Effects of Exercise Program Intervention on Muscle Activity in Rotator Cuff Repair Patient

운동프로그램 중재가 돌림근띠 복원술 환자의 근 활성도에 미치는 영향

  • Kang, Jeong-Il (Department of Physical Therapy, Sehan University) ;
  • Moon, Young-Jun (Department of Physical Therapy, Graduate School, Sehan University) ;
  • Park, Seung-Kyu (Department of Physical Therapy, Sehan University) ;
  • Lee, Joon-Hee (Department of Physical Therapy, Sehan University) ;
  • Yang, Dae-Jung (Department of Physical Therapy, Sehan University) ;
  • Choi, Hyun (Department of Physical Therapy, Graduate School, Sehan University) ;
  • Jeong, Dae-Keun (Department of Physical Therapy, Graduate School, Sehan University) ;
  • Kim, Yong-Nam (Department of Physical Therapy, Nambu University) ;
  • Kwon, Hye-Min (Department of Physical Therapy, Seonam University)
  • 강정일 (세한대학교 물리치료학과) ;
  • 문영준 (세한대학교 대학원 물리치료학과) ;
  • 박승규 (세한대학교 물리치료학과) ;
  • 이준희 (세한대학교 물리치료학과) ;
  • 양대중 (세한대학교 물리치료학과) ;
  • 최현 (세한대학교 대학원 물리치료학과) ;
  • 정대근 (세한대학교 대학원 물리치료학과) ;
  • 김용남 (남부대학교 물리치료학과) ;
  • 권혜민 (서남대학교 물리치료학과)
  • Received : 2013.03.12
  • Accepted : 2013.04.15
  • Published : 2013.04.25

Abstract

Purpose: This study was conducted in order to examine how an effective rehabilitation exercise program influences the activity of shoulder muscles, and to help the clinical application of a rehabilitation program, for prevention and relief of pain, adhesion, and joint stiffness of patients who undergo rotator cuff repair. Methods: Nine test subjects were placed randomly into each group for a total of 27 subjects and exercise program interventions according to the group were conducted for six weeks, after which maximum voluntary isometric contraction (%MVIC) value was re-measured for supraspinatus muscle, infraspinatus muscle, serratus anterior muscle, and middle deltoid muscle in all groups in order to compare changes in muscle activity before and after the experiment in order to perform comparative analysis of changes in muscle activity between groups, based on which four experimental hypotheses were confirmed. Results: Changes in muscle activity according to %MVIC showed a statistically significant difference (p<0.01) (p<0.001) in all muscles, except the middle deltoid muscle, and post-verification results showed that changes in muscle activity according to %MVIC were greater in test groups I and II, compared with the control group, for the supraspinatus muscle, infraspinatus muscle, and serratus anterior muscle. Conclusion: Therefore, rehabilitation through use of the methods described above should be applied efficiently in clinical settings and more research in development of much more efficient rehabilitation program interventions must be conducted.

Keywords

References

  1. Williams GR Jr, Rockwood CA Jr, Bigliani LU et al. Rotator cuff tears: why do we repair them? J Bone Joint Surg Am. 2004;86-A(12):2764-76.
  2. Escamilla RF, Andrews JR. Shoulder muscle recruitment patterns and related biomechanics during upper extremity sports. Sports Med. 2009;39(7):569-90. https://doi.org/10.2165/00007256-200939070-00004
  3. Parsons BO, Gruson KI, Chen DD et al. Does slower rehabilitation after arthroscopic rotator cuff repair lead to long-term stiffness? J Shoulder Elbow Surg. 2010;19(7):1034-9. https://doi.org/10.1016/j.jse.2010.04.006
  4. Yamaguchi K, Ditsios K, Middleton WD et al. The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am. 2006;88(8):1699-704. https://doi.org/10.2106/JBJS.E.00835
  5. Waltrip RL, Zheng N, Dugas JR et al. Rotator cuff repair. A biomechanical comparison of three techniques. Am J Sports Med. 2003;31(4):493-7.
  6. Gartsman GM. All arthroscopic rotator cuff repairs. Orthop Clin North Am. 2001;32(3):501-10. https://doi.org/10.1016/S0030-5898(05)70219-4
  7. Shima N, Ishida K, Katayama K et al. Cross education of muscular strength during unilateral resistance training and detraining. Eur J Appl Physiol. 2002;86(4):287-94. https://doi.org/10.1007/s00421-001-0559-z
  8. Koo SS, Burkhart SS. Rehabilitation following arthroscopic rotator cuff repair. Clin Sports Med. 2010;29(2):203-11. https://doi.org/10.1016/j.csm.2009.12.001
  9. Farthing JP, Krentz JR, Magnus CR. Strength training the free limb attenuates strength loss during unilateral immobilization. J Appl Physiol. 2009;106(3):830-6. https://doi.org/10.1152/japplphysiol.91331.2008
  10. Neer CS. Shoulder rehabilitation. In: shoulder reconstruction. Philadelphia, Saunders, 1990:487-533.
  11. Carroll TJ, Herbert RD, Munn J et al. Contralateral effects of unilateral strength training: evidence and possible mechanisms. J Appl Physiol. 2006;101(5):1514-22. https://doi.org/10.1152/japplphysiol.00531.2006
  12. Lee SY, Gong WT, Park MC et al. A study of shoulder stabilizer muscle exercise using the contraction of the finger flexor muscle. J Phys Ther Sci. 2011;23(1):41-3. https://doi.org/10.1589/jpts.23.41
  13. Taylor NF, Dodd KJ, Damiano DL. Progressive resistance exercise in physical therapy: a summary of systematic reviews. Phys Ther. 2005;85(11):1208-23.
  14. Inman VT, Saunders JB, Abbott LC. Observations of the function of the shoulder joint 1944. Clin Orthop Relat Res. 1996;(330):3-12.
  15. Jeong JG, Kim TY, Kim YN et al. Analysis of sEMG median frequency and ultrasound image echodensity of normal skeletal muscle. J Korean Soc Phys Ther. 2006;18(1):83-94.
  16. Cram JR, Kasman GS, Holtz J. Introduction to surface electromyography. Gaithersburg Maryland, Aspen Publishers, 1998:273-89.
  17. Murphy CA, McDermott WJ, Petersen RK et al. Electromyographic analysis of the rotator cuff in postoperative shoulder patients during passive rehabilitation exercises. J Shoulder Elbow Surg. 2013;22(1):102-7. https://doi.org/10.1016/j.jse.2012.01.021
  18. Koo CH, Lee IH, Park KL et al. The effect of passive joint mobilization and massge on subacute lateral ankle ligament injuroes. J Korean Soc Phys Ther. 2005;17(4):457-67.
  19. Salter RB. The physiologic basis of continuous passive motion for articular cartilage healing and regeneration. Hand Clin. 1994;10(2):211-9.
  20. Bennett WF. Addressing glenohumeral stiffness while treating the painful and stiff shoulder arthroscopically. Arthroscopy. 2000;16(2):142-50. https://doi.org/10.1016/S0749-8063(00)90027-6
  21. Bae SS, Kim CY, Hwangbo G et al. The effects of motor control with active movement and passive movement. J Korean Soc Phys Ther. 1999;11(3):13-21.
  22. Arndt J, Clavert P, Mielcarek P et al. Immediate passive motion versus immobilization after endoscopic supraspinatus tendon repair: a prospective randomized study. Orthop Traumatol Surg Res. 2012;98(6 Suppl):S131-8. https://doi.org/10.1016/j.otsr.2012.05.003
  23. Jang HJ, Kim JS, Choi JD et al. The effects of hand grip force on shoulder muscle activity in two arm posture. JKIS. 2012;13(3):1229-37.
  24. Antony NT, Keir PJ. Effects of posture, movement and hand load on shoulder muscle activity. J Electromyogr Kinesiol. 2010;20(2):191-8. https://doi.org/10.1016/j.jelekin.2009.04.010
  25. Chu M, Hwang BD. Changes of the hand grip strength according to shoulder joint angle. J Korean Soc Phys Ther. 1998;10(2):77-86.
  26. MacDonell CW, Keir PJ. Interfering effects of the task demands of grip force and mental processing on isometric shoulder strength and muscle activity. Ergonomics. 2005;48(15):1749-69. https://doi.org/10.1080/00140130500319757
  27. Sharkey NA, Marder RA. The rotator cuff opposes superior translation of the humeral head. Am J Sports Med. 1995;23(3):270-5. https://doi.org/10.1177/036354659502300303
  28. Reed D, Halaki M, Ginn K. The rotator cuff muscles are activated at low levels during shoulder adduction: an experimental study. J Physiother. 2010;56(4):259-64. https://doi.org/10.1016/S1836-9553(10)70009-6
  29. Roman-Liu D, Tokarski T, Kaminska J. Assessment of the musculoskeletal load of the trapezius and deltoid muscles during hand activity. Int J Occup Saf Ergon. 2001;7(2):179-93.
  30. Hodder JN, Keir PJ. Targeted gripping reduces shoulder muscle activity and variability. J Electromyogr Kinesiol. 2012;22(2):186-90. https://doi.org/10.1016/j.jelekin.2011.11.011
  31. Munn J, Herbert RD, Gandevia SC. Contralateral effects of unilateral resistance training: a meta-analysis. J Appl Physiol. 2004;96(5):1861-6. https://doi.org/10.1152/japplphysiol.00541.2003
  32. Adler SS, Beckers D, Buck M. PNF in practice: an illustrated guide. Heidelberg, Springer, 2008:6-7.
  33. Sherrington C. the integrative action of the nervous system. New Haven, Yale University Press, 1947.
  34. Carr LJ, Harrison LM, Stephens JA. Evidence for bilateral innervation of certain homologous motoneurone pools in man. J Physiol. 1994;475(2):217-27.
  35. Magnus CR, Barss TS, Lanovaz JL et al. Effects of cross-education on the muscle after a period of unilateral limb immobilization using a shoulder sling and swathe. J Appl Physiol. 2010;109(6):1887-94. https://doi.org/10.1152/japplphysiol.00597.2010
  36. Choi JH, Park SH. The effect of cross education using serial reaction time. J Korean Soc Phys Ther. 2008;20(4):15-20. https://doi.org/10.1589/jpts.20.15
  37. Choi JH, Lee MY. The effect of cross-education in nondominant arm with normal adult. J Korean Soc Phys Ther. 2011;23(2):31-6.
  38. Jeong WS, Jeong JY, Kim CK et al. Effect of lower limb muscle activity on balancing through sprinter patterns of PNF. J Korea Contents Assoc. 2011;11(3):281-92. https://doi.org/10.5392/JKCA.2011.11.3.281
  39. Choi JC. The evaluation of overflow and cross training effect after isometric quadriceps training. J Korean Soc Phys Ther. 2000;12(1):9-13.