ORIGINAL ARTICLES   Free access

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

Copyright © 1999 EDIZIONI MINERVA MEDICA

lingua: Inglese

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.