Savoie Alexandre, Mercier Catherine, Desmeules François, Frémont Pierre, Roy Jean-Sébastien
Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada G1M 2S8.
Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada G1M 2S8; Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada G1R 1P5.
Man Ther. 2015 Oct;20(5):703-8. doi: 10.1016/j.math.2015.04.004. Epub 2015 Apr 14.
Multiple factors have been associated with the presence of a subacromial pain syndrome (SPS), including deficits in performance of scapular and glenohumeral muscles. Such deficits can lead to inadequate kinematics and decreased acromiohumeral distance (AHD). Exercises that aim at correcting these deficits, such as movement training, were suggested to improve symptoms and functional limitations. To date, few studies have assessed outcomes following an intervention focused on movement training.
Evaluate the effects of a rehabilitation program based on movement training on symptoms, functional limitations and AHD in individuals with SPS.
Prospective single group pre-post design.
Twenty-five participants with SPS (SPS group) participated in a 6-week program. Twenty asymptomatic volunteers were recruited for normative AHD values (control group). Outcomes of both groups were evaluated at baseline and 6 weeks, i.e. immediately following intervention for the SPS group. Changes in symptoms and functional limitations for SPS group were assessed using the Western Ontario Rotator Cuff (WORC) index and Disability of the Arm Shoulder and Hand (DASH) questionnaire. Changes in AHD for both groups were assessed using ultrasonographic measures.
Following the rehabilitation program, the scores on WORC and DASH were significantly improved (p < 0.001). AHD increased significantly in the SPS group (p = 0.019), especially in a subgroup with initial deficits (p < 0.001).
The rehabilitation program yielded improvements in symptoms and functional limitations in participants with SPS. Moreover, it led to an increase of the AHD--thus potentially decreasing subacromial compression, particularly in participants with an initially smaller AHD. The trial was registered at ClinicalTrials.gov: identifier--NCT02395770.
多种因素与肩峰下疼痛综合征（SPS）的存在相关，包括肩胛和盂肱肌肉功能缺陷。这些缺陷可导致运动学异常和肩峰下间隙（AHD）减小。旨在纠正这些缺陷的运动，如运动训练，被建议用于改善症状和功能受限情况。迄今为止，很少有研究评估专注于运动训练的干预后的结果。
评估基于运动训练的康复计划对SPS患者症状、功能受限和AHD的影响。
前瞻性单组前后对照设计。
25名SPS患者（SPS组）参加了为期6周的计划。招募了20名无症状志愿者作为AHD正常值的对照（对照组）。两组的结果在基线和6周时进行评估，即SPS组干预结束后立即评估。SPS组症状和功能受限的变化使用西 Ontario 肩袖（WORC）指数和手臂、肩部和手部功能障碍（DASH）问卷进行评估。两组AHD的变化使用超声测量进行评估。
康复计划后，WORC和DASH评分显著改善（p < 0.001）。SPS组的AHD显著增加（p = 0.019），尤其是在初始有缺陷的亚组中（p < 0.001）。
康复计划使SPS患者的症状和功能受限得到改善。此外，它导致AHD增加——从而可能减少肩峰下压迫，特别是在初始AHD较小的参与者中。该试验已在ClinicalTrials.gov注册：标识符——NCT02395770。
