CLINICAL REPORT ON IMPROVEMENT OF MOBILITY OF AFFECTED SHOULDER JOINT CAUSED BY ACUTE CEREBRAL INFARCTION TREAT-ED WITH ACUPUNCTURE AND MASSAGE

Objective To observe the effects of acupuncture and massage to improve the mobility of affected shoulder joint caused by acute cerebral infarction. Methods 120 cases of acute cerebral infarction were randomized into two groups, named treatment group with acupuncture and massage and control group with western medicine. Acupoint selection of treatment group with acupuncture and massage： Yōngquán （涌泉 KI1）, Láogōng （劳宫 PC8）, Hòuxī （后溪SI3）, Gōngsūn （公孙 SP4）, Fēngchī （风池 GB20）, Jiānyú （肩髃 LI15）, Qūchí （曲池 LI11）, Hégǔ （合谷 LI4）, Huántiào （环跳 GB30）, Zúsānlǐ （足三里 ST36）, Tàichōng （太冲 LR3）, Anterior Oblique Line of Vertex-Temporal and Posterior Oblique Line of Vertex-Temporal. Massage techniques： roll for relax, hold and press, flick and fiddle, and shake. Control group with western medicine was treated with mannitol ＋ low molecular weight dextran ＋ CDP-choline. Results Compared with control group, treatment group could apparently improve the mobility of shoulder joint and lower the injury percentage （P〈0. 01） ; and the therapeutic effect of treatment group is better than that of control group （P〈0. 05） for treating acute cerebral infarction. Conclusion The therapy of acupuncture combined with massage could improve the function of the affected shoulder joint caused by acute cerebral infarction, and enhance therapeutic effect.

Therapeutic efficacy of acupuncture combined with neuromuscular joint facilitation in treatment of hemiplegic shoulder pain

BACKGROUND Stroke is a type of cerebrovascular disease with high prevalence,mortality,and onset of disability.As a neurodevelopmental therapy,neuromuscular joint facilitation(NJF)is widely used in the treatment of orthopedic and neurological disorders in the clinical practice.It is mainly used for central nervous system diseases or orthopedic diseases,movement disorders,and pain rehabilitation.According to related studies,NJF can also be used as a rehabilitation treatment in patients with hemiplegic shoulder pain(HSP).AIM To investigate the clinical efficacy of acupuncture combined with NJF in patients with HSP.METHODS Forty patients with HSP were randomly divided into a treatment group and a control group.The treatment group was treated with acupuncture combined with NJF and the control group was treated with acupuncture alone.All patients were assessed by using the visual analogue scale(VAS),Fugl-Meyer assessment(FMA),Barthel index(BI),and passive range of motion(PROM)before and after the training.All the clinical data were analyzed using SPSS 20.0 statistical software.RESULTS There was no statistical difference in the general characteristics between the two groups.In the terms of duration of treatment,age,and pre-treatment indicators,the two groups were comparable(P>0.05).After the treatment,VAS,PROM,BI,and FMA scores were significantly improved in the two groups of patients(P<0.05).The VAS,PROM and FMA scores were significantly higher in the treatment group than in the control group(P<0.05).However,there was no significant difference in BI scores between the two groups(P>0.05).CONCLUSION Both acupuncture alone and acupuncture combined with NJF in the treatment of HSP are effective,and can improve the clinical symptoms of patients.Acupuncture combined with NJF can improve the upper limb motor function,relieve pain,and increase joint mobility in patients with HSP.The combination therapy is better than acupuncture alone.However,there is no significant difference in improving the score of patients’self-care ability.

Restoration of the joint geometry and outcome after stemless TESS shoulder arthroplasty

AIM To evaluate the joint geometry and the clinical outcome of stemless, anatomical shoulder arthroplasty with the TESS system.METHODS Twenty-one shoulders with a mean follow-up 18 of months were included. On scaled digital radiographs the premorbid center of rotation(CoR) was assessed and compared to the CoR of the prosthesis by using the MediC AD~? software. Additionally, the pre-and post-operative geometry of the CoR was assessed in relation to the glenoid, the acromion as well as to the proximal humerus. Radiological changes, such as radiolucencies, were also assessed. Clinical outcome was assessed with the Constant and DASH score. RESULTS Both, the Constant and DASH scores improved signifi-cantly from 11% to 75% and from 70 to 30 points, P < 0.01 respectively. There were no significant differences regarding age, etiology, cemented or metal-backed glenoids, etc.(P > 0.05). The pre-and postoperative humeral offset, the lateral glenohumeral offset, the height of the CoR, the acromiohumeral distance as well as neckshaft angle showed no significant changes(P > 0.05). The mean deviation of the CoR of the prosthesis from the anatomic center was 1.0 ± 2.8 mm. Three cases showed a medial deviation of more than 3 mm. These deviations of 5.1, 5.7 and 7.6 mm and were caused by an inaccurate humeral neck cut. These 3 patients showed a relatively poor outcome scoring.CONCLUSION TESS arthroplasty allows an anatomical joint reconstruction with a very good outcome. Outliers described in this study sensitize the surgeon for an accurate humeral neck cut.

A Case of Septic Arthritis of the Shoulder Joint That Developed after Suprascapular Nerve Block

Septic arthritis of the shoulder is uncommon in the immunocompetent patient with no previous risk factors for joint infection. We treated an immunocompetent patient who developed septic arthritis of the shoulder after suprascapular nerve block for pain due to rotator cuff tear. An 80-year-old man with no underlying disease visited a nearby orthopedics clinic with complaint of left shoulder joint pain. Left suprascapular nerve block was performed, but the pain gradually aggravated. On the day after the block, he had a fever of 39&deg;C and came to our department. On examination, enlargement and tenderness were present at the injection site. Cellulitis at the site was suspected. He was admitted and administration of a cephem anti-biotic was started. Pain subsequently decreased. Magnetic resonance imaging (MRI) performed 4 days after hospitalization showed massive effusion close to the injection site. The effusion spread into the joint cavity through the tear site of the supraspinatus. Septic arthritis of the shoulder was strongly suspected, open irrigation and debridement were performed 11 days after hospitalization. After surgery, pain immediately improved. In our case the extra-articular infection caused by suprascapular nerve block considered to spread into the shoulder joint cavity through the site of rotator cuff tear, although there have been no reports of such cases. This case suggests the possibility that patients with rotator cuff tear may easily develop septic arthritis because extra-articular infection may spread into the joint cavity through the site of tear.

Analysis of CT and MRI in the Diagnosis of Shoulder Joint Injury

Objective: To observe the effect of multi-slice spiral CT and magnetic resonance imaging (MRI) in the diagnosis of shoulder injury. Methods: 120 patients with shoulder injury who were treated in our hospital (January 2020 to December 2021) and underwent surgical treatment were diagnosed as shoulder injury. They were divided into CT group, MRI group and joint diagnosis group. The detection rates of the two methods were compared. Results: In the diagnosis of shoulder injury, MRI group was higher than CT group, and the joint diagnosis group was higher than the other two groups. Conclusion: In the diagnosis of shoulder injury, the joint examination of multi-slice spiral CT and magnetic resonance imaging (MRI) can obtain a higher diagnostic rate and ideal effect.

Shoulder joint flexibility in top athletes

Joint range of motion (ROM) is very important in daily activities, sport and in clinical diagnosis. Many factors have been reported to influence joint ROM. Musculoskeletal adaptation and some special side effects due to his or her physical demands and movement patterns in professional athletes are very important subjects in sport sciences. The present study is a comparison of shoulder joint ROM in elite athlete and non-athlete groups and its relationship to their age, post and years of their tournament play. The subjects in this study included 106 men with mean age (23.65 &#177;3.45) and mean years of tournament play (5.60 &#177;2.23). The groups of subjects included 26 handball players, 25 volleyball players, 25 soccer players and 30 non-athletes. Data were collected through questionnaires and inspection, and subjects’ ROM was measured by “Leighton flex- ometer” (r = 0.90 – 0.99) in external rotation and abduction of shoulder joint in dominant and non-domi- nant hands. Data were analyzed by correlation coefficient, t – test, ANOVA and post hock Schaffe test. The results showed that an increase in age and years of tournament play reduced the shoulder ROM of subjects (p ≤ 0.05). There were significant differences in shoulder ROM among athletic groups. Additionally, there are significant differences between dominant and non-dominant hands (p ≤ 0.05). It can be concluded that more specific stretching exercises and warm-up for shoulder in all athletes and especially in older and experienced players should be performed by coaches. The results also emphasized routine screening, corrective exercise programs and a design of preventing strategies by athletic trainers and coaches.

High Frequency Ultrasound in Determining the Causes of Acute Shoulder Joint Pain

Shoulder ultrasonography is approved as the examination of choice for rotator cuff abnormality in many centers around the world since it is an inexpensive and safe tool for investigation of rotator cuff abnormalities. The goal of this study was to determine the ultrasound findings in patients with acute shoulder joint pain, and also to identify possible predictors of shoulder pain, as well as to compare the ultrasound diagnostic performance to that of MRI in such condition. A total of 65 (mean age 28 ± 1.2 years) consequential patients were recruited for a period of six months between July 2015 and June 2016 in this study. Collected data were confined on age, medical history, and clinical symptoms. Shoulder ultrasound was performed with a linear array transducer (10 - 15 MHz) connected to HI vision Avius ultrasound unit;Hitachi. MRI for the shoulder joint was performed in all cases to confirm the ultrasound results, using 1.5-T MRI system (Magnetom Espree);Siemens. Statistical analysis was completed using the standard Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) version 20 for windows. Ultrasound manages to determine the causes of acute shoulder joint pain in 98% of the patients. Fitted achievement values for shoulder ultrasound in the diagnosis the causes of shoulder joint pain were 100% sensitivity and a range of 96% to 100% of accuracy. Ultrasound presents a high sensitivity and accuracy in diagnosis a wide spectrum of shoulder joint lesions, with a diagnostic performance near to that of MRI.

Follow-up effect and safety value of nano-carbon on shoulder joint after lymphatic chemotherapy for breast cancer

Objective:To investigate the effect and safety of nano-carbon on shoulder joint after lymphatic chemotherapy for breast cancer. Methods:164 patients Breast cancer patients, Sc group (docetaxel + CNP), Dd group (docetaxel), Sc group and Dd group were selected to observe shoulder joint function, docetaxel concentration in Sc group and Dd group after 12 h, 24 h, 36 h and 48 h injection of chemotherapy, apoptotic index of metastatic lymph nodes, apoptosis rate of lymph node cells, Sc group and Dd group were observed. The occurrence of adverse reactions. Results:The concentration of paclitaxel in the lymph nodes of the Sc group was significantly higher than that of the Dd group at 12h, 24h, 36, 48h. The concentration of paclitaxel was the highest in the group of 24h in the Sc group, and the lowest in the 48h group. 0.05);The AI index of the chemotherapy group was significantly higher than that of the Dd group at 12h, 24h, 36, 48h in the Sc group (P<0.05). The AI index of the AI index of the 36h injection chemotherapy group and the 48h injection chemotherapy group in the Sc group and the Dd group were compared. The difference was not significant (P>0.05). The apoptosis rate of lymphocytes in the group of 12h, 24h, 36th and 48h in the Sc group was significantly higher than that in the Dd group (P<0.05). The patients in the Sc group and the Dd group were injected with chemotherapy for 48 hours. There was no significant difference in lymph node cell apoptosis rate between the injection chemotherapy patients (P>0.05);the incidence of adverse reactions in the Dd group (15%) was higher than that in the Sc group (7.1%), but there was no difference (P>0.05);There was no significant difference in the function of shoulder joint function between the Dd group and the Dd group (P>0.05). The score of the shoulder joint function score in the Sc group was increased compared with the Dd group (P<0.05). Conclusions:Carbon nanoparticles are of high value and safety in the application of lymphatic chemotherapy to shoulder joint after breast cancer surgery, which is worthy of wide application in clinical treatment of breast cancer.

Effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries

BACKGROUND The rotator cuff is located below the acromion and deltoid muscles and comprises multiple tendons that wrap around the humeral head,maintaining shoulder joint stability.AIM To explore the effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries.METHODS We selected 97 patients with rotator cuff injuries treated in the People's Hospital of Yuhuan from February 2020 to May 2023.Patients were grouped using the envelope method.RESULTS After treatment,the study group’s treatment effective rate was 94.90%(46/49 patients),significantly higher than that in the control group(79.17%,38/48 cases;P<0.05).Before treatment,there was no difference in Constant Murley Score(CMS)scores,shoulder mobility,or 36-Item Short Form Health Survey(SF-36)scale scores(P>0.05).Compared with those before treatment,the CMS scores(including pain,daily living ability,shoulder mobility,and muscle strength),all aspects of shoulder mobility(forward flexion,posterior extension,external rotation,internal rotation),and SF-36 scale scores(including physiological,psychological,emotional,physical,vitality,and health status)were higher in both groups after treatment and significantly higher in the study group(P<0.05).There was no difference in the occurrence of complications between the two treatment groups(P>0.05).CONCLUSION Electroacupuncture combined with rehabilitation techniques has a good treatment effect on patients with rotator cuff injuries,helps accelerate the recovery of shoulder function,improves the quality of life,and is highly safe.

Study on the Effect of Repetitive Peripheral Magnetic Stimulation Combined with Conventional Rehabilitation Measures on Shoulder Dysfunction in Early Stroke

Objective:To study the effect of repetitive peripheral magnetic stimulation(rPMS)combined with conventional rehabilitation measures on shoulder dysfunction in early stroke.Methods:60 patients with shoulder dysfunction in early stroke were selected,and all of them were admitted to our hospital from August 2021 to August 2023.The patients were randomly grouped into a control group(conventional rehabilitation measures intervention,30 cases)and an intervention group(rPMS and conventional rehabilitation measures intervention,30 cases)according to the lottery method.The pain scores,shoulder mobility,and motor function scores of the two groups were compared.Results:The pain score was lower in the intervention group,and the shoulder mobility and motor function scores were higher in the intervention group(P<0.05)as compared to that of the control group.Conclusion:The effect of combining rPMS and conventional rehabilitation measures in treating shoulder dysfunction in early stroke was remarkable and should be popularized.

有限元分析不同程度冈上肌断裂对肩关节应力的影响

背景:目前研究冈上肌的精细解剖及各亚区域的生物力学表现的实验较多,但是对冈上肌不同区域的损伤所带来的肩关节应力的影响鲜有耳闻。很有必要了解不同区域的冈上肌损伤对关节软骨及关节盂的应力大小及分布的影响,从而给临床诊治提供一些理论支持。目的:探究在三维有限元软件中模拟不同程度的冈上肌断裂对肱骨软骨面、关节盂唇及关节盂软骨关节面的最大应力值。方法:获取正常健康的肩关节CT或MRI导入Mimics、Geomagic进行提取模型,再通过Soildworks对模型构建,再对各个模型的冈上肌进行不同程度的损伤,模拟出不同区域的断裂。最后导入机械软件Ansys,进行三维有限元生物力学分析,计算肱骨软骨面、关节盂唇及关节盂软骨关节面的应力数值。结果与结论:①随着冈上肌损伤程度的加重肩关节软骨面及盂唇的应力也会增加;②冈上肌前部在各区域中最为重要;③不同程度的冈上肌断裂对肩关节盂唇面的软骨应力大小有影响,而应力的分布区域无明显改变;④提示肩关节水平外展起始时,前部发挥着重要的作用,其次为后部深区;当冈上肌前部损伤时肩关节软组织应力增加明显,还容易引起关节盂唇顶部及关节盂软骨前下方的损伤。

基于Joint HOG特征复杂场景下的头肩检测

视频监控领域的行人检测是一项重要的研究课题,然而很多情况下行人姿态多样、相互遮挡使得检测变得困难,故采用了头肩的轮廓特征来进行检测。头肩的定位检测采用了Haar特征和HOG特征的层级分类方法,并根据头肩的对称性特点,提出了一种称为Joint HOG的组合型特征。通过Haar分类器滤除大部分负样本后,接着用HOG进行精细的验证从而得到头肩目标框。实验表明,本文的方法取得了80%~90%的准确率,并且完全可以用于实时处理。

Recurrent anterior shoulder instability: Review of the literature and current concepts

The purpose of this review article is to discuss the clinical spectrum of recurrent traumatic anterior shoulder instability with the current concepts and controversies at the scientific level. Because of increasing participation of people from any age group of the population in sports activities, health care professionals dealing with the care of trauma patients must have a thorough understanding of the anatomy, patho-physiology, risk factors, and management of anterior shoulder instability. The risk factors for recurrent shoulder dislocation are young age, participation in high demand contact sports activities, presence of Hill-Sachs or osseous Bankart lesion, previous history of ipsilateral traumatic dislocation, ipsilateral rotator cuff or deltoid muscle insufficiency, and underlying ligamentous laxity. Achieving the best result for any particular patient depends onthe procedure that allows observation of the joint surfaces, provides the anatomical repair, maintains range of motion, and also can be applied with low rates of complications and recurrence. Although various surgical techniques have been described, a consensus does not exist and thus, orthopedic surgeons should follow and try to improve the current evidence-based treatment modalities for the patients.

Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty

To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score(CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score.

Kinematic Optimization of Bionic Shoulder Driven by Pneumatic Muscle Actuators Based on Particle Swarm Optimization

A bionic shoulder joint with three degree-of-freedom(DOF)driven by pneumatic muscle actuator is proposed and its corresponding kinematic model is established.The bionic shoulder is optimized by particle swam optimization(PSO)with the fitness standards that the requirements of rotation indexes are met and the fluctuation of motion is kept in the lowest resolution in a pneumatic muscle actuator range.Simulation considering rotation indexes only(first simulation)is compared with the one considering both rotation indexes and motion resolution(second simulation)subsequently.Mounting position of the pneumatic muscle actuators in bionic shoulder is optimized after initializing the same condition in simulations.Results show that the fluctuations of parameters are consistent,and the parameters of the first simulation have good convergence than those of the second one.With the increase of stretch rate of the pneumatic muscle actuator,the needed length of fixed link in the center of static platform decreases in optimization.

Acupuncture and the Elevation Manipulation of Massage for Treatment of Frozen Shoulder

The authors have treated 50 cases of frozen shoulder in recent years with electro-acupuncture and the elevation manipulation. The results were satisfactory and reported as follows.

Advanced septic arthritis of the shoulder treated by a two-stage arthroplasty

BACKGROUND The usual treatment of septic shoulder arthritis consists of arthroscopic or open lavage and debridement.However,in patients with advanced osteoarthritic changes and/or massive rotator cuff tendon tears,infection eradication can be challenging to achieve and the functional outcome is often not satisfying even after successful infection eradication.In such cases a two-stage approach with initial resection of the native infected articular surfaces,implantation of a cement spacer before final treatment with a total shoulder arthroplasty in a second stage is gaining popularity in recent years with the data in literature however being still limited.AIM To evaluate the results of a short interval two-stage arthroplasty approach for septic arthritis with concomitant advanced degenerative changes of the shoulder joint.METHODS We retrospectively included five consecutive patients over a five-year period and evaluated the therapeutic management and the clinical outcome assessed by disability of the arm,shoulder and hand(DASH)score and subjective shoulder value(SSV).All procedures were performed through a deltopectoral approach and consisted in a debridement and synovectomy,articular surface resection and insertion of a custom made antibiotic enriched cement spacer.Shoulder arthroplasty was performed in a second stage.RESULTS Mean age was 61 years(range,47-70 years).Four patients had previous surgeries ahead of the septic arthritis.All patients had a surgical debridement ahead of the index procedure.Mean follow-up was 13 mo(range,6-24 mo).Persistent microbiological infection was confirmed in all five cases at the time of the first stage of the procedure.The shoulder arthroplasties were performed 6 to 12 wk after insertion of the antibiotic-loaded spacer.There were two hemi and three reverse shoulder arthroplasties.Infection was successfully eradicated in all patients.The clinical outcome was satisfactory with a mean DASH score and SSV of 18.4 points and 70%respectively.CONCLUSION Short interval two-stage approach for septic shoulder arthritis is an effective treatment option.It should nonetheless be reserved for selected patients with advanced disease in which lavage and debridement have failed.

Two-hundred and Ten Cases of Shoulder Periarthritis Treated by Needling Lingxia and Sanjian

From January of 1996 to June of 2001, the author treated 210 cases of shoulder periarthritis by needling Lingxia and Sanjian (LI 3), and achieved satisfactory therapeutic results. This is reported as follows.

Biodynamic investigation on electr ic acupuncture-kinesiatrics in therapy of periarth ritis of shoulder

Objective To introduce the treatment for peria rthritis of shoulder by detachment o f impulse electrotherapeutic equip ment and kinesiatrics,and discuss the principles of biomechanics.Method76cases with periarthritis of shoul der had been treated with electrotherapeutic equipment and tri-dimensional movement,and mean treatment times were 8.2.Results65cases were fully recover,9cases were effective,2cases took a favorable turn and 0case were n on-effective.Conclusion The therapeutic method is effective and aim directly at periarthritis of shoul-der.We have explored the direction,strength and position of the force.

针刺对肩周炎患者生存质量改善及临床效果研究

目的研究针刺治疗后肩周炎患者的临床疗效和生存质量改善情况。方法严格按照纳入排除标准选择2022年3月—2023年3月收治的80例肩周炎患者进行研究,按照等比例随机数字表法分为两组,对照组40例采用口服药物+功能锻炼治疗,研究组40例采用经络别通法针刺治疗,治疗1个疗程后观察比较两组临床疗效、肩关节功能、日常生活能力、炎症因子水平以及疼痛恢复情况。结果研究组治疗总有效率(97.50%,39/40)显著高于对照组(77.50%,31/40),差异有统计学意义(P<0.05);均未发生严重安全事件,仅少数患者发生不良反应,差异无统计学意义(P>0.05)。治疗前,两组肩关节评分量表(CMS)分值、疼痛程度、简化生活质量量表(ADL)评分和炎症因子水平比较差异均无统计学意义(P>0.05);治疗后,研究组CMS分值、ADL评分高于对照组,疼痛状况(PPI)分值、视觉模拟疼痛(VAS)分值、疼痛分级指数(PRI)分值、C反应蛋白(CRP)、白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平低于对照组,差异有统计学意义(P<0.05)。结论经络别通法针刺治疗肩周炎疗效显著,可显著改善疼痛,从而改善患者生存质量,相关作用机制可能与降低炎症因子水平,恢复肩关节功能相关。