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Functional Rehabilitation
Published in James Crossley, Functional Exercise and Rehabilitation, 2021
Trainers should encourage a balance between pushing and pulling exercises. Many trainers suggest balancing a press with ‘pull-down’ exercises to work the latissimus dorsi muscles. The lats actually generate an internal rotation force at the shoulder, which rather than helping maintain good posture actually pulls us into a rounded, internally rotated position. This position closes the shoulder down, disrupts function and predisposes shoulder impingement, especially when we reach overhead. Pull-down exercises do not create balance with pushing exercises, they actually create imbalance.
Chest wall deformities
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Robert E. Kelly, Marcelo Martinez-Ferro, Horacio Abramson
Figure 20.41 is a schematic depiction of a severe deformity with rotation of the sternum and aplasia of three ribs. Ironically, the contralateral side of the chest may have a carinate protrusion which accentuates the depression on the ipsilateral side. The rotation of the latissimus dorsi muscle that is occasionally utilized in males has the potential drawback of decreasing strength of the shoulder.
Advanced autologous tissue flaps for whole breast reconstruction
Published in Steven J. Kronowitz, John R. Benson, Maurizio B. Nava, Oncoplastic and Reconstructive Management of the Breast, 2020
Steven J. Kronowitz, John R. Benson, Maurizio B. Nava
The patient is positioned in the lateral decubitus position with the ipsilateral arm prepped and placed on a sterile Mayo stand. An axillary roll is placed to avoid contralateral brachial plexopathy. The boundaries of the latissimus dorsi muscle are marked.
BOBATH vs. TASK-ORIENTED TRAINING AFTER STROKE: An assessor-blind randomized controlled trial
Published in Brain Injury, 2023
Gülşah Sütçü, Levent Özçakar, Ali İmran Yalçın, Muhammed Kılınç
The exercises were planned by a therapist with 20 years of Bobath experience. According to the Bobath concept, trunk control has critical significance in terms of proximal stabilization in voluntary movements of the extremities, balance and mobility activities (5). Therefore, functional exercises that activate the trunk bilaterally in line with the needs of patients were selected as follows: Functional strengthening of trunk musclesStretching the latissimus dorsi muscleScapular mobilizationPlacing exercises to facilitate trunk extensionRotations of the trunk and extremities with trunk extensionFunctional reach of the upper extremity in different directionsFunctional exercises for extremitiesWeight transfers for upper and lower extremitiesGait and balance exercises
“Functional trapezius muscle reconstruction after resection of a desmoid tumor using an innervated gracilis free flap”
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Federico De Michele, Olindo Massarelli, Mara Franza, Vittorio Gebbia, Salvatore D’Arpa
Since the morbidity of upper trapezius palsy following neck dissection with spinal accessory nerve sacrifice is well known, we sought a functional restoration of the upper trapezius by means of an innervated gracilis free flap [7,14]. Adequate muscle tensioning and precise technique enabled us to restore most of the trapezius strength minimizing postoperative morbidity. The outcome of surgical treatment was excellent, suggesting that when adequate reconstructive techniques to restore function are available, the threshold to consider surgical treatment of DT can be lowered. As described by Ihara et al., another optimal donor site suitable for reconstruction of the trapezius muscle can be the latissimus dorsi [15]. We believe that the gracilis is the best reconstructive option for small and medium-size defects mostly because of the minimal morbidity of the donor site and its use in reconstructions of the head and neck district is well established. In addition, it has the advantage that it can be comfortably harvested by a second surgical team while the first one takes care of the resection. The latissimus dorsi is a broad and flat trunk muscle that is closer in features to the trapezius and has been described as a pedicled flap for its reconstruction. Its shape and dimensions make it a valid option for the reconstructions of larger defects
Elastofibroma presented as shoulder pain in an amateur swimmer: screening for referral in physiotherapy. A case report
Published in Physiotherapy Theory and Practice, 2022
Fabrizio Brindisino, Firas Mourad, Filippo Maselli
The patient underwent surgery 3 weeks after her physiotherapy consultation. She was positioned in prone, under general anesthesia, with ipsilateral arm draped freely to allow better access to the lesion. The latissimus dorsi muscle was split with a transverse incision over the lesion and the serratus anterior muscle was accessed. Hard white tissue with uncertain margin that was firmly attached to the serratus anterior and periosteum of the fourth, fifth, sixth and seventh ribs and was separated using electrocautery. Marginal resection was performed (Figure 5(a-c)). To avoid the main complications of this surgical procedure such as hematoma and seroma ranging from 11.8% to 35.1% especially in the case of EF with large diameter, a suction drain was kept in place for 2 days after resection and a pressure dressing was applied. The patient was prescribed an arm sling for 1 week after surgery. A biopsy is in general not necessary but analyzing a small piece of the EF to further ensure the benign nature of the tumor is advisable and was done in this case.