Elektrische Muskelstimulation zur Behandlung funktioneller posteriorer Schulterinstabilität: Fallvorstellung

Abstract

IntroductionAberrant muscle activation patterns of periscapular and shoulder muscles can result in severe functional posterior shoulder instability (FPSI) without demonstrating underlying structural defects. Conventional physiotherapy as well as surgical interventions are often unsuccessful in the treatment of FPSI. Case presentationWe report a 13-year-old girl with rare, tic-like non-positional FPSI. 3 months of conventional conservative therapy failed and a rapid progression of the pathology resulted in an extremely limited shoulder function including repetitive posterior subluxations, chronic pain and stigmatization. The application of electric muscle stimulation (“EMS”) immediately achieved a dislocation-free shoulder motion. After 6 weeks of treatment using an EMS therapy concept, the patient regained a stable shoulder motion for all retrained shoulder movements and a persistent effect of the treatment was observed at the 12 months’ follow-up. However, rapid and uncoordinated shoulder movements still cause involuntary subluxations. ConclusionElectric muscle stimulation (“EMS”) is able to successfully re-establish glenohumeral stability even in patients with rare, tic-like non-positional FPSI. A sustained therapeutic effect that allows for a stable shoulder motion can be achieved after only a few therapeutic sessions.