Journal of Orthopaedic and Sports Physical Therapy

Introdução: A reparação artroscópica do Manguito Rotador (MR) é um tratamento com boas taxas de sucesso para patologia do manguito rotador, proporcionando bons resultados funcionais. Objetivo: identificar e descrever as principais estratégias na reabilitação pós-operatória de pacientes submetidos a reparação do MR. Além do mais avaliar os resultados dessas intervenções nos parâmetros dor, função e incapacidade. Método: A revisão foi baseada em artigos indexados nas bases de dados PubMede Cochrane Library. Como critérios de inclusão foram definidos: ensaios clínicos randomizados controlados; em inglês; com amostras constituídas por adultos que apresentavam lesão parcial ou total de componentes musculares que compõem o manguito rotador. Além do mais, são incluídos artigos publicados nos últimos 05 anos. Resultado: Foram encontrados 74 artigos no total. Aplicando os critérios de inclusão e exclusão, filtros e em seguida feito a elegibilidade através da leitura dos resumos o total de estudo inclusos foi de 06 artigos. Conclusão: tratamento ativo e precoce não mostrou benefícios significativos em comparação aos tratamentos habituais e conservadores. A imobilização pós-operatória com uma tipóia pode, portanto, não ser necessária para pacientes após reparação artroscópica.

/pdf/reabilitacao-pos-operatoria-de-reparacao-do-manguito-rotador-31i4kkw9.pdf

Reabilitação pós-operatória de reparação do manguito rotador: revisão integrativa

Rehabilitation outcome domains following rotator cuff surgical repair: a systematic review

Background: The number of rotator cuff repairs performed worldwide is increasing every year. However, there are still controversies regarding when rehabilitation after surgery should start.
Objectives: To assess and to compare clinical and biomechanical outcomes of patients who were randomised and allocated to early or conservative rehabilitation after rotator cuff repairs.
Methods: Twenty patients were randomised to two treatment groups. The biomechanical assessments were performed before surgery and at three and six months, consisting of 3D kinematics and muscle activity from 5 muscles (upper trapezius, anterior deltoid, middle deltoid, posterior deltoid and biceps brachii) from six movement tasks. In addition, the Oxford Shoulder Score and EQ-5D-5L were also recorded. At 12 months an ultrasound scan was performed to check the repair integrity. 
Results: Overall, both groups had similar results for function and health-related quality of life. However, at six months patients in the early group had better range of motion (ROM) than those in the conservative group, especially for shoulder flexion (Early: median=152.1° vs Conservative: median=140.0°). The number of re-tear events was higher in the early group (5 vs 1), and of these only two patients reported symptoms at 12 months.
Conclusion: Early rehabilitation may improve ROM but it does not seem to be superior to a conservative management in improving function and quality of life. In addition, more re-tear events were observed in the early group. However, the results should be interpreted with caution due to the small sample size.

/pdf/what-is-the-impact-of-early-rehabilitation-following-rotator-2iebipc35x.pdf

What is the impact of early rehabilitation following rotator cuff repairs on clinical and biomechanical outcomes? A randomised controlled trial

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What is the impact of early rehabilitation following rotator cuff repairs on clinical and biomechanical outcomes? A randomised controlled trial