Ellenbecker Todd S, Elmore Eric, Bailie David S
Clinic Director, Physiotherapy Associates Scottsdale Sports Clinic, Scottsdale, AZ 85258, USA.
J Orthop Sports Phys Ther. 2006 May;36(5):326-35. doi: 10.2519/jospt.2006.2191.
Retrospective chart review.
To measure short-term postsurgery glenohumeral internal rotation and external rotation strength, shoulder range of motion (ROM), and subjective self-report ratings following mini-open rotator cuff repair of full-thickness rotator cuff tears.
Physical therapists provide rehabilitation for patients following mini-open rotator cuff repair. Long-term outcome studies have reported a high percentage of good and excellent results following surgery; however, little has been published regarding the immediate short-term results of this procedure, during which the patient is under the direct care of the physical therapist.
Charts from 11 female and 26 male patients, with a mean +/- SD age of 57.3 +/- 9.9 years, were reviewed following rotator cuff repair, using an arthroscopically assisted mini-open deltoid-splitting approach. All patients underwent postsurgery rehabilitation by the same therapist using a standard protocol. Retrospective chart review was used to obtain descriptive profiles of shoulder joint ROM at 6 and 12 weeks postsurgery and isokinetically assessed shoulder strength at 12 weeks postsurgery.
For the postsurgical shoulder, ROM deficits ranging between 5 degrees to 7 degrees were measured for shoulder abduction and external rotation and internal rotation at 90 degrees of abduction. The postsurgical extremity had greater flexion ROM (9 degrees ) compared to the contralateral side. Isokinetic external rotation strength deficits of 5% to 7% were present at 12 weeks postsurgery, with 2% to 11% greater internal rotation shoulder strength on the operative extremity, when compared to the other side. Patients completed the self-report section of the modified American Shoulder Elbow Surgeons (ASES) Rating Scale at 12 weeks postsurgery and scored a mean of 38.7/45.0 points.
The application of early ROM and progressive strengthening following mini-open rotator cuff repair allows for the successful return of ROM and strength 12 weeks postsurgery. The results of this study provide objective data for both shoulder ROM and strength at time points during which patients are traditionally receiving physical therapy following surgery.
回顾性病历审查。
测量全层肩袖撕裂的小切口肩袖修复术后短期的盂肱关节内旋和外旋力量、肩关节活动范围（ROM）以及主观自我报告评分。
物理治疗师为接受小切口肩袖修复术的患者提供康复治疗。长期结果研究报告称手术后有很高比例的良好和优秀结果；然而，关于该手术的即刻短期结果的报道很少，而在此期间患者处于物理治疗师的直接护理之下。
回顾了11名女性和26名男性患者的病历，平均年龄为57.3±9.9岁，采用关节镜辅助下小切口三角肌劈开入路进行肩袖修复。所有患者均由同一名治疗师按照标准方案进行术后康复治疗。通过回顾性病历审查获取术后6周和12周时肩关节ROM的描述性资料，并在术后12周对等速肩部力量进行评估。
对于术后肩部，在外展和外旋以及外展90度时的内旋方面，测量到的ROM缺失在5度至7度之间。与对侧相比，术后肢体的屈曲ROM更大（9度）。术后12周时存在5%至7%的等速外旋力量缺失，与另一侧相比，手术侧肢体的内旋肩部力量大2%至11%。患者在术后12周完成了改良美国肩肘外科医生（ASES）评分量表的自我报告部分，平均得分为38.7/45.0分。
小切口肩袖修复术后早期ROM和渐进性强化的应用可使术后12周ROM和力量成功恢复。本研究结果为患者术后传统上接受物理治疗期间的肩关节ROM和力量提供了客观数据。
