• 대한간호학회지
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• 제45권3호
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• pp.378-387
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• 2015

Purpose: Acute myocardial infarction (AMI) leads to death if the patient does not receive emergency treatment. Thus it is very important to recognize the symptoms in the early stage. The purpose of this study was to identify clusters of symptoms that represent AMI in Koreans. Methods: The study used a retrospective, descriptive design with secondary data analysis. Data were abstracted from 725 medical records of AMI patients admitted from June 1, 2006 to August 15, 2014 at a university hospital. Results: Analysis of the AMI symptoms revealed five symptom clusters; Cluster 1 (n=140): middle chest pain (100%), shortness of breath, and cold sweating, Cluster 2 (n=256): substernal pain (100%), cold sweating, and shortness of breath, Cluster 3 (n=47): substernal pain (95.7%), left arm pain, shortness of breath, cold sweating, left shoulder pain, right arm pain, and the lower neck pain, Cluster 4 (n=212): shortness of breath (28.3%), left chest pain, and upper abdominal pain, and Cluster 5 (n=70): cold sweating (100%), left chest pain, shortness of breath, left shoulder pain, and upper abdominal pain. Length of hospital stay and mortality rate were significantly different according to symptom clusters (F=2.52, p =.040; F=3.62, p =.006, respectively). Conclusion: Symptom clusters of AMI from this study can be used for AMI patients in order to recognize their symptoms at an early stage. The study findings should be considered when developing educational prevention programs for Koreans with AMI.

• Clinics in Shoulder and Elbow
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• 제24권2호
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• pp.55-65
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• 2021

Background: Although ultrasound-guided needle decompression (US-GND) can treat calcific tendinitis of the shoulder effectively, repeat procedures might be required for unresolved symptoms. We evaluated the overall clinical outcomes of US-GND with subacromial steroid injection and the final results and factors predisposing toward repeat procedures. Methods: Ninety-eight patients who underwent US-GND for calcific tendinitis of the supraspinatus/infraspinatus were analyzed between March 2017 and December 2018. The clinical outcomes (pain visual analog scale, functional visual analog scale [FVAS], and American Shoulder and Elbow Surgeons [ASES] score) and final subjective satisfaction were compared between groups A (single US-GND) and B (repeat US-GND). The factors predisposing toward repeated US-GNDs were analyzed. Results: We found that 59.3% (58/98) of patient ASES scores were ≥80, and 73.5% of patients (72/98) were satisfied with the outcome. Group B (n=14) demonstrated a significantly higher rate of dominant-arm involvement compared to group A (78.6% vs. 48.8%, p=0.046). However, initial calcification size, shape, number, density, subscapularis involvement, lavage, and procedure time did not differ significantly between the groups. Group B showed poorer final FVAS (7 [interquartile range, 6-8] vs. 8 [interquartile range, 7-9], p=0.036) and subjective satisfaction compared to group A (satisfied: 5 [35.7%] vs. 67 [79.8%], p<0.001]. Conclusions: US-GND with subacromial steroid injection is a viable treatment option for calcific tendinitis of the shoulder. Dominant-arm involvement was the only independent factor for repeated US-GND. Final outcome of repeated US-GND for unimproved patients was promising; however, these outcomes were poor compared to those of the patients who improved after the first procedure.

• Clinics in Shoulder and Elbow
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• 제7권1호
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• pp.10-13
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• 2004

Superior labrum anterior to posterior (SLAP) lesions of the shoulder has recently been a popular issue to shoulder surgeons. Now we are correlating many shoulder symptoms to this SLAP lesion. A 45 year-old female patient injured her shoulder when her arm sleeve was entrapped in moving automobile door. A forceful pull of the arm in external and abduction position was suspected. She complained continuous shoulder pain with limited range of motion for 2 months. Magnetic resonance image showed possible SLAP lesion but no definite diagnosis were made prior to the operation. Arthroscopic evaluation revealed SLAP type Ⅱ lesion with concomitant avulsion of the superior glenoid cartilage. In addition anterior labrocapsular tear was seen from 7 to 9 o'clock of anterior glenoid. The SLAP lesion and the anterior capsulolabral lesion were repaired properly to the glenoid. We report a case of glenoid-cartilage avulsion type of SLAP Ⅱwith anterior labrocapsular lesion.

• Biomaterials and Biomechanics in Bioengineering
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• 제3권2호
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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.

• Journal of Acupuncture Research
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• 제22권1호
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• pp.177-190
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• 2005

본 연구는 도인기공체조가 여성의 견비통 및 견부 근육에 미치는 효과를 알아보기 위하여 실시하였다. 연구설계는 유사실험설계로 비동등성 대조군 전후설계이며, 연구방법은 실험군, 대조군에게 사전조사로 일반적인 특성, 견비, 견배통 자각 증상, 주관적 동통(VAS), 근육경결정도를 측정하였다. 실험처치로 본 연구자와 한의학 전공교수 1인, 도인기공 전문가 1인이 함께 개발한 도인기공체조를 첫 2주 동안에는 도인기공 전문가와 연구자가 함께 연구대상자들에게 1회 45분, 주 3일을 실시하였다. 3주째부터는 연구자가 혼자 지도하면서 1회 45분 동안 주 3일 총 24회를 실시했다. 매회 출석을 체크하고, 불참 시에는 개발된 도인 기공체조 비디오를 사전 배부하여 집에서 개인 적으로 도인기공체조를 실시하도록 격려하였고, 운동실시여부는 전화로 확인했다. 실험처치 후 사후조사는 사전조사와 동일하게 측정하였다. 자료분석은 SPSS/WIN 10.0을 사용하였으며, 동질성 검증은 $x^2$검정, t검정, Fisher's exact test로 분석하였고, 가설검정은 ANCOVA와 t점정으로 측정도구의 신뢰도는 Cronbach' alpha 계수를 산출하였다. 본 연구의 결과는 다음과 같다. 1. 도인기공체조를 받은 실험군은 대조군에 비해 유의하게 견비, 견배통 자각증상의 점수가 감소되었다(t=10.245, p=.000). 2. 도인기공체조를 받은 실험군은 대조군에 비해 유의하게 주관적인 동통 점수(VAS)가 감소되었다(t=6.816, p=.000). 3. 도인기공체조를 받은 실험군은 대조군에 비해 근육경결정도가 감소되었다(t=7.114, p=.000).

• The Korean Journal of Pain
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• 제9권1호
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• pp.98-101
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• 1996

Background: Lumbar epidural steroid injection for relief of low back pain and sciatica has become a popular procedure. further, cervical epidural steroid injection with nerve block (CESNB) is known to be effective for the management of acute and chronic pain of neck, shoulder and arm. However, many anesthesiologists are not familiar with CESNB. Methods: Charts of 34 patients who had undergone 60 cervical epidural steroid injections over a three year period, 1993 to 1995, were reviewed. We studied the followings: initial visit and department, injected interspaces, personal characteristics, indications for injection and complications. Results: Patients' first visits were mainly to orthopaedics (11 patients) and neurosurgery (10 patients). Epidural injection sites were: C7-T1 interspace (29 patients) and C6-C7 interspace (6 patients). Mean age of patients were 50.1 years. range 21~73 years. There were twenty male and fourteen female patients. Complications varied from dizziness after CESNB (1 patient). loss of consciousness with transient apnea (2 patients), and local infection with suspicious meningitis (1 patient). Conclusion: We conclude from the above data that CESNB is a good, safe and conservative form of therapeutic procedure in the management of patients suffering from cervical radiculopathy, and neck and shoulder pain.

• 한국치위생학회지
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• 제9권2호
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• pp.45-56
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• 2009

The purposes of this study were to investigate the relationships between the degree of physical pain and the knowledge and preventive actions of musculoskeletal diseases among dental hygiene students with a potential risk of contracting those diseases and thus to help them prevent them. A survey was taken among 207 sophomores and juniors specializing in dental hygiene at S1 and S2, Gyeonggi Province in the area of physical pain, knowledge of musculoskeletal diseases, and preventive actions against them. The findings were as follows: 1. The mean scores of the sophomore in the knowledge of musculoskeletal diseases were $6.20{\pm}2.21$, and those of the juniors were $6.72{\pm}2.29$. The mean scores of the sophomores and juniors in the preventive actions against musculoskeletal diseases were $22.50{\pm}2.37$ and $22.29{\pm}3.01$, respectively. 2. The subjects displayed severe physical pain in the lower back, shoulder, and neck in the descending order and medium physical pain in the neck, shoulder, and lower back in the descending order. 3. The higher level knowledge of musculoskeletal diseases they had, the less physical pain they felt. And there were significant differences among the shoulder, lower back, hip, ankle, and foot. 4. There were relationships between physical pain and the preventive actions against musculoskeletal diseases in "placing the hands at the height of the elbows during treatment", "reducing such positions as bending and extending during treatment", "narrowing the distance with the patient", "taking regular breaks during treatment for recovery", "trying not to incline the neck, back, arm, and wrist as much as possible", and "trying to keep the torso in the neutral position." 5. As for the education about musculoskeletal diseases, 74 sophomores(88.10%) and 102 juniors(89.74%) answered they received no such education. The results suggest that there should be some instructions to help dental hygiene students practice the preventive actions against musculoskeletal diseases and further prevention programs against those diseases.

• 대한물리의학회지
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• 제10권4호
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• pp.113-121
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• 2015

PURPOSE: The purpose of this study was to determine the effect of shoulder external rotation on muscle activities of the scapular upward rotators during arm elevation. METHODS: Nineteen healthy subjects with no medical history of shoulder pain or upper extremity disorders were recruited for this study. Electromyography (EMG) was used to measure the muscle activities of the serratus anterior (SA), upper trapezius (UP), lower trapezius (LT) and infraspinatus (IS) muscles during arm elevation. The EMG activities were recorded while the subjects performed $90^{\circ}$ arm elevation with three different arm positions; palm down (PD), neutral position (NP), and palm up (PU). While seated in a chair, the subject was asked to raise the upper extremity in the sagittal plane in random order. Subjects performed $90^{\circ}$ arm elevations in three trials at each arm position. The mean EMG activity normalized by the maximal voluntary isometric contraction was analyzed across three arm positions. Repeated measures one-way ANOVA and the post hoc Bonferroni tests were used to determine the differences in muscle activities among the three arm positions. RESULTS: The EMG activities of the SA and IS were significantly greater in the PU condition than in the other conditions during arm elevation. No significant difference was noted between the NP and PD conditions during arm elevation. CONCLUSION: These results suggest that shoulder external rotation (palm up position) can be used to activate the SA. Therefore, we recommend a scapular protraction exercise in the palm up position for strengthening the SA.

• Journal of Acupuncture Research
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• 제38권3호
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• pp.175-182
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• 2021

To evaluate the effectiveness of acupuncture treatment for shoulder impingement syndrome (SIS) a literature review was conducted of randomized controlled trials (RCTs) where acupuncture was used as an intervention for patients diagnosed with SIS. Relevant clinical studies (N = 181) were retrieved from several databases based on the inclusion/exclusion criteria, and the interventions and results were analyzed. Six RCTs were selected to review based on the inclusion and exclusion criteria. In all 6 studies, the acupuncture treatment group showed significant positive changes in indicators evaluating pain, disability, and quality of life. A significant decrease in the evaluation indicators (Shoulder Pain and Disability Index, numeric rating scale, Visual Analogue Scale, Constant Murley Shoulder Assessment Score, patient's global assessment, and doctor's global assessment) and a significant increase in the questionnaire scores (UCLA, AL-score, EuroQol 5 Dimension Self-Report Questionnaire, and disabilities of the arm, shoulder, and hand) were observed. In addition, 1 study showed similar improvements in pain and quality of life measures in the acupuncture group and corticosteroid injection group. No major side effects were reported. Acupuncture may be an effective and safe treatment for SIS however, further RCTs are required.

• PNF and Movement
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• 제17권2호
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• pp.167-175
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• 2019

Purpose: This study aims to determine the effect of Jeonbuk tri-pull taping and proprioceptive neuromuscular facilitation (PNF) exercise on the shoulder's active range of motion, pain, subluxation, upper extremity function, and activities of daily living in patients with stroke. Methods: In this study, Jeonbuk tri-pull taping and PNF exercise were applied to three patients with stroke and subluxation. The tape was removed and new tape applied for two days every Monday, Wednesday, and Friday over six consecutive weeks. PNF exercise was applied five times a week for six weeks. To measure the range of motion, a smart phone clinometer application was used, and the degree of pain was measured using a visual analogue scale (VAS). A jig measuring method was employed to measure the distance of subluxation. The Fugl-Meyer Assessment (FMA) was used to evaluate arm function, and the modified Barthel Index (MBI) was employed to evaluate the activities of daily living. Results: The shoulder's active range of motion was improved in the patients compared to the range of pre-tests, and the pain and subluxation distance were reduced compared to those of pre-tests. Arm function and activities of daily living were increased compared to those of pre-tests. Conclusion: The study results verified that Jeonbuk tri-pull taping and PNF exercise are useful when applied to patients with subluxation and stroke.