Department of Physiotherapy, The Alfred, Prahran, Victoria 3181, Australia.
Burns. 2012 Aug;38(5):638-44. doi: 10.1016/j.burns.2012.01.010. Epub 2012 Feb 13.
Exercises are commonly prescribed to improve shoulder range following axillary burns, but the effect of additional splinting is unclear.
To compare splinting and exercise to exercise alone in adults with axillary burns.
Prospective randomised study allocating participants to a splinting (n=27) or no splinting group (n=25). Outcomes measured at six and twelve weeks were shoulder abduction and flexion range, quality of life using the Burn Specific Health Scale-Brief (BSHS-B) questionnaire and upper limb function using the Upper Extremity Functional Index (UEFI) and the Grocery Shelving Task (GST).
At week twelve, there was no difference between groups for shoulder abduction (mean difference 0°, 95% CI -22 to 22°), flexion (mean difference 2°, 95% CI -18 to 23°), BSHS-B (mean difference -2 points, 95% CI -23 to 18 points), UEFI (mean difference -3 points, 95% CI -19 to 14 points) and GST (mean difference -9s, 95% CI -20 to 3s). Adherence to splinting decreased from 77% of participants at week one to 16% at week twelve.
Shoulder splints did not improve clinical outcomes in this study population and low adherence rates suggest splinting may be unacceptable to patients and makes drawing firm conclusions difficult.
锻炼常用于改善腋窝烧伤后的肩部活动范围,但附加夹板固定的效果尚不清楚。
比较夹板固定与运动锻炼在腋窝烧伤成人患者中的应用。
前瞻性随机研究将参与者分为夹板组(n=27)和无夹板组(n=25)。在 6 周和 12 周时测量的结果包括肩外展和屈曲范围、使用烧伤专用健康量表-简短版(BSHS-B)问卷评估的生活质量以及使用上肢功能指数(UEFI)和杂货架任务(GST)评估的上肢功能。
在 12 周时,两组间的肩外展(平均差异 0°,95%CI-22 至 22°)、屈曲(平均差异 2°,95%CI-18 至 23°)、BSHS-B(平均差异-2 分,95%CI-23 至 18 分)、UEFI(平均差异-3 分,95%CI-19 至 14 分)和 GST(平均差异-9 秒,95%CI-20 至 3 秒)均无差异。在第 1 周时,有 77%的参与者坚持使用夹板,而在第 12 周时,这一比例降至 16%。
在本研究人群中,肩部夹板并未改善临床结局,且低依从率表明夹板可能不被患者接受,使得难以得出明确结论。