DPT, Center for Orthopedic and Sports Physical Therapy, Tallahassee, FL, USA.
J Man Manip Ther. 2020 Feb;28(1):41-48. doi: 10.1080/10669817.2018.1563316. Epub 2019 Jan 24.
: A prospective observational cohort study was conducted to (1) determine the prevalence of Mechanical Diagnosis and Therapy (MDT) syndromes for patients with shoulder impairments and (2) report the interaction between MDT classification and clinical outcomes, including pain intensity and disability, at discharge.: Clinical outcome measures were completed at intake and discharge by 115 patients. A two-way mixed model analysis of variance with subsequent pairwise comparisons was done to examine differences in clinical outcomes between the following MDT classifications: Shoulder Derangement, Shoulder Dysfunction, and Other.: The primary findings were that (1) 44.3 (35.3, 53.4), 40.0 (31.0, 48.9), and 15.6 (9.0, 22.3) percent of patients' conditions were classified as Shoulder Derangement, Shoulder Dysfunction, and Other, respectively, (2) all groups managed via MDT methods made clinically significant improvements in disability and pain intensity at discharge, (3) a statistically significant difference in pain intensity at discharge was observed between the Shoulder Derangement and the Shoulder Dysfunction classifications ( = 0.01), and (4) patients with the Shoulder Derangement classification were discharged, on average, 35.3 days earlier than the Shoulder Dysfunction classification and 28.3 days earlier than the Other classification.: This study confirms previous reports that the Shoulder Derangement and Shoulder Dysfunction classifications are common and represent distinct clinical trajectories when assessed and managed via MDT methods.
(1)确定有肩部损伤的患者的机械诊断与治疗(MDT)综合征的流行率;(2)报告 MDT 分类与临床结果之间的相互作用,包括出院时的疼痛强度和残疾。临床结果评估在 115 名患者入组和出院时完成。采用双向混合模型方差分析和随后的两两比较来检查以下 MDT 分类之间的临床结果差异:肩部紊乱、肩部功能障碍和其他。主要发现是:(1)分别有 44.3%(35.3%,53.4%)、40.0%(31.0%,48.9%)和 15.6%(9.0%,22.3%)的患者病情被归类为肩部紊乱、肩部功能障碍和其他;(2)所有接受 MDT 方法治疗的组在出院时在残疾和疼痛强度方面均有显著的临床改善;(3)在出院时的疼痛强度方面观察到肩部紊乱和肩部功能障碍分类之间有统计学显著差异(=0.01);(4)肩部紊乱分类的患者平均比肩部功能障碍分类早出院 35.3 天,比其他分类早出院 28.3 天。本研究证实了先前的报告,即肩部紊乱和肩部功能障碍分类很常见,并且当通过 MDT 方法进行评估和管理时,代表着不同的临床轨迹。