Bankart Tamiri Sonrası Kontralateral Eğitimin Omuz Kas Kuvvet ve Fonksiyonları Üzerine Etkisi

Abstract

The aim of this study was to investigate the effects of contralateral training (CT) on shoulder muscle strength and upper extremity function on patients with bankart repair. Twenty-eight patients with Bankart repair were included to the study. Patients were randomized into either contralateral group (age: 24,6±7,9 years, height: 179±8,8 cm, weight: 77,2±8,4 years) or control group (age: 22,4±7,2 years, height: 175,7±4,4 cm, weight: 77,6±14,8 kg). Both groups received a standardized rehabilitation until the post-operative 12th weeks after the surgery. Patients in the contralateral group were also received CT program, which focused on the shoulder internal and external rotator muscles, between the post-operative 2th and 12th weeks. Concentric strength of the shoulder internal and external rotator muscles was measured pre-operatively and three and six months postoperatively using isokinetic dynamometer. Eccentric strength of the shoulder internal and external rotator muscles was measured pre-operatively and six months postoperatively. Upper extremity function was assessed with closed kinetic chain upper extremity stability (CKCUES) test, unilateral seated shout put (USSP) test and Y-balance test-upper quarter (YBT-UQ) at the post-operative six months. In addition, shoulder range of motion (ROM) of the patients were measured pre and post-operatively using a universal goniometer. Functional activity level of the patients was assessed with Western Ontario Shoulder Instability Index (WOSI), TAMPA Kinesiophobia Scale and American Shoulder and Elbow Surgeon’s Score (ASES). Changes in the muscle strength between the groups at the post-operative three and six months were analyzed using repeated measures ANCOVA. The upper extremity function at the post-operative six months was assessed with Mann-Whitney U test. Changes in the shoulder ROM pre and post-operatively were analyzed using 2*4 Mixed Model ANOVA. Lastly, functional scores of the operated side were compared with the non-operated side at the post-operative six months. Both the contralateral and the control groups showed similar improvements in the muscle strength on the operated shoulder in the post-operative period (p>0,05). Shoulder ROM and upper extremity function were also similar between the two groups (p>0,05). The muscle strength of the non-operated shoulder was higher in the contralateral group compared to the control group at the post-operative 3 months (p<0,05). Patients on both groups showed favorable results in terms of shoulder muscle strength and function and could be allowed to return to play. The results of the current study revealed that contralateral training had no effects on shoulder rotator muscle strength and upper extremity function on patients with Bankart repair. Patients on both groups had adequate muscle strength and functional capacity to return to sport at the post-operative six months.