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伸展运动对急性减轻术后人群肩部后方紧绷感的疗效:一项单盲随机对照试验。

The efficacy of stretching exercises to reduce posterior shoulder tightness acutely in the postoperative population: a single blinded randomized controlled trial.

作者信息

Salamh Paul A, Kolber Morey J, Hegedus Eric J, Cook Chad E

机构信息

a Department of Orthopedic Surgery , Duke University School of Medicine , Durham , USA.

b Department of Physical Therapy , Nova Southeastern University , Fort Lauderdale , USA.

出版信息

Physiother Theory Pract. 2018 Feb;34(2):111-120. doi: 10.1080/09593985.2017.1376020. Epub 2017 Sep 13.

Abstract

BACKGROUND

Posterior shoulder tightness (PST) is a postoperative complication leading to pain, impaired mobility, and reduced function. Despite the potential morbidity associated with PST, no studies have investigated the efficacy of shoulder-stretching methods in the postsurgical population. The purpose of this study was to determine the short-term efficacy of two stretches designed to reduce PST.

METHODS

The study enrolled 63 patients [mean age 51 (12) years, height 173.7 (3.6) cm, body mass 88.2 (17.9) kg]. The study was a single-blinded randomized control trial in which patients who had arthroscopic shoulder surgery were assigned to one of three groups: [(horizontal adduction stretch (n = 21), supine sleeper (n = 21), or control (n = 21)]. Dependent variables included measurements of internal rotation mobility, sidelying PST, pain, and the QuickDASH. Following the physical therapy (PT) initial evaluation, subjects were instructed to perform the allocated intervention twice daily until their first follow-up appointment 48-72 h following the initial PT visit.

RESULTS

Between group analyses of dependent variables revealed significant differences within PST measurements (p = 0.005) (eta squared = 0.14) taken at baseline and follow-up (48-72 h) favoring horizontal adduction stretching. Post-hoc testing demonstrated superiority of horizontal adduction stretching over both the supine sleeper group (p = 0.01) and control (p = 0.002).

DISCUSSION AND CONCLUSION

The horizontal adduction stretch is more effective at reducing acute PST in the postoperative shoulder population when compared to the supine sleeper stretch and no stretch at all. Knowledge of efficacious stretching methods may serve to reduce the potential morbidity associated with postoperative stiffness.

摘要

背景

肩后部紧绷(PST)是一种术后并发症,可导致疼痛、活动受限和功能下降。尽管PST存在潜在的发病率,但尚无研究调查肩部伸展方法对术后人群的疗效。本研究的目的是确定两种旨在减轻PST的伸展方法的短期疗效。

方法

该研究纳入了63例患者[平均年龄51(12)岁,身高173.7(3.6)厘米,体重88.2(17.9)千克]。该研究为单盲随机对照试验,接受肩关节镜手术的患者被分为三组之一:[水平内收伸展组(n = 21)、仰卧睡眠者组(n = 21)或对照组(n = 21)]。因变量包括内旋活动度、侧卧PST、疼痛和QuickDASH测量值。在物理治疗(PT)初始评估后,受试者被指示每天进行两次分配的干预,直到在初始PT就诊后48 - 72小时的首次随访预约。

结果

因变量的组间分析显示,在基线和随访(48 - 72小时)时进行的PST测量存在显著差异(p = 0.005)(偏 eta 平方 = 0.14),支持水平内收伸展。事后检验表明,水平内收伸展优于仰卧睡眠者组(p = 0.01)和对照组(p = 0.002)。

讨论与结论

与仰卧睡眠者伸展和不进行伸展相比,水平内收伸展在减轻术后肩部人群的急性PST方面更有效。了解有效的伸展方法可能有助于降低与术后僵硬相关的潜在发病率。

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