and flexibility in elders who live in elderly facilities. Method: This study was designed using one group pretest-posttest experimental design, 19 elders, the subjects of the group participated in the BeHaS exercise program. The BeHaS exercise program was provided for 60-80 minutes per session once a week for 8 weeks. Data was collected by research assistants using structured interview and measurement tool, from January, 2011 to March, 2011. Data were analyzed using the SPSS Win 17.0, general characteristics were analyzed with real number and percentage, muscle strength and flexibility were analyzed with Mean and SDs. Results: There were significant increase pre and post test for the left shoulder flexibility (p=.000) and waist flexibility (p=.030). Conclusion: In conclusion, this study confirms that BeHaS exercise program played a useful role in partial improving flexibility in the Institutionalized Elders.