Gazi HURİ, İrem DÜZGÜN, Taha İbrahim YILDIZ, Serdar DEMİRCİ, Dilara KARA

Artroskopik anterior omuz instabilite cerrahisi sonrası kontralateral tarafta kas atrofisinde rehabilitasyon: vaka raporu

Omuz anterior instabilite cerrahisi sonrası normal omuz fonksiyonlarının sağlanması için düzgün bir postür ve yeterli bir skapular stabilizasyona ihtiyaç vardır. Artroskopik anterior omuz instabilitesi cerrahisi sonrası, cerrahi tarafın kontralateralinde belirgin olmak üzere bilateral idiopatik proksimal kas atrofisi gelişen ve postüründe belirgin bozulma ile skapular kanatlaşma görülen rekreasyonel bir sporcuya; tam omuz fonksiyonlarını kazandırmak ve spora dönüşü sağlamak amacıyla, cerrahi sonrası altı aylık süreçte rehabilitasyon programı uygulandı. Cerrahi sonrası eklem hareketi, ağrı, skapular kinematik ve omuz izokinetikrotator kas kuvveti ile omuz fonksiyonel değerlendirmesi bilateral olarak yapıldı. İlk üç ay hastanın cerrahi uygulanan omzunda, dereceli eksternal rotasyon kazanımını hedefleyen rehabilitasyon programı uygulandı. Zamanla oluşan kontralateral taraf trapezius ve infraspinatus kas atrofisi sonrasında üçüncü aydan itibaren elektrik stimülasyonuyla kombine uygulanan skapula temelli egzersiz tedavisi ile cerrahi sonrası altıncı aya kadar takip edildi. Uygulanan rehabilitasyon protokolüyle, altıncı ayın sonunda, her iki omuzda da eklem hareketi ve kas kuvvetinde artış ve cerrahi uygulanan omzundaki ağrıda azalma sağlandı. Skapular hareketlerin tedavi sonrasında daha simetrik olduğu ve yukarı rotasyon ve posterior tilt hareketlerinde artış olduğu gözlendi. Cerrahi sonrası altıncı ayda olgu tam omuz fonksiyonlarını kazandı ve spora dönüşü sağlandı.

Anahtar Kelimeler:

Egzersiz, Kas atrofisi, Skapula, Trapezius

Rehabilitation of contralateral muscle atrophy following arthroscopic anterior shoulder instability surgery: a case study

Proper posture and sufficient scapular stabilization is necessary to provide normal shoulder functions after anterior shoulder instability surgery. A six-months rehabilitation program was performed to gain full shoulder functions and return to the sport after arthroscopic anterior shoulder instability surgery, a recreational athlete with bilateral idiopathic proximal muscular atrophy with marked prominence in the contralateral side of the surgery and scapular winging with significant deterioration in posture. Range of motion, pain, scapular kinematics, shoulder isokinetic rotator muscle strength and shoulder functions were measured bilaterally after surgery. Rehabilitation program was performed to achieve gradual external rotation in the surgical shoulder during the first three months. Scapular exercises combined with electrical stimulation were performed after contralateral trapezius and infraspinatus muscle atrophy and followed up since six months. Shoulder motions and muscle strength improved with rehabilitation end of the six-months in both shoulders and pain decreased on the surgical shoulder. The scapular movements were more symmetrical after treatment and scapular upward rotation and posterior tilt movements increased. At six months after surgery, the patient achieved full shoulder function and returned to the sport.

Keywords:

Exercise, Muscular atrophy, Scapula, Trapezius,

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