著者

山鹿 眞紀夫 高木 克公 森沢 佳三 井手 淳二 生田 拓也 北川 敏夫 鬼木 泰博 山隈 維昭

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.12, no.2, pp.129-133, 1988-08-10 (Released:2012-11-20)

参考文献数

6

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Neurovascular compression in the thoracic outlet produces great variation of signs and symptoms. The clinical picture is often complex, being made up of the derangement of blood vessels, somatic nerves and autonomic nervous networks in varying degrees. Thirty-eight of the 150 patients (25%) treated in our clinic because of possible thoracic outlet syndrome (TOS), complained of general malaise such as headache, dizziness, sleeplessness, nausea, anorexia or general fatigue, in addition to their peculiar signs and symptoms due to brachial plexus involvement.In order to find out whether or not autonomic nerve dysfunction can be demonstrated in patients with TOS, a non-invasive and quantitative technique was developed for assessing the mean (M) and coefficient of variations (CV) of R-R intervals in ECG at resting position. Thirty patients (13-39; mean 29.5 y/o) were put into two groups of 15 patient s each. In the first group patients with autonomic nerve disorder had complaints of general discomfort, M was 803.72 ± 106.9 msec and CV was 3.214±0.717%. In the second group, those without general discomfort, M was 972.21 ± 120.64 msec and CV was 5.926±0.720%. The first group had a significantly shorter M (P < 0.001) and smaller CV (P < 0.001) compared to the second group. Furthermore, in two cases in the first group diagnosed by psychologists as having schizophrenia and anxiety neurosis, it was found that their M and CV were the nearly same as those in the second group.Decompressive ope r a tions were performed on five patients in the first group. Their complaints decreased or vanished after the operation and the M and CV progressed to near the normal rate.From these results, we belive that this method in useful in differentiating between autonomic nervous disorders and psychological disorders; and that in patients with TOS, a decompressive operation can help eliminate complaints of general discomfort due to autonomic nervous disorders.

著者

副島 義久 下永吉 耕一 高嶋 研介 原 道也 山下 信哉 吉村 豊暢 森沢 佳三 高岸 直人 竹下 満 友清 哲 大田 佳介 荒木 義雄 上田 章雄 尾上 敏博 蒲原 光義

出版者

西日本整形・災害外科学会

雑誌

整形外科と災害外科 (ISSN:00371033)

巻号頁・発行日

vol.34, no.3, pp.932-937, 1986

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We examined the shoulder function of the 458 aged (50-80) and 1264 children (6-12) who had no complaint about their shoulders. The purpose of this study is to determine the normal limit of ROM, muscle power and instability for criteria of shoulder functions. Holding the dumbbell in 90&deg; elevation, serial elevation of the shoulder, and ROM were evaluated in each age group. In addition, inferior instability of the shoulders were examined in children. Shoulder function of the aged seemed to be dependent on personality rather than their ages. All the children have had full ROM, but muscle power was influenced by their age. 4.7% of children has inferior instability of the shoulder.

著者

井手 淳二 森沢 佳三 山鹿 真紀夫 北川 敏夫

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.12, no.1, pp.91-94, 1988-08-10 (Released:2012-11-20)

参考文献数

5

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We have determined the effectiveness of muscular strengthening exercises of the rotator muscles for shoulder instability. These exercises are one of the conservative treatments for shoulder instability.As of y et, there have only been a few reports about the effectiveness of this procedure due to lack of data. So we have attemped to clarify this treatment and its effect. In this study, we will report on 11 cases-19 shoulders with inferior and/or multidirectional instability and 3 cases-3 shoulders with recurrent anterior dislocation.All the patients began isometric rehabilitation exercises and followed up using a Cybex machine and a grading system. As a result, we found muscular strengthening exercises to be effective and useful in 75% of the patients with inferior and/or multidirectional instability. Patients with recurrent anterior dislocation also had a good rate of response. However the success and effectiveness of this technique has certain limitations.We should first try muscular strengthening exercises of the rotator muscles in the treatment of shoulder instability.