Efectividad de ejercicios submaximales versus protocolo convencional en el rango de movimiento glenohumeral tras reparación artroscópica del supraespinoso

Resumen

Objetivo Determinar si la aplicación precoz de un programa de ejercicios submaximal, disminuye el dolor y aumenta el rango de movimiento glenohumeral en comparación a un protocolo convencional, en sujetos sometidos a artroscopia del supraespinoso.

Material y método El presente estudio corresponde a un diseño casi experimental, longitudinal y prospectivo. La muestra contó con 30 sujetos, con un promedio de edad de 52,8 años. Los sujetos se dividieron aleatoriamente por sorteo simple. Un grupo recibió un protocolo de ejercicios submaximales de forma precoz, y el otro, péndulo de Codman. Las variables analizadas fueron: dolor y rango de movimiento glenohumeral.

Resultados Ambos grupos mostraron diferencias estadísticamente significativas al término de las intervenciones para todas las variables (p < 0,05). Al comparar la efectividad entre ambos tratamientos, la rehabilitación submaximal precoz mostró una disminución del dolor y un aumento en la rotación externa glenohumeral estadísticamente significativa en comparación con el tratamiento con péndulo de Codman (p = 0,004 p = 0,001 respectivamente).

Discusión Estudios hechos han establecido un margen seguro para la activación del manguito rotador, menor al 20% de la contracción voluntaria máxima para tendones reparados mediante cirugía. Nuestros resultados arrojan que este protocolo de ejercicios que cumple con esos niveles de activación aplicados de forma precoz, muestran beneficios sobre el rango y el dolor.

Conclusiones La aplicación de un programa de ejercicio submaximal de forma precoz, podría disminuir el dolor y aumentar los rangos de flexión, abducción y rotación externa glenohumeral, disminuyendo las complicaciones de la inmovilización.

Abstract

Objective Determine if the application of an early submaximal exercise program reduces pain and increases the glenohumeral joint range of motion in comparison to a conventional protocol, in subjects with supraspinatus arthroscopic surgery.

Method The present study corresponds to a prospective quasi-experimental longitudinal design study. The sample was formed by 30 subjects, with a mean aged of 52,8 years old. The subjects were randomly divided by a simple draw. One of the groups received the early submaximal exercise protocol, and the other the Codman pendulum exercises. The analyzed variables were; pain, glenohumeral range of motion.

Results Both groups showed significant statistical differences for all variables at the end of the intervention (p < 0.05). When the effectiveness of both treatments were compared, the early submaximal rehabilitation showed a significant statistical difference in pain decreased, and an increased in glenohumeral external rotation, in comparison to the Codman pendulum treatment plan (p = 0.004 and p = 0.001 respectively).

Discussion Studies have established a secure margin for the rotator cuff activation of less than 20% of maximal voluntary contraction for the surgery repaired tendons. Our results show that this exercise protocol complies with these levels of activation when applied in an early stage, show benefits in range of motion and pain.

Conclusions The application on an early submaximal exercise program might decrease pain and increased glenohumeral flexion, abduction and external rotation range of motion, decreasing the complication due to immobilization.

Nivel de evidencia: 2B

Palabras Clave

artroscopia - ejercicios submaximales - manguito rotador - terapia física

Keywords

arthroscopic - submaximal exercises - rotator cuff - physical therapy

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