Rehabilitation of contralateral muscle atrophy following arthroscopic anterior shoulder instability surgery: a case study
Öz
Proper posture and sufficient scapular stabilization is necessary to provide normal shoulder functions after anterior shoulder instability surgery. A six-months rehabilitation program was performed to gain full shoulder functions and return to the sport after arthroscopic anterior shoulder instability surgery, a recreational athlete with bilateral idiopathic proximal muscular atrophy with marked prominence in the contralateral side of the surgery and scapular winging with significant deterioration in posture. Range of motion, pain, scapular kinematics, shoulder isokinetic rotator muscle strength and shoulder functions were measured bilaterally after surgery. Rehabilitation program was performed to achieve gradual external rotation in the surgical shoulder during the first three months. Scapular exercises combined with electrical stimulation were performed after contralateral trapezius and infraspinatus muscle atrophy and followed up since six months. Shoulder motions and muscle strength improved with rehabilitation end of the six-months in both shoulders and pain decreased on the surgical shoulder. The scapular movements were more symmetrical after treatment and scapular upward rotation and posterior tilt movements increased. At six months after surgery, the patient achieved full shoulder function and returned to the sport.
Anahtar Kelimeler
Kaynakça
- 1. Owens BD, Agel J, Mountcastle SB, et al. Incidence of glenohumeral instability in collegiate athletics. Am J Sports Med. 2009;37:1750-1754.
- 2. Kim S-H, Ha K-I, Cho Y-B, et al. Arthroscopic anterior stabilization of the shoulder: two to sixyear follow-up. J Bone Joint Surg Am. 2003;85:1511-1518.
- 3. Kibler BW, McMullen J. Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg. 2003;11:142-151.
- 4. Aktaş İ, Akgun K. Kanat Skapula. Turk J Phys Med Rehab. 2007;53.
- 5. McGarvey AC, Chiarelli PE, Osmotherly PG,et al. Physiotherapy for accessory nerve shoulder dysfunction following neck dissection surgery: a literature review. Head Neck. 2011;33:274-280.
- 6. Wang H, Cochrane T. Mobility impairment, muscle imbalance, muscle weakness, scapular asymmetry and shoulder injury in elite volleyball athletes. J Sports Med Phys Fitness. 2001;41:403.
- 7. van Meeteren J, Roebroeck M, Stam H. Testretest reliability in isokinetic muscle strength measurements of the shoulder. J Rehabil Med. 2002;34:91-95.
- 8. Hazar Kanik Z, Gunaydin G, Pala OO, et al. Translation, cultural adaptation, reliability, and validity of the Turkish version of the Penn Shoulder Score. Disabil Rehabil. 2018;40:1214-1219.
- 9. Gaunt BW, Shaffer MA, Sauers EL, et al. The American Society of Shoulder and Elbow Therapists' consensus rehabilitation guideline for arthroscopic anterior capsulolabral repair of the shoulder. J Orthop Sports Phys Ther. 2010;40:155-168.
- 10. Doucet BM, Lam A, Griffin L. Neuromuscular electrical stimulation for skeletal muscle function. Yale J Biol Med. 2012;85:201.
- 11. Karaahmet ÖZ, Umay E, Ünlü E, et al. İyatrojenik kanat skapula: bir olgu sunumu. Turk J Phys Med Rehab. 2011;57:348-350.
- 12. Keleş Z, Zinnuroğlu M, Beyazova M. Impairment of upper trapezius branch of the spinal accessory nerve during bypass grafting: a stretch injury? Muscle Nerve. 2010;41:144-147.
- 13. Black KP, Lombardo JA. Suprascapular nerve injuries with isolated paralysis of the infraspinatus. Am J Sports Med. 1990;18:225-228.
- 14. Liveson JA, Bronson MJ, Pollack M. Suprascapular nerve lesions at the spinoglenoid notch: report of three cases and review of the literature. J Neurol Neurosurg Psychiatry. 1991;54:241-243
Artroskopik anterior omuz instabilite cerrahisi sonrası kontralateral tarafta kas atrofisinde rehabilitasyon: vaka raporu
Öz
Omuz anterior instabilite cerrahisi sonrası normal omuz fonksiyonlarının sağlanması için düzgün bir postür ve yeterli bir skapular stabilizasyona ihtiyaç vardır. Artroskopik anterior omuz instabilitesi cerrahisi sonrası, cerrahi tarafın kontralateralinde belirgin olmak üzere bilateral idiopatik proksimal kas atrofisi gelişen ve postüründe belirgin bozulma ile skapular kanatlaşma görülen rekreasyonel bir sporcuya; tam omuz fonksiyonlarını kazandırmak ve spora dönüşü sağlamak amacıyla, cerrahi sonrası altı aylık süreçte rehabilitasyon programı uygulandı. Cerrahi sonrası eklem hareketi, ağrı, skapular kinematik ve omuz izokinetikrotator kas kuvveti ile omuz fonksiyonel değerlendirmesi bilateral olarak yapıldı. İlk üç ay hastanın cerrahi uygulanan omzunda, dereceli eksternal rotasyon kazanımını hedefleyen rehabilitasyon programı uygulandı. Zamanla oluşan kontralateral taraf trapezius ve infraspinatus kas atrofisi sonrasında üçüncü aydan itibaren elektrik stimülasyonuyla kombine uygulanan skapula temelli egzersiz tedavisi ile cerrahi sonrası altıncı aya kadar takip edildi. Uygulanan rehabilitasyon protokolüyle, altıncı ayın sonunda, her iki omuzda da eklem hareketi ve kas kuvvetinde artış ve cerrahi uygulanan omzundaki ağrıda azalma sağlandı. Skapular hareketlerin tedavi sonrasında daha simetrik olduğu ve yukarı rotasyon ve posterior tilt hareketlerinde artış olduğu gözlendi. Cerrahi sonrası altıncı ayda olgu tam omuz fonksiyonlarını kazandı ve spora dönüşü sağlandı.
Anahtar Kelimeler
Kaynakça
- 1. Owens BD, Agel J, Mountcastle SB, et al. Incidence of glenohumeral instability in collegiate athletics. Am J Sports Med. 2009;37:1750-1754.
- 2. Kim S-H, Ha K-I, Cho Y-B, et al. Arthroscopic anterior stabilization of the shoulder: two to sixyear follow-up. J Bone Joint Surg Am. 2003;85:1511-1518.
- 3. Kibler BW, McMullen J. Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg. 2003;11:142-151.
- 4. Aktaş İ, Akgun K. Kanat Skapula. Turk J Phys Med Rehab. 2007;53.
- 5. McGarvey AC, Chiarelli PE, Osmotherly PG,et al. Physiotherapy for accessory nerve shoulder dysfunction following neck dissection surgery: a literature review. Head Neck. 2011;33:274-280.
- 6. Wang H, Cochrane T. Mobility impairment, muscle imbalance, muscle weakness, scapular asymmetry and shoulder injury in elite volleyball athletes. J Sports Med Phys Fitness. 2001;41:403.
- 7. van Meeteren J, Roebroeck M, Stam H. Testretest reliability in isokinetic muscle strength measurements of the shoulder. J Rehabil Med. 2002;34:91-95.
- 8. Hazar Kanik Z, Gunaydin G, Pala OO, et al. Translation, cultural adaptation, reliability, and validity of the Turkish version of the Penn Shoulder Score. Disabil Rehabil. 2018;40:1214-1219.
- 9. Gaunt BW, Shaffer MA, Sauers EL, et al. The American Society of Shoulder and Elbow Therapists' consensus rehabilitation guideline for arthroscopic anterior capsulolabral repair of the shoulder. J Orthop Sports Phys Ther. 2010;40:155-168.
- 10. Doucet BM, Lam A, Griffin L. Neuromuscular electrical stimulation for skeletal muscle function. Yale J Biol Med. 2012;85:201.
- 11. Karaahmet ÖZ, Umay E, Ünlü E, et al. İyatrojenik kanat skapula: bir olgu sunumu. Turk J Phys Med Rehab. 2011;57:348-350.
- 12. Keleş Z, Zinnuroğlu M, Beyazova M. Impairment of upper trapezius branch of the spinal accessory nerve during bypass grafting: a stretch injury? Muscle Nerve. 2010;41:144-147.
- 13. Black KP, Lombardo JA. Suprascapular nerve injuries with isolated paralysis of the infraspinatus. Am J Sports Med. 1990;18:225-228.
- 14. Liveson JA, Bronson MJ, Pollack M. Suprascapular nerve lesions at the spinoglenoid notch: report of three cases and review of the literature. J Neurol Neurosurg Psychiatry. 1991;54:241-243
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Case Reports |
| Yazarlar | |
| Yayımlanma Tarihi | 25 Aralık 2018 |
| Gönderilme Tarihi | 11 Mayıs 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 5 Sayı: 3 |
