Effect of neuromuscular control on the shoulder function of patients with healed rotator cuff and those with retear after arthroscopic rotator cuff repair

IF 5 2区医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-11-05 DOI:10.1002/ksa.12517

Jin Hyuck Lee, Ji Soon Park, Woong Kyo Jeong

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Abstract

Purpose

To compare functional outcomes such as muscle strength, neuromuscular control and patient-reported outcomes (PROs) between patients with healed rotator cuffs and those with retears after arthroscopic rotator cuff repair (RCR).

Methods

One hundred and nine patients who underwent arthroscopic RCR were included (85 in the healed group, 24 in the retear group). Shoulder muscle strength and neuromuscular control index (acceleration time [AT]) were evaluated using an isokinetic device. PROs were assessed using the pain visual analogue scale (VAS), Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons (ASES) and University of California at Los Angeles (UCLA) scores. Continuous variables were compared using independent t tests. Multiple linear regression analysis was used to identify the influence of the predictor variables on the dependent variable.

Results

The muscle strength and ATs for external rotators (ERs), internal rotators (IRs) and forward flexors as well as PROs including VAS, SST and ASES scores, were not significantly different between the two groups pre- and postoperatively (n.s.). Multiple linear regression analysis revealed that postoperative ATs for the IRs (p = 0.006) and ERs (p = 0.028) in the operated shoulders were closely associated with the postoperative UCLA score.

Conclusions

Compared with the healed group after arthroscopic RCR, the retear group had no clinically relevant differences in muscle strength, ATs and PROs, including VAS, SST, ASES and UCLA scores. However, postoperative ATs for IRs and ERs in the operated shoulders were a significant predictor of postoperative UCLA scores. Therefore, clinicians and therapists need to be aware of the importance of neuromuscular control in patients who have undergone arthroscopic RCR and prioritize therapeutic exercises to restore neuromuscular control.

Level of Evidence

Level III.

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神经肌肉控制对肩袖痊愈患者和肩袖关节镜修复术后再次撕裂患者肩部功能的影响

目的：比较关节镜下肩袖修复术（RCR）后肩袖痊愈患者和肩袖再撕裂患者的肌力、神经肌肉控制和患者报告结果（PROs）等功能结果：方法：纳入了接受关节镜下肩袖修复术的 109 名患者（痊愈组 85 人，再撕裂组 24 人）。使用等动装置评估肩部肌肉力量和神经肌肉控制指数（加速时间 [AT]）。采用疼痛视觉模拟量表（VAS）、简易肩关节测试（SST）、美国肩肘外科医生协会（ASES）和加州大学洛杉矶分校（UCLA）的评分来评估PROs。连续变量采用独立 t 检验进行比较。多元线性回归分析用于确定预测变量对因变量的影响：结果：两组患者术前和术后的肌力、外旋肌（ER）、内旋肌（IR）和前屈肌的ATs以及包括VAS、SST和ASES评分在内的PROs无显著差异（n.s.）。多元线性回归分析表明，手术后肩部内侧肌（p = 0.006）和外侧肌（p = 0.028）的ATs与术后UCLA评分密切相关：结论：与关节镜 RCR 术后痊愈组相比，再撕裂组在肌力、ATs 和 PROs（包括 VAS、SST、ASES 和 UCLA 评分）方面没有临床相关性差异。然而，手术后肩部IR和ER的ATs是术后UCLA评分的重要预测因素。因此，临床医生和治疗师需要意识到接受关节镜RCR手术的患者神经肌肉控制的重要性，并优先考虑恢复神经肌肉控制的治疗性锻炼：证据等级：三级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).