McGinniss John H, Mason John S, Morris Jamie B, Pitt Will, Miller Erin M, Crowell Michael S
Baylor University - Keller Army Community Hospital Division I Sports Physical Therapy Fellowship.
Int J Sports Phys Ther. 2022 Oct 2;17(6):1144-1155. doi: 10.26603/001c.37865. eCollection 2022.
Traumatic shoulder instability is a common injury in athletes and military personnel. Surgical stabilization reduces recurrence, but athletes often return to sport before recovering upper extremity rotational strength and sport-specific abilities. Blood flow restriction (BFR) may stimulate muscle growth without the need for heavy resistance training post-surgically.
HYPOTHESIS/PURPOSE: To observe changes in shoulder strength, self-reported function, upper extremity performance, and range of motion (ROM) in military cadets recovering from shoulder stabilization surgery who completed a standard rehabilitation program with six weeks of BFR training.
Prospective case series.
Military cadets who underwent shoulder stabilization surgery completed six weeks of upper extremity BFR training, beginning post-op week six. Primary outcomes were shoulder isometric strength and patient-reported function assessed at 6-weeks, 12-weeks, and 6-months postoperatively. Secondary outcomes included shoulder ROM assessed at each timepoint and the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), the Upper Extremity Y-Balance Test (UQYBT), and the Unilateral Seated Shotput Test (USPT) assessed at the six-month follow-up.
Twenty cadets performed an average 10.9 BFR training sessions over six weeks. Statistically significant and clinically meaningful increases in surgical extremity external rotation strength ( < 0.001; mean difference, .049; 95% CI: .021, .077), abduction strength ( < 0.001; mean difference, .079; 95% CI: .050, .108), and internal rotation strength ( 0.001; mean difference, .060; CI: .028, .093) occurred from six to 12 weeks postoperatively. Statistically significant and clinically meaningful improvements were reported on the Single Assessment Numeric Evaluation ( < 0.001; mean difference, 17.7; CI: 9.4, 25.9) and Shoulder Pain and Disability Index ( < 0.001; mean difference, -31.1; CI: -44.2, -18.0) from six to 12 weeks postoperatively. Additionally, over 70 percent of participants met reference values on two to three performance tests at 6-months.
While the degree of improvement attributable to the addition of BFR is unknown, the clinically meaningful improvements in shoulder strength, self-reported function, and upper extremity performance warrant further exploration of BFR during upper extremity rehabilitation.
4, Case Series.
创伤性肩关节不稳定是运动员和军事人员常见的损伤。手术稳定可降低复发率，但运动员常在恢复上肢旋转力量和特定运动能力之前就重返运动。血流限制（BFR）可能在术后无需进行重度抗阻训练的情况下刺激肌肉生长。
假设/目的：观察接受肩关节稳定手术的军校学员在完成六周BFR训练的标准康复计划后，肩部力量、自我报告的功能、上肢表现和活动范围（ROM）的变化。
前瞻性病例系列研究。
接受肩关节稳定手术的军校学员从术后第六周开始进行六周的上肢BFR训练。主要结局指标为术后6周、12周和6个月时评估的肩部等长力量和患者报告的功能。次要结局指标包括在每个时间点评估的肩部ROM，以及在六个月随访时评估的闭链上肢稳定性测试（CKCUEST）、上肢Y平衡测试（UQYBT）和单侧坐姿推铅球测试（USPT）。
20名学员在六周内平均进行了10.9次BFR训练。术后6至12周，手术侧上肢的外旋力量（<0.001；平均差异，0.049；95%CI：0.021，0.077）、外展力量（<0.001；平均差异，0.079；95%CI：0.050，0.108）和内旋力量（<\u003c0.001；平均差异，0.060；CI：0.028，0.093）出现了具有统计学意义和临床意义的增加。术后6至12周，在单项评估数字评分（<0.001；平均差异，17.7；CI：9.4，25.9）和肩部疼痛与功能障碍指数（<0.001；平均差异，-31.1；CI：-44.2，-18.0）方面报告了具有统计学意义和临床意义的改善。此外，超过70%的参与者在6个月时的两到三项表现测试中达到了参考值。
虽然增加BFR所带来的改善程度尚不清楚，但肩部力量、自我报告的功能和上肢表现的临床意义上的改善值得在进行上肢康复时进一步探索BFR。
4，病例系列。
