Service de médecine physique et de réadaptation, hôpital Bellevue, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
Ann Phys Rehabil Med. 2010 Oct;53(8):499-510. doi: 10.1016/j.rehab.2010.07.033. Epub 2010 Aug 27.
The rotator cuff muscles help stabilize the glenohumeral joint. Postoperative recovery of rotator cuff muscle strength appears to be an important factor for optimal joint stabilization and the resumption of professional and/or sports activities.
To study the relationship between internal rotator (IR) and external rotator (ER) muscle strength, shoulder function and the resumption of sports activities (as typically evaluated with functional scores) following surgical stabilization with the Bristow-Latarjet procedure in cases of chronic shoulder instability.
Twenty patients with anterior, post-traumatic, chronic shoulder instability were included prospectively in a cohort study. The Rowe and Walch-Duplay functional scores were rated for the operated shoulder and the isokinetic IR and ER peak torque values were evaluated with a Con-Trex(®) dynamometer before surgery and then 3, 6 and 21 months afterwards. The isokinetic evaluation was performed (at 180°/s, 120°/s and 60°/s) in the seated position, with the arms in 45° of abduction and 30° of antepulsion in the plane of the scapula.
There were no significant postoperative correlations between shoulder function (as judged by the Rowe and Walch-Duplay scores) and IR or ER muscle strength.
This study did not provide evidence for a correlation between IR and ER muscle strength and functional scores after surgical stabilization of the shoulder. However, it is necessary to objectively measure the rotator cuff strength recovery to adequate the strengthening of rotator muscle prior to the resumption of sports activities. Isokinetic strength assessment may thus be a valuable decision support tool for the resumption of sports activities and would complement the functional scores studied here.
肩袖肌群有助于稳定盂肱关节。肩袖肌肉力量的术后恢复似乎是最佳关节稳定和恢复专业和/或运动活动的重要因素。
研究慢性肩不稳定患者行 Bristow-Latarjet 手术后内部旋转(IR)和外部旋转(ER)肌肉力量、肩部功能与运动活动恢复(通常通过功能评分评估)之间的关系。
前瞻性纳入 20 例慢性创伤性前肩不稳患者进行队列研究。对手术肩的 Rowe 和 Walch-Duplay 功能评分进行评估,并使用 Con-Trex(®)测力计在术前以及术后 3、6 和 21 个月时评估等速 IR 和 ER 峰值扭矩值。等速评估(180°/s、120°/s 和 60°/s)在坐姿下进行,手臂外展 45°,肩胛骨平面前推 30°。
肩部功能(根据 Rowe 和 Walch-Duplay 评分判断)与 IR 或 ER 肌肉力量之间无显著术后相关性。
本研究未提供证据表明肩手术后 IR 和 ER 肌肉力量与功能评分之间存在相关性。然而,在恢复运动活动之前,有必要客观测量肩袖力量的恢复情况,以加强肩袖肌肉。等速力量评估可能是恢复运动活动的有价值的决策支持工具,并补充这里研究的功能评分。