Issue №4-21, 2022

Evaluation of Functional and Biomechanical Deficiency in the Shoulder Joint: a Prospective Cohort Study of 119 Patients with Rotator Cuff Injury

¹ Vasiliy A. Kolyshenkov, ¹ Anatoliy D. Fesyun, ¹ Maxim Y. Yakovlev

¹ National Medical Research Center of Rehabilitation and Balneology, Moscow, Russian Federation

ABSTRACT

AIM. To assess the degree of change in functional and biomechanical characteristics of the shoulder joint in patients with rotator cuffinjury.MATERIAL AND METHODS. The study included 119 patients, 59 patients with rotator cuff injury and 60 practically healthy volunteerswith no history of injuries and shoulder disorders, aged 18 to 66 years. All patients completed DASH questionnaires and underwentclinical examination by a traumatologist, neurologist and physical therapist, as well as a biomechanical examination of the shoulderjoint. The biomechanical parameters of the shoulder joint were studied using the «Con-Trex MJS» (Physiomed, Germany) computerizedisokinetic dynamometer. We chose the inward/outward rotation test as the diagnostic test. The inward/outward rotation test wasperformed lying on the back. The elbow was bent at an angle of 90º, the upper limb was moved 90º at the shoulder joint. The handle ofthe dynamometer was set individually according to the patient’s limb length. The axis of rotation of the dynamometer coincided withthe axis of rotation in the shoulder joint. The maximum allowable amount of motion in the test was limited to 90º movement of theexternal rotation and 80º internal rotation. The neutral position of the shoulder joint retraction equal to 90 ° and the elbow joint flexionat 90 ° were taken as the zero point of reference.RESULTS AND DISCUSSION. Patients with rotator cuff injury have a high shoulder pain level, 6.00 [5.00;7.00] VAS, a severe degree offunctional limitations 63.33 [55.92;66.67] scores on the DASH questionnaire, a pronounced decrease in shoulder range of motions, aswell as a significant deficit in dynamic strength and endurance indices and muscle performance.CONCLUSION. Patients with shoulder rotator cuff injury experience extensive functional limitations expressed in a high level of pain inthe shoulder joint, high points of the questionnaire of the upper limb functioning (DASH, more – worse) and a significant decrease inthe biomechanical indicators of the shoulder joint and upper limb in general, which ultimately leads to a serious limitation of functionalactivity, a decrease in the working capacity and, consequently, a decrease in the quality of life.

KEYWORDS: rehabilitation, rotator cuff, rotator cuff injury, isokinetic testing, biomechanic

For citation: Kolyshenkov V.A., Fesyun A.D., Yakovlev M.Y. Evaluation of Functional and Biomechanical Deficiency in the Shoulder Joint: a Prospective Cohort Study of 119 Patients with Rotator Cuff Injury. Bulletin of Rehabilitation Medicine. 2022; 21 (4): 148-158. https://doi.org/10.38025/2078-1962-2022-21-4-148-158

References:

1. Danilenko L.I., Danilenko O.A., Sav- chuk A.V. et al. Comparative Results of the Physiotherapeutic Treatment of Patients with Damages of the Shoulder Rotator Cuff and the Tender of the Long Shoulder Bicycle Head. Military Medicine. 2020; (3): 27-31 (In Russ.).
2. Rossi L.A., Chahla J. et al. Rotator Cuff Retears. JBJS Reviews. 2020; 8(1): e0039 p. https://doi.org/10.2106/JBJS.RVW.19.00039
3. White J.J., Titchener A.G., Fakis A. et al. An epidemiological study of rotator cuff pathology using The Health Improvement Network database. The Bone & Joint Journal. 2014; 96(3): 350-353. https://doi.org/10.1302/0301-620X.96B3.32336
4. Ensor K.L., Kwon Y.W., Dibeneditto M.R. et al. The rising incidence of rotator cuff repairs. Journal of Shoulder and Elbow Surgery. 2013; 22(12): 1628- 1632. https://doi.org/10.1016/j.jse.2013.01.006
5. Ji X., Bi C., Wang F. et al. Arthroscopic versus mini-open rotator cuff repair: an up-to-date meta-analysis of randomized controlled trials. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2015; 31(1): 118-124. https://doi.org/10.1016/j.arthro.2014.08.017
6. Wu P.T., Jou I.M., Yang C.C. et al. The severity of the long head biceps tendinopathy in patients with chronic rotator cuff tears: macroscopic versus microscopic results. Journal of Shoulder and Elbow Surgery. 2014; (23): 1099-1106. https://doi.org/10.1016/j.jse.2013.11.013
7. Yamamoto A., Takagishi K., Kobayashi T. et al. Factors involved in the presence of symptoms associated with rotator cuff tears: a comparison of asymptomatic and symptomatic rotator cuff tears in the general population. Journal of Shoulder and Elbow Surgery. 2011; 20(7): 1133-1137. https://doi.org/10.1016/j.jse.2011.01.011
8. Brindisino F., Salomon, M., Giagio, S. et al. Rotator cuff repair vs. nonoperative treatment: a systematic review with meta-analysis. Journal of Shoulder and Elbow Surgery. 2021; 30(11): 2648-2659. https://doi.org/10.1016/j.jse.2021.04.040
9. Greis A.C., Derrington S.M., McAuliffe M. Evaluation and nonsurgical management of rotator cuff calcific tendinopathy. Orthopedic Clinics of North America. 2015; 46(2): 293-302.
10. Li S., Sun H., Luo X. et al. The clinical effect of rehabilitation following arthroscopic rotator cuff repair: A meta-analysis of early versus delayed passive motion. Medicine. 2018; 97(2): e9625 p. https://doi.org/10.1097/MD.0000000000009625
11. Mihata T., Lee T.Q., Fukunishi K. et al. Return to Sports and Physical Work After Arthroscopic Superior Capsule Reconstruction Among Patients with Irreparable Rotator Cuff Tears. The American Journal of Sports Medicine. 2018; 46(5): 1077-1083. https://doi.org/10.1177/0363546517753387

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Эта статья открытого доступа по лицензии CC BY 4.0. Издательство: ФГБУ «НМИЦ РК» Минздрава России.
This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.