Department of Physical Therapy, University of Valencia, Valencia, Spain; Departments of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium; Pain in Motion International Research Group, Spain.
Physical Therapy Department, University of Alcalá, Alcalá de Henares, Madrid, Physiotherapy and Pain Group, Spain.
Musculoskelet Sci Pract. 2018 Dec;38:91-98. doi: 10.1016/j.msksp.2018.09.009. Epub 2018 Sep 25.
Passive oscillatory mobilizations are often employed by physiotherapists to reduce shoulder pain and increase function. However, there is little data about the neurophysiological effects of these mobilizations.
To investigate the initial effects of an anteroposterior (AP) shoulder joint mobilization on measures of pain and function in overhead athletes with chronic shoulder pain.
Double-blind, controlled, within-subject, repeated-measures design.
Thirty-one overhead athletes with chronic shoulder pain participated. The effects of a 9-min, AP mobilization of the glenohumeral joint were compared with manual contact and no-contact interventions. Self-reported pain, pressure pain threshold (PPT), range of movement (ROM), muscle strength, and disability were measured immediately before and after each intervention.
RESULTS/FINDINGS: No significant differences were found among the treatment conditions in any of the variables investigated. A significantly greater mean decrease in self-reported shoulder pain was observed following treatment condition [0.63 (0.12, 1.14); p = 0.01]. PPT at the affected shoulder increased significantly following both the treatment [0.23 (-0.43, 0.02); p = 0.02] and manual contact [0.28 (-0.51, 0.04); p = 0.01] conditions. Shoulder AP joint mobilization also increased PPT at a distal, non-painful site [0.42 (-0.85, 0.01); p = 0.04]. No changes were observed in shoulder ROM or muscle strength.
This study found no superior effects in various pain or function-related outcome measures of a passive oscillatory anteroposterior mobilization applied to the glenohumeral joint compared to manual contact and no-contact interventions in overhead athletes with chronic shoulder pain. Some ability to modulate shoulder pain and local and widespread pain sensitivity was observed in the short term after the passive oscillatory anteroposterior mobilization.
物理治疗师常采用被动振荡松动术来减轻肩部疼痛并提高功能。然而,关于这些松动术的神经生理学效应的数据很少。
研究前-后(AP)肩关节松动术对慢性肩部疼痛的 overhead 运动员的疼痛和功能的初始影响。
双盲、对照、自身对照、重复测量设计。
31 名患有慢性肩部疼痛的 overhead 运动员参与了研究。比较了 9 分钟的盂肱关节 AP 松动术与手动接触和无接触干预的效果。在每次干预前后,测量自我报告的疼痛、压力疼痛阈值(PPT)、活动范围(ROM)、肌肉力量和残疾情况。
结果/发现:在所研究的变量中,治疗条件之间没有显著差异。与治疗条件相比,自我报告的肩部疼痛明显降低[0.63(0.12,1.14);p=0.01]。受影响的肩部 PPT 在治疗后显著增加[0.23(-0.43,0.02);p=0.02]和手动接触后[0.28(-0.51,0.04);p=0.01]。AP 肩关节松动术还增加了远端无痛部位的 PPT[0.42(-0.85,0.01);p=0.04]。肩部 ROM 和肌肉力量没有变化。
本研究发现,与慢性肩部疼痛的 overhead 运动员的手动接触和无接触干预相比,应用于盂肱关节的被动振荡前-后松动术在各种疼痛或功能相关的结果测量中没有优越的效果。在短期的被动振荡前-后松动术之后,观察到对肩部疼痛和局部及广泛的疼痛敏感性的一些调节能力。