a Department of Neuroscience/Rehabilitation Medicine , Uppsala University , Uppsala , Sweden.
b School of Health, Care and Social Welfare , Mälardalen University , Västerås , Sweden.
Disabil Rehabil. 2019 Jun;41(12):1435-1442. doi: 10.1080/09638288.2018.1430177. Epub 2018 Jan 24.
The aim of this study was to investigate how health-related quality of life (HRQoL) and functional shoulder range of motion are affected among patients with diabetes with shoulder problems, treated with a specific physiotherapy programme. A further aim was to investigate how health-related quality of life, functional shoulder range of motion, pain intensity, and shoulder function correlate within the group of patients after the treatment period.
A pre-post treatment design was applied for a study group of ten patients with type 1 diabetes and shoulder problems. The physiotherapy treatment consisted of exercises promoting enhanced micro-circulation in the shoulder tissues, optimal shoulder co-ordination, and muscle relaxation. The Short Form-36 (SF-36), shoulder range of motion measures, the Shoulder Rating Scale - Swedish version, and pain intensity measures were used. The results regarding SF-36 were compared with the results of a control group of patients having either type 1 or type 2 diabetes and shoulder problems that did not receive any specific physiotherapy treatment.
As a potential result of physiotherapy training, a significant change towards higher scores was observed in the physical component summary (PCS) measure of SF-36. There was a significant improvement regarding PCS in the study group as compared with the control group. There were negative correlations between the four aspects of pain intensity and PCS and Shoulder Rating Scale - Swedish version, respectively, but a positive correlation between PCS and Shoulder Rating Scale - Swedish version. "Hand-raising" and "hand-behind-back" were significantly improved, and proved to be positively correlated with Shoulder Rating Scale - Swedish version.
The results of this study indicate that patients with type 1 diabetes and shoulder problems, treated with a specific physiotherapy programme, may improve with respect to physical aspects of health-related quality of life, and partially regain their range of motion in the shoulder joint. Based on these results, the associated treatment protocol may be recommended for physiotherapy treatment in such patients. Implications for Rehabilitation Diabetes is a significant risk factor in the development of shoulder pain and disability. Health-related quality of life (HRQoL) is affected in patients with diabetes and shoulder problems. A specific physiotherapy programme may improve physical aspects of HRQoL in patients with diabetes and shoulder problems. Specific physiotherapy intervention may also improve range of motion in the shoulder joint in patients with diabetes and shoulder problems.
本研究旨在探讨针对患有肩部问题的糖尿病患者，采用特定物理疗法治疗后，健康相关生活质量（HRQoL）和肩部功能活动范围会受到怎样的影响。进一步的目的是探讨在治疗期结束后，患者组内健康相关生活质量、肩部功能活动范围、疼痛强度和肩部功能之间如何相互关联。
采用治疗前后设计，纳入 10 例患有 1 型糖尿病且肩部有问题的患者作为研究组。物理疗法治疗包括促进肩部组织微循环、最佳肩部协调性和肌肉放松的运动。采用 SF-36 简短量表、肩部活动范围测量、瑞典版肩部评定量表和疼痛强度测量。SF-36 的结果与患有 1 型或 2 型糖尿病且肩部有问题但未接受任何特定物理疗法治疗的患者对照组的结果进行比较。
作为物理治疗训练的潜在结果，SF-36 的生理成分综合评分（PCS）观察到向更高分数的显著变化。与对照组相比，研究组的 PCS 有显著改善。疼痛强度的四个方面与 PCS 和瑞典版肩部评定量表呈负相关，而 PCS 与瑞典版肩部评定量表呈正相关。“举手”和“手放后背”有显著改善，且与瑞典版肩部评定量表呈正相关。
本研究结果表明，患有 1 型糖尿病且肩部有问题的患者接受特定的物理治疗方案治疗后，可能会在健康相关生活质量的生理方面得到改善，并部分恢复肩部关节的活动范围。基于这些结果，该治疗方案可能被推荐用于此类患者的物理治疗。
糖尿病是肩部疼痛和残疾发展的重要危险因素。患有肩部问题的糖尿病患者健康相关生活质量（HRQoL）会受到影响。特定的物理疗法方案可能会改善患有肩部问题的糖尿病患者的生理方面的 HRQoL。特定的物理治疗干预也可能改善患有肩部问题的糖尿病患者的肩部关节活动范围。
