Journal List > Korean J Sports Med > v.37(3) > 1131238

Jang and Kim: Wrist Rehabilitation after Scapholunate Interosseous Ligament Reconstruction for a Collegiate Basketball Player

Abstract

For a basketball player who had scapholunate interosseous ligament injury related to sport, it is crucial to secure the active range of motion (ROM) and regain proprioception of the wrist. The player was involved in a 21-week rehabilitation procedure based on controlling pain with inactive treatments, restoring the wrist ROM with active treatments. We measured the visual analog scale (VAS) for pain, upper extremity functional outcome measurement (Disabilities of Arm, Shoulder, and Hand [DASH]) for the functionality, and active ROMs of the wrist. The VAS was decreased (after surgical treatment, 8.7; 1 week, 2.5; 12 week, 3–5; 21 week, 0). The DASH score was decreased when he returned to play (after surgical treatment, 78; end of the rehabilitation, 23). Wrist flexion and extension ROM were increased to 55o and 67o, respectively. To restore the function of the wrist for basketball performance, improvement of active ROM and proprioception is the primary goal to return to play.

References

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Fig. 1.
(A) Lateral X-rays showing a scapholunate angle of 55.5°. (B) Preoperative X-rays showing scapholunate instability. (C) Postoperative X-rays showing reduction and pinning of the scapholunate interval (Juggerknot soft anchors).
kjsm-37-101f1.tif
Fig. 2.
(A, B) Active release technique for active range of motion.
kjsm-37-101f2.tif
Fig. 3.
Active range of motion of the wrist in all planes. (A) Extension. (B) Flexion. (C) Ulna deviation. (D) Radial deviation.
kjsm-37-101f3.tif
Table 1.
Summary of therapeutic interventions
Aim Parameter, dosage, duration
Pain Inactive treatment
TENS
20 Minutes; 100 pps; phase duration, 100 μs
US
7 Minutes; around the scapholunate joint; 50%−100%, 3 MHz, 0.7−1.0 W/cm2
MHP
20 Minutes
Paraffin bath
10 Layers; 15 minutes
Cryotherapy with CWI or ice bag
20 Minutes
ROM Inactive treatments
Friction massage+ART with wrist flexion & extension
5−7 Minutes
Joint mobilization
Grade I & II for radiocarpal joint; 5−7 minutes
Active treatment
Mirror therapy
Active movement; 15−20 reps×4−5 sets
PNF with D1 & D2 assisted movement
15−20 reps×4−5 sets
Strength Active treatment
PNF with D1 & D2 active movement
Manual emphasizing concentric phase; 18−20 reps×4−5 sets
Rhythmic stabilization exercise
Manual emphasizing eccentric phase; 18−20-reps×4−5-sets
Power web and soft ball exercise for conscious finger stabilizer
18−20 reps×4−5 sets
Tower curl and DTM with medicine ball, and finger pushup for wrist and finger strength
12−15 reps×4−5 sets
Gyroscope and body blade exercise for unconscious neuromuscular wrist and finger strength
30−40 Seconds×4−5 sets
Function Active treatments
Dribbling drills with ladder & cone for sports specific training
40 Minutes
Shooting
200 reps×3−4 sets

TENS: transcutaneous electrical nerve stimulation, pps: pulse per second, US: ultrasound, MHP: moisture heat pack, CWI: cold water immersion, ROM: range of motion, ART: active release technique, reps: repetition, D: diagonal, PNF: proprioceptive neuromuscular facilitation, DTM: dart throwing motion.

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