An Integer Programming Model for Optimizing Shoulder Rehabilitation

Strength restoration is one goal of shoulder rehabilitation following rotator cuff repair surgery. However, the time spent in a physical rehabilitation setting is limited. The objective of this study was to develop a novel mathematical formulation for determining the optimal shoulder rehabilitation...

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Bibliographic Details
Published in:Annals of biomedical engineering Vol. 36; no. 7; pp. 1242 - 1253
Main Authors: Gatti, Christopher J., Scibek, Jason, Svintsitski, Oleg, Carpenter, James E., Hughes, Richard E.
Format: Journal Article
Language:English
Published: Boston Springer US 01.07.2008
Springer Nature B.V
Subjects:
Biochemistry
Biological and Medical Physics
Biomedical and Life Sciences
Biomedical Engineering and Bioengineering
Biomedicine
Biophysics
Classical Mechanics
Computer Simulation
Exercise Therapy - methods
Humans
Models, Biological
Objective function
Physical Fitness
Rotator Cuff - physiopathology
Rotator Cuff Injuries
Tendon Injuries - physiopathology
Tendon Injuries - rehabilitation
Therapy, Computer-Assisted - methods
Treatment Outcome
Integer programming
Computer model
Rehabilitation
Shoulder
Optimization
ISSN:0090-6964, 1573-9686, 1573-9686, 1521-6047
Online Access:Get full text
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Summary:Strength restoration is one goal of shoulder rehabilitation following rotator cuff repair surgery. However, the time spent in a physical rehabilitation setting is limited. The objective of this study was to develop a novel mathematical formulation for determining the optimal shoulder rehabilitation exercise protocol to restore normal shoulder strength given a time-constrained rehabilitation session. Strength gain was modeled using a linear dose–response function and biomechanical parameters of the shoulder musculature. Two different objective functions were tested: (1) one based on a least squares support vector machine using healthy and pathologic shoulder strengths (normative objective function), and (2) one which seeks to match the strength of the contralateral shoulder (contralateral objective function). The normative objective function was subject-independent and the optimal protocol consisted of four sets each of adduction and external rotation. The contralateral objective function was subject-specific and the typical optimal protocol consisted of various set combinations of abduction and internal and external rotation. These results are only partially consistent with current practice. Improvement of the current model is dependent on a better understanding of strength training adaptation and shoulder rehabilitation.
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ISSN:0090-6964
1573-9686
1573-9686
1521-6047
DOI:10.1007/s10439-008-9491-2