Casper Preston C, Benedict Timothy, Morris Jamie, McHenry Paige, Dummar Max, Crowell Michael S
Baylor University - Keller Army Community Hospital Division I Sports Physical Therapy Fellowship, United States Military Academy, West Point, New York.
University of Scranton, Scranton, Pennsylvania.
Sports Health. 2025 May-Jun;17(3):523-532. doi: 10.1177/19417381241270360. Epub 2024 Aug 28.
Traumatic shoulder instability is a common injury in the general population and the military. Surgical stabilization surgery reduces recurrence rates compared with nonsurgical management. Time since surgery is generally the primary measure of return to sport. There is a gap in knowledge on psychological variables and time since surgery and their relationship to rotator cuff strength and functional performance.
It was hypothesized that, after shoulder stabilization surgery, psychological factors and time since surgery will be associated positively with objective physical performance tests, that physical performance will differ significantly between postsurgery cadets and healthy controls, and that surgical stabilization of the nondominant arm will demonstrate greater range of motion deficits than surgical intervention on the dominant arm.
Case-control study.
Level 4.
The 52 participants (26 postsurgical [6-24 months after surgery] and 26 healthy controls) were all military cadets. Outcome measures were patient-reported outcomes, range of motion, isometric strength, and functional performance.
No significant relationships existed between time since surgery and psychological factors to rotator cuff strength or functional performance. Significant differences were found between groups in self-reported outcomes, including the Shoulder Instability Return to Sport After Injury scale, Single Assessment Numeric Evaluation, Numeric Pain Rating Scale, quickDASH, flexion and external rotation (ER), and ER limb symmetry. Those who received dominant-sided shoulder surgery demonstrated a greater mean active range of motion deficit than those who received nondominant-sided surgery. Both groups demonstrated a significant loss in ER, but dominant-sided surgical participants also demonstrated significant flexion loss.
Time since surgery and psychological variables did not demonstrate a relationship to rotator cuff strength and functional performance. Significant differences existed between the stabilization surgical participants and healthy controls in all patient-reported outcomes. Surgical participants with dominant-sided shoulder surgery demonstrated a greater mean motion deficit when compared with those who received nondominant-sided surgery.
创伤性肩关节不稳定在普通人群和军人中都是常见损伤。与非手术治疗相比，手术稳定术可降低复发率。术后时间通常是恢复运动的主要衡量指标。关于心理变量、术后时间及其与肩袖力量和功能表现之间的关系，目前存在知识空白。
假设在肩关节稳定术后，心理因素和术后时间将与客观身体性能测试呈正相关，术后学员与健康对照组的身体性能将存在显著差异，并且非优势臂的手术稳定术将比优势臂的手术干预表现出更大的活动范围缺陷。
病例对照研究。
4级。
52名参与者（26名术后患者[术后6 - 24个月]和26名健康对照）均为军校学员。结果测量指标包括患者报告的结果、活动范围、等长力量和功能表现。
术后时间和心理因素与肩袖力量或功能表现之间不存在显著关系。在自我报告的结果方面，两组之间存在显著差异，包括损伤后肩关节不稳定恢复运动量表、单项评估数字评价、数字疼痛评分量表、快速DASH、屈曲和外旋（ER）以及ER肢体对称性。接受优势侧肩部手术的患者比接受非优势侧手术的患者表现出更大的平均主动活动范围缺陷。两组在ER方面均表现出显著下降，但优势侧手术参与者在屈曲方面也表现出显著下降。
术后时间和心理变量与肩袖力量和功能表现无关。在所有患者报告的结果中，稳定手术参与者与健康对照组之间存在显著差异。与接受非优势侧手术的患者相比，接受优势侧肩部手术的参与者表现出更大的平均运动缺陷。
