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OEMG-Diagnostik und OEMG-biofeedback-Therapie nach Latissimus-dorsi-Plastik

SEMG-diagnostic and SEMG-biofeedback therapy after latissimus dorsi tendon transfer

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Abstract

Latissimus dorsi tendon transfer is an established method in the treatment of the nonrepairable rotator cuff tear. Originally, the muscle has to realize retroversion and internal rotation of the arm. After tendon transfer the function of the muscle is completely different from this – the muscle supports the elevation of the arm now. To take over the new function, patients need regulary for 9 to 12 months. In some studies this fact was controlled by surface electromyography (SEMG).

In our study we examined two groups of patients with a constant SEMG score 12 weeks after tendon transfer. One group received (a=30) common rehabilitation and the other patients (a=23) worked with SEMG-feedback therapy.

Muscle activity in patients with common rehabilitation (a=30) was not significantly increased in SEMG. But the latissimus dorsi in patients with SEMG (a=23) produced a high activity and a significant increase in the SEMG values. So far we found these results only in patients with normal therapy after 12 months.

In our opinion with the SEMG-feedback therapy it is possible to activate the latissimus dorsi in supporting the elevation of the arm in a more effective way and in a significantly shorter time.

Zusammenfassung

Die Latissimus-dorsi-Plastik (LDP) ist eine etablierte Methode zur Behandlung irreparabler Rotatorenmanschettenmassendefekte. Die Aufgabe des Muskels besteht originär in einer Abwärtsbewegung und Innenrotation des Armes. Nach der Transposition muss der Muskel eine völlig neue Funktion erlernen – er muss die Elevation unterstützen. Eine effiziente Übernahme der neuen Funktion (Rekrutierungszeitpunkt) dauert bei den meisten Patienten zwischen 9–12 Monaten und wurde in verschiedenen Studien mittels Oberflächenelektromyographie (OEMG) beschrieben.

In einer prospektiven Studie überprüften wir in einer Gruppe (n=30) nach üblicher Rehabilitation bzw. in einer Gruppe (n=23) mit Einsatz des OEMG-feedback-Trainings die Mittelwerte des Aktivitätsmusters im Oberflächen-EMG (OEMG) und den constant score 12 Wochen postoperativ.

Die Patienten mit konventioneller Nachbehandlung zeigten kaum erhöhte Aktivitätsmuster des Latissimus dorsi im OEMG. Demgegenüber fanden wir in der Gruppe mit OEMG-feedback-Training signifikant gestiegene OEMG-Werte, wie sie üblicherweise erst nach 9 bis 12 Monaten auftreten.

Diese Untersuchungsergebnisse widerspiegeln sich ebenfall im Constant Score beider Gruppen.

Unserer Meinung nach führt der postoperative Einsatz des OEMG-feedback-Trainings zu einer entscheidenden Verbesserung des Rekrutierungszeitpunktes des transferierten Muskels.

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Authors and Affiliations

  1. Orthopädische Privatpraxis, Zentrum für Ganzheitliche Medizin, Ludwig-Feuerbach-Str. 7b, 99425, Weimar, Germany

    M. Bernsdorf

  2. Marienstift Arnstadt, Orthopädische Klinik, Arnstadt, Germany

    S. Born &  U. Irlenbusch

Authors
  1. M. Bernsdorf
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  2. S. Born
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  3. U. Irlenbusch
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Correspondence to M. Bernsdorf.

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Bernsdorf, M., Born, S. & Irlenbusch, U. OEMG-Diagnostik und OEMG-biofeedback-Therapie nach Latissimus-dorsi-Plastik. Obere Extremität 2, 137–142 (2007). https://doi.org/10.1007/s11678-007-0047-0

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  • DOI: https://doi.org/10.1007/s11678-007-0047-0

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