Shah K M, Clark B R, McGill J B, Mueller M J
Program in Physical Therapy, Washington University School of Medicine in St. Louis, USA.
Program in Physical Therapy, Washington University School of Medicine in St. Louis, USA.
Physiotherapy. 2015 Jun;101(2):147-54. doi: 10.1016/j.physio.2014.07.003. Epub 2014 Sep 19.
To determine the severity of, and relationships between, upper extremity impairments, pain and disability in patients with diabetes mellitus, and to compare upper extremity impairments in patients with diabetes with non-diabetic controls.
Case-control, cross-sectional design.
University-based, outpatient diabetes centre and physical therapy research clinic.
Two hundred and thirty-six patients with diabetes attending an outpatient diabetes clinic completed the Shoulder Pain and Disability Index (SPADI) questionnaire. A detailed shoulder and hand examination was conducted on a subgroup of 29 volunteers with type 2 diabetes, and 27 controls matched for age, sex and body mass index.
None.
SPADI score, passive shoulder range of motion (ROM) and strength, grip strength, hand sensation, dexterity and limited joint mobility of the hand.
Sixty-three percent (149/236) of patients with diabetes reported shoulder pain and/or disability [median SPADI score 10.0 (interquartile range 0.0 to 39.6)]. Compared with the control group, the subgroup of patients with diabetes had substantial reductions in shoulder ROM, shoulder muscle strength, grip and key pinch strength (P<0.05). Patients with diabetes had a greater prevalence of decreased sensation (26/27 vs 14/27) and limited joint mobility of the hand (17/27 vs 4/27) compared with the control group. Total SPADI score was negatively correlated (P<0.05) with shoulder ROM (r=-0.42 to -0.74) and strength measures (r=-0.44 to -0.63) in patients with diabetes.
Upper extremity impairments in this sample of patients with diabetes were common, severe and related to complaints of pain and disability. Additional research is needed to understand the unique reasons for upper extremity problems in patients with diabetes, and to identify preventative treatments.
确定糖尿病患者上肢损伤、疼痛及功能障碍的严重程度及其相互关系，并比较糖尿病患者与非糖尿病对照者的上肢损伤情况。
病例对照横断面研究。
大学附属医院门诊糖尿病中心及物理治疗研究诊所。
236名就诊于门诊糖尿病诊所的糖尿病患者完成了肩痛和功能障碍指数（SPADI）问卷。对29名2型糖尿病志愿者及27名年龄、性别和体重指数相匹配的对照者进行了详细的肩手部检查。
无。
SPADI评分、被动肩部活动范围（ROM）及力量、握力、手部感觉、灵活性及手部关节活动受限情况。
63%（149/236）的糖尿病患者报告有肩部疼痛和/或功能障碍[SPADI评分中位数为10.0（四分位间距0.0至39.6）]。与对照组相比，糖尿病患者亚组的肩部ROM、肩部肌肉力量、握力和捏力显著降低（P<0.05）。与对照组相比，糖尿病患者感觉减退（26/27 vs 14/27）和手部关节活动受限（17/27 vs 4/27）的患病率更高。糖尿病患者的SPADI总分与肩部ROM（r=-0.42至-0.74）和力量指标（r=-0.44至-0.63）呈负相关（P<0.05）。
该糖尿病患者样本中上肢损伤常见、严重，且与疼痛和功能障碍主诉相关。需要进一步研究以了解糖尿病患者上肢问题的独特原因，并确定预防性治疗方法。
