Isokinetic rehabilitation in the chronic former instability of the shoulder: For individualized rehabilitative care.

OBJECTIVE: The isokinetic exploration of the shoulder seems little standardized, particularly at the time of the choice of the studied muscular groups, of the installation of the subject as well as positioning of the articulation itself.

OBSERVATIONS: Rehabilitation treatment of a 17 year old patient, hyperlaxe, swimmer, in the context of a painful chronic former instability of the shoulder without osseous, muscular lesion or labrale. An isokinetic work of reinforcement of the internal rotators is carried out, into concentric of 60°/s to 240°/s, position known as of Davies modified then in decubitus dorsal of 45° to 90° of abduction. At the end of the rehabilitation a work of reinforcement of the external rotators out of eccentric is associated with 60°/s in decubitus dorsal with 90° of abduction. The parameters of follow-up were the maximum moment of force, its bilateral comparison between homologous muscles, the quality of relative force and the shape of the curves of contraction. At 6 months, the evolution is favorable, with a complete disappearance of the painful phenomena and of instability, allowing even a resumption of swimming in competition.

DISCUSSION/CONCLUSION: The isokinetic rehabilitation of the shoulder offers a rehabilitation treatment personalized interesting as regards chronic former instability of the shoulder, which corresponds to a muscular weakness of the RI and RE without imbalance determining of ratio RE/RI.