Chaconas Eric J, Kolber Morey J, Hanney William J, Daugherty Matthew L, Wilson Stanley H, Sheets Charles
University of St. Augustine for Health Sciences, Doctor of Physical Therapy Program, St. Augustine, FL, USA.
Nova Southeastern University, College of Healthcare Sciences, Department of Physical Therapy, Ft. Lauderdale, FL, USA.
Int J Sports Phys Ther. 2017 Dec;12(7):1121-1133. doi: 10.26603/ijspt20171121.
Shoulder pain affects up to 67% of the population at some point in their lifetime with subacromial pain syndrome (SAPS) representing a common etiology. Despite a plethora of studies there remains conflicting evidence for appropriate management of SAPS.
To compare outcomes, for individuals diagnosed with SAPS, performing a 6-week protocol of eccentric training of the shoulder external rotators (ETER) compared to a general exercise (GE) protocol.
Randomized controlled trial.
Forty-eight individuals (mean age 46.8 years + /-17.29) with chronic shoulder pain, and a clinical diagnosis of SAPS were randomized into either an experimental group performing ETER or a control group performing a GE program. The intervention lasted for six weeks, and outcomes were measured after three weeks, six weeks, and again at six months post intervention.
The primary outcome of function, measured by the Western Ontario Rotator Cuff Index, demonstrated a significant interaction effect derived from a multilevel hierarchical model accounting for repeated measures favoring the experimental group at week 3: 14.65 (p=.003), Week 6: 17.04 (p<.001) and six months: 15.12 (p=.007). After six months, secondary outcome measures were improved for Numeric Pain Rating Scale levels representing pain at worst (p=.006) and pain on average (p=0.02), external rotator (p<.001), internal rotator (p=0.02), and abductor strength (p<.001). There were no statistically significant differences in secondary outcome measures of Global Rating of Change, Active Range of Motion, the Upper Quarter Y Balance Test and strength ratios after six months.
An eccentric program targeting the external rotators was superior to a general exercise program for strength, pain, and function after six months. The findings suggest eccentric training may be efficacious to improve self-report function and strength for those with SAPS.
2b.
肩痛在一生中影响着多达67%的人群，肩峰下疼痛综合征（SAPS）是常见病因。尽管有大量研究，但对于SAPS的恰当管理仍存在相互矛盾的证据。
比较被诊断为SAPS的个体进行为期6周的肩部外旋肌离心训练（ETER）方案与一般运动（GE）方案的效果。
随机对照试验。
48名慢性肩痛且临床诊断为SAPS的个体（平均年龄46.8岁±17.29）被随机分为进行ETER的实验组或进行GE方案的对照组。干预持续6周，在干预后3周、6周以及6个月时测量结果。
通过西安大略肩袖指数测量的主要功能结局显示，在考虑重复测量的多级分层模型中存在显著的交互作用效应，有利于实验组在第3周时：14.65（p = 0.003），第6周时：17.04（p < 0.001）以及6个月时：15.12（p = 0.007）。6个月后，次要结局指标在表示最严重疼痛（p = 0.006）和平均疼痛（p = 0.02）的数字疼痛评分量表水平、外旋肌（p < 0.001）、内旋肌（p = 0.02）以及外展肌力量（p < 0.001）方面有所改善。6个月后，在总体变化评分、主动活动范围、上肢Y平衡试验和力量比值的次要结局指标上没有统计学显著差异。
针对外旋肌的离心训练方案在6个月后在力量、疼痛和功能方面优于一般运动方案。研究结果表明离心训练可能对改善SAPS患者的自我报告功能和力量有效。
2b。
