Muscle Injury Research Paper

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A Comparison Between Standard Physical Therapy and Neuromuscular Re-education Following Arthroscopic Rotator Cuff Repair
The number of rotator cuff surgeries has increased 141% in the decade from 1996 to 2006. Surgical advancements from open to arthroscopic repair were seen along with this trend. Rotator cuff surgery is intended to restore the integrity of the tendons and reduce pain. After surgery, physical therapists may confront a potential loss of dynamic mechanical stability at the glenohumeral joint resulting in altered glenohumeral and scapular arthrokinematics during arm movement. Shoulder stiffness may develop and there is potential for tendon repair failure.
Physical therapy may be initiated as early as one to two weeks …show more content…
For example, kinesthetic sense is tested by attempting to stimulate Pacinian corpuscles. The test most often administered to determine kinesthetic sense is the threshold to detection of passive motion (TTDPM). Threshold to detection of passive motion quantifies the ability to consciously detect when motion begins. Latency in the ability to detect when movement begins signals a deficit in kinesthetic sense. , . Joint position sense is assessed by stimulating joint and muscle mechanoreceptors. Joint position sense is most commonly tested by measuring reproduction of active positioning (RAP) or reproduction of passive repositioning (RPP), the ability to actively or passively reproduce upper extremity angular motion typically in internal and external rotation. Reproduction of active positioning theoretically assesses function of GTO’s and muscle spindles since muscle contraction occurs during the test. Reproduction of passive positioning theoretically assesses function of Pacinian corpuscles, Ruffini endings, and Golgi tendon organ like endings, since the contractile tissues are at rest during the …show more content…
reported an exercise protocol based on ‘motor control theory’ does produce positive outcomes on sub-acromial impingement syndrome. According to this theory, abnormal movement by damage or disease re-organizes the cerebral cortex, leading to changes in the brain. Therefor exercise aimed at achieving normal motion control (motor control exercises) can help restore normal movement in patients with sub-acromial impingement. Bae et al. and Roy et al. suggested that when their exercise protocol based on motor control theory were performed, normal pain free movement could be achieved in this population. More importantly, in their research they found there was a statistically significant greater effect on strength, AROM, pain and function when compared to strength training alone.Currently, there are no studies evaluating if deficits in proprioception or neuromuscular control exist in the rotator cuff repair population. Further, there aren’t studies examining the efficacy of NMR after rotator cuff repair. Even so, Ghodadra et al. advocated the use of NMR during certain phases of rehabilitation after rotator cuff repair. They recommended controlled activities that can safely activate the rotator cuff muscles including submaximal and pain-free rhythmic stabilization exercises in the supine position. They supported that rhythmic stabilization improved kinesthetic sense, pre-activation, and muscle stiffness of the rotator cuff, and surrounding shoulder muscles.
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