Department of Orthopeadics and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Division of Physiotherapy, Institution of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Br J Sports Med. 2014 Oct;48(19):1431-6. doi: 10.1136/bjsports-2013-093233. Epub 2014 Jun 26.
A programme based on eccentric exercises for treating subacromial pain was in a previous study found effective at 3-month follow-up. The purposes of the present study were to investigate whether the results were maintained after 1 year and whether the baseline Constant-Murley score, rotator cuff status and radiological findings influenced the outcome.
97 patients on the waiting list for arthroscopic subacromial decompression had been randomised to a specific exercise programme or unspecific exercises (controls). After 3 months of exercises, the patients were asked whether they still wanted surgery and this option was available until a 1-year follow-up. 1 year after inclusion or 1 year after surgery, the number of patients who decided to have surgery in each group was compared. The choice of surgery was related to the baseline Constant-Murley score, ultrasound and radiographs taken at inclusion.
All patients had improved significantly (p<0.0001) in the Constant-Murley score at the 1-year follow-up. Significantly more patients in the control group decided to have surgery (63%) than those in the specific exercise group (24%; p<0.0001). Patients who decided to have surgery had a significantly lower baseline Constant-Murley score and more often a full-thickness tear. Patients with partial tears did not differ from those with intact tendons.
The positive short-term results of specific exercises were maintained after 1 year, and this exercise strategy reduces the need for surgery. Full-thickness tear and a low baseline Constant-Murley score appear to be a predictive marker for a less good outcome.
Clinical trials NCT01037673.
一项基于治疗肩峰下疼痛的离心运动方案在先前的研究中发现，在 3 个月随访时有效。本研究的目的是探讨该结果在 1 年后是否仍能维持，以及基线 Constant-Murley 评分、肩袖状况和影像学发现是否会影响结果。
97 名等待关节镜下肩峰下减压术的患者被随机分为特定运动方案组或非特异性运动（对照组）。在进行 3 个月的运动后，询问患者是否仍希望接受手术，直到 1 年随访。在纳入后 1 年或手术后 1 年，比较两组中决定手术的患者人数。手术的选择与基线 Constant-Murley 评分、纳入时进行的超声和 X 线检查有关。
所有患者在 1 年随访时 Constant-Murley 评分均显著提高（p<0.0001）。对照组中决定手术的患者（63%）明显多于特定运动组（24%；p<0.0001）。决定手术的患者基线 Constant-Murley 评分明显较低，且更常出现全层撕裂。部分撕裂的患者与完整肌腱的患者没有差异。
特定运动的短期积极结果在 1 年后仍能维持，这种运动策略减少了手术的需求。全层撕裂和较低的基线 Constant-Murley 评分似乎是预后较差的预测指标。
Clinical trials NCT01037673。
