Apprehension-Based Training: A Novel Treatment Concept for Anterior Shoulder Dislocation - A Case Report.

IF 1.6 Q3 SPORT SCIENCES
International Journal of Sports Physical Therapy Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI:10.26603/001c.118928
Alon Rabin, Livneh Noyman, Noa Yaakobi, Efi Kazum
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Abstract

Background and purpose: Conservative management of anterior shoulder dislocation (ASD) is associated with greater recurrence compared with surgical management. Current rehabilitation protocols may not adequately challenge shoulder stability to encourage adaptive coping strategies. Apprehension-based training (ABT) is a new treatment concept derived from the supine moving apprehension test (SMAT), a previously validated performance measure among patients with ASD. The purpose of this case report is to describe the application of ABT in a patient with recurrent ASD.

Study design: Case report.

Case description: The subject was a 23-year-old male with bilateral recurrent ASD. The subject underwent a 17-week exercise program involving gradual exposure to increased anterior instability loads based on the SMAT movement pattern. The Western Ontario Shoulder Instability Index (WOSI), Patient-Specific Functional Scale (PFPS), Tampa Scale of Kinesiophobia, SMAT, shoulder internal and external rotation muscle strength were measured via hand-held dynomometry before and after training.

Outcomes: Following treatment, clinically meaningful gains in quality of life (WOSI) and shoulder function (PSFS) were noted. Kinesiophobia decreased, SMAT and shoulder internal rotator strength increased beyond their respective minimal detectable change. Four months after treatment, quality of life and shoulder function remained improved, and the subject reported a reduced rate of ASD.

Discussion: Apprehension-based training involving gradual exposure to shoulder instability loads may hold potential for improving the management of patients with ASD. Further testing of this concept is warranted.

Level of evidence: 4, single case report.

基于理解的训练:肩关节前脱位的新治疗理念--病例报告。
背景和目的:与手术治疗相比,保守治疗肩关节前脱位(ASD)的复发率更高。目前的康复方案可能无法充分挑战肩关节的稳定性,从而鼓励采取适应性应对策略。基于忧虑的训练(ABT)是一种新的治疗理念,它源于仰卧位移动忧虑测试(SMAT),该测试之前已在 ASD 患者中得到验证。本病例报告旨在描述 ABT 在一名复发性 ASD 患者身上的应用:研究设计:病例报告:研究对象是一名 23 岁的男性,患有双侧复发性 ASD。受试者接受了为期 17 周的锻炼计划,其中包括根据 SMAT 运动模式逐步增加前方不稳定负荷。在训练前后,通过手持测力计测量了西安大略省肩关节不稳定指数(WOSI)、患者特定功能量表(PFPS)、坦帕运动恐惧量表、SMAT、肩关节内旋和外旋肌力:治疗后,生活质量(WOSI)和肩关节功能(PSFS)均有临床意义的提高。运动恐惧症有所减轻,SMAT和肩关节内旋肌力量的增加超过了各自的最小可检测变化。治疗四个月后,患者的生活质量和肩部功能仍然有所改善,而且其 ASD 发生率也有所下降:讨论:逐渐暴露于肩部不稳定负荷的忧虑训练可能会改善 ASD 患者的治疗。证据级别:4,单例报告:4,单一病例报告。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.50
自引率
5.90%
发文量
124
审稿时长
16 weeks
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