• The Journal of Korean Physical Therapy
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• 제35권3호
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• pp.83-88
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• 2023

Purpose: This study was to investigate the effect of forward head posture (FHP) and round shoulder posture (RSP) on changes in muscle activities according to shoulder flexion and abduction tasks. Methods: Twenty-two male subjects with no history of neurological, musculoskeletal surgery or injuries, or pain in the spine region within the previous 3-month periods were recruited for this study. Craniovertebral angle (CVA) and Scapula Index were measured before performing 90° abduction and flexion tasks holding a 3kg dumbbell. Muscle activities were measured during the tasks. All measurements except height of the acromion were carried out in a sitting position at the height of the subject's knee angle of 90 degrees, and two tasks were randomly performed with the arm that the subject mainly use to throw the ball. The abduction and flexion angles were checked by the examiner using a goniometer beside the subject. Results: Correlation coefficient analysis between Scapular Index and upper trapezius muscle activity during shoulder abduction task showed significant positive correlation. No significant correlation was observed between CVA, Scapular Index, and other muscle activities. Conclusion: FHP showed increased muscle activation, making it difficult to change muscle activity under lower loads, and RSP was correlated with UT activation in shoulder abduction. Therefore, in the RSP, the loaded shoulder abduction is considered a potential risk factor for increasing shoulder muscle tension. This paper proposes an approach to treating RSP before FHP.

• 대한정형도수물리치료학회지
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• 제1권1호
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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).

• The Korean Journal of Pain
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• 제19권2호
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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.

• 대한정형도수물리치료학회지
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• 제25권1호
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• pp.53-61
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• 2019

Background: This study aimed to investigate the effects of manual lymph drainage (MLD) on women with breast cancer and lymph edema. Methods: This study was carried out with a total of 23 women with breast cancer and lymph edema. By drawing lots, women were assigned to either the manual drainage group (MLD, n=12), a control group (n=11). Outcomes such as the arm size, visual analogue scale, shoulder pain and disability index, and functional assessment cancer therapy-breast (FACT-B) were measured to 0 week, 2 weeks, 4 weeks, and 8 weeks intervention for both groups. Results: A significant difference was found in the arm size, pain, functional disability level, and quality of life between the two groups and time(p<.01). Significant difference in functional disability level between 2 and 8 weeks at 4 weeks and 8 weeks for pain(p<.01), and the quality for life was significantly different at all time points (p<.01). Conclusions: Applying MLD treatment to women with breast cancer proved to have a positive effect.

• The Korean Journal of Pain
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• 제22권2호
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• pp.171-175
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• 2009

Neuralgic amyotrophy is a syndrome with a broad range of clinical manifestations. It is characterized by acute, severe pain in the shoulder or arm lasting several days or weeks, followed by muscle weakness and atrophy as the pain diminishes. The diagnosis is based on typical clinical features, electromyography (EMG) and a nerve conduction study. The early and correct diagnosis is important to preclude unnecessary testing or surgical procedures. A 59-year-old female patient presented with pain and weakness involving her right palm and 1 3rd fingers. Three weeks before presentation, she noted the sudden onset of severe right shoulder and forearm pain. After the pain was reduced, she noted persistent right palm and 1-3rd finger pain and weakness. On cervical MRI, there was a mild central disc protrusion at C4 5 and C5 6. Electrodiagnostic testing was performed and she was diagnosed with neuralgic amyotrophy. One week after hospital treatment, her pain was relieved from VAS 10 to 3 and she was discharged with mild weakness of the thumb and index finger during pinch grips.

• Clinics in Shoulder and Elbow
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• 제24권2호
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• pp.80-87
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• 2021

Background: Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR. Methods: Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups. Results: Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (p<001). Comparisons between the two groups were not significantly different, except for SF-36 "general health perception" (p<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema. Conclusions: CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.

• The Korean Journal of Pain
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• 제11권1호
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• pp.138-142
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• 1998

Fibromyalgia syndrome is defined as a diffuse, aching musculoskeletal pain associated with multiple and discrete predictable tender points along with stiffness. A primary form associated without any disease is uncommon compared to the secondary diffuse fibrositis. We witnessed a case of a primary fibromyalgia syndrome. A 28-year-old woman was suffering from pain on posterior neck, right shoulder, upper back, left hand and arm for two years. She also complained of morning stiffness, fatigue, and headache. We treated her with stellate ganglion block with 0.25% bupivacaine, medication that included amitriptyline, TENS and superlizer. We also recommended aerobic exercise.

• 한국직업건강간호학회지
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• 제14권2호
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• pp.164-170
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• 2005

Purpose: The present study attempted to find subjective musculoskeletal symptoms of operating room nurses (OR nurses) and then to use them as basic data for prevention and management of musculoskeletal symptoms of OR nurses. Method: This study was an exploratory research, and data were collected from OR nurses working in 8 polyclinics in Korea from July 26 to August 19, 2004, using a self-report questionnaire. The questionnaire contains items concerned with subjective musculoskeletal symptoms include ones with the presence of symptoms and with the degree of discomfort, in the joints such as neck, shoulder, arm/elbow, hand/wrist/finger and waist. For data collection, the aim of the study was explained to the operating room managers to obtain their help, and these questionnaires were sent to hospitals, and were retrieved by post. 271(90.3%) questionnaires were returned among those sent to 300 nurses. 249 questionnaires excluding 22 insufficient ones such as no response were used for data analysis. Data were analyzed using SPSS WIN 12.0. Subjective musculoskeletal symptoms were analyzed in the number and percentage. Result: 187(75.1%) nurses said they 'had' subjective musculoskeletal symptoms and 62 (24.9%) said they had 'nothing'. 130(52.2%), 125 (50.2%), 113 (45.4%), 86(34.5%), and 42 (16.9%) nurses had subjective musculoskeletal symptoms in waist, shoulder, hand/wrist/finger, neck, and arm/elbow, respectively. 51(27.3%) and 136 (72.7%) nurses complained of the pain in one site, and in two or more sites, respectively. In particular, 51% and 47.4% nurses said that they were 'discomforted' due to the pain in waist and in shoulder, respectively. Conclusion: Subjective musculoskeletal symptoms which OR nurses complained of were significant. This may cause difficulty in nursing tasks in the operating room. So various arrangements have to be made for OR nurse with subjective musculoskeletal symptoms at an early stage.

• 한국산학기술학회논문지
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• 제14권6호
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• pp.2862-2868
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• 2013

본 연구는 비특이성 경부통 환자의 경부통증수준과 상지 기능장애간에 상관성을 알아보고자 실시하였다. 경부통증과 경부기능장애는 Northwick Park Neck Pain Questionnaire(NPQ)로 상지 기능장애는 상지기능장애 설문지(disabilities of arm, shoulder, hand questionnaire; DASH)를 이용하여 평가하였다. 잠재적인 교란변수로 작용할 수 있는 심리학적 변수는 통증 자아효능감(Pain Self Efficacy; PES)과 공포회피반응 설문지(fear-avoidence beliefs questionnaire; FABQ)를 이용하여 측정하였다. 분석 결과, NPQ 점수와 DASH 점수는 피어슨 상관 계수가 0.628점의 양의 상관관계가 있었으며, PES과 FABQ 점수와도 유의한 상관성을 나타내었다. 이 결과를 통해 경부통 환자의 경부통 및 경부기능장애 수준과 상지 기능장애 수준 간에 상관성이 나타날 수 있음을 알 수 있었다. 또한 통증에 대한 부정적인 인식과 공포회피반응이 심한 환자의 경우 상지 기능평가에 직접적인 영향을 줄 수 있는 것으로 확인되었다. 이에 경부통 환자의 관리 시 상지 기능장애와 심리학적 요인을 평가하여야만 할 것이다.

• Clinics in Shoulder and Elbow
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• 제23권4호
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• pp.169-177
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• 2020

Background: We evaluated the need for arthroscopic capsular release (ACR) in refractory primary frozen shoulder (FS) by comparing clinical outcomes of patients treated with ACR and manipulation under anesthesia (MUA). Methods: We assessed patients with refractory primary FS, 57 patients (group A) who were treated with MUA and 22 patients (group B) who were treated with ACR. In group A, manipulation including a backside arm-curl maneuver was performed under interscalene brachial block. In group B, manipulation was performed only to release the inferior capsule before arthroscopic circumferential capsular release, which was carried out for the unreleased capsule after manipulation. Pain, range of shoulder motion, and American Shoulder and Elbow Surgeons score were recorded at 1 week, 3 months, 6 months, and 1 year after surgery. We compared outcome variables between treatment groups and between diabetics and non-diabetics and also evaluated the numbers of patients receiving additional intra-articular steroid injection. Results: Outcome variables at 3 months after surgery and improvements in outcome variables did not differ between groups. Group A showed significantly better results than group B in the evaluation of pain and range of motion at 1 week. Diabetics showed comparable outcomes to non-diabetics for most variables. Eleven patients required additional steroid injections between 8 to 16 weeks after surgery: 12.2% in group A, 18.2% in group B. Additional injections were given three times more often in diabetics compared to non-diabetics. Conclusions: MUA alone can yield similar clinical outcomes to ACR in refractory FS.