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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici
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Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Europa Medicophysica 1999 Marzo;35(1):11-17
Metabolic quantification of disability and post-rehabilitation outcome of workers with sequelae of rotator cuff surgery
Aquilani R. 1, Bertoni M. 2, Bonelli R. 3, Crespi M. G. 2, Mariani P. 1, Ruffato L. 2, Spinatonda G. 4, Galli M. 2
1 Service of Nutritional and Metabolic Pathophysiology and of Clinical Nutrition, ;“S. Maugeri” Foundation, Care and Research Institute, Rehabilitation Institute of Tradate (Varese), Italy
2 Division of Rehabilitation, “S. Maugeri” Foundation, Care and Research Institute, Rehabilitation Institute of Tradate (Varese), Italy;
3 Division of Cardiology, “S. Maugeri” Foundation, Care and Research Institute, Rehabilitation Institute of Tradate (Varese), Italy;
4 Service of Biomedical Engineering, “S. Maugeri” Foundation, Care and Research Institute, Rehabilitation Institute of Tradate (Varese), Italy
BACKGROUND: The ability to perform domestic and work activities requires contemporary biochemical, cardiovascular, metabolic and psychophysical capacities. In employment aged patients with sequelae of surgical treatment of the rotator cuff tears (SRCT) one or more of the above capacities may be impaired. Aims: to measure strength, work performance and to quantify the impact of SRCT on metabolic capacities (aerobic + anaerobic processes) before and after non-occupational physical rehabilitation in a group of working women with SRCT.
METHODS: Five working women with bilateral SRCT and five healthy working women (control group) were submitted to a session of maximal effort performance in simulating weight lifting using an isokinetic method on both arms. Oxygen consumption (V.O2) and heart rate (HR) were continuously monitored during rest (5 mins), during work (1 min) and during recovery (5 mins). This procedure was repeated in the patient group after 21 days of rehabilitation.
RESULTS: Patients had less strength and work performance in both arms than the controls (p<0.01), while their net total oxygen cost (TΔV.O2/J/m2) was significantly higher because of an increase in net anaerobic oxygen consumption (Deb O2/J/m2), (p<0.01), Net mechanical efficiency (Ew) was lower in patients than in controls. After 21 days of rehabilitation the patients had increased work performance in the right arm (+86%) and normalized both their net oxygen cost (by reducing aerobic and anaerobic costs) and mechanical efficiency. On the right side the cardiovascular load was significantly reduced.
CONCLUSIONS: Patients with SRCT have reduced work performance and mechanical efficiency because of decreased anaerobic capacity when they are requested to perform a maximal effort in weight lifting. A brief rehabilitation programme may be effective in reversing the major part of the observed mechanical and metabolic alterations.