Escalante A, Lichtenstein M J, Hazuda H P
Division of Clinical Immunology and Rheumatology, University of Texas Health Science Center at San Antonio, USA.
Arthritis Care Res. 1999 Aug;12(4):277-86.
To gain a knowledge of factors associated with impaired upper extremity range of motion (ROM) in order to understand pathways that lead to disability.
Shoulder and elbow flexion range was measured in a cohort of 695 community-dwelling subjects aged 65 to 74 years. Associations between subjects' shoulder and elbow flexion ranges and their demographic and anthropometric characteristics, as well as the presence of diabetes mellitus or self-reported physician-diagnosed arthritis, were examined using multivariate regression models. The relationship between shoulder or elbow flexion range and subjects' functional reach was examined to explore the functional significance of ROM in these joints.
The flexion range for the 4 joints studied was at least 120 degrees in nearly all subjects (> or = 99% of the subjects for each of the 4 joints). Multivariate models revealed significant associations between male sex, Mexican American ethnic background, the use of oral hypoglycemic drugs or insulin to treat diabetes mellitus, and a lower shoulder flexion range. A lower elbow flexion range was associated with male sex, increasing body mass index, and the use of oral hypoglycemic drugs or insulin. A higher shoulder or elbow flexion range was associated with a lower likelihood of having a short functional reach.
The great majority of community-dwelling elderly have a flexion range of shoulder and elbow joints that can be considered functional. Diabetes mellitus and obesity are two potentially treatable factors associated with reduced flexion range of these two functionally important joints.
了解与上肢活动范围（ROM）受损相关的因素，以理解导致残疾的途径。
对695名年龄在65至74岁的社区居住受试者测量了肩部和肘部的屈曲范围。使用多元回归模型研究了受试者的肩部和肘部屈曲范围与其人口统计学和人体测量学特征，以及糖尿病或自我报告的医生诊断的关节炎之间的关联。研究了肩部或肘部屈曲范围与受试者功能性伸展之间的关系，以探讨这些关节ROM的功能意义。
在所研究的4个关节中，几乎所有受试者（每个关节≥99%的受试者）的屈曲范围至少为120度。多元模型显示，男性、墨西哥裔美国人种族背景、使用口服降糖药或胰岛素治疗糖尿病与较低的肩部屈曲范围之间存在显著关联。较低的肘部屈曲范围与男性、体重指数增加以及使用口服降糖药或胰岛素有关。较高的肩部或肘部屈曲范围与功能性伸展较短的可能性较低有关。
绝大多数社区居住的老年人肩部和肘关节的屈曲范围可被视为具有功能。糖尿病和肥胖是与这两个功能重要关节屈曲范围减小相关的两个潜在可治疗因素。
