Desenvolvimento e aplicação de um protocolo de reabilitação nas cirurgias de manguito rotador: rupturas completas e lesões maciças

Abstract

Shoulder pain is a musculoskeletal condition, a significant cause of functional disability in occupational and daily life activities, contributing to increased social and economic costs for individuals, companies and the State. Rotator cuff tears are the most common dysfunction of the upper limbs, reaching a prevalence of one in three people over 60 years of age. As the number of operations to repair the rotator cuff increases and surgical techniques advance, there is uncertainty about the optimal approach to postoperative rehabilitation, a key component of the recovery process. Therefore, the objective of this study was to develop and test a rehabilitation protocol after arthroscopic rotator cuff surgery, in order to contribute to the understanding of the prognostic factors of the postoperative treatment of these injuries. The sample was randomly allocated into two groups, with twelve participants taking part in the experimental group and twelve in the conventional group. To calculate the sample size, the G*Power software version 3.2.9.7 (Dusseldorf German) was used. The tool was adjusted with an effect measure of 0.40, a significance level of 95% and a power of 0.80. A minimum of 20 participants was estimated for the construction of the protocol. The treatment was divided into four phases, and participants were instructed to perform specific exercises according to the type of tendon undergoing the surgical procedure. The protocol developed showed favorable post-test results in the modified sphygmomanometer test of external rotation and internal rotation, between pairs, with a gain of more than 50% in strength and VAS reaching almost 5 points on the pain scale. It can be concluded then that the definition of a post-operative rehabilitation treatment for participants undergoing rotator cuff surgery brought better cost-benefit to health services, proven by the fact that participants in the intervention group underwent 37 physiotherapy consultations, accounting for 25 hours of care. . On the other hand, the control group carried out 60 physiotherapeutic interventions, totaling 40 hours of care. The difference in treatment hours resulted in savings of 40% for participants. In addition to assisting the professional in better clinical decision-making.