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Different programmes of physiotherapy influence functional outcome after arthroscopic labral repair
Author(s):
Szuba L. (Poland)
Szuba L. (Poland)
Affiliations:
ESSKA Academy. Szuba L. May 9, 2018; 209888; P21-931
Dr. Lukasz Szuba
Dr. Lukasz Szuba
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Abstract
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Objectives: Arthroscopic labral repair is a common way of treatment after a repeated shoulder injury with instability symptoms. Recovery after surgery is based on physiotherapy early oriented on reducing inflammation and pain, further followed by restoring the range of motion, improving proprioception and restoration of strength qualities. Previous studies clearly explain peak torque assessment and interpretation after labral repair, however many other isokinetic parameters may be helpful in setting waypoints of functional improvements. We aimed to use isokinetic testing to assess differences in the power, strength and shoulder active range of motion functional tests of patients following arthroscopic labral repair in short supervised physiotherapy vs. long supervised physiotherapy regimes. Secondly, we assess healthy individuals as a reference for functional and biomechanical outcomes.

Methods: Group I included 23 males who had undergone arthroscopic labral repair after being diagnosed with recurrent anterior glenohumeral joint instability without associated bony joint lesions. Postoperatively, they participated in short-term supervised physical therapy, followed by self-guided home-based exercises. Group II included 25 males who had undergone arthroscopic labral repair with long-term supervised physiotherapy. Group III included 25 healthy individuals without an upper limb or cervical spine injuries. The three groups were matched for age, body height, body mass and were equal to gender distribution. The orthopedic examination, functional tests, and biomechanical measurements under isokinetic conditions were performed 17±5 months postoperatively in Group I and 19±3 months postoperatively in Group II. Comparative statistical analyses with post hoc Tukey test were conducted.

Results: In Group I significant differences in the internal glenohumeral rotation were observed on the operated side. The patients from Group I were also found to have significant deficits in biomechanical parameters such as peak torque, power, and total work. An inter-group comparison revealed significantly lower values of obtained biomechanical parameters in Group I and II in reference to healthy individuals.

Conclusions: Patients who obtain shorter postoperative physiotherapy after labral repair had worse functional and biomechanical outcomes in comparison to patients with longer physiotherapy programme and healthy individuals.

Keywords:
shoulder instability, rehabilitation, isokinetics, glenohumeral rotation
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