Cassinelli Juan, Delsol Philippe, Rieussec Clémentine, Barth Johannes
Department of Orthopedic Surgery, Clinique des Cedres, Echirolles, France.
Department of Rehabilitation, Centre Osteo Articulaire des Cedres, Echirolles, France.
Video J Sports Med. 2024 Jun 4;4(3):26350254241237538. doi: 10.1177/26350254241237538. eCollection 2024 May-Jun.
Voluntary posterior shoulder instability is a rare condition, with a prevalence of 0.5% to 2.6% in young adults, in which the patient is able to provoke a dislocation or subluxation through voluntary activation of the muscles. Studies have shown results that highlight the importance of abnormal cortical activation in this population and suggest physiotherapeutic treatment as first line.
Currently, there are a wide range of options of physiotherapeutic treatment for this condition, such as muscle reinforcement, scapulohumeral coordination, and/or muscle activation with electrodes, all with acceptable results. Simple, low-cost neuromotor rehabilitation is based on the simplicity of a different approach. We believe that with distal-proximal neuromotor rehabilitation we can improve a physiological muscle function.
The goal of the pencil exercise is to stimulate the cerebral cortex by making circular movements with a pen between the fingers, bridging abnormal voluntary stimulation and activation of the shoulder muscles, allowing the patient to focus, by the view, only on hand movements.
In this case, we have achieved the bypass of the abnormal voluntary stimulation and activation of the shoulder muscles and improve the patient's physiological shoulder function with the implementation of the pencil exercise.
This technique may be an effective option for the treatment of voluntary posterior shoulder dislocation because it is based on the stimulation of the cerebral cortex and not on traditional physiotherapeutic or surgical interventions. It is important to note that more research is needed to validate the results of this technique and determine its long-term efficacy.
The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
自愿性肩关节后脱位是一种罕见病症，在年轻成年人中的患病率为0.5%至2.6%，患者能够通过自主激活肌肉引发脱位或半脱位。研究结果表明，该人群中异常皮质激活具有重要意义，并建议将物理治疗作为一线治疗方法。
目前，针对这种病症有多种物理治疗选择，如肌肉强化、肩肱协调训练和/或电极肌肉激活，所有这些方法都取得了可接受的效果。简单、低成本的神经运动康复基于一种不同方法的简洁性。我们认为，通过远端到近端的神经运动康复，我们可以改善生理肌肉功能。
铅笔练习的目的是通过在手指间用钢笔做圆周运动来刺激大脑皮层，架起异常自主刺激与肩部肌肉激活之间的桥梁，使患者仅通过视觉专注于手部动作。
在这个案例中，通过实施铅笔练习，我们实现了绕过肩部肌肉的异常自主刺激和激活，并改善了患者的生理性肩部功能。
这项技术可能是治疗自愿性肩关节后脱位的一种有效选择，因为它基于对大脑皮层的刺激，而非传统的物理治疗或手术干预。需要注意的是，需要更多研究来验证这项技术的结果并确定其长期疗效。
作者证明已获得本出版物中出现的任何患者的同意。如果个体可能被识别，作者在提交本稿件以供发表时已包含患者的豁免声明或其他书面批准形式。
