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关节镜肩峰成形术后监督强化锻炼与家庭运动锻炼的比较:一项随机临床试验。

Supervised strengthening exercises versus home-based movement exercises after arthroscopic acromioplasty: a randomized clinical trial.

机构信息

Departement of Medical health Sciences, Division of Physiotherapy, Linköping University, Linköping, Sweden.

出版信息

J Rehabil Med. 2012 Jan;44(1):12-8. doi: 10.2340/16501977-0889.

Abstract

OBJECTIVE

To evaluate and compare the efficacy of 2 rehabilitation strategies after arthroscopic acromioplasty: supervised physical therapy focusing on strengthening exercises of the rotator cuff and scapula stabilizers (PT-group) vs home-based movement exercises (H-group).

DESIGN

A randomized, single-blinded, clinically controlled study.

PATIENTS

Thirty-six patients entered the study. Thirteen in the PT-group and 16 in the H-group fulfilled all the assessments.

METHODS

For 12 weeks following surgery, patients performed either supervised physical therapy or home exercises. Follow-ups were conducted periodically for 6 months after surgery to evaluate shoulder function, pain (Constant-Murley (CM) and Disabilities of the Arm, Shoulder, and Hand (DASH) scores), and health-related quality of life.

RESULTS

The PT-group exhibited significantly greater improvements in CM (p =0.02) and DASH (p=0.05) scores. After treatment, the between-group mean difference in CM scores was 14.2 p (95% confidence interval 2-26). At the 6-month follow-up, the between-group mean difference in DASH scores was 13.4 p (95% confidence interval 0.1-23).

CONCLUSION

PT-supervised rehabilitation with strengthening exercises of the rotator cuff and scapula stabilizers seems to be superior to home exercises focusing on mobility for improving shoulder function after arthroscopic acromioplasty.

摘要

目的

评估和比较关节镜肩峰成形术后两种康复策略的疗效:以肩袖和肩胛稳定器强化锻炼为重点的监督物理治疗(PT 组)与基于家庭的运动锻炼(H 组)。

设计

随机、单盲、临床对照研究。

患者

36 名患者入组。PT 组 13 例和 H 组 16 例均完成了所有评估。

方法

术后 12 周内,患者分别接受监督物理治疗或家庭锻炼。术后定期进行 6 个月的随访,以评估肩部功能、疼痛(Constant-Murley(CM)和上肢功能障碍(DASH)评分)和健康相关生活质量。

结果

PT 组在 CM(p=0.02)和 DASH(p=0.05)评分方面的改善明显更大。治疗后,CM 评分的组间平均差异为 14.2p(95%置信区间 2-26)。在 6 个月的随访中,DASH 评分的组间平均差异为 13.4p(95%置信区间 0.1-23)。

结论

与侧重于活动度的家庭锻炼相比,以肩袖和肩胛稳定器强化锻炼为重点的监督 PT 康复似乎更能改善关节镜肩峰成形术后的肩部功能。

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