功能性能测试显示，肩部稳定手术后6个月取得了令人鼓舞的结果。
Functional Performance Tests Reveal Promising Results at 6 Months After Shoulder Stabilization Surgery.
作者信息
Yildiz Taha Ibrahim, Turhan Egemen, Ocguder Durmus Ali, Yaman Firat, Huri Gazi, Duzgun Irem
机构信息
Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Turkey.
Department of Orthopedy and Traumatology, Hacettepe University, Turkey.
出版信息
Sports Health. 2023 Nov-Dec;15(6):878-885. doi: 10.1177/19417381221141075. Epub 2022 Dec 20.
BACKGROUND
Although athletes are mostly allowed to return to play 6 months after shoulder stabilization surgery, there are inadequate data about their functional status during this period.
HYPOTHESES
Performance tests would reveal insufficiency in the functional capacity of shoulder 6 months after stabilization surgery.
STUDY DESIGN
Prospective cohort study.
LEVEL OF EVIDENCE
Level 3.
METHODS
A total of 32 male athletes with arthroscopic anterior capsulolabral repair (AACR) were included in the study. Shoulder internal and external rotator (IR-ER) strength was assessed using isokinetic dynamometer at 60°/s and 180°/s angular velocities preoperatively and 6 months postoperatively. Shoulder function was assessed with closed kinetic chain upper extremity stability (CKCUES) test, Y balance test-upper quarter (YBT-UQ), and unilateral seated shot-put test (USSPT) at 6 months postoperation. Western Ontario shoulder instability index (WOSI) and Tampa scale of kinesiophobia (TSK) were used for the self-assessment of the shoulder. Mixed-model ANOVA was used to analyze the changes in the IR-ER strength on both shoulders. Limb symmetry index (LSI) was calculated for the IR-ER strength, YBT-UQ, and USSPT scores.
RESULTS
Shoulder IR strength was higher at 6 months postoperatively compared with preoperatively. The LSI was 76.4% and 76.6% for ER strength, and 94.2% and 94% for IR strength at 60°/s and 180°/s angular velocities, respectively, at the postoperative 6 month timepoint. The mean CKCUES test score was 21.8 ± 2.6 touches and the LSI was 94.7% for the YBT-UQ and 102.5% for the USSPT. WOSI ( < 0.001) and TSK ( = 0.001) scores were significantly lower at 6 months postoperatively.
CONCLUSION
Functional status of the patients with shoulder stabilization surgery improved considerably 6 months after surgery, yet they did not fully recover function.
CLINICAL RELEVANCE
Exercise programs focusing on shoulder ER strength and shoulder performance should be emphasized after stabilization surgery.
背景
尽管运动员大多在肩部稳定手术后6个月被允许恢复比赛，但关于他们在此期间功能状态的数据并不充分。
假设
性能测试将揭示稳定手术后6个月肩部功能能力不足。
研究设计
前瞻性队列研究。
证据水平
3级。
方法
本研究共纳入32名接受关节镜下前盂唇修复术（AACR）的男性运动员。术前及术后6个月，使用等速测力计以60°/秒和180°/秒的角速度评估肩部内、外旋转肌（IR-ER）力量。术后6个月，采用闭链上肢稳定性（CKCUES）测试、Y平衡测试-上肢（YBT-UQ）和单侧坐姿推铅球测试（USSPT）评估肩部功能。采用西安大略肩部不稳定指数（WOSI）和坦帕运动恐惧量表（TSK）对肩部进行自我评估。采用混合模型方差分析来分析双肩IR-ER力量的变化。计算IR-ER力量、YBT-UQ和USSPT分数的肢体对称指数（LSI）。
结果
术后6个月肩部IR力量高于术前。术后6个月时，在60°/秒和180°/秒角速度下，ER力量的LSI分别为76.4%和76.6%，IR力量的LSI分别为94.2%和94%。CKCUES测试平均得分为21.8±2.6次触碰，YBT-UQ的LSI为94.7%，USSPT的LSI为102.5%。术后6个月WOSI（<0.001）和TSK（=0.001）评分显著降低。
结论
肩部稳定手术患者术后6个月功能状态有显著改善，但功能未完全恢复。
临床意义
稳定手术后应强调以肩部ER力量和肩部性能为重点的锻炼计划。
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