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Master thesis

Evaluation du traitement conservateur guidé par isocinétisme dans l'instabilité chronique de l'épaule

Abstract : Introduction: If the dismemberment of chronic shoulder instability is still a topical issue, initial surgical or conservative treatment is all the more. Hypothesis: An initial isokinetic assessment of shoulder rotator muscles allowing targeted therapy, could give amediumtermsatisfactoryfunctionalresults, thus avoiding an invasive surgical procedure in chronically unstable shoulders so-called "atraumatic."Materials and methods: This series of 41 patients treated between 2000 and 2007 for shoulder pain and instability. The average age is 23.3 years [15-38] of 29.5 with a mean of 74.8 months [41-126], 23 men, 18 women, 38 constitutional hyperlaxity, 5 microtraumatic hyperlaxity, 5 with an Voluntary subluxation history, 41% of high-risk sports. The instability was anterior in 51%, posterior in 29% and 22% multidirectional. The isokinetic dynamometer assessment gives: peak torque, external / internal rotator ratio and general appearance of the curve. The rehabilitation protocol includes: targeted and overall muscle strengthening and proprioceptive work. The initial functional assessment is carried out by a score of Rowe and Walch-Duplay, and the final evaluation by the Rowe score, Walch-Duplay, quick-dash and an overall satisfaction questionnaire.Results: In hindsight, Rowe scores increased from 45.7 to 75.3 on average (p <0.05), Walch increasing significantly from 35.5 to 78.2. The Quick-Dash is 11.4 or 86.4% of capacity and 85.4% are satisfied with their shoulder. The results of posterior subgroup was significantly higher, and the voluntary instability subgroup significantly lower.Discussion: A non-operative treatment guided by isokinetic evaluation gives goodresults in medium term. The indications, methods and results of surgery in this type of instability are still poorly defined, it should be proposed after a failure of a well done rehabilitation.
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  • HAL Id : hal-01732037, version 1

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Damien Bellan. Evaluation du traitement conservateur guidé par isocinétisme dans l'instabilité chronique de l'épaule. Sciences du Vivant [q-bio]. 2010. ⟨hal-01732037⟩

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