Ruiz Jose Orlando
University of New England, Post-Professional Doctor of Physical Therapy Program, North Broward Medical Center, Deerfield Beach, FL.
J Man Manip Ther. 2009;17(1):58-63. doi: 10.1179/106698109790818232.
Idiopathic frozen shoulder is a common medical diagnosis for patients seeking physical therapy. Radiographic and surgical evidence exists that describes the coracohumeral ligament (CHL) as a major contributor to lack of external rotation in patients diagnosed with frozen shoulder. No stretching techniques targeting the anatomical fiber orientation of the CHL have been reported in the literature. This single-patient case-report describes the use of a positional stretching technique of the CHL on a 51-year-old female diagnosed with phase I frozen shoulder. The patient completed 8 in-office visits and 17 home exercise program sessions of positional CHL stretching combined with a simple volitional rotator cuff exercise program in a 4-week period. The patient's Disabilities of the Arm Shoulder and hand (DASH) scores improved from 65 to 36 and Shoulder Pain and Disability Index (SPADI) scores improved from 72 to 8 and passive external rotation from 20 degrees to 71 degrees . While a cause-and-effect relationship cannot be inferred from a single case, this report may foster further investigation regarding the role of the CHL in patients with stage-I and stage-II frozen shoulder as well as therapeutic strategies to help reduce loss of mobility and function.
特发性冻结肩是寻求物理治疗的患者常见的医学诊断。有影像学和手术证据表明,喙肱韧带(CHL)是导致冻结肩患者外旋受限的主要因素。文献中尚未报道针对CHL解剖纤维方向的拉伸技术。本单病例报告描述了对一名51岁诊断为I期冻结肩的女性患者应用CHL定位拉伸技术的情况。患者在4周内完成了8次门诊就诊以及17次家庭锻炼计划课程,包括CHL定位拉伸并结合简单的随意性肩袖锻炼计划。患者的上肢、肩部和手部功能障碍(DASH)评分从65分提高到36分,肩部疼痛和功能障碍指数(SPADI)评分从72分提高到8分,被动外旋从20度提高到71度。虽然不能从单个病例推断因果关系,但本报告可能会促进对CHL在I期和II期冻结肩患者中的作用以及有助于减少活动度和功能丧失的治疗策略的进一步研究。