Shoulder Dysfunction - Biodex

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CLINICAL TREATMENT OPTIONS (cont): • Open Kinetic Chain (OKC) Proprioception: Device: Biodex Multi-Joint System Passive, Active and Threshold to detect passive movement* Pattern: ER/IR 90/90 Mode: Passive and Isokinetic Sets and Reps: 1 x 10-12 each mode Target Angle: 15º less than maximal ER Passive speed: 2 deg/sec Active speed: 180 deg/sec Target angle hold: 10 sec Recommendations: Be cautious with the target angle selected. There should be NO incidence of pain or inhibition. *NOTE: Threshold to detect passive movement for System 2 users with 4.5 or 4.6 software • Closed Kinetic Chain (CKC) Proprioception: Push ups and push ups with a plus 25 Positioning: May begin with different levels of hand placement Sets and Reps: 2 x 10-12 Recommendations: For increased difficulty, have the patient begin with hands on a 3" high raised surface on either side. Instruct patient to lower chest to below hand height before beginning the press upward off the blocks. Floor stabilization exercises: Sets and Duration: 2 x 20 seconds (progress to 40 seconds by end of phase) Recommendations: Have the patient assume a push-up position. Begin with feet on floor and progress to an unstable surface (ball /wobble board) Device: Biodex Stability System Begin with a stable platform and progress as tolerated to an unstable platform Sets and Duration: 1-2 x 20 seconds (progress as tolerated) Recommendations: CAUTION must be noted about the platform • Closed Kinetic Chain Exercises Device: Biodex Multi-Joint System Attachment: Closed Chain Attachment Pattern: Shoulder protraction/retraction and horizontal ABD/ADD Mode: Passive Speeds: 5 deg/sec Sets and Duration: 1 x 3 min (progress to 5 by end of phase) Recommendations: Have no shoulder flexion greater than 90º. There should be no pain or scapular winging noted. • Cardiovascular training Device: Biodex Upper Body Cycle Direction: forward and reverse Duration: Begin at 7 min and progress as needed Speed: 120 deg/second Recommendations: Ensure that shoulder is below 90° of shoulder flexion Device: Biodex BioStep ® Semi-Recumbent Elliptical Duration: As needed Speed: Vary speeds as needed Device: Rehabilitation Treadmill Setup: 0% incline Duration: Begin with 5-10 min and progress as tolerated Speed: Begin at speed used at end of the last phase Recommendations: Monitor levels of intensity and progress as tolerated 1-18 PHASE III: INITIAL AND INTERMEDIATE STRENGTHENING
CLINICAL TREATMENT OPTIONS (cont): • Plyometrics (Stretch-Shortening exercise drills): 32 Underhand throws Sets and Reps: 2 x 10 Setup: Rebound device with a 3-4 pound weight Chest throws Sets and Reps: 2 x 10 Setup: Rebound device with a 3-4 pound weight 2 hand side-to-side throws Sets and Reps: 2 x 10 Setup: Rebound device with a 3-4 pound weight Assisted wall push-ups Sets and Reps: 2 x 10 Recommendations: Have the clinician stand behind the patient and instruct them to press out having the hands lift "slightly" of the wall and then back on. • Plyometrics (Stretch-Shortening exercise drills): ER/IR plyometrics with exercise tubing Position: Neutral (progress to 90º/90º) Sets and Reps: 2 x 10 Resistance: Light tubing (progress to heavier) D1/D2 plyometrics with exercise tubing Sets and Reps: 2 x 10 Resistance: Light tubing (progress to heavier) Recommendation: Begin with extension only and progress to full ROM) NOTE: It is recommended that prior to beginning any plyometric training session, adequate warm-up exercises should be performed. • Manual Resistance exercises: Shoulder PNF patterns D1/D2 Sets and Reps: 3 x 10-12 Recommendations: Ensure that there is no increased pain with diagonals over 90º of shoulder FLEX/EXT Scapular neuromuscular control (elevation/depression and protraction/retraction) 32 Sets and Reps: 2 x 10 Recommendations: Progress from straight movements to circular and diagonal patterns © BIODEX MEDICAL SYSTEMS, INC. 1-19
Page 1 and 2: FN: 03-028 Evidence-based Clinical
Page 3 and 4: INTRODUCTION clinical protocol The
Page 5 and 6: GOALS: • Mentally prepare patient
Page 7 and 8: CLINICAL TREATMENT OPTIONS: • Reh
Page 9 and 10: SUPERVISED PROGRAM: • Control ede
Page 11 and 12: GOALS: • Full pain free PROM and
Page 13 and 14: CLINICAL TREATMENT OPTIONS: • Red
Page 15 and 16: SUPERVISED PROGRAM: • Range of Mo
Page 17 and 18: GOALS: • Full pain free PROM and
Page 19: CLINICAL TREATMENT OPTIONS: • Con
Page 23 and 24: HOME PROGRAM: • Control pain and
Page 25 and 26: GOALS: (for return to full activity
Page 27 and 28: CLINICAL TREATMENT OPTIONS: • Red
Page 29 and 30: CLINICAL TREATMENT OPTIONS (cont):
Page 31 and 32: HOME PROGRAM: • Control pain and
Page 33 and 34: 23. Mosely, BJ, Jobe, FW, Pink, M,
Page 35: EVIDENCE BASED CLINICAL PROTOCOL FO

Shoulder Dysfunction - Biodex

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