Background: Limitations of shoulder range of motion (ROM), particularly shoulder internal rotation (SIR), are commonly associated with musculoskeletal disorders in both the general population and athletes. The limitation can result in connective tissue lesions such as superior labrum tears and symptoms such as rotator cuff tears and shoulder impingement syndrome. Maintaining the center of rotation of the glenohumeral joint during SIR can be challenging due to the compensatory scapulothoracic movement and anterior displacement of the humeral head. Therefore, observing the path of the instantaneous center of rotation (PICR) using the olecranon as a marker during SIR may provide valuable insights into understanding the dynamics of the shoulder joint. Objects: The aim of the study was to compare the displacement of the olecranon to measure the rotation control of the humeral head during SIR in individuals with and without restricted SIR ROM. Methods: Twenty-four participants with and without restricted SIR ROM participated in this study. The displacement of olecranon was measured during the shoulder internal rotation control test (SIRCT) using a Kinovea (ver. 0.8.15, Kinovea), the 2-dimensional marker tracking analysis system. An independent t-test was used to compare the horizontal and vertical displacement of the olecranon marker between individuals with and without restricted SIR ROM. The statistical significance was set at p < 0.05. Results: Vertical displacement of the olecranon was significantly greater in the restricted SIR group than in the control group (p < 0.05). However, no significant difference was observed in the horizontal displacement of the olecranon (p > 0.05). Conclusion: The findings of this study indicated that individuals with restricted SIR ROM had significantly greater vertical displacement of the olecranon. The results suggest that the limitation of SIR ROM may lead to difficulty in rotation control of the humeral head.

PURPOSES : In this study, the initial behaviors of shoulder concrete slabs and tiebars at the longitudinal construction joints between the shoulder JCP and mainline CRCP are investigated. METHODS : The strains of concrete and tiebars were measured at the longitudinal construction joint between the CRCP and JCP. Measurements were performed using data accumulated over a month after concrete placement. The contact conditions were investigated by comparing the strains at each location. RESULTS : The longitudinal construction joints between the shoulder JCP and mainline CRCP exhibited the composite behavior of bonding and friction, and a virtual neutral axis was formed inside the JCP. At the connection of the shoulder concrete, the strain and temperature of the concrete were inversely proportional. The tiebars connecting the CRCP and JCP exhibited different behaviors depending on the bonding conditions around the tiebars of the construction joints. In the presumed state in which the bonding condition was maintained, the concrete temperature and tiebar strain were directly proportional; however, the presumed state of the separation condition exhibited an inversely proportional relationship. In the 24-h behaviors of the tiebars, the effects of the horizontal and curling movements overlapped, and the strains of the measured tiebars increased at the minimum and maximum temperatures of the shoulder JCP. CONCLUSIONS : The strains in the tiebars and concrete slabs primarily depended on the boundary conditions (bonding and friction) of the longitudinal construction joint between the shoulder JCP and mainline CRCP.

Background: The Trunk Stabilization Exercise and Respiratory Muscle Exercise may help address the complex biomechanical and neuromuscular issues that contribute to shoulder joint disorders and can help improve patient outcomes in terms of pain relief, range of motion, and functional ability. Objectives: To investigated the effects of conventional physical therapy, trunk stabilization exercise, and respiratory muscle exercise, on the Range of Motion (ROM), ULF and balance in patients with shoulder joint disorder. Design: A randomized controlled trial. Methods: This study randomly allocated 18 subjects to the control group, 19 to the trunk stabilization exercise group, and 19 to the respiratory muscle exercise group, while all interventions were performed five times a week for four weeks. The result measurement involved the ROM, the upper limb function test (ULT), and balance tests. Results: The respiratory muscles exercise group indicated significant improvement in ROM and balance tests than the trunk stabilization exercise group and control group. Conclusion: The respiratory muscle exercise is a more effective way to improve ROM and balance ability than trunk stabilization exercise for patients with shoulder joint disorder.

Background: Individuals with scapular winging may have proprioceptive dysfunction which is important for motor control and causes shoulder instability. Reduced serratus anterior (SA) and lower trapezius (LT) muscle activity accompanied by over-active upper trapezius (UT), and pectoralis major (PM) may be contributing factors. Flexi-bar (FB) exercise may be used to increase joint position sense (JPS) and alter the target muscle activities. Objects: This study aimed to investigate the immediate effects of flexi-bar exercise prior to knee push-up plus (FPK) versus knee push-up plus (KPP) on JPS and muscle activity of SA, LT, UT, and PM in subjects with scapular winging. Methods: Eighteen subjects with scapular winging were recruited. JPS was investigated at baseline, after KPP and after FPK. Passive and active JPS errors were calculated by isokinetic equipment. Surface electromyography was used to record muscle activities during KPP and FPK. One-way repeated-measures analysis of variance and post hoc analyses were used to analyze the JPS error measured at baseline, after KPP and after FPK. Paired t-tests were used to compare muscle activities between KPP and FPK. Results: Passive JPS error was significantly decreased after KPP (p = 0.005) and after FPK (p = 0.003) compared to the baseline. Active JPS error was also significantly decreased after KPP (p = 0.016) and after FPK (p = 0.012) compared to the baseline. There was no significant difference in the passive and active JPS errors between KPP and FPK. SA activity during FPK was significantly increased (p = 0.024), and LT activity during FPK was significantly increased (p = 0.006). There were no significant differences in the UT and PM activity. Conclusion: FB might be recommended to immediately improve passive and active JPS and to selectively increase SA and LT muscle activities during KPP in individuals with scapular winging.

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: 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.

The purpose of this study was to identify the immediate effects of Maitland joint mobilization with kinematic taping in subacromial impingement syndrome patients. The Maitland joint mobilization was applied glenohumeral joint. The mobilization was performed at the end of rage to Grade IV. After that, kinematic tape was attached to shoulder joint (supraspinatis, infraspinatis, and trapezius muscles). The intervention period was four days. The measurement was done five times. The shoulder pain, range of motion (flexion, abduction, and rotation of the shoulder joint), muscle tone and stiffness (upper trapezius and deltoid muscle) were measured. The shoulder pain decreased. The range of motion (ROM) was increased all flexion, abduction, and rotation of the shoulder joint. Muscle tone and stiffness were decreased, especially upper trapezius of those was greatly decreased. The findings of present study suggest that Maitland joint mobilization with kinematic taping is effective in decreasing pain, muscle tone and stiffness, and in increasing shoulder ROM in patients with subacromial impingement syndrome.

The purpose of the study was to investigate the strength of sokinetic muscle by the position of a volleyball players. Analysis and comparison of shoulder dynamic stability will be conducted according to rotational movement of the shoulder during spiking and serving amongst the various positions. Fifty professional Korean female volleyball players (age: 20~30), all different positions – attacker (left and right), center, setter, and libero were The concentric peak torque, strength ration of the internal and external rotation of the shoulder girdle for both dominant and non-dominant arms. Firstly, there were significant differences found for the strength ratio between the setter and the other positions in the dominant arm. On a second note, there was a significant decrease in shoulder dynamic stabilization for both the attacker and center in the dominant arm. However, there were no significant differences for the setter or the libero. This study suggests that the isokinetic muscle strengths of the volleyball players are different from each other.

Background:Rounded shoulder posture (RSP), a postural abnormality, might cause shoulder pain and pathologic conditions. Although most previous research has investigated RSP focusing on the proximal structures of the shoulder, such as the scapula and pectoralis muscles, the relationship between RSP and anterior distal structures of the upper extremity, such as the biceps brachii muscle and elbow joint, is not clearly understood.Objects:This study aimed to investigate the correlations between RSP and the biceps brachii length, elbow joint angle (EJA), pectoralis minor length, general pectoralis major length, humeral head anterior translation (HHAT), glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HAD).Methods:Twelve subjects with RSP (6 male, 6 female) were recruited. All subjects fulfilled the RSP criteria indicated by a distance ≥2.5 cm from the posterior aspect of the acromion to the table in the supine position. The examiner measured each of the following parameters twice: RSP, biceps brachii length, EJA, pectoralis minor length, pectoralis major length, HHAT, glenohumeral IR, ER, and HAD. Pearson’s correlation coefficient(r) was used to assess the correlation between RSP and all the variables.Results:There was a significant moderate positive correlation between RSP and biceps brachii length (r=.55, p=.032), moderate negative correlation between RSP and pectoralis minor length (r=-.62, p=.015), and moderate positive correlation between RSP and HHAT (r=.53, p=.038).Conclusion:The biceps brachii length, pectoralis minor length, and HHAT could be used to evaluate patients with RSP. Better understanding of the correlation between these factors and RSP could help in the development of effective methods to treat patients with this condition in clinical management.

This study used both kinesiotaping and extracorporeal shock wave therapy on patients diagnosed with frozen shoulder - a common musculoskeletal disorder in adults - in order to observe the effects on the joint range of motion. 21 adult(male 12, female 9) were selected and distributed into randomized groups. One group received kinesiotaping (n=10) and the other group received kinesiotaping together with extracorporeal shockwave therapy (n=11). After a 6 week duration of receiving kinesiotaping and extracorporeal shockwave therapy, changes in the joint range of motion in the patients were observed. Post-treatment of frozen shoulder, the changes in abduction within the shoulder joint were as follows: in both groups there was a noticeable increase in the joint range of motion (p<.05). Post-treatment of frozen shoulder, the changes in external rotation within the shoulder joint were as follows: both groups showed a significant increase in the joint range of motion (p<.05). The result of suggest that, it can be inferred that both the extracorporeal shockwave therapy and kinesiotaping are effective in increasing the joint range of motion in patients with frozen shoulder.

The techniques of joint mobilization and traction are used to improve joint mobility or to decrease pain by restoring accessory movements to the shoulder joints and thus allowing full, nonrestriced, pain-free range of motion. In the glenohumeral joint, the humeral head would be the convex surface, while the glenoid fossa would be the concave surface. The medial end of the clavicle is concave anterioposteriorly and convex superioinferiorly, the articular surface of the sternum is reciprocally curved. The acromioclavicular joint is a plane synovial joint between a small convex facet on lateral end of the clavicle and a small concave facet on the acromion of the scapula. The relationship between the shape of articulating joint surface and the direction of gliding is defined by the Convex-Concave Rule. If the concave joint surface is moving on a stationary convex surface, gliding occur in the same direction as the rolling motion. If the convex surface is moving on a stationary concave surface, gliding will occur in an opposite direction to rolling. Hypomobile shoulder joints are treated be using a gliding technique.

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.

이 연구는 동결견 진단을 받은 환자에 대한 한국전통 정골요법(이하 KTO)을 적용하여 통증완화에 대한 유의성 연구가 진행하였던 환자를 대상으로 통증의 감소가 견관절의 가동범위도 증가하는지를 추가적으로 확인하기 위하여 진행하였다. 대상자는 총 14명으로 구성되어 있으며, 두 개 그룹으로 나누어 7명의 실험군과 7명의 대조군으로 하여 2그룹으로 나누어 연구를 진행하였다. 7명은 KTO를 총 10회 시술하고, 7명은 시술하지 않았다. 견관절의 가동범위의경우 항목별로 살펴보면 KTO를 적용한 그룹은 가동치의 변화를 살펴보았을 때 굴곡(7.33) 신전(10.00) 외전(8.76)내전(9.05) 외회전(8.10) 내회전(10.00)의 변화가 나타났다. KTO를 적용하지 않은 그룹의 가동치의 변화를 살펴보았을 때 굴곡(4.67), 신전(7.50), 외전(7.14), 내전(9.14), 외회전(6.59), 내회전(9.31)의 변화가 나타났다. 동결견 환자에게 한국전통정골요법을 적용하면 견관절의 가동범위 증가를 가져올 수 있음을 확인하였다.

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.