Thomas Stein, MD, PhD etal of the Department of Sporttraumatology, Knee and Shoulder Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany provided the following research:
Background: Reports of return to shoulder-dependent sport after surgical stabilization previously underestimated impairments, which were not reflected in the score systems used.
Hypothesis: Return to shoulder-dependent sport depends on the type of sport performed.
Study Design: Case series; Level of evidence, 4.
Methods: Forty-seven athletes (26.9 years of age at surgery) who underwent isolated arthroscopic Bankart repair were longitudinally monitored by shoulder-dependent sport-specific activity (Shoulder Sport Activity Score [SSAS]) and ability (Athletic Shoulder Outcome Scoring System [ASOSS]) scores and visual analog scales for reachieved proficiency level, sport-specific shoulder pain, and functional deficits. Data were assessed at 4 points of treatment: preoperatively, and postoperatively after 6, 16, and 32 months (P0-P3). Athletes were analyzed separately according to shoulder sport: noncollision/nonoverhead (G1), collision (G2), overhead (G3), and martial arts (G4).
Results: The G1 and G2 athletes had reachieved the preinjury sport activity and sport proficiency status and excellent ASOSS scores after 32 months (SSASG1 = 7.2, SSASG2 = 8.1, ASOSSG1 = 94.4, ASOSSG2 = 95.2), whereas G3 and G4 athletes remained at an inferior activity level (SSASG3 = 8.0, SSASG4 = 8.3) and proficiency level. The ASOSS documented a prolonged period of shoulder rehabilitation for G3 and G4 athletes to reach a good shoulder-dependent sport ability outcome after 32 months (ASOSSG3 = 89.0, ASOSSG4 = 93.1). All groups recorded persisting limitations in visual analog scales for sport-specific shoulder function and pain. The established scores (Rowe = 95.9, Walch-Duplay = 93.3, Constant = 94.0) did not reflect these sport-specific impairments. Athletes with 5 or more preoperative dislocations had significantly longer surgery-to-sport resumption intervals with a prolonged proficiency recovery.
Conclusion: The athletes’ shoulder stabilization resulted in a prolonged rehabilitation depending on the functional demand of the performed shoulder-dependent sport, as shown by the specific shoulder sport score systems.
The newly developed ArmTutor can play an integral part in post shoulder surgery rehabilitation. The ArmTutor™ together with its sister devices (HandTutor, LegTutor, 3DTutor) has been developed to allow for functional rehabilitation of the upper extremity. The Tutor system consists of an ergonomic wearable arm brace and dedicated rehabilitation software. The ArmTutor™ system allows for a range of biomechanical evaluation including speed, passive and active range of motion and motion analysis of the upper extremity. Quantitative biomechanical data allow for objective evaluation and rehabilitation treatment follow up. The ArmTutor™ rehabilitation concept is based on performing controlled exercise rehabilitation practice at a patient customized level with real time accurate feedback on the patient’s performance. The exercises are designed in the form of challenging games that are suitable for a wide variety of neurological and orthopedic injury and disease.
The games challenge the patient to perform the exercise task to their best ability and to continue exercise practice.
The ArmTutor™ allows for isolated and a combination of elbow and three directional shoulder treatment. The system provides detailed exercise performance instructions and precise feedback on the patients exercise performance. Controlled exercise of multijoints within the normal movement pattern prevents the development of undesired and compensatory joint movement and ensures better performance of functional tasks.
The ArmTutor™ system is used by many leading rehabilitation centers worldwide and has full FDA and CE certification. See www.HandTutor.com
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