Open kinetic chain versus closed kinetic chain in advanced rehabilitation rotator cuff

Rudiel Luciano Boeck Marcelo Baptista Döhnert Tiago Sebastiá Pavão About the authors

INTRODUCTION: Shoulder impingement syndrome is a prevalent musculoskeletal alteration that leads to a significant reduction of health and to functional disability. This injury is caused by repetitive use of arms above the shoulder line or pathological condition to which the supraspinatus tendon irritation occurs secondary to an abrasion on its surface by the anterior third of the acromion. Physiotherapy is often the first choice of treatment, although its effectiveness is still under debate. Clinically, the kinetic chain rehabilitation has been effective in restoring shoulder function with good therapeutic results. OBJECTIVES: To evaluate the effectiveness of a protocol for rehabilitation of the shoulder in a closed kinetic chain for impact syndrome rotator cuff. MATERIALS AND METHODS: Randomized clinical trial of equivalence with 20 patients with grade I and II lesions of the rotator cuff in the classification of Neer. Patients were divided into two groups: group I, with the exercise protocol in closed kinetic chain (CKC), and group II, with exercises in open kinetic chain (OKC). Patients underwent 20 sessions, three times a week, and were evaluated on pain, mobility, active, passive, muscular strength, muscular activity and functionality. This evaluation occurred three times: initially, with 10 sessions and at the end of treatment. Statistical analysis used parametric measures such as the t-Student test (comparison between groups) and ANOVA for repeated measures (comparison within each group), and nonparametric measures (Kruskal Wallis and Friedman test). RESULTS: Both groups showed significant results regarding the scores obtained in the UCLA and Constant scale. The active mobility of the shoulder increased in the injured group CCF in flexion (p = 0.01), external rotation (p = 0.000) and internal rotation (p = 0.000). The movement of abduction improved in both groups (p = 0.02 in CCF group and 0.04 in CCA group). Muscle strength of flexion and abduction showed an increase only in the CCF group, while in the rotation movements were external and internal significant in both groups. CONCLUSION: It was concluded that CKC exercises have major improvements in mobility, functionality and strength for patients with shoulder impact syndrome.

Shoulder impingement syndrome; exercise therapy; Physical therapy

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