Title Page
Abstract
Contents
1. Introduction 14
1.1. Background and Necessity 14
1.2. Purpose 17
1.3. Hypotheses 17
2. Theoretical Background 18
2.1. Anatomical structure of the shoulder complex 18
2.1.1. Anatomical structure of the glenohumeral joint 20
2.1.2. Anatomical structure of scapulothoracic joint 22
2.2. Movements of the glenohumeral joint 23
2.3. Movements of scapula and scapula thoracic joint 24
2.4. Kaltenborn-Evjenth stretch mobilization 26
2.4.1. Stretch-traction mobilization 28
2.4.2. Stretch-glide mobilization 29
3. Methods 30
3.1. Subjects 30
3.2. Process of research 31
3.3. Intervention 33
3.3.1. Kaltenborn-Evjenth concept 33
3.3.2. Traditional Chinese Tuina 39
3.4. Clinical Measurements 41
3.4.1. Pain 41
3.4.2. Shoulder pain and disability index (SPADI). 42
3.4.3. Range of motion (ROM) 43
3.4.4. grip strength 45
3.5. Statistical Analysis 47
4. Result 48
4.1. General characteristics of the subjects 48
4.2. Comparison of the pain between the two groups 49
4.3. Comparison of the disability index between two groups 51
4.4. Comparison of the ROM between the two groups 53
4.4.1. Comparison of the flexion ROM between the two groups 53
4.4.2. Comparison of the abduction ROM between the two groups 55
4.4.3. Comparison of the internal rotation ROM between the two groups 57
4.4.4. Comparison of the external rotation ROM between the two groups 59
4.5. Comparison of the grip strength between the two groups 61
5. Discussion 63
6. Conclusion 68
II. List of references 69
III. List of abbreviations 84
VI. Appendix 88
Appendix 1. Abstract of Korean 88
Appendix 2. The position of Tuina acupoints 90
Appendix 3. Shoulder pain and disability Index (SPADI) 93
Appendix 4. Informed consent form(The Chinese version) 94
Appendix 5. Shoulder joint ROM check 98
Table 1. General characteristics of the subjects 48
Table 2. Effects of EG and CG on pain 49
Table 3. Effects of EG and CG on disability index 51
Table 4. Effects of EG and CG on shoulder join flexion ROM 53
Table 5. Effects of EG and CG on shoulder join abduction ROM 55
Table 6. Effects of EG and CG on shoulder join Internal rotation ROM 57
Table 7. Effects of EG and CG on shoulder join external rotation ROM 59
Table 8. Effects of EG and CG on grip strength 61
Figure 1. The joints of the right shoulder complex. 19
Figure 2. Posterior view of the right shoulder complex after the arm abducts 180 degrees 19
Figure 3. Anterior view of the right glenohumeral joint 21
Figure 4. Features of scapula thorax joint 22
Figure 5. The right glenohumeral joint 23
Figure 6. Motions of the right scapula against the posterior-lateral thorax. A. Elevation and... 25
Figure 7. The 3 grades of Kaltenborn-Evjenth mobilization 27
Figure 8. The direction of Stretch-traction mobilization 28
Figure 9. The direction of stretch-glide mobilization 29
Figure 10. Experimental Process 32
Figure 11. Shoulder stretch start position 33
Figure 12. Shoulder stretch end position 33
Figure 13. Shoulder posterior glide start position 34
Figure 14. Shoulder posterior glide end position 34
Figure 15. Shoulder ventral glide start position 35
Figure 16. Shoulder ventral glide end position 35
Figure 17. Shoulder caudal glide start position 36
Figure 18. Shoulder caudal glide end position 36
Figure 19. Scapula caudal glide start position 37
Figure 20. Scapula caudal glide end position 37
Figure 21. Scapula winging mobilization start position 38
Figure 22. Scapula winging mobilization end position 38
Figure 23. Finger pointing manipulation 40
Figure 24. Treatment in supine position 40
Figure 25. Treatment in prone position 40
Figure 26. Visual Analog Scale 41
Figure 27. Analysis of reliability of disability index 42
Figure 28. Standard plastic goniometer 43
Figure 29. Shoulder flexion ROM test 44
Figure 30. Shoulder abduction ROM test 44
Figure 31. Shoulder internal rotation ROM test 44
Figure 32. Shoulder external rotation ROM test 44
Figure 33. Hand dynamometer(reliability=0.8-0.9) 46
Figure 34. Test in siting position 46
Figure 35. Effects of EG and CG on pain 50
Figure 36. Effects of EG and CG on disability index 52
Figure 37. Effects of EG and CG on shoulder joint flexion ROM 54
Figure 38. Effects of EG and CG on shoulder join abduction ROM 56
Figure 39. Effects of EG and CG on shoulder join Internal rotation ROM 58
Figure 40. Effects of EG and CG on shoulder join external rotation ROM 60
Figure 41. Effects of EG and CG on shoulder grip strength 62