몸 마음 영혼을 건강하게

Phase2 (4~8weeks)

⇒ PSOT OP 0~6weeks

* Limited to 45° for small to large posterior-superior suff tears

-Limited to 0° (straight ahead)for massive tears and subscapularis tears(No AA,AROM)

-Full AROM(only small & medium tear)

Phase2 (4~8weeks)

▣ Gradually restore muscle strengh and proprioception thereby establishing muscular balance

▣ PSOT OP 0~6weeks

-Limited to 45° for small to large posterior-superior

cuff tears

-Limited to 0° (straight ahead)for massive tears and subscapularis tears(No AA,AROM)

-No active assisted motion

▣ Active Range of Motion (6~12 weeks)

□ Use of AAROM during this timeframe

- including supine glenohumeral external and internal rotation with a cane as well as supine flextion with the assistance of the uninvoved limb

□ scapular plane

- shown to have less rotator cuff EMG activity, in terms of percent of maximal voluntary isometric contraction

- first 30~60° scapular plane elevation: superior translation

- 30~60° lying supine abduction: inferior translation

The salute exercise

- is an effective way to initiate recruitment of the supraspinatus muscle fibers

- This exercise can be progressed to "the full can acvivity", which is known th exhibit high supraspinatus muscle activity

AAROM ex

Deltoid reeducation

□ This deltoid muscle rehabilitation regimen, associated with pain medication, was effective in improving the function and pain in elderly patients with massive cuff tears, reverse total shoulder arthroplasty

Isometric & muscle recruitment

Back & periscapular exe

Started CKC exercise

□ started closed chain stability exercises

* improve neuromuscular control of the shoulder complex

□ Rhythmic stabilization(supine, quadruped)

* increase muscle activation and improve static stability of the shoulder complex

□ The exercise may be started at elevations of 60° or less and then moved up to 90° as tissue healing allows.

□ 3 weeks after surgery for glenoid labral repair or instability repair

□ 5 weeks after rotator cuff repairs

reference

Myers, Joseph B. shoulder muscle reflex latencies under various levels of muscle contraction. Clinical Orthopaedics & Related Research. 407:92-101, February 2003.

Frederick A. Matsen, III, Caroline Chebli and Steven Lippitt. Principles for the Evaluation and Management of Shoulder Instability. J Bone Joint Surg Am. 2006;88:647-659.

Morrey BF, An KN (1990) Biomechanics of the shoulder. In: Rockwood CR, Matsen FA (ed) The shoulder. Saunders, Philadelphia, pp 208–245Google Scholar.

Philip Mcclure, Lori A. Michener. Direct 3-dimensional measurement of scapular kinematics during dynamic movements in vivo. Published in Journal of shoulder and elbow surgery 2001

Parsons IM1, Apreleva M, Fu FH, Woo SL. The effect of rotator cuff tears on reaction forces at the glenohumeral joint. J Orthop Res. 2002 May;20(3):439-46.

MET

Young Jin Jo1, Young Kyun Kim. Consideration of Shoulder Injury Prevention and Rehabilitation Exercise for Overhead Sports Population. Asian J Kinesiol 2019; 21(2): 40-50 · DOI: https://doi.org/10.15758/ajk.2019.21.2.40

Ofer Levy, Hannan Mullett, The role of anterior deltoid reeducation in patients with massive irreparable degenerative rotator cuff tears. Medicine Published in Journal of shoulder and elbow surgery2005 DOI:10.1016/j.jse.2008.04.005

https://www.hep2go.com/index_b.php?userRef=120148

Olivier A. van der Meijden, MD1. Rehabilitation after arthroscopic rotator cuff repair: Current concepts review and evidence-based guidelines. International Journal of Sports Physical Therapy · April 2012