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[一项自我管理的康复计划对基层医疗中肩痛综合征的有效性]

[Effectiveness of a self-administered rehabilitation program for shoulder pain syndrome in primary health care].

作者信息

Contreras Julio, Liendo Rodrigo, Díaz Cristóbal, Díaz María, Osorio Matías, Guzmán Ricardo, Soza Francisco, Beltrán Manuel, Palomo Héctor, Córdova Carlos, Manosalvas Daniel, Lecaros Juan, Torres Ramón, Grau Gilberto, Silva Pablo, Parada Cristián, Cibie Dominique, Martínez Rodrigo, Pérez Iván

机构信息

Instituto Traumatológico, Santiago, Chile.

Departamento de Ortopedia y Traumatología, Pontificia Universidad Católica de Chile, Santiago, Chile.

出版信息

Rev Med Chil. 2018 Sep;146(9):959-967. doi: 10.4067/s0034-98872018000900959.

Abstract

BACKGROUND

Shoulder pain syndrome (SPS) is frequent and management in primary care is precarious, with a high rate of referral without adequate treatment, overloading rehabilitation and orthopedic services.

AIM

To assess the effectiveness of a self-administered rehabilitation program in adults with shoulder pain syndrome in primary care.

PATIENTS AND METHODS

A randomized, single-blind clinical trial (evaluators) with an experimental group (self-administered rehabilitation) and a control group (standard physical therapy) was carried out in 271 adult patients aged 18 or older with unilateral shoulder pain lasting more than six weeks and less than three months. The primary outcome was the recovery perceived by the patient. Constant score for function, quality of life using SF-36, simple shoulder test (SST) and the Disabilities of the Arm, Shoulder, and Hand (DASH) score were also calculated at six, 12 and 24 weeks of follow-up.

RESULTS

The self-administered rehabilitation program showed an adjusted effectiveness of 51% at the end of treatment compared to 54% of the standard physical therapy (p > 0.05). No differences in the evolution of the other scores assessed were observed between groups.

CONCLUSIONS

A self-administered rehabilitation program for painful shoulder was non-inferior than usual physical therapy.

摘要

背景

肩痛综合征(SPS)很常见,基层医疗中的管理不稳定,转诊率高但未得到充分治疗,导致康复和骨科服务负担过重。

目的

评估自我管理康复计划对基层医疗中患有肩痛综合征的成年人的有效性。

患者与方法

对271名18岁及以上的成年患者进行了一项随机、单盲临床试验(评估者),分为实验组(自我管理康复)和对照组(标准物理治疗),这些患者单侧肩部疼痛持续超过六周且少于三个月。主要结局是患者感知到的恢复情况。在随访的6周、12周和24周时,还计算了功能的Constant评分、使用SF - 36的生活质量、简单肩部测试(SST)以及手臂、肩部和手部功能障碍(DASH)评分。

结果

与标准物理治疗的54%相比,自我管理康复计划在治疗结束时的调整后有效性为51%(p>0.05)。两组之间在评估的其他评分变化方面未观察到差异。

结论

针对肩部疼痛的自我管理康复计划不劣于常规物理治疗。

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