Rehabilitation of symptomatic atraumatic degenerative rotator cuff tears: A clinical commentary on assessment and management

Bleichert, Sarah; Renaud, Genevieve; MacDermid, Joy C.; Watson, Lyndsey F.; Faber, Ken; Lenssen, Ross; Saulnier, Marie; Phillips, Paul; Evans, Tyler A.; Sadi, Jackie

doi:10.1016/j.jht.2017.05.006

Cited by 10 publications

(5 citation statements)

References 114 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The global EMG amplitude of the standard PU was nearly 40% MVIC, bordering on high activity. This activity level is consistent with the recommendation that PU progressions are added to end-stage rehabilitation programs when muscles are able to tolerate higher loads 2,51 or prescribed to individuals interested in building general upper extremity strength.…”

Section: Standard Push-upsupporting

confidence: 85%

“…1,2 Selection of appropriate exercises to address these components is an important determinant of successful rehabilitation outcomes. [2][3][4] Axial loading during closed chain exercises enhances neuromuscular control through increased proprioceptive input and facilitates co-contraction to improve functional stability of the shoulder. 5 Therefore, upper extremity closed chain exercises can be an important component of a shoulder rehabilitation program.…”

Section: Introductionmentioning

confidence: 99%

“…Neuromuscular control, endurance, and strength are key components of many shoulder rehabilitation programs. 1,2 Selection of appropriate exercises to address these components is an important determinant of successful rehabilitation outcomes. [2][3][4] Axial loading during closed chain exercises enhances neuromuscular control through increased proprioceptive input and facilitates co-contraction to improve functional stability of the shoulder.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Shoulder electromyography activity during push-up variations: a scoping review

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Push-ups (PU) are a common closed chain exercise used to enhance shoulder girdle stability, with variations that alter the difficulty or target specific muscles. To appropriately select and prescribe PU exercises, an understanding of muscle activity during variations of the PU is needed. The purpose of this scoping review was to identify common PU variations and describe their muscle activation levels. Methods Databases searched included PubMed, CINAHL, Scopus, and SPORTDiscus for articles published between January 2000 and November 2019. Results Three hundred three articles were screened for eligibility with 30 articles included in the analysis. Six PU types and five muscles met the criteria for analysis. Weighted mean electromyography (EMG) amplitude was calculated for each muscle across PU types and for each PU type as a measure of global muscle activity. Triceps and pectoralis major had the highest EMG amplitude during unstable, suspension, incline with hands on a ball and the standard PU. Serratus anterior had the highest EMG amplitude during PU plus and incline PU. The greatest global EMG amplitude occurred during unstable surface PU. Discussion These results provide clinicians with a framework for prescribing PU to target specific muscles and scale exercise difficulty to facilitate rehabilitation outcomes.

show abstract

Section: Standard Push-upsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Shoulder electromyography activity during push-up variations: a scoping review

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…19 Currently, 3 primary hypotheses attempt to describe the relationships between movement/motor control and pain/ injury. These hypotheses are described by Hodges 20 in more detail elsewhere but outlined briefly here: (1) suboptimal movement/tissue loading can lead to injury/pain, [21][22][23] (2) actual or perceived threat of injury/pain can impair or interfere with motor output at various levels of the neuromuscular system, and (3) altered movement patterns in response to injury/pain or the perceived threat of injury/pain serve to protect the affected body region (includes altered movement as a learned or conditioned response to pain with movement even in the absence of an ongoing painful stimulus). These concepts can overlap.…”

Section: Pain-related Neuromuscular Adaptation Hypotheses and Theoriesmentioning

confidence: 99%

The interaction between pain and movement

Merkle

Sluka

Law

2020

Journal of Hand Therapy

View full text Add to dashboard Cite

Motor output is highly adaptable, can be influenced by multiple mechanisms at various levels along the nervous system, and may vary between individuals despite similar diagnoses. Therefore, interventions need to be individualized and consider both the types of motor response observed (ie, whether the response is protective or maladaptive), and the patient's acute physical activity tolerance when prescribing exercise/movement.

show abstract

“…Shoulder pain is one of the most common musculoskeletal complaints, with a lifetime prevalence of up to 67% [ 1 ], and rotator cuff (RC) tendinopathy is among the most frequent diagnoses of shoulder pain. RC tendinopathy consists of tendinopathy of one or more of the four components of RC tendons, may or may not involve inflammation of the shoulder bursae, and can advance to partial or complete tendon rupture [ 2 , 3 ]. In Brazil, a study conducted by Malavolta and colleagues [ 4 ] in patients with shoulder pain found a prevalence of 64.3% of RC related conditions, with 41.2% of cases being tendinopathy.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic exercises in the clinical practice of Brazilian physical therapists in the management of rotator cuff tendinopathy: An online survey

Augusto,

Scattone Silva,

Pinheiro

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

The objective of this study was to investigate how Brazilian physical therapists (PTs) use therapeutic exercises in the rehabilitation of individuals with rotator cuff (RC) tendinopathy. The study used an online survey with a mix of 62 open- and closed-ended questions divided into three sections: participant demographics, professional experience, and clinical practice in the rehabilitation of patients with RC tendinopathy. One hundred and fifty-nine Brazilian physical therapists completed the survey. Most of our sample recommended isometric exercises (69.9%) in the initial phase of rehabilitation and eccentric exercises (47.4%) in the advanced phase. However, there was a wide variability in determining the volume of exercises, particularly with isometric exercises. Most of our sample considered patient comfort and pain levels when adjusting exercise intensity, regardless of exercise type. The majority (48.40%) recommended weekly reassessment and modification of exercises. Additionally, despite pain being a key factor for discharge and the primary adverse effect of exercise, most of our sample would not discontinue exercises in case of pain during the early and late phases of rehabilitation. Despite the lack of consensus on some aspects, the clinical practice of our sample is in line with the current literature and practice in other countries. However, further research and implementation are crucial to enhance future rehabilitation outcomes, including exploring the exercise training volume, the safety and effectiveness of exercising with pain and identifying the optimal pain level for best results.

show abstract

Rehabilitation of symptomatic atraumatic degenerative rotator cuff tears: A clinical commentary on assessment and management

Cited by 10 publications

References 114 publications

Shoulder electromyography activity during push-up variations: a scoping review

Shoulder electromyography activity during push-up variations: a scoping review

The interaction between pain and movement

Therapeutic exercises in the clinical practice of Brazilian physical therapists in the management of rotator cuff tendinopathy: An online survey

Contact Info

Product

Resources

About