Shoulder Manipulation After Distention Arthrography: Does Audible Cracking Affect Improvement in Adhesive Capsulitis? A Preliminary Study

최준규,손석범,박범준,양승남,윤준식 대한재활의학회 2015 Annals of Rehabilitation Medicine Vol.39 No.5

Objective To investigate whether an audible cracking sound during shoulder manipulation following distention arthrography is clinically significant in patients with adhesive capsulitis of the shoulder.Methods A total of 48 patients (31 women, 17 men) with primary adhesive capsulitis of the shoulder completed the study. All participants underwent C-arm–guided arthrographic distention of the glenohumeral joint with injections of a corticosteroid and normal saline. After distention, we performed flexion and abduction manipulation of the shoulder. The patients were grouped into sound and non-sound groups based on the presence or absence, respectively, of an audible cracking sound during manipulation. We assessed shoulder pain and disability based on a Numeric Rating Scale (NRS), the Shoulder Pain and Disability Index (SPADI), and passive range of motion (ROM) measurements (flexion, abduction, internal and external rotation) before the procedure and again at 3 weeks and at 6 weeks after the intervention.Results The patients were divided into two groups: 21 were included in the sound group and 27 in the non-sound group. In both groups, the results of the NRS, SPADI, and ROM assessments showed statistically significant improvements at both 3 and 6 weeks after the procedure. However, there were no significant differences between the two groups except with respect to external rotation at 6 weeks, at which time the sound group showed a significant improvement in external rotation when compared with the non-sound group (p<0.05).Conclusion These findings showed that manipulation following distention arthrography was effective in decreasing pain and increasing shoulder range of motion. In addition, the presence of an audible cracking sound during manipulation, especially on external rotation, was associated with better shoulder range of motion. Objective To investigate whether an audible cracking sound during shoulder manipulation following distention arthrography is clinically significant in patients with adhesive capsulitis of the shoulder.Methods A total of 48 patients (31 women, 17 men) with primary adhesive capsulitis of the shoulder completed the study. All participants underwent C-arm–guided arthrographic distention of the glenohumeral joint with injections of a corticosteroid and normal saline. After distention, we performed flexion and abduction manipulation of the shoulder. The patients were grouped into sound and non-sound groups based on the presence or absence, respectively, of an audible cracking sound during manipulation. We assessed shoulder pain and disability based on a Numeric Rating Scale (NRS), the Shoulder Pain and Disability Index (SPADI), and passive range of motion (ROM) measurements (flexion, abduction, internal and external rotation) before the procedure and again at 3 weeks and at 6 weeks after the intervention.Results The patients were divided into two groups: 21 were included in the sound group and 27 in the non-sound group. In both groups, the results of the NRS, SPADI, and ROM assessments showed statistically significant improvements at both 3 and 6 weeks after the procedure. However, there were no significant differences between the two groups except with respect to external rotation at 6 weeks, at which time the sound group showed a significant improvement in external rotation when compared with the non-sound group (p<0.05).Conclusion These findings showed that manipulation following distention arthrography was effective in decreasing pain and increasing shoulder range of motion. In addition, the presence of an audible cracking sound during manipulation, especially on external rotation, was associated with better shoulder range of motion.

The Shoulder Gradient in Patients with Unilateral Shoulder Impingement Syndrome

김희상,Dae Gyu Hwang,Jong Ha Lee,윤동환,Jee-Sang Yun,Yong Won Shin,Jinmann Chon 대한재활의학회 2011 Annals of Rehabilitation Medicine Vol.35 No.5

Objective To investigate the relationship between the shoulder gradient and acromiohumeral interval of both shoulders in patients with unilateral shoulder impingement syndrome. Method Using the angulometer, we measured the shoulder gradient in patients with unilateral shoulder impingement syndrome in a standing position. Using the radiography, we measured the acromiohumeral interval and the angle between a vertical line and a line connecting a superior angle with an inferior angle of the scapula. Results In patients with unilateral shoulder impingement syndrome, the frequency of shoulder impingement syndrome was 76.2% (16 of 21) on the side of the relatively lower shoulder. The mean acromiohumeral interval on the side of the lower shoulder was 10.03±1.28 mm, compared with 10.46±1.50 mm for the higher shoulder. Th e angle between a vertical line and a line connecting a superior angle with an inferior angle of the scapular of the side of the lower shoulder was -0.31±3.73 degrees, compared with 3.85±4.42 degrees for the higher shoulder. Conclusion The frequency of shoulder impingement syndrome was significantly higher on the side of the relatively lower shoulder, and there is no signifi cant diff erence in the acromiohumeral interval between the side of the lower shoulder and that of the higher shoulder. In patients with unilateral shoulder impingement syndrome,the scapular on the side of lower shoulder was more rotated downward than on the side of the higher shoulder.

전방 불안정성 견관절에서 이두박근의 근전도 활동성

김승호,하권익,김현숙,김선우,박종혁,김영민 대한견.주관절학회 2000 大韓肩.주關節學會誌 Vol.3 No.2

견관절의 임상적 평가도구에 관한 고찰

양동훈,김건형,김행범,최양식,박영배 대한침구의학회 2007 대한침구의학회지 Vol.21 No.5

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 Ins- tability Index(WOSI), Western Ontario Osteoarthritis of the Shoulder Index(WOOS), Western Ontario Ro- tator 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 qua- lity of research.

견관절 불안정성에서의 이중 조영 전산화단층촬영 소견

양재범 대한영상의학회 1993 대한영상의학회지 Vol.29 No.6

Cleno-humeral Joint is a ball and socket joint. It has the greatest range of movement among all the joints of the body. The greatest range of movement is inevitably accompanied by a considerable loss in stability. Thir-ty-three persons underwent Double Contrast CT arthrography of the shoulder for the evaluation of suspected shoulder derangement. We performed 62 shoulder arthrography (33 abnormal shoulders and 29 normal shoulders) and reviewed their findings retrospectively. They had recurrent shoulder dislocation (30 shoulders) or nonspecific shoulder pain (3 shoulders). Injury of the glenoid labrum was seen in 28 shoulders at double contrast CT arhrography. Among 28 eases oft he labral injury, labral detachment was seen in 15 cases, labral tear in 5 cases, and labral erosion in 8 cases. Double contrast CT arthrography also showed Hill-Sachs defect in 20 shoulders. The numbers of type 1, type 2, and type 3 capsulolabral attachment in 33 shoulder instability cases were 10, 16 and 7, respectivity, while, 16, 12 and 1 in 29 normal controls. Type 2 and 3 are more common in shoulder instability group than normal control group. Operation was done in 18 shoulders. Comparing with operation findings. the sensitivity of double contrast CT arthrography in the detection of Hill-Sachs defect was 100% with the specificity of 71% and the accuracy of 89%. The sensitivity, specificity, and accuracy of double contrast CT arthrography in the detection of labral injury were 94%, 100%, and 95% respectively. Double contrast CT arthrography is a minimally invasive and highly accurate technique for in the evaluation of glenohumeral instability.

견관절의 임상적 평가도구에 관한 고찰

양동훈,김건형,김행범,최양식,박영배,Yang, Dong-Hoon,Kim, Kun-Hyung,Kim, Haeng-Beom,Choi, Yang-Sik,Park, Young-Bae 대한침구의학회 2007 대한침구의학회지 Vol.24 No.6

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.

Effect of Chuna (Shoulder Traction) Treatment on Frozen Shoulder During Korean Medical Treatment

Jo, Na Young,Yeo, In Ho,Jung, Se Ho,Sung, Hee Jin,Lee, Cham Geol,Lee, Eun Yong,Roh, Jeong Du Korean AcupunctureMoxibustion Medicine Society 2014 대한침구의학회지 Vol.21 No.1

Objectives : Through an analysis of the previous studies, It is estimated that Chuna(shoulder traction) is effective in reducing the pain and increasing motion range of shoulder joint of the patient. So this study is to investigate the effects of Chuna(shoulder traction) on frozen shoulder. Methods : After treated with acupuncture and electro stimulating therapy, the subjects were measured list of measurement. And then treated with Chuna(shoulder traction) therapy, the subjects were measured list of measurement again. All treatment was performed by the same doctor who is a highly qualified about Chuna(shoulder traction). Chuna(shoulder traction) treatment takes 15 minutes. Three kind of Chuna(shoulder traction) therapy were performed for 5 minutes each. Depending on the degree of the subject's pain, treatment strength was adjusted. Results : - Chuna simultaneous treatment group, shoulder joint range of flexion, extension, abduction, adduction, external rotation and internal rotation movement improved statistically significant. - Chuna simultaneous and acupuncture treatment group, visual analogue scale(VAS) scores of two groups decreased statistically significant. Conclusions : The result suggests that Chuna(shoulder traction) can be effective to recover range of motion and reduce pain on patients with frozen shoulder.

Unrecognized Shoulder Disorders in Treatment of Cervical Spondylosis Presenting Neck and Shoulder Pain

조현진,신명훈,허정우,김진성,류경식,박춘근 대한척추신경외과학회 2012 Neurospine Vol.9 No.3

Objective: Cervical spondylosis and shoulder disorders share with neck and shoulder pain. Differentiating between the two can be challenging and patient with combined pathologies is less likely to have pain improvement even after successful cervical operation. We investigated clinical characteristics of the patients who were diagnosed as cervical spondylosis however, were turned out to have shoulder disorders or the patients whose pain was solely originated from shoulder. Methods: Between January 2008 and October 2009, the patients presenting neck and shoulder pain with diagnosis of cervical spondylosis were enrolled. Among them, the patients who met following inclusion criteria were grouped into shoulder disorder group and the others were into cervical spondylosis group. Inclusion criteria were as follows. (1) To have residual or unresponsive neck and shoulder pain despite of optimal surgical treatment due to concomitant shoulder disorders. (2) When the operation was cancelled for the reason that shoulder and neck pain was proved to be related with unrecognized shoulder disorders. The authors retrospectively reviewed and compared clinical characteristics, level of pathology, diagnosis of cervical spondylosis and shoulder disorders. Results: A total of 96 patients were enrolled in this study. Shoulder disorder group was composed of 15 patients (15.8%) and needed additional orthopedic treatment. Cervical spondylosis group was composed of 81 patients (84.2%). There was no significant differences in mean age, sex ratio and major diagnosis in both shoulder disorder and cervical spondylosis group (p=0.33, 0.78, and 0.68 respectively). However, the distribution of pathologic levels was found to be significantly different(p=0.03). In shoulder disorder group, the majority of lesions (15 of 19 levels, 78.9%) were located at the level of C4-5(36.8%) and C5-6 (42.1%). On the other hand, in cervical spondylosis group, C5-6 (39.0%) and C6-7 (37.1%) were the most frequently observed level of lesions (80 of 105 levels, 16.1%). Conclusion: It is very important for spine surgeons to perform a complete history taking and physical examination using the special tests, and to discover the underlying shoulder disorders causing of symptom in treatment of cervical spondylosis presenting neck and shoulder pain. Objective: Cervical spondylosis and shoulder disorders share with neck and shoulder pain. Differentiating between the two can be challenging and patient with combined pathologies is less likely to have pain improvement even after successful cervical operation. We investigated clinical characteristics of the patients who were diagnosed as cervical spondylosis however, were turned out to have shoulder disorders or the patients whose pain was solely originated from shoulder. Methods: Between January 2008 and October 2009, the patients presenting neck and shoulder pain with diagnosis of cervical spondylosis were enrolled. Among them, the patients who met following inclusion criteria were grouped into shoulder disorder group and the others were into cervical spondylosis group. Inclusion criteria were as follows. (1) To have residual or unresponsive neck and shoulder pain despite of optimal surgical treatment due to concomitant shoulder disorders. (2) When the operation was cancelled for the reason that shoulder and neck pain was proved to be related with unrecognized shoulder disorders. The authors retrospectively reviewed and compared clinical characteristics, level of pathology, diagnosis of cervical spondylosis and shoulder disorders. Results: A total of 96 patients were enrolled in this study. Shoulder disorder group was composed of 15 patients (15.8%) and needed additional orthopedic treatment. Cervical spondylosis group was composed of 81 patients (84.2%). There was no significant differences in mean age, sex ratio and major diagnosis in both shoulder disorder and cervical spondylosis group (p=0.33, 0.78, and 0.68 respectively). However, the distribution of pathologic levels was found to be significantly different(p=0.03). In shoulder disorder group, the majority of lesions (15 of 19 levels, 78.9%) were located at the level of C4-5(36.8%) and C5-6 (42.1%). On the other hand, in cervical spondylosis group, C5-6 (39.0%) and C6-7 (37.1%) were the most frequently observed level of lesions (80 of 105 levels, 16.1%). Conclusion: It is very important for spine surgeons to perform a complete history taking and physical examination using the special tests, and to discover the underlying shoulder disorders causing of symptom in treatment of cervical spondylosis presenting neck and shoulder pain.

Effect of Chuna(Shoulder Traction) Treatment on Frozen Shoulder During Korean Medical Treatment

조나영,여인호,정세호,Hee Jin Sung,이참결,이은용,노정두 대한침구의학회 2014 대한침구의학회지 Vol.31 No.2

Objectives : Through an analysis of the previous studies, It is estimated that Chuna(shoulder traction) is effective in reducing the pain and increasing motion range of shoulder joint of the patient. So this study is to investigate the effects of Chuna(shoulder traction) on frozen shoulder. Methods : After treated with acupuncture and electro stimulating therapy, the subjects were measured list of measurement. And then treated with Chuna(shoulder traction) therapy, the subjects were measured list of measurement again. All treatment was performed by the same doctor who is a highly qualified about Chuna(shoulder traction). Chuna(shoulder traction) treatment takes 15 minutes. Three kind of Chuna(shoulder traction) therapy were performed for 5 minutes each. Depending on the degree of the subject's pain, treatment strength was adjusted. Results :- Chuna simultaneous treatment group, shoulder joint range of flexion, extension, abduction, adduction, external rotation and internal rotation movement improved statistically significant. - Chuna simultaneous and acupuncture treatment group, visual analogue scale(VAS) scores of two groups decreased statistically significant. Conclusions : The result suggests that Chuna(shoulder traction) can be effective to recover range of motion and reduce pain on patients with frozen shoulder.

파워숄더 재킷의 어깨 구성 방법과 디테일 대응 분석

박정아 ( Jeongah Park ),이정란 ( Jeongran Lee ) 복식문화학회 2021 服飾文化硏究 Vol.29 No.3

This study classifies the compositional methods of power shoulder jackets from 1980 to the present. It analyzes the relevance of jacket details according to how the power shoulder changes and its compositional methods by era. The research subdivides shoulder compositional techniques into seven, based on shoulder variation, sleeve variation, and the body and sleeve combination. The researcher investigates the frequency and trends of composing shoulders and analyzes details pertaining to the silhouette, jacket length, collar shape, and front closure. The most common method of shoulder composition is an angular shoulder variation. The others are a rounded shoulder variation, puffed sleeve, sleeve variation using pattern incision, raglan and kimono sleeves, and a shoulder variation that expanded the angle and width. The frequency differs slightly for each era. The relationship between shoulder compositional methods and details of power shoulder jackets is statistically significant, showing period-related differences. The homogeneity analysis results reveal that the shoulder composition of power shoulder jackets, the times, and details fall into distinct groups. This analysis shows that the silhouette, length, collar, and front closure of the power shoulder jacket differ depending on the power shoulder’s compositional methods. Moreover, the shape of the power shoulder jacket is distinctly different. One can use this data to help develop the power shoulder jacket design by reflecting the details of shoulder compositional methods and changing trends over time.