Purpose: 본 연구의 목적은 본 연구의 목적은 2주간의 회전근개의 강화운동이 회전근개의 근육 두께, 견봉하 공간, 어깨 불안정성에 미치는 영향을 알아보고자 하는 것이다. Methods: 근골격계 질환이 없는 대상자 35명을 대상으로 수행하였으며, 횡격막 호흡을 하는 그룹과 횡격막 호흡을 하지 않는 그룹으로 나누었으며, 두 그룹 모두 필라테스를 수행하였다. 실험에 사용한 기기로는 Ultrasonography(US), Pulmonary function tests(FEV1 / FVC), Bioeletic Impedance Analysis, Sit and reach test를 사용하였다. 근골격계 질환이 없는 대상자 20명이 실험에 참여하였다. 근력 강화 운동은 2주 동안 주 5세트, 총 50세트 실시하였으며, 운동은 풀캔, 빈캔, 외회전 운동으로 진행하였다. 초음파를 이용하여 극상근과 극하근의 근육 두께와 견봉하 공간의 변화를 확인하였다. CSMI는 가시위근과 가시아래근의 근력을 평가하는 데 사용되었다. 정규성 검증을 실시한 후, 반복측정분산분석 (repeated measures of ANOVA)를 사용하여 운동 전, 1주후, 2주후를 비교하였다. 사후 분석을 위해 Fisher’s LSD를 실시하였다. Results: 근력의 비교에서 운동 2주 후 측정 시 내회전에서 유의한 차이가 있었다 (P <0.05). 외회전에서는 유의한 차이가 없었다 (P >0.05). 근육두께에서는 가시위근과 가시아래근의 근육 두께는 유의한 차이가 없었다 (P >0.05). 또한 봉우리밑 공간에서도 유의한 차이가 없었다 (P >0.05). Conlusion: 결론적으로, 빈캔 운동과 풀캔 운동, 측면 외회전 운동은 어깨관절 안쪽돌림의 근력 강화에 긍정적인 효과가 있었다
Background: Posterior shoulder tightness, which is a problem mainly seen in patients with shoulder impingement syndrome, disrupts the scapulohumeral rhythm between the humerus and scapulae.
Objects: The aim of this study was to compare the effects of joint mobilization and stretching on shoulder muscle activity and internal rotation range of motion (ROM) of the glenohumeral joint in patients with impingement syndrome with posterior shoulder tightness.
Methods: The research subjects included 22 in-patients with impingement syndrome with posterior shoulder tightness. They were randomly divided into two groups: one group (12 patients) was treated with joint mobilization and the other group (10 patients) was treated with stretching for the posterior shoulder tightness. Each treatment was performed five times a week for two weeks, and there were 15 sessions for each treatment. The ROM of the internal rotation and muscle activities of shoulder joint were evaluated pretest and posttest in each group. Electromyography data were collected from the upper, middle, and lower trapezius and serratus anterior during shoulder abduction of 90°, 120°, and 150°.
Results: Both the joint mobilization and stretching groups showed significant decreases in muscle activity in the upper, middle, and lower trapezius on the posttest (p < 0.05). There was a significant difference in serratus anterior at 150° (p < 0.05), but there was no significant difference between group in post-hoc analysis (p > 0.025). The internal rotation ROM was significantly increased in the stretching group compared to that in the joint mobilization group (p < 0.025).
Conclusion: This study found that both joint mobilization and stretching for posterior shoulder tightness were effective in muscle activity during arm abduction, also in order to increase internal rotation ROM of shoulder joint, stretching was effective in patients with impingement syndrome with posterior tightness.
Background: Stretch-oriented home exercise programs are often used as treatments for patients with adhesive capsulitis; however, there is lack of research on home exercise programs to strengthen rotator cuffs.
Objects: The aim of this study is to investigate the effect of home exercise programs for rotator cuff strengthening on pain, range of motion (ROM), disability level, and quality of life in patients with adhesive capsulitis.
Methods: Twenty-two patients with adhesive capsulitis volunteered to participate in this study. The subjects were randomly divided into an experimental group (n = 11) and control group (n = 11). For the experimental group, manual therapy and home exercise programs for rotator cuff strengthening were applied for 6 weeks; for the control group, only manual therapy was applied for 6 weeks. Shoulder pain (quadruple visual analogue scale, QVAS), ROM, disability (shoulder pain and disability index-Korean version, SPADI), and quality of life (world health organization quality of life scale-Korean version, WHOQOL-BREF) were evaluated at baseline, after 3 weeks, and after 6 weeks of intervention. The changes in the measurement variables were analyzed by using repeated measure analysis of variance.
Results: Significant differences were observed between the experimental group and control group in the QVAS; SPADI-pain scores; SPADI-disability scores; SPADI-total scores; flexion, abduction, internal and external rotation ROM of the glenohumeral joint; and WHOQOLBREF total, overall, physical health, and psychological scores. All groups displayed statistically significant improvements as observed in the QVAS, SPADI, flexion, abduction, external and internal rotation ROM of the glenohumeral joint, and WHOQOL-BREF.
Conclusion: Home exercise programs for rotator cuff strengthening had a positive impact on shoulder pain, shoulder ROM, disability level, and quality of life in patients with adhesive capsulitis. Therefore, we propose the use of home exercise programs for rotator cuff strengthening in the exercise rehabilitation of patients with adhesive capsulitis.
Background: Sling exercises are frequently used for the rehabilitation process of patients with shoulder joint injuries, but research on the significant frequency intensity and appropriate treatment duration for sling exercises with local vibration stimulation is lacking.
Objects: The aim of this study was to investigate the effects of sling exercise with vibration on shoulder range of motion (ROM), muscle strength, pain, and dysfunction in patients with a medical diagnosis of shoulder joint injury.
Methods: Twenty-two patients were randomly assigned to the experiment and control groups. Six sling exercises with and without 50 ㎐ vibrations were applied in the experiment and control groups, respectively. Each exercise consisted of 3 sets of 5 repetitions performed for 6 weeks. The assessment tools used included shoulder joint range of motion, muscle strength, pain level, and shoulder pain and disability index for functional disability. We conducted re-evaluations before and 3 and 6 weeks after intervention. The changes in the measurement variables were analyzed and compared between the two groups.
Results: The ROM of the external rotation of the shoulder joint had a significant interaction between the group and the measurement point (F=3.652, p<.05). In both groups, we found a significant increase in external rotation angle between the measurement points (p<.05). The flexor strength of the shoulder joint significant interaction between the group and the measurement point (F=4.247, p<.05). Both the experiment (p<.01) and control groups (p<.05) showed a significant increase in shoulder flexor strength at the measurement points. After 6 weeks of the interventions, both the groups showed significantly improved VAS (p<.01), SPADI (p<.01), and orthopedic tests (p<.01). However, there was no significant difference between the group and the measurement point in terms of the clinical outcomes observed.
Conclusion: The sling exercise with local vibration of 50 ㎐ affected the external rotation of the shoulder range of motion and improved shoulder flexor strength in the patients with shoulder injuries. Therefore, we propose the use of the sling exercise intervention with vibration in the exercise rehabilitation of patients with shoulder joint injuries.
본 연구는 스탠스 자세와 운동면의 차이가 어깨돌림동작 시 활동근의 %MVIC를 비교분석하여 어깨강화운동을 위한 기초자료를 제공하는데 목적이 있다. 남성 8명을 무선배정하여 두발지지 자세, 한발지지 자세, 런지자세와 이마면, 수평면, 시상면에서 회전동작을 10회씩 수행하였다. 수행 중 가시위근, 가시아래근, 작은원근, 앞세모근, 배곧은근, 척수세움근, 큰가슴근, 넓은등근의 근활성도를 측정하였다. SPSS 22.0 통계프로그램을 사용하여 반복측정 일원분산분석(repeted one-way ANOVA)을 실시하였다. 첫째, 이마면에서 바깥돌림 동작 시 척추세움근은 두발지지 자세와 한발지지 자세보다 런지자세에서 높게 나타났고 안쪽돌림 동작 시 가시위근은 두발지지 자세보다 한발지지 자세, 한발지지 자세보다 런지자세에서 높게 나타났다. 둘째, 수평면에서 바깥돌림 동작 시 앞세모근은 두발지지 자세보다 한발지지 자세과 런지자세에서 높게 나타났고 안쪽돌림 동작 시 가시아래근은 두발지지 자세와 한발지지 자세보다 런지자세에서 높게 나타났으며, 큰가슴근에서는 한발지지 자세보다 두발지지 자세, 한발지지 자세보다 런지자세가 높게 나타났다. 셋째, 시상면 바깥돌림 동작 시 배곧은근은 두발지지 자세보다 한발지지 자세와 런지자세에서 유의하게 높게 나타났다. 안쪽돌림 동작 시 가시위근은 두발지지 자세보다 한발지지 자세와 런지자세에서 높게 나타났고 가시아래근은 두발지지 자세와 한발지지 자세보다 런지자 세에서 높게 나타났다. 배곧은근에서 두발지지 자세와 런지자세보다 한발지지 자세에서 높게 나타났고 척추세움근은 한발지지 자세보다 두발지지 자세와 런지자세에서 높게 나타났다. 결론적으로 스탠스와 어깨의 운동면의 차이가 어깨위팔관절의 돌림운동 시 활동근들의 근활성도에 미치는 영향은 스탠스자세와 운동면에 따라서 다른 양상이 나타났으며, 이를 어깨 강화 운동프로그램에 적용한다면 보다 긍정적 효과를 기대할 수 있는 운동프로그램이 될 것으로 생각 된다.
Background: There are insufficient objective or quantitative evidence for the better intervention to improve proprioception particularly for the application of external load. There are conflicting opinions whether the external load is effective for proprioception improvement or not. Objects: The purpose of this study was to investigate effects of external load on proprioception of shoulder joint quantitatively using 3D motion capture system. Methods: Nine healthy adults joined for this study. They were asked to perform scapular plane abduction motion with attaching reflective markers on the trunk and upper limb. The 3D positions of finger marker, while they performed the same task with and without external load, were recorded and analyzed. Results: All participants showed decreased variable errors in the vertical direction when the external load was applied (p<.02). Even though other directions (y, z) and absolute errors increased, they did not have statistical significances. Conclusion: Based on this study results, the external load application would be effective for shoulder joint position sense improvement.
Background: Patients after rotator cuff (RC) surgery experienced pain, weakness and limited of motion of the shoulder. Physical therapists have used heat therapy, electrotherapy, range of motion (ROM) exercise and other methods to treat patients after RC surgery. In addition, functional taping is also used to support joint movement and to increase shoulder joint stability. Objects: The purpose of this study was to determine the initial effects of functional taping using non-elastic tape on pain, strength and ROM of the shoulder following RC surgery. Methods: Forty-eight patients with who underwent RC surgery volunteered for this study. The subjects were randomly divided into an experimental group (EG, n1=25) and a control group (CG, n2=23). First, non-allergic tape was applied to the shoulder to prevent skin irritation. The EG applied functional taping using non-elastic tape and the CG applied sham taping using elastic tape. Assessment tools included the shoulder pain and disability index for functional activity score, visual analog scale for level of pain, shoulder muscle strength, hand grip strength and ROM testing.
Results: Pain score in the both group significantly decreased (p<.05), and change in pain score of in the EG increased significantly than in the CG (p<.05). Shoulder strength and ROM in the both group significantly increased (p<.05). Especially external rotation and extension of the shoulder ROM in the EG increased significantly more than in the CG (p<.05), but the rate of change in the two groups showed no significant difference.
Conclusion: These results suggest that functional taping using non-elastic tape was initially effective in decreasing pain score level in patients with RC surgery.
The purpose of this study were to determine the intra-rater and inter-rater reliability of shoulder
passive range of motion measurement using the “Clinometer + bubble level”, a smartphone application and to compare with the intra-rater and inter-rater reliability of measurement using a goniometer. Twenty six patients with stroke were recruited for this study. Two raters measured the passive range of motion of four types of shoulder movements (forward flexion; FF, abduction; ABD, external rotation at 90° abduction; ER90 and internal rotation at 90° abduction; IR90) using a goniometer and a smartphone to determine within-day inter-rater reliability. A retest session was performed thirty minutes later to determine within-day intra-rater reliability. The reliability was assessed using intraclass correlation coefficients (ICC) and the standard error of measurement (SEM). The ICC (2,1) for the inter-rater reliabilities of the goniometer and smartphone were good in FF and ABD [ICC (2,1)=.75∼.87] and excellent in ER90 [ICC (2,1)=.90∼.95]. The intra-rater reliabilities for the goniometer and smartphone were good or more than good, with an ICC (3,1) value >.75, the exception was IR90 measured by rater 2 on the smartphone. These results suggest that smartphone could be used as an alternative method tool for measurement of passive shoulder range of motion in patients with stroke.
The purpose of this study was to analyze of the upper extremities joint momet during handspring. The conclusion of this study were as follows First, Handspring touched on the hand when operating the landing, when the body becomes rigid, while the isometri
The purpose of this study was to measure intra-rater and inter-rater reliability and range of motion for measurement of passive shoulder internal rotation range of motion and to compare anterior glide distance of humeral head in three methods. Fifty healthy subjects and fifty patients with shoulder musculoskeletal pain were recruited for this study. The subjects' passive shoulder internal rotation range of motion was measured by visual estimation, manual stabilization, and pressure biofeedback unit methods. In two trials, measurements were performed on each subject by two examiners. Intraclass correlation coefficient (ICC(3,1)) was used to determine the reliability of each measurement. The intra-rater reliability of the three methods was excellent (ICC=.77~.93) in both groups. The inter-rater reliability of the visual estimation method was poor (ICC=.20, .29), the manual scapular stabilization method was poor and fair (ICC=.09, .50), and the pressure biofeedback unit method was excellent (ICC .86, .75) in the experimental and control groups. In the experimental group, the difference of examined range of motion by each examiner was significant in the visual estimation method and manual scapular stabilization method, but there was an insignificant difference between the groups is the pressure biofeedback unit method. This result suggests that the intra-rater and inter-rater reliability of a pressure biofeedback unit was better than the other methods. The difference in distance of the anterior glide of humeral head was insignificant among all the methods. The pressure biofeedback unit method was the most reliable method, so it is proposed to be a new and reliable method to measure internal rotation range of motion.
Altered scapular kinematics in the scapular joint is commonly believed to be a factor contributing to trunk posture. The purpose of this study was to analyze the muscle activity with several changes of the shoulder angle. Tests were performed on 10 male subjects by repeated measures. Each subject was measured while sitting in both erect and slouched trunk positions. In each sitting posture, a three-dimensional motion analysis measurement was used to measure thoracic angle and shoulder abduction angle. Measurements were taken with the shoulder abdcution angle at , , , , , and . By using surface Electromyography (EMG) electrodes, we recorded the activity of the upper trapezius, middle trapezius, lower trapezius, middle deltoid, and serratus anterior muscle while the subject held a 4 kg weight at each angle. The mean of root mean square (RMS) of EMG activity was calculated. The middle trapezius, lower trapezius, and middle deltoid muscle activity showed significantly higher results but serratus anterior muscle activity showed significantly lower results (p<.05). With the shoulder angle increased, the muscle activity was also significantly increased (p<.05). In conclusion, the thoracic spine posture significantly affects the scapular muscle during scapular plane abduction, and the slouched posture is associated with increased trapezius muscle activity and with decreased serratus anterior muscle activity.
Glenohumeral joint`s 를 나타내는 단순방사선 촬영법으로 전후사방향 자세에서 촬영하는 Grashey법이 있다. 이 촬 영법 자세는 선 자세에서 검사 측을 들어 올리고 촬영한다. 하지만 촬영 시 환자를 몸통을 들어 올리고 회전하는 정도 에 따라 관찰범위가 변화한다. Glenohumeral joint`s 를 가장 잘 나타내기 위한 몸통 회전 각도를 알아보기 위하여 총 20명(남:13명, 여:7명)을 대상으로 촬영을 실시하였으며, 정확한 영상의 판단을 위하여 정형외과 전문의 2명, 방사선 사 2명(경력 15년 이상자)이 관찰 평가하였다. 평가의 척도는 Glenohumeral joint`s 분리 정도의 점수를 0점은 ‘분리 안 됨’, 1점은 ‘불량’, 2점은 ‘보통’, 3점은 ‘양호’로 점수를 부여하였다. 몸통 회전 각도를 30° 인 영상은 Humerus head와 Glenoid fossa가 겹쳐서 나타났고, 35° 인 영상에서는 Humerus head와 Glenoid fossa가 약간 겹쳐서 나타났 고, 40° 인 영상에서는 Humerus head와 Glenoid fossa의 관절강이 가장 겹침이 적게 나타났고, 45° 인 영상에서도 겹침 정도가 많았다. 각 영상의 평가 점수는 30°는 0.40±0.499, 35°는 1.34±0.657, 40°는1.84±0.573, 45°는 0.76±0.649로 나타났고 통계적으로 유의한 차이를 나타냈다.(p < .05).선 자세에서 Glenohumeral joint`s 를 나타내기 위한 자세에서 환자 몸통을 40° 검사 반대 측을 들어 올리고 촬영하였을 경우 우리는 가장 양호한 접시오목 (Glenoid fossa)를 나타낼 수 있었다.
본 연구는 오른쪽 어깨관절에 칼텐본-에비엔즈컨셉 미끄러뜨림 등급Ⅱ와 Ⅲ으로 아래쪽미끄러뜨림적용시 위팔뼈머리의 이동거리 및 벌림각도(abduction angle)의 변화를 알아보고자 하였다. 미끄러뜨림 등급Ⅱ(Grade Ⅱ) 적용시 위팔뼈머리는 초기보다 아래쪽으로 5㎜ 가량 이동하였고 등급Ⅲ 적용시 8㎜ 가량 이동하였다. 이동거리에 대한 성별 비교에서는 남자가 여자에 비해 등급별로 이동거리가 높게 나타났으나 통계적으로 유의한 차이는 나타나지 않았다. 등급Ⅱ(Grade Ⅱ) 적용시 벌림각도는 초기보다 10°가량, 등급Ⅲ(Grade Ⅲ) 적용시 12°가량 증가하였다. 벌림각도에 대한성별 비교에서는 모든 등급별로 여자가 남자보다 벌림각도가 크게 나타났으나 통계적으로 유의한 차이는 나타나지 않았다.본 연구를 통해 미끄러뜨림 등급 적용시 위팔뼈머리의 운동형상학적 변화를 알아보았으며 향후 추가 연구를 통해이들 변화가 주변 구조물에 미치는 영향에 대해 알아본다면 보다 과학적인 근거중심의 치료를 기대할 수 있을 것으로사료된다.