肩部运动干预对糖尿病患者关节活动度、疼痛和残疾的影响：一项随机对照试验。
Effect of a Shoulder Movement Intervention on Joint Mobility, Pain, and Disability in People With Diabetes: A Randomized Controlled Trial.
机构信息
Program in Physical Therapy and Department of Radiology, Washington University School of Medicine, Campus Box 8502, 4444 Forest Park Blvd, St Louis, MO 63108 (USA).
Program in Physical Therapy, Washington University School of Medicine.
出版信息
Phys Ther. 2018 Sep 1;98(9):745-753. doi: 10.1093/ptj/pzy070.
BACKGROUND
People with diabetes are at high risk for shoulder pain, limited joint mobility, and adhesive capsulitis.
OBJECTIVE
The objective of this study was to evaluate the effects of a shoulder movement intervention (ShoMo) compared to a wellness intervention on the primary outcomes of active shoulder flexion and reported Shoulder Pain and Disability Index (SPADI) measured after intervention and 9 months later.
DESIGN
The design was a prospective, randomized, controlled clinical trial.
SETTING
The setting was a research center at an academic medical center.
PARTICIPANTS
Fifty-two participants with type 2 diabetes and shoulder pain or limited motion were randomized to a group receiving ShoMo (N = 27; mean age = 59.3; SD = 7.0) or a group receiving wellness activities (N = 25; mean age = 57.9; SD = 7.7).
INTERVENTION
The ShoMo group received instruction in a progressive, active shoulder movement program. The wellness group received instruction in diabetes management.
MEASUREMENTS
Measurements were made at baseline, after 3 months of intervention, and at 6, 9, and 12 months after baseline.
RESULTS
After intervention, the ShoMo group had a 7.2-degree increase in active shoulder flexion compared with the wellness group (95% CI = 0.9-13.5°), but there was no difference at subsequent follow-ups. The ShoMo group showed a 12.7-point improvement in the SPADI score compared to the wellness group after intervention (95% CI = 1.1-24.3), which remained better than the wellness group 9 months later.
LIMITATIONS
The number of participants and duration of follow-up were inadequate to determine if intervention can help to prevent future severe shoulder problems.
CONCLUSIONS
A progressive shoulder movement program can have meaningful effects on active motion and symptoms in people with type 2 diabetes and mild-to-moderate shoulder symptoms, with symptom improvement lasting at least 9 months.
背景
糖尿病患者患肩痛、关节活动度受限和粘连性肩关节囊炎的风险较高。
目的
本研究旨在评估肩部运动干预（ShoMo）与健康干预对主要结局（干预后和 9 个月后的主动肩部前屈和报告的肩痛和残疾指数（SPADI））的影响。
设计
前瞻性、随机、对照临床试验。
设置
在学术医学中心的研究中心。
参与者
52 名患有 2 型糖尿病和肩部疼痛或运动受限的患者被随机分为接受 ShoMo 治疗的组（n=27；平均年龄 59.3；SD=7.0）或接受健康活动治疗的组（n=25；平均年龄 57.9；SD=7.7）。
干预措施
ShoMo 组接受了渐进式主动肩部运动方案的指导。健康组接受了糖尿病管理的指导。
测量
在基线、干预 3 个月后以及基线后 6、9 和 12 个月进行测量。
结果
干预后，ShoMo 组的主动肩部前屈增加了 7.2 度，而健康组则增加了 0.9-13.5 度，但在随后的随访中没有差异。干预后，ShoMo 组的 SPADI 评分改善了 12.7 分，而健康组则改善了 1.1-24.3 分，9 个月后仍优于健康组。
局限性
参与者数量和随访时间不足，无法确定干预是否有助于预防未来严重的肩部问题。
结论
渐进式肩部运动方案可对 2 型糖尿病患者轻度至中度肩部症状患者的主动运动和症状产生有意义的影响，症状改善至少持续 9 个月。
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