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肩周炎患者的生活质量和功能能力:确定与神经阻滞治疗后更好预后相关的风险因素。

Quality of life and functional capacity of patients with adhesive capsulitis: identifying risk factors associated to better outcomes after treatment with nerve blocking.

作者信息

Fernandes Marcos Rassi, Barbosa Maria Alves, Faria Ruth Minamisawa

机构信息

Universidade Federal de Goiás (UFG), Pós-Graduação em Ciências da Saúde, Goiânia, GO, Brazil.

Universidade Federal de Goiás (UFG), Pós-Graduação em Ciências da Saúde, Goiânia, GO, Brazil.

出版信息

Rev Bras Reumatol Engl Ed. 2017 Sep-Oct;57(5):445-451. doi: 10.1016/j.rbre.2017.05.003. Epub 2017 Jun 12.

Abstract

INTRODUCTION

The objectives of this study were to assess the quality of life and functional capacity of adhesive capsulitis patients at the beginning and end of procedure and to identify risk factors associated to better outcomes after treatment with nerve blocking.

METHODS

A prospective cohort study was performed. Inclusion criteria were clinical signs of adhesive capsulitis and disease changes on shoulder imaging exams. The short form of World Health Organization Quality of life and Disabilities of the Arm, Shoulder and Hand questionnaires were administered at the beginning and end of treatment. A score of 55 points or more on the Constant index was used for discontinuation of treatment. We used the Wilcoxon test for paired samples. Multiple regression analysis of Poisson was carried out using exposure variables with p<0.20 in the univariate analysis and the satisfactory quality of life and better functional capability as outcomes. The significance level was 5%.

RESULTS

43 patients were evaluated. For the comparison between medians values at the beginning and end of treatment (physical domain: 46.43-67.86; psychologic domain: 66.67-79.17; social domain: 66.67-75; environment domain: 62.5-68.75; DASH: 64.16-38.33), p was <0.05. Aging (physical/psychologic/DASH), higher educational level (physical/environment/DASH), less severity (only physical) and fewer nerve blocking (only psychologic) were these independent risk factors.

CONCLUSIONS

Quality of life and functional capacity of the patients improve at the end of procedure. Older patients and higher education levels are the risk factors most associated to satisfactory quality of life and better functional capacity after treatment with nerve blocking.

摘要

引言

本研究的目的是评估粘连性囊炎患者在手术开始和结束时的生活质量和功能能力,并确定与神经阻滞治疗后更好预后相关的危险因素。

方法

进行了一项前瞻性队列研究。纳入标准为粘连性囊炎的临床体征和肩部影像学检查中的疾病变化。在治疗开始和结束时分别发放世界卫生组织生活质量简表和手臂、肩部和手部功能障碍问卷。当Constant指数得分达到55分或更高时停止治疗。我们使用配对样本的Wilcoxon检验。使用单因素分析中p<0.20的暴露变量进行Poisson多元回归分析,并将生活质量满意和功能能力改善作为结果。显著性水平为5%。

结果

对43例患者进行了评估。治疗开始和结束时中位数的比较(身体领域:46.43 - 67.86;心理领域:66.67 - 79.17;社会领域:66.67 - 75;环境领域:62.5 - 68.75;DASH:64.16 - 38.33),p<0.05。年龄增长(身体/心理/DASH)、教育水平较高(身体/环境/DASH)、病情较轻(仅身体方面)和神经阻滞次数较少(仅心理方面)是这些独立的危险因素。

结论

患者的生活质量和功能能力在手术结束时有所改善。老年患者和较高的教育水平是与神经阻滞治疗后生活质量满意和功能能力改善最相关的危险因素。

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