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粘连性肩关节囊炎:改善被动活动范围的新管理方案。

Adhesive capsulitis: a new management protocol to improve passive range of motion.

机构信息

Stanford University School of Medicine, 450 Broadway St, Mailcode: 6342, Redwood City, CA 94063, USA.

出版信息

PM R. 2009 Dec;1(12):1064-8. doi: 10.1016/j.pmrj.2009.10.005.

Abstract

OBJECTIVE

To examine the short-term efficacy of a nonoperative shoulder protocol for the treatment of adhesive capsulitis.

DESIGN

A retrospective chart review was used to collect data for a 3-year period.

SETTING

Academic tertiary medical center.

PATIENTS

28 consecutive patients diagnosed as having adhesive capsulitis were identified and managed with a new protocol.

METHODS

The protocol consisted of the administration of a suprascapular nerve block, the subsequent injection of an intra-articular steroid, and then the injection of an anesthetic agent with brisement normal saline volume dilation. The final step was manipulation of the shoulder.

RESULTS

A paired t test was used to examine the difference in the preprocedure and postprocedure passive range of motion (flexion and abduction). The average shoulder abduction before the procedure was 89.5 degrees ; this improved by an average of 51.7 degrees (P<.0001). The average shoulder flexion improved from 117.3 degrees by an average of 37.7 degrees (P<.0001). There was no significant difference in either abduction or flexion based on age, gender, or chronicity of symptoms. White patients experienced significantly more improvement in abduction than did nonwhite patients.

CONCLUSIONS

This study suggests that this adhesive capsulitis management protocol is effective and produces a significant improvement in the passive range of motion immediately after the procedure.

摘要

目的

探讨一种非手术性肩关节方案治疗粘连性肩关节囊炎的短期疗效。

设计

回顾性图表分析,收集了 3 年的数据。

地点

学术型三级医疗中心。

患者

连续 28 例被诊断为粘连性肩关节囊炎的患者,根据新方案进行管理。

方法

方案包括肩胛上神经阻滞、关节内皮质类固醇注射,然后是麻醉剂和生理盐水混合扩张剂注射,最后是肩部手法治疗。

结果

采用配对 t 检验分析术前和术后被动活动范围(前屈和外展)的差异。术前平均肩关节外展 89.5°,平均增加 51.7°(P<.0001)。平均肩关节前屈从 117.3°平均增加 37.7°(P<.0001)。年龄、性别或症状的慢性程度与外展或前屈均无显著差异。白人患者的外展改善明显优于非白人患者。

结论

本研究表明,这种粘连性肩关节囊炎管理方案是有效的,可在术后即刻显著改善被动活动范围。

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