• Journal of The Korean Society of Integrative Medicine
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• v.9 no.4
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• pp.19-28
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• 2021

Purpose : The purpose of this study was to apply manual lymphatic drainage (MLD) and high-frequency diathermy (HFD) to patients with axillary web syndrome (AWS), one of the side effects of breast cancer surgery, and to treat upper extremity pain, volume, function of the upper extremity, (joint range of motion; ROM, disabilities of the arm, shoulder and hand; DASH) and quality of life before and after treatment. It is to determine the effect of treatment by checking the level change. Methods : This study is a case series. A total of 5 patients diagnosed with AWS after breast cancer surgery voluntarily participated in this study. The intervention program consisted of stretching, MLD and HFD. It was conducted 3 times a week for 30 minutes for 4 weeks. In order to compare the effects of pain (numeric pain rating scale; NPRS), volume, upper limb function (ROM, DASH) and quality of life (the European organization for research and treatment of cancer quality of life questionnaire-breast, EORTC QLQ-BR23) evaluations were compared before and after 4 weeks of intervention. All measured variables were analyzed and expressed as mean, standard deviation and percentage. Results : The shoulder NPRS level of the subjects in all case groups decreased, the volume decreased and the shoulder flexion, abduction ROM increased. It showed improvement in DASH and quality of life, QLQ-BR23. Conclusion : After breast cancer surgery, we confirmed the possibility that MLD and HFD treatments could be effective in improving pain, decreasing volume, increasing upper extremity function, and quality of life for patients who have difficulties with AWS. The possibility has been confirmed, and additional research is needed by increasing the number of participants in the experiment in the future.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.5
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• pp.2240-2250
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• 2012

This study was to identify treatment effects of the shoulder control and strengthening exercise, on the subjects with secondary shoulder impingement syndrome at postmastectomy. The subjects were patients who visited our hospital due to secondary shoulder impingement syndrome(1-2 stage) at postmastectomy and they randomly allocated to two groups: a shoulder control and strengthening group (n=10) and a conservative therapy group (n=10). Both groups received conservative therapy for 5 sessions (40 minutes per week) for 4week. The shoulder control and strengthening exercises group practiced additional motor control and strengthening exercises for 60 minutes. Values of handgrip strength, pain(visual analog scale), upper extremity circumference, Disabilities of the Arm, Shoulder and Hand questionnaire, range of motion were compared with those of the conservative therapy group. There were significant differences in the amount of change of the range of motion and Disabilities of the Arm, Shoulder and Hand scale between the two groups (p<.05), however as a measure of handgrip strength, pain(visual analog scale), upper extremity circumference did not show a significant differences. These results suggest that a motor control and strengthening exercise program is feasible, secure and suitable for secondary shoulder impingement syndrome at postmastectomy.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.1 no.1
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• pp.65-74
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• 1995

There is no line of demarcation between the shoulder and elbow regions. Pain In the arm may originate at the shoulder with reference downwards or less often at the elbow with reference upwards. Most pains indicated by the patient at the elbow or forearm have a local origin, since at the more distal part of the upper limb the capacity for correct localization is good. Once it is clear that the elbow region is at fault, the joint and the muscles about it are tested by ten movements. 1. Four. Passive extension, flexion, pronation, supination-full range, LOM, painful, painless. 2. Four. Resisted extension, flexion, pronation, supination-strong, weak, painful, painless. 3. Two. Resisted flexion, extension at the wrist-painful, painless. The muscles that perform theses two movements arise from the humeral epicondyles and a lesion in either often causes pain felt at the elbow although the tissuse affected is not functionally a part of the elbow (i. e. Tennis elbow and Golfer's elbow).

• Journal of Acupuncture Research
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• v.24 no.6
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• pp.123-135
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• 2007

Objectives : A number of instruments have been developed to measure the quality of life in patients with various shoulder disorders. Much progress has been made in this area, and currently an appropriate instrument exists for each shoulder state. The purpose of this study is to review the instruments that are currently in use for assessing the shoulder joint. Methods : A literature research was performed to choose appropriate scales for assessment of function and the disability of the shoulder. Theoretically based scales were selected for review. Therefore, 11 scales were reviewed. The status of scales involved in shoulder treatment of acupuncture throughout several countries was evaluated. Results : 11 scales: The American shoulder and elbow surgeons evaluation form(ASES), Constant Shoulder Score, The disabilities of the arm, shoulder and hand(DASH), Shoulder Disability Questionnaire (SDQ), The Shoulder Pain And Disability index(SPADI), The simple shoulder test(SST), Oxford Shoulder Questionnaire(OSQ), The Rotator Cuff quality-of-life Measure(RC-QoL), Western Ontario Shoulder Instability Index(WOSI), Western Ontario Osteoarthritis of the Shoulder Index(WOOS), Western Ontario Rotator Cuff Index(WORC), wereevaluated. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 3 domestic and 10 overseas papers about shoulder treatments using acupuncture assessed with shoulder scales. Conclusions : In clinical research, the selection of the measurement scale should take account of the condition of disease, the patient's traits and the characteristics of the research. Moreover, appropriate scales, which havevalidity, reliability, responsiveness and practical characteristics, are needed to enhance the quality of research.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.253-256
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• 2006

Cervical disc herniation is one of the most common causes of neck, shoulder and arm pain. There are many treatments for a cervical disc herniation, such as rest, physical therapy, medication, epidural steroid injection and surgery. However, conservative treatments sometimes have limited effectiveness, and a surgical discectomy is often associated with numerous complications. Nowadays, a percutaneous discectomy, using a $Dekompressor^{(R)}$, has been used in herniated disc patients, but a posterolateral extruded disc is not an indication. Herein, our experience using a 19 G $Dekompressor^{(R)}$, on a 52 year-old male patient with a left C6-⁣7 posterolateral extruded disc, is reported. Decompression was successfully performed, and the pain and range of motion was immediately improved.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.241-243
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• 2006

Central pain is defined as pain associated with lesions of the central nervous system, and is among the most intractable of chronic pain syndromes. A 47 year-old-female, who had right arm and shoulder pain, was diagnosed with syringomyelia of the Arnold Chiari malformation type I and received foramen magnum decompression and a syringo-subarachnoid shunt. After the operation, the evoked pain was improved, but she complained of a continuous burning pain, coupled with cold and tactile allodynia. This symptom failed to fully subside on administration of oral medicine; therefore, brachial plexus block was performed, which relieved her pain transiently. Through repeated trials, a gradual decrease in the pain intensity and frequency was found. However, the way in which brachial plexus block improves spinal central pain is not completely known.

• Journal of Chest Surgery
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• v.27 no.12
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• pp.1008-1014
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• 1994

Increased interest in alternative approach to thoractomy has developed because of the considerable morbidity associated with the standard posterolateral thoracotomy[ST]. Muscle sparing thoracotomy is appeared as excellent alternative because of less postoperative pain and morbidity than standard posterolateral one. Vertical axillary muscle sparing thoracotomy[VM] is the newly revised modified muscle sparing thoracotomy that overcomes the disadvantages of previous lateral muscle sparing thoracotomy such as seroma, cosmetic problems, and need of subcutaneous drains. We conducted a prospective study of 45 consecutive patients to compare postoperative pain, muscle strength of serratus anterior and latissimus dorsi, and range of motion of the shoulder girdle between ST and VM group. There were no difference in preoperative status, surgical procedure, morbidity, mortality and hospital stay between two groups. But there were significant less postoperative narcotics requirements, more preserved latissimus dorsi and serratus anterior muscle strength, nd larger range of motion of shoulder girdle [ especially flexion and internal rotation in VM group. The opening time was prolonged[p<0.01] but closing time was less in VM group [p<0.01]. The sum of opening and closing time was not different in two group. The length of incision line was shorter in VM group. The vertical skin incision was concealed by the upper arm.In conclusion vertical axillary muscle sparing thoracotomy is good alternative for various intrathoracic procedures with less postoperative pain, well preserved muscle strength,increased range of motion of the shoulder girdle and impressive cosmetic outcome.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.6
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• pp.2862-2868
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• 2013

The purpose of this study was to investigate the relationship between neck pain and upper limb disability in patients with non-specific neck pain (n=132) recruited from physiotherapy departments in the Korea. Baseline neck pain/disability was measured using the Northwick Park Neck Pain Questionnaire (NPQ) and upper limb disability was measured using the Disabilities of Arm, Shoulder, Hand questionnaire (DASH). A range of baseline psychosocial variables were measured as potential confounding variables. Pairwise analysis revealed a positive correlation between NPQ score and DASH score (Pearsons' r=0.628, p<0.05). This study provides preliminary evidence that patients with severe neck pain/disability also report severe upper limb disability. The presence of severe neck pain or low pain self efficacy and high fear-avoidence beliefs questionnaire should clinicians towards a careful examination of upper limb function in patients presenting with neck pain. Our data suggest the upper limb disability may need to be addressed as part of the neck management process.

• Journal of the Korea Society of Computer and Information
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• v.25 no.1
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• pp.109-115
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• 2020

The shoulder refers to the area connecting the human torso and arms, and plays a key role in moving both arms. In particular, it plays the most important role in sending both hands behind the head or away from our bodies. In this paper, we measure the angles of the medial and lateral rotations of the arm from the shoulder, identify the symptoms associated with abnormalities, and propose ways to prevent these symptoms. The angle of medial rotation and lateral rotation of the upper limb in the shoulder is generally 70° ~ 90°. If the angle falls below the reference value or feels pain, something is wrong with the shoulder. In addition, a total of 100 people (50 men and 50 women each) were tested to determine patients with abnormalities.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.51-55
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• 2006

Background: A cervical transforaminal steroid injection is an effective therapeutic modality for radiculopathy of a herniated cervical disc or a cervical foraminal stenosis. However, there is some debate regarding the safety of the transforaminal approach under C-arm guidance compared with the posterior interlaminar approach. We report a new technique for cervical transforaminal steroid injection guided by MDCT. Methods: Patients presenting with radiating pain on their shoulder or arm were diagnosed using CT or MRI of a cervical herniated disc or a foraminal stenosis. Each patient whose symptoms were compatible with the image scan was enrolled in this study. They received a cervical transforaminal steroid injection under CT guidance, and the effectiveness and complications of this technique were evaluated over a 2-month period. Results: According to the CT scan, none of the participants had an internal jugular vein or a carotid artery invasion during the procedure. No vertebral artery injection was noted, and no patient developed a hematoma after the injection. The VAS score had improved significantly by 2, 4 and 8 weeks after the injection. Conclusions: While a conventional C-arm guided cervical transforaminal steroid injection does not appear to differentiate between the major vessels and structures in images, a CT guided approach is a more useful and safer technique for the precise placement of a needle.