Evaluation of the Effectiveness of Using the Post-Isometric Relaxation (PIR) Technique and Exercises on the Mechanotherapy Apparatus in the Postoperative Period in Patients with Damage to the Rotator Cuff of the Shoulder

Abstract

Objective: to evaluate the effectiveness of performing exercises on an innovative mechanotherapy apparatus and the PIR technique for the recovery of patients with damage to the rotator cuff of the shoulder at the postoperative stage.
 Materials and Methods. The study involved 46 patients after arthroscopic intervention due to damage to the structures of the shoulder joint. The reasons for arthroscopic intervention were: adhesive capsulitis (3 patients), damage to the rotator cuff of the shoulder (39 patients), and impingement syndrome (4 patients). The average age of patients was 44.7±8.3 years. All patients were divided into 2 groups: the control group (CG, n=21) and the main group (MG, n=25). The beginning of rehabilitation among patients averaged 4.9±2.4 weeks after the surgery. The duration of treatment was 4.5±3.2 weeks. The study was carried out on the basis of the Department of Rehabilitation of the SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine” during 2020-2021.
 Results and Discussion. According to the VAS results, the pain level after the rehabilitation program significantly decreased in both groups (p<0.05). In the MG, the dynamics of pain syndrome according to the VAS ranged from 6.2±1.2 cm to 0.9±0.7 cm 6 weeks after the surgery. In the CG, the majority of patients also noted an improvement in the level of pain after surgery (from 6.5±1.1 cm to 1.1±1.2 cm); no significant differences after treatment in terms of the level of pain between the patients in the MG and the CG (p>0.05) were observed. Also, patients who were included in the main group and did exercises with a simulator and elements of PIR according to the rehabilitation program showed generally better indicators of recovery of the function of the shoulder joint, namely there was a higher dynamics in increasing the amplitude of movements in the shoulder joint (112.5±10.60 flexion before physical rehabilitation (PR), 173.2±5.50 after РR). In the CG, the positive dynamics was less pronounced (107.7±6.80 flexion before PR, 151.2±6.50 after PR). Similar results were found according to the data of manual muscle testing (MMT).
 Conclusions. Therefore, the method of post-isometric muscle relaxation using the proposed technique of training on a mechanotherapy apparatus for developing the shoulder joint is an effective method for treating postoperative contractures and can be recommended for the use in the complex rehabilitation of patients with contracture of the shoulder joint as a result of arthroscopic intervention in patients with injury of the rotator cuff of the shoulder.