Purpose
Even though the need of wearing a brace after shoulder surgery is still a matter of debate, an abduction brace is almost always used for 4 to 6 weeks after shoulder surgery and before starting a rehabilitation program. Due to its possible harmful effects, including stiffness and balance problems, the use of a shoulder abduction brace (SAB) needs to be carefully evaluated. However, it is still unclear whether the use of a brace after surgery might affect patients’ functional outcomes, and whether these changes persist after rehabilitation. Therefore, this study aimed to analyse gait and functional mobility in patients undergoing shoulder arthroplasty and rotator cuff repair and wearing a 15° SAB.
Methods
Gait parameters and functional mobility evaluations were carried out on thirty-five participants (age: 53.3 ± 10.4 years; BMI: 25.9 ± 4.7 kg/m2) using a wearable inertial device for gait analysis (G-Walk System by BTS Bioengineering). Each participant performed the 10-meter walk test (10MWT) at normal speed and the Timed Up and Go (TUG) test before surgery (T0), 24 hours after surgery (T1), 1 week after surgery (T2) and after removal of the shoulder brace (T3).
Results
Regarding the 10MWT, time of execution was significantly lower at T0 than at T1 (p<0.01) and significantly higher at T1 than at T3 (p<0.01). Therefore, speed was significantly higher at T0 than at T1 (p<0.01) and significantly lower at T1 than at T3 (p<0.05). Cadence was significantly lower at T1 than at T3 (p<0.05). No significant differences were found for right and left step lengths. Regarding the TUG test, the final turning phase was significantly higher at T2 than at T3 (p<0.01). No significant differences were found for all the other variables.
Conclusions
The use of SAB negatively influenced walking speed and cadence during the 10MWT and the final turning phase before sitting during the TUG test. However, after SAB removal these variables returned to basal values (ie, before surgery). We may hypothesise that patients wearing a SAB pay more attention when walking and before sitting due to the fear of falling. Exercise specialists, together with physiotherapists, should take into consideration these effects in order to define the optimal rehabilitation protocol.