This clinical study investigates whether contralateral training (exercising the non-immobilized arm) can help preserve muscle strength and mass in patients recovering from shoulder surgery with elbow immobilization. Immobilization is often necessary to prevent further injury, but it can lead to significant muscle loss and reduced strength, delaying recovery and increasing healthcare costs. Recent studies suggest that training the non-immobilized arm may help maintain muscle function in the immobilized arm, particularly when using eccentric exercises (where muscles lengthen under tension). This study aims to compare the effects of eccentric and concentric (shortening) contralateral training versus standard care (no training) in patients undergoing shoulder surgery.
The study involves 4 visits: pre-surgery assessments, a 4-6 weeks' immobilization period with or without training, and follow-ups at the end of immobilization, 6 weeks' post-immobilization, and 17 weeks' post-immobilization. Participants will be randomly assigned to one of three groups: a control group receiving standard care, a group performing eccentric training, or a group performing concentric training. Muscle strength, mass, and function will be measured using tests such as isometric strength, ultrasound imaging, and functional scores.
The hypothesis is that eccentric contralateral training will better preserve neuromuscular function and muscle mass in the immobilized arm compared to both standard care and concentric training. This could lead to faster recovery and improved outcomes for patients. The study will provide valuable insights into optimizing rehabilitation strategies for patients recovering from shoulder surgery.
Adult patient (≥ 18 years old) undergoing shoulder surgery (i.e., Bankart procedure, rotator cuff repair, arthroplasty)
With an indication for immobilization, expected to last 4 to 6 weeks
Free from any neurological pathology
Having provided their informed consent before any participation in the research
Having a medical contraindication to the practice of physical and sports activities
Presenting an expected modification of their physical activity of the non-immobilized limb
Having suffered an injury to the upper limbs in the last 6 months
Having already undergone surgery on the upper limbs
Parallel
Standard care
Other interventionStandard care including rehabilitation sessions three times per week.
Eccentric training of the non-immobilized arm
Other interventionThe training protocol involves 3 sessions per week, separated by 24-48 hours. Each session includes 4-6 sets of 10 repetitions of elbow flexion/extension exercises on the non-immobilized arm at 60-90% of 1-RM, depending on the week. Eccentric actions are performed with controlled contraction duration (4 seconds) using a metronome. Rest periods of 2 seconds between repetitions and 2 minutes between sets are provided.
Concentric training of the non-immobilized arm
Other interventionThe training protocol involves 3 sessions per week, separated by 24-48 hours. Each session includes 4-6 sets of 10 repetitions of elbow flexion/extension exercises on the non-immobilized arm at 60-90% of 1-RM, depending on the week. Concentric actions are performed with controlled contraction duration (4 seconds) using a metronome. Rest periods of 2 seconds between repetitions and 2 minutes between sets are provided.
Isometric maximal voluntary strength of the immobilized arm
Isometric maximal voluntary strength will be assessed using an isokinetic dynamometer.
Isometric maximal voluntary strength of the immobilized arm
Isometric maximal voluntary strength will be assessed using an isokinetic dynamometer.
Isometric maximal voluntary strength of the non-immobilized arm
Isometric maximal voluntary strength will be assessed using an isokinetic dynamometer.
Circumference of the immobilized arm and the non-immobilized arm
Arm circumference will be assessed in cm at 5, 10, and 15 cm from the elbow crease and forearm circumference at 5 cm from the elbow crease
Anatomical cross-sectional area of the immobilized arm and the non-immobilized arm
Anatomical cross-sectional area of arms muscles will be measured by ultrasound.
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Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer
Lead sponsor
Sainte-Anne Military Teaching Hospital
Collaborator
