Πρωτόκολλο Αποκατάστασης Ρήξης Τενοντίου Πετάλου

Rehab Protocol for Medium (2-5) Rotator Cuff Repair
Rehab Progression Summary

• 0-4 weeks Sling/immobilization
• 0-6 weeks Passive gentle ROM (Phase I)
• 4-8 weeks Active-assisted ROM (Phase II)
• 6-12 weeks Active ROM (Phase III)
• 12+ weeks Strengthening (Phase IV)
  Immobilization
• Sling/abduction pillow is worn for 4 weeks during the day and night
• Remove sling for light activity and home exercise program as indicated by therapist

Phase I – PROM: 1st post-op visit / 0-6 weeks
Goals for Treatment:
• Decrease pain and swelling
• Increase nutrition and healing response
• Infection prevention
PROM:
• Begin passive ROM exercises in clinic
• Pendulum exercise without weight: clockwise, counterclockwise, side to side, front – back
• PROM above abduction pillow: ER, IR, flexion, extension, abduction
• Table slides
• Therapist: grade I, II joint mobilizations
• Scapular retractions
• Wrist/elbow exercises; grip exercises

Patient Education:
• Wound inspection
• Begin active assisted ROM at 4 weeks
• No active motion for 6 weeks, all planes
• No weights/PRE for 12 weeks
• No active external rotation for 4 weeks
• Limit external rotation to neutral for 4 weeks
• Sling use as indicated by repair
• Icing 3x/day for 20 minutes

Other:
• Ice – PRN
• Modalities –PRN

Phase II – Assisted-AROM: 4 weeks post-op
AROM:
• Pendulum exercises with light weight
• AAROM with cane & pulleys, to patient tolerance (flexion, abduction
-ER to neutral)
• Body Blade – opposite hand, straight plane
• Shoulder shrugs – light weight/high reps
Progress with:
• Wall climbing/finger ladder
• Scar mobility
• Joint mobilizations – grade I/II
• Quadruped rhythmic stabilization
• Body Blade – opposite hand diagonals with trunk rotation
• Biceps curls
• Shoulder extension with Theraband
• Shoulder shrugs
• UBE – active assist only

Other:
• Ice – PRN
• Modalities – PRN

Phase III – AROM – 6 weeks post-op
AROM:
• Continue with Phase II A – AROM
• AAROM exercises with cane
• AROM – all planes, no resistance
• UBE – forward/reverse
• Scapular retraction
• Prone extension
• Supine “holds” at 90° flexion; progress to small circles
• Side-lying “holds” at 90° abduction; progress to small circles
• Isometrics <50% effort, no pain (flexion, extension, abduction, ER)
• Biceps curls/triceps extensions with light resistances, elbow at side

Other:
• Ice – PRN
• Modalities – PRN

Phase III – AROM continue – 8 weeks post-op
Goal:
Should have full PROM; with gentle passive stretching
AROM:
• Continue with Phase III exercises, adding weight/resistance as indicated by therapist
• Low-weight exercise (begin at 90° and increase to full ROM):
o flexion/extension
o abduction
o rows
o scaption
• Wall push-ups, wall push-ups plus
• Shoulder IR/ER with low resistance
• Scapular protraction (“serratus punch”)
• Prone fly
Other:
• Ice -PRN
•Modalities – PRN

Phase IV – Strength – 12 weeks post-op
Goal:
Should have full AROM; if not, begin aggressive stretching to achieve full ROM
Strength:
• Body Blade, involved extremity:
o one-handed grip, abduction to 90°
o two-handed grip, flexion to 90°
• Kneeling push-ups, kneeling push-ups plus
• Step-ups in kneeling push-up position
• UBE with increased resistance
• StairMaster in quadruped at level 12-15
• Treadmill in quadruped at 1.0 mph
• Plyoball:
o circles, CW & CCW, 1 minute each direction
o squares, CW & CCW, 1 minute each direction

Other:
• Ice – PRN
• Modalities – PRN

Return to Sport – Specific Training: 12-16+ weeks post-op

Στο σημείο αυτό του ιστότοπου μπορείτε να βρείτε εγχειρίδια που θα σας πληροφορήσουν αναλυτικά για κάποιες ορθοπεδικές επεμβάσεις, θα σας βοηθήσουν στην κατεύθυνση της αναζήτησης των ερωτήσεων που θα καλύψουν το φάσμα των αποριών σας για τις επεμβάσεις και τέλος θα σας παρέχουν υλικό προς εκτύπωση χρήσιμο για τη συγκατάθεσή σας σε μια μεγάλη επέμβαση.