Kararti Caner, Özüdoğru Anıl, Basat Hakkı Çağdaş, Özsoy İsmail
Kırşehir Ahi Evran University Department of Physiotherapy and Rehabilitation, Kırşehir, Turkey.
Kırşehir Ahi Evran University Department of Orthopedics and Traumatology, Kırşehir, Turkey.
Sports Health. 2025 Mar;17(2):312-321. doi: 10.1177/19417381241235184. Epub 2024 Mar 18.
The coactivation (Co-A) of shoulder muscles that contribute to humeral head depression can lead to mechanical unloading of the subacromial structures during abduction and thus can be beneficial for patients with arthroscopic rotator cuff repair (ARCR). The present study aims to examine the effectiveness of humeral head depressor muscle Co-A (DM-Co-A) training on clinical outcomes in a sample of patients with ARCR.
We hypothesized that DM-Co-A training with medioinferior vector during glenohumeral exercises can improve clinical results in the rehabilitation of ARCR.
Randomized controlled single-blind study.
Level 1B.
A total of 27 patients who underwent ARCR after a medium-sized rotator cuff tear and completed their Phase 1 training with ≥80% compliance were included. Together with 14 weeks of conservative treatment (6 weeks of Phase 2 training and 8 weeks of Phase 3 training), synchronized "DM-Co-A Training" was applied to the treatment group with an electromyography (EMG) biofeedback (EMG-BF) device. Patients in the treatment group were asked to voluntarily activate the humeral head depressor muscles guided by visual and auditory feedback of the EMG-BF device during the Phase 2 and Phase 3 conservative treatment exercises performed by the control group. Demographic characteristics of the participants were recorded. Visual analog scale and universal goniometer were used to assess pre- and posttreatment pain severity and joint range of motion, respectively. The Disabilities of Arm, Shoulder and Hand Questionnaire, Revised Oxford Shoulder Score, Modified Constant-Murley Shoulder Score, and the Western-Ontario Rotator Cuff Index were used to assess functionality.
There was a clinically meaningful improvement in pain severity, active ROM excluding internal rotation, and functionality in the treatment group compared with the control group ( < 0.05).
A 14-week duration DM-Co-A with EMG may be beneficial in the postoperative rehabilitation of patients after ARCR.
有助于肱骨头下压的肩部肌肉协同激活（Co - A）可在外展过程中导致肩峰下结构的机械性卸载，因此对关节镜下肩袖修复术（ARCR）患者可能有益。本研究旨在检验肱骨头下压肌协同激活（DM - Co - A）训练对ARCR患者样本临床结局的有效性。
我们假设在盂肱关节运动期间采用中下向量进行DM - Co - A训练可改善ARCR康复的临床效果。
随机对照单盲研究。
1B级。
纳入27例中度肩袖撕裂后接受ARCR且以≥80%的依从性完成其1期训练的患者。在14周的保守治疗（2期训练6周和3期训练8周）期间，使用肌电图（EMG）生物反馈（EMG - BF）设备对治疗组应用同步“DM - Co - A训练”。在对照组进行2期和3期保守治疗练习期间，要求治疗组患者在EMG - BF设备的视觉和听觉反馈引导下自愿激活肱骨头下压肌。记录参与者的人口统计学特征。分别使用视觉模拟量表和通用角度计评估治疗前后的疼痛严重程度和关节活动范围。使用手臂、肩部和手部功能障碍问卷、修订的牛津肩部评分、改良的Constant - Murley肩部评分以及西安大略肩袖指数评估功能。
与对照组相比，治疗组在疼痛严重程度、不包括内旋的主动活动范围和功能方面有临床意义的改善（<0.05）。
为期14周的带EMG的DM - Co - A训练可能对ARCR术后患者的康复有益。
