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对肩痛患者进行家庭锻炼计划教育对肩痛和残疾的影响:一项随机对照试验。

Effects on shoulder pain and disability of teaching patients with shoulder pain a home-based exercise program: a randomized controlled trial.

机构信息

Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.

出版信息

Clin Rehabil. 2020 Oct;34(10):1245-1255. doi: 10.1177/0269215520930790. Epub 2020 Jun 7.

Abstract

OBJECTIVE

To investigate the effect on shoulder pain and disability of teaching patients with shoulder pain how to undertake a home-based exercise program.

DESIGN

A randomized controlled trial conducted from September 2015 to January 2016.

SETTING

Participants' home.

PARTICIPANTS

Sixty participants with shoulder pain who were waiting for physiotherapeutic treatment.

INTERVENTIONS

The control group ( = 30) received minimal education about their shoulder condition and instructions to continue their activities as normal. The intervention group ( = 30) received a two-month home exercise program with one-hour sessions delivered by a physiotherapist to begin and one month after the program for exercise instructions.

MAIN MEASURES

The primary outcome was change in the Shoulder Pain and Disability Index (SPADI). The secondary outcomes included change in the numeric pain rating scale and medication intake for pain relief.

RESULTS

The patients' average age was 54.3 (13.8) years. SPADI scores at baseline were 60.9 (16.5) in the intervention and 64.7 (15.3) in the control group. After two months, the SPADI scores decreased to 18.8 (28.6) and to 61.4 (24.0), respectively, in the intervention and control groups with an estimated mean difference of 40.0, effect size: 1.61. The intervention group showed a reduced pain intensity (estimated mean difference: 3.7, effect size: 2.43) and medication intake (chi-square: 0.001). The number needed to treat was 1.2 for one patient to have a SPADI score <20.

CONCLUSION

Teaching patients with shoulder pain how to undertake a home-based exercise program improved shoulder function and reduced pain intensity and medication intake over two months.

摘要

目的

研究向肩痛患者教授家庭锻炼方案对其肩痛和功能障碍的影响。

设计

2015 年 9 月至 2016 年 1 月进行的一项随机对照试验。

地点

参与者的家庭。

参与者

60 名等待物理治疗的肩痛患者。

干预措施

对照组(n=30)接受了关于其肩部状况的最低限度教育,并指示他们继续正常活动。干预组(n=30)接受了为期两个月的家庭锻炼计划,由一名物理治疗师进行一次一小时的课程,并在计划开始后一个月和一个月后提供锻炼指导。

主要观察指标

主要结局指标是肩痛和功能障碍指数(SPADI)的变化。次要结局指标包括数字疼痛评分量表的变化和缓解疼痛的药物摄入。

结果

患者的平均年龄为 54.3(13.8)岁。干预组和对照组的 SPADI 评分基线分别为 60.9(16.5)和 64.7(15.3)。两个月后,干预组和对照组的 SPADI 评分分别降至 18.8(28.6)和 61.4(24.0),估计平均差异为 40.0,效应量为 1.61。干预组疼痛强度(估计平均差异:3.7,效应量:2.43)和药物摄入(卡方检验:0.001)均降低。需要治疗的患者人数为 1.2,以确保一名患者的 SPADI 评分<20。

结论

向肩痛患者教授家庭锻炼方案可在两个月内改善肩部功能,并降低疼痛强度和药物摄入。

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