Horschig Aaron, Sayers Stephen P, Lafontaine Tom, Scheussler Scott
Boost Physical Therapy and Sport Performance, Kansas City, Missouri, USA.
Int J Sports Phys Ther. 2012 Dec;7(6):663-71.
Complete rupture of the distal tendon of the biceps brachii is relatively rare and there is little information to guide therapists in rehabilitation after this injury. The purposes of this case report are to review the rehabilitation concepts used for treating such an injury, and discuss how to modify exercises during rehabilitation based on patient progression while adhering to physician recommended guidelines and standard treatment protocols.
The patient was an active 38-year old male experienced in weight-training. He presented with a surgically repaired right distal biceps tendon following an accident on a trampoline adapted with a bungee suspension harness. The intervention focused on restoring range of motion and strengthening of the supporting muscles of the upper extremity without placing undue stress on the biceps brachii.
The patient was able to progress from a moderate restriction in ROM to full AROM two weeks ahead of the physician's post-operative orders and initiate a re-strengthening protocol by the eighth week of rehabilitation. At the eighth post-operative week the patient reported no deficits in functional abilities throughout his normal daily activities with his affected upper extremity.
The results of this case report strengthen current knowledge regarding physical therapy treatment for a distal biceps tendon repair while at the same time providing new insights for future protocol considerations in active individuals. Most current protocols do not advocate aggressive stretching, AROM, or strengthening of a surgically repaired biceps tendon early in the rehabilitation process due to the fear of a re-rupture. In the opinion of the authors, if full AROM can be achieved before the 6(th) week of rehabilitation, initiating a slow transition into light strengthening of the biceps brachii may be possible.
4-Single Case report.
肱二头肌远端肌腱完全断裂相对罕见，且几乎没有信息可指导治疗师对该损伤进行康复治疗。本病例报告的目的是回顾用于治疗此类损伤的康复理念，并讨论如何在遵循医生推荐的指导方针和标准治疗方案的同时，根据患者的进展情况在康复过程中调整锻炼方法。
患者是一名38岁活跃的男性，有举重训练经验。他在一个装有蹦极悬挂装置改造的蹦床上意外受伤后，接受了右肱二头肌远端肌腱的手术修复。干预措施侧重于恢复活动范围和加强上肢的支撑肌肉，同时不给肱二头肌施加过度压力。
患者能够比医生术后医嘱提前两周从中度活动范围受限进展到完全主动活动范围，并在康复的第八周开始重新加强训练方案。术后第八周，患者报告其受影响上肢在正常日常活动中的功能能力没有缺陷。
本病例报告的结果强化了目前关于肱二头肌远端肌腱修复物理治疗的知识，同时为活跃个体未来方案的考虑提供了新的见解。由于担心再次断裂，目前大多数方案不主张在康复早期对手术修复的肱二头肌肌腱进行积极拉伸、主动活动范围训练或加强训练。作者认为，如果在康复的第6周之前能够实现完全主动活动范围，那么可能可以开始缓慢过渡到对肱二头肌进行轻度加强训练。
4 - 单病例报告。
