Nakajima Daisuke, Yamamoto Atsushi, Kobayashi Tsutomu, Osawa Toshihisa, Shitara Hitoshi, Ichinose Tsuyoshi, Takasawa Eiji, Takagishi Kenji
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, Japan.
J Orthop Sci. 2012 Mar;17(2):136-40. doi: 10.1007/s00776-011-0186-4. Epub 2012 Jan 17.
Few reports have so far evaluated the possible restrictions of activities of daily living (ADL) in patients with asymptomatic rotator cuff tears (RCTs). The purpose of this study was to examine the effects of RCTs, including shoulders without pain, on ADL in the general population.
We performed medical checkups on 462 individuals (924 shoulders). All participants completed a questionnaire regarding their background and medical history. We then assessed their shoulder functions with the Simple Shoulder Test (SST) and performed US (US) examinations of both shoulders to diagnose RCTs. We divided participants into tear and nontear groups and performed statistical analysis to compare total SST scores and each SST item between groups. Furthermore, we performed the same examinations for participants identified as having shoulders without pain.
Among participants, those in the tear group showed significantly lower total SST scores than those in the nontear group. After examining each SST item, a significant difference was observed regarding the ability to sleep comfortably and to lift 3.6 kg to shoulder level. In shoulders without pain, the tear group showed significantly lower total SST scores than the nontear group. A significant difference was observed only regarding the ability to lift 3.6 kg to shoulder level.
In the general population, ADL were restricted in participants with RCTs; they experienced night pain in the shoulder and muscle weakness during shoulder elevation. Furthermore, participants with RCTs, even if the condition itself did not induce any pain, tended to experience muscle weakness during shoulder elevation, thus resulting in restrictions of ADL.
到目前为止,很少有报告评估无症状肩袖撕裂(RCT)患者日常生活活动(ADL)可能受到的限制。本研究的目的是研究RCT,包括无痛的肩部,对普通人群ADL的影响。
我们对462名个体(924个肩部)进行了体检。所有参与者都完成了一份关于他们的背景和病史的问卷。然后我们用简单肩部测试(SST)评估他们的肩部功能,并对双肩进行超声(US)检查以诊断RCT。我们将参与者分为撕裂组和非撕裂组,并进行统计分析以比较两组之间的SST总分和每个SST项目。此外,我们对被确定为肩部无痛的参与者进行了相同的检查。
在参与者中,撕裂组的SST总分明显低于非撕裂组。在检查每个SST项目后,观察到在舒适睡眠和将3.6千克重物举至肩部高度的能力方面存在显著差异。在无痛的肩部中,撕裂组的SST总分明显低于非撕裂组。仅在将3.6千克重物举至肩部高度的能力方面观察到显著差异。
在普通人群中,RCT参与者的ADL受到限制;他们肩部出现夜间疼痛,肩部抬高时出现肌肉无力。此外,RCT参与者即使病情本身未引起任何疼痛,在肩部抬高时也往往会出现肌肉无力,从而导致ADL受限。