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Europa Medicophysica 1999 March;35(1):11-17

Copyright © 1999 EDIZIONI MINERVA MEDICA

language: English

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


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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.

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