Exercise programs for multidirectional shoulder instability
Rehabilitation is considered the primary treatment option for non-traumatic multidirectional instability (MDI) of the shoulder. This RCT compared the effectiveness of the Rockwood and Watson MDI programs in participants with nontraumatic, nonstructural MDI. The Rockwood program focuses on strengthening the deltoid and rotator cuff, while the Watson program focuses on patient-specific scapular motor control.
41 participants attended a weekly 30-minute physiotherapy session for 12 weeks in either program.
Despite less compliance in the Watson group, participants demonstrated significantly greater improvements on the Western Ontario Shoulder Index (WOSI) at 12 and 24 weeks and improved Melbourne Instability Shoulder Score (MISS) and pain at 24 weeks as compared with participants in the Rockwood program.
The Watson group also demonstrated a significantly larger increase in flexion strength and improved scapula biomechanics at 12 weeks and a larger reduction in pain at 24 weeks. The difference between groups may be explained by Watson's progressions into more sport specific ranges or building more proximal stability and scapula motor control.
For people with MDI, 12 sessions of the Watson MDI program were more effective than the Rockwood program at 12- and 24-week follow-up. The larger effects found at 24 weeks serve to inform practitioners of an approximate time at which they can expect their patients with MDI to show best functional improvements.
> From: Warby et al., Am J Sports Med (2017-12-18 07:43:23) (Epub ahead of print). All rights reserved to The Author(s). Click here for the online summary.