de Almeida Luane Landim, Mendes Júnior Adriano Fernando, Neto José da Mota, Simoni Leandro Furtado De, Lopes Karine Helena Souza, Guimarães Paloma Carvalho, Valério Brenda Iasmin de Oliveira, Sciascia Aaron
Hospital e Maternidade Therezinha de Jesus; Espaço Maria Inês, Centro de Fisioterapia e Condicionamento Físico.
Hospital Universitário da Universidade Federal de Juiz de Fora.
Int J Sports Phys Ther. 2021 Feb 1;16(1):216-226. doi: 10.26603/001c.18654. eCollection 2021.
Pre-operative rehabilitation aims to improve the functional capacity of the individual to enable him/her to prepare for the period of inactivity associated with the surgical procedure.
To evaluate the impact of preoperative scapular rehabilitation before arthroscopic repair of traumatic rotator cuff injury, regarding pain, range of motion of the shoulder, and functional activity.
Randomized Clinical Trial (RCT) - pilot.
Twenty adult individuals (age range: 47-69 years), with a diagnosis of traumatic rotator cuff tear and arthroscopic surgical repair, were randomized and allocated into two groups: experimental (EG) (n = 10) and control group (CG) (n = 10). All participants underwent preoperative rehabilitation for six weeks, consisting of mobility exercises of the cervical spine, elbow, wrist, and hand, and analgesics education. The EG also performed scapular and core stabilization exercises, which were not performed by the CG. Exercise instruction was performed by the same physiotherapist and the surgical team was blinded to group participation in the preoperative period. After arthroscopic repair, the patients followed the same protocol of postoperative rehabilitation for 16 weeks, and functional evaluation was conducted after three months and in a follow-up of at least one year.
Compared to the CG, the EG presented with a significant decrease in pain between the preoperative period and after one year (p < 0.05). In relation to the preoperative period, flexion and external rotation increased significantly in both groups after three months (p<0.05), and abduction was significantly higher in the EG (p < 0.05). Compared to CG, the EG presented a significantly higher SF-12 physical component after three months (48.47 vs. 40.33, p < 0.05), and a significantly lower Western Ontario Rotator Cuff Index (WORC) total after one year (85.00 vs. 1130.00, p < 0.05).
Preoperative scapular rehabilitation had a positive impact on recovery after arthroscopic repair of traumatic rotator cuff injury, in the assessment of pain, range of motion of the shoulder, and quality of life.
Level 1.
术前康复旨在提高个体的功能能力，使其为与手术相关的不活动期做好准备。
评估创伤性肩袖损伤关节镜修复术前肩胛康复对疼痛、肩关节活动范围和功能活动的影响。
随机临床试验（RCT）——试点研究。
20名成年个体（年龄范围：47 - 69岁），诊断为创伤性肩袖撕裂并接受关节镜手术修复，被随机分为两组：实验组（EG）（n = 10）和对照组（CG）（n = 10）。所有参与者均接受为期六周的术前康复，包括颈椎、肘部、腕部和手部的活动度练习以及镇痛教育。实验组还进行了肩胛和核心稳定练习，对照组未进行。运动指导由同一名物理治疗师进行，手术团队在术前对分组情况不知情。关节镜修复术后，患者遵循相同的术后康复方案16周，并在三个月及至少一年的随访后进行功能评估。
与对照组相比，实验组在术前至术后一年期间疼痛显著减轻（p < 0.05）。与术前相比，两组在三个月后屈曲和外旋均显著增加（p < 0.05），实验组外展显著更高（p < 0.05）。与对照组相比，实验组在三个月后SF - 12身体成分显著更高（48.47对40.33，p < 0.05），术后一年西部安大略肩袖指数（WORC）总分显著更低（85.00对1130.00，p < 0.05）。
在创伤性肩袖损伤关节镜修复术后的疼痛、肩关节活动范围和生活质量评估中，术前肩胛康复具有积极影响。
1级。
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