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肩峰下疼痛综合征患者的冈上肌腱微观形态学

Supraspinatus tendon micromorphology in individuals with subacromial pain syndrome.

作者信息

Pozzi Federico, Seitz Amee L, Plummer Hillary A, Chow Kira, Bashford Gregory R, Michener Lori A

机构信息

Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.

Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine Northwestern University, Chicago, IL, USA.

出版信息

J Hand Ther. 2017 Apr-Jun;30(2):214-220. doi: 10.1016/j.jht.2017.04.001. Epub 2017 May 11.

Abstract

STUDY DESIGN

Cross-sectional cohort.

INTRODUCTION

Tendon collagen organization can be estimated by peak spatial frequency radius (PSFR) on ultrasound images. Characterizing PSFR can define the contribution of collagen disruption to shoulder symptoms.

PURPOSE OF THE STUDY

The purpose of this was to characterize the (1) supraspinatus tendon PSFR in participants with subacromial pain syndrome (SPS) and healthy controls; (2) PSFR between participants grouped on a tendon visual quality score; and (3) relationship between PSFR with patient-reported pain, function, and shoulder strength.

METHODS

Participants with SPS (n = 20) and age, sex, and arm-dominance-matched healthy controls (n = 20) completed strength testing in scaption and external rotation, and patient-reported pain, and functional outcomes. Supraspinatus tendon ultrasound images were acquired, and PSFR was calculated for a region of interest 15 mm medial to the supraspinatus footprint. PSFR was compared between groups using an independent t-test and an analysis of variance to compare between 3 groups for visually qualitatively rated tendon abnormalities. Relationships between PSFR with pain, function, and strength were assessed using Pearson correlation coefficient.

RESULTS

Supraspinatus tendon PSFR was not different between groups (P = .190) or tendon qualitative ratings (P = .556). No relationship was found between PSFR and pain, functional loss, and strength (P > .05).

CONCLUSIONS

Collagen disruption (PSFR) measured via ultrasound images of the supraspinatus tendon was not different between participants with SPS or in those with visually rated tendon defects. PSFR is not related to shoulder pain, function, and strength, suggesting that supraspinatus tendon collagen disorganization may not be a contributing factor to shoulder SPS. However, collagen disruption may not be isolated to a single region of interest.

LEVEL OF EVIDENCE

3b: case-control study.

摘要

研究设计

横断面队列研究。

引言

肌腱胶原组织可通过超声图像上的峰值空间频率半径(PSFR)进行评估。对PSFR进行特征分析可确定胶原破坏对肩部症状的影响。

研究目的

本研究的目的是:(1) 对患有肩峰下疼痛综合征(SPS)的参与者和健康对照者的冈上肌腱PSFR进行特征分析;(2) 根据肌腱视觉质量评分分组的参与者之间的PSFR;(3) PSFR与患者报告的疼痛、功能和肩部力量之间的关系。

方法

患有SPS的参与者(n = 20)以及年龄、性别和优势手臂匹配的健康对照者(n = 20)完成了前屈上举和外旋的力量测试,以及患者报告的疼痛和功能结果评估。采集冈上肌腱超声图像,并计算冈上肌腱足迹内侧15 mm感兴趣区域的PSFR。使用独立t检验比较组间PSFR,并使用方差分析比较3组视觉定性评定的肌腱异常情况。使用Pearson相关系数评估PSFR与疼痛、功能和力量之间的关系。

结果

组间(P = 0.190)或肌腱定性评分(P = 0.556)的冈上肌腱PSFR无差异。未发现PSFR与疼痛、功能丧失和力量之间存在相关性(P > 0.05)。

结论

通过冈上肌腱超声图像测量的胶原破坏(PSFR)在患有SPS的参与者或有视觉评定肌腱缺陷的参与者之间没有差异。PSFR与肩部疼痛、功能和力量无关,这表明冈上肌腱胶原紊乱可能不是肩部SPS的一个促成因素。然而,胶原破坏可能并不局限于单个感兴趣区域。

证据水平

3b级:病例对照研究。

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