Protocol Guide. 2 days Post-op Light compressive dressing/garment for biceps area. Sling or hinged...
-
Upload
abraham-zachery -
Category
Documents
-
view
218 -
download
0
Transcript of Protocol Guide. 2 days Post-op Light compressive dressing/garment for biceps area. Sling or hinged...
Distal Bicep RupturesProtocol Guide
Protocol Guide for Partial Biceps Muscle Tear
2 days Post-op Light compressive dressing/garment for biceps area. Sling or
hinged elbow brace at 90 degrees neutral forearm for comfort. Gentle unlimited A/AAROM hand to shoulder
HEP 10 min 3 times per day and wound care Clinic ROM program 3+ times per week and PRN wound
checks/care 10 days Post-op Continue HEP Clinic program BTE light (1 to 2 pounds) resistance AROM
hand to shoulder 3 times per week
Protocol Guide for Partial Biceps Muscle Tear
10days Post-op Continue HEP Clinic program BTE light (1 to 2 pounds) resistance AROM
hand to shoulder 3 times per week
3wks Post-op Continue HEP UEB endurance exercises 3 times per week (At 3wks
muscle should be scared in satisfactorily) Wean from sling/brace wear by 4wks s/p
Protocol Guide for Partial Biceps Muscle Tear
4 wks Post-op Continue HEP Baseline BTE power test sup/pro. BTE progressive strengthening
program 3 times per week (Ultimate Goal to have 70% sup/pro power of uninjured side)
6 wks Post-op Start 1 month HEP progressive pushup program
8 wks Post-op Transition to HEP progressive UE strengthening. Clinic follow up monthly BTE power test sup/pro until goal achieved.
May take up to 1yr.
12 wks Post-op Start progressive pullup/chinup program
Protocol Guide for Repair of Acute Distal Biceps Tendon Rupture
7 days Post-op Light compressive dressing/garment for biceps area.
Posterior long arm splint at 90 degrees neutral rotation. AROM extension and pronation. PROM flexion and supination
Flexion and extension in neutral rotation with 65 degree extension block
1 to 4 wks Post-op Progress to full AROM extension and pronation. Initially
flexion place-and-hold exercises. AROM flexion from 90 degrees
Protocol Guide for Repair of Acute Distal Biceps Tendon Rupture
6 wks Post-op Wean from splint to 8wks 4 to 8 wks Post-op Progress to full AROM flexion
Continue with 9 wk Post-op guidance from Dynamic Hinged brace protocol
Protocol Guide for Repair of Acute Distal Biceps Tendon Rupture
48 hours Post-op Light compressive dressing/garment for biceps area Posterior splint with elbow hinge locked at 90 degrees,
forearm in neutral for 3weeks AROM wrist and digits Codman’s pendulum exercises US, scar massage and edema control Clinic program 3+ times per week
Protocol Guide for Repair of Acute Distal Biceps Tendon Rupture
3 wks Post-op Dynamic component (theratube/band) applied to the
posterior splint allowing resisted extension and passive flexion
From 3rd to 6th week progress to elbow extension 30 degree block
Gravity eliminated AROM out of splint in clinic with 30 degree extension block
Continue modalities Initiate AROM shoulder without resistance
Protocol Guide for Repair of Acute Distal Biceps Tendon Rupture
6 to 9 wks Post-op Progress dynamic splint to 0 degrees extension (10 degree
increments per week) Initiate clinic exercise program with gravity focusing on
flexion and extension of elbow Continue modalities Continue flexion and extension of shoulder without resistance
9 wks Post-op Continue splint without extension block Initiate resistive exercises in clinic (shoulder, elbow and
forearm against gravity) Continue modalities as needed
Protocol Guide for Repair of Acute Distal Biceps Tendon Rupture
12 wks Post-op Initiate progressive strengthening program elbow flexion
and forearm supination Continue modalities as needed
18 wks Post-op Cleared for full use Continue progressive strengthening program Ultimate Goals: AROM WNL compared to uninjured side100% preinjury strength. Full use in all activities (airborne
operations included) without pain
Distal Bicep RepairDySuFlex Protocol Guide
3 to 5 days post-op Light compressive dressing/garment for biceps area Scar massage, edema control
Fabricate DySuFlex splint. Elbow extension block at post-op resting position (typically 90 degrees). Clinic ROM program 10 min 3+ times per week and wound checks/care
Each week elbow extension is increased 15 degrees from
post op rest position
HEP 10 reps each hour within splint
Distal Bicep Repair DySuFlex Protocol Guide
6wks post-op Wean splint to discharge at 8 wks
Clinic AROM with gravity focusing on flexion and extension of elbow
Continue HEP
Continue with 9 wk Post-op guidance from Dynamic Hinged brace Protocol
Distal Bicep RepairDySuFlex Protocol Guide
Protocol Guide for Bicep short head, long head tendon and musculature repair
5days Post-op Light compressive dressing/garment for biceps area
Dynamic Elbow hinge splint extension blocked at 100 degrees, forearm in neutral. Dynamic component (theratube/band) allowing resisted extension and passive flexion, resting position of 120 degrees
Clinic and home program gentle ROM all without pain: AAROM shoulder
Splint exercises 10 reps per hour AROM extension from120 to 100 degrees, with rubber band traction PROM flexion resting at 120
Protocol Guide for Bicep short head, long head tendon and musculature repair
5 days Post-op Continued PROM forearm supination to neutral with elbow at 100 AROM hand, wrist Sling wear for comfort over splint for night wear Splint wear all times except therapy exercises and wound
care 2 wks Post-op Codman’s pendulum exercises with splint on Ultrasound over wound area
Protocol Guide for Bicep short head, long head tendon and musculature repair
3 wks Post-op Extension to 85 degrees. From 3rd to 6th week progress
dynamic splint extension block by 15 degrees extension of elbow each week
Continue modalities Initiate AROM shoulder without resistance
4 wks Post-op Initiate Elbow flexion place-and –hold exercises Extension to 70 Continue modalities
Protocol Guide for Bicep short head, long head tendon and musculature repair
5 wks Post-op Initiate gravity eliminated AROM out of splint in clinic
respecting current extension block of that week Extension to 55 Continue modalities
6 wks Post-op Extension to 40 Initiate Gentle AROM supination and pronation with elbow
at 90 degrees. (Progress dynamic elbow splint by 10 degree increments per week)
Protocol Guide for Bicep short head, long head tendon and musculature repair
6 wks Post-op (continued) Initiate clinic exercise program with gravity focusing on
flexion and extension of elbow Continue modalities Continue flexion and extension of shoulder without
resistance 10 wks Post-op Continue splint wear PRN for protection without extension
block. Initiate gentle resistive exercises in clinic (shoulder, elbow
and forearm against gravity) Continue modalities as needed
Protocol Guide for Bicep short head, long head tendon and musculature repair
11 wks Post-op Discharge splint 12 wks Post-op Initiate progressive strengthening program elbow flexion and
forearm supination Continue modalities as needed
18 wks Post-op Cleared for full us Continue progressive strengthening program.
Ultimate Goals - AROM WNL compared to uninjured side,100% pre-injury strength. Full use in all activities without significant discomfort