The Effect of ASSET Rehabilitation Protocol on the Shoulder Kinematics after Rotator Cuff Tendons Repair
Journal of Clinical Physiotherapy Research,
Vol. 8 No. 2 (2023),
1 April 2023
https://doi.org/10.22037/jcpr.v8i2.46103
Abstract
Background and aim: After rotator cuff tendon surgery, rehabilitation is important for aiding recovery and preventing excessive strain, especially in the early stages post-surgery. This study aimed to examine how rehabilitation exercises following rotator cuff surgery using the ASSET protocol affect shoulder kinematics.
Methods: In this quasi-experimental study, 15 individuals aged 40 to 65 years old with a degenerative rupture of the supraspinatus tendon underwent tendon repair surgery and received two stages of rehabilitation treatment. The first stage involved passive treatment for the first 6 weeks of the ASSET rehabilitation protocol, totaling 18 sessions. The second stage involved active-assisted and active motions for 4 weeks, consisting of 12 sessions. Shoulder kinematics, including scapular upward rotation, glenohumeral elevation, and shoulder elevation in two sagittal and scaption planes, were evaluated using a motion analysis system. The kinematic data of these variables included maximum range of motion (ROM), peak time, and raising velocity. Additionally, the scapulohumeral rhythm of scapular upward rotation movement in two sagittal and scaption planes was extracted from the kinematic data. The shoulder kinematics were measured before and after the ASSET protocol at the sixth and tenth week following rotator cuff tendon repair.
Results: The results on glenohumeral elevation and shoulder elevation indicated employing the ASSET rehabilitation protocol between the sixth and tenth week following rotator cuff tendon repair lead to a significant increase in the ROM in the sagittal and scaption planes (P<0.001), but not for ROM on scapula upward rotation. The peak time scapula upward rotation significantly decreased in both the sagittal and scaption planes (P<0.001), while the raising velocity significantly increased in the scaption plane (P<0.001), but not in the sagittal plane (P=0.128). There was a significant decrease in peak time and a significant increase in raising velocity in both planes on glenohumeral elevation and shoulder elevation (P<0.05). For the scapulo-humeral rhythm in scapula upward rotation movement, the results showed a significant increase in both the sagittal (P=0.049) and scaption (P=0.008) planes.
Conclusion: The study's results demonstrate that the ASSET protocol can enhance shoulder function following rotator cuff repair surgery by striking a balance between increasing ROM and preserving muscle control. However, it is crucial to emphasize the significance of careful supervision and monitoring throughout the rehabilitation process to avoid potential injuries.
- Rotator cuff tendon surgery, Shoulder kinematics, ASSET, Shoulder rehabilitation
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