Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Faculty of Rehabilitation Medicine/Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Institute of Health Economics, Edmonton, Alberta, Canada.
J Manipulative Physiol Ther. 2020 Sep;43(7):691-699. doi: 10.1016/j.jmpt.2019.01.005. Epub 2020 Aug 26.
This study aimed to verify a possible relationship between shoulder disability and shoulder pain intensity and the variables related to cervical-spine dysfunction, and determine which of these can differentiate moderate to severe shoulder pain (>4 on a numerical rating scale [NRS]) from mild shoulder pain (≤4 on the NRS) in individuals with subacromial impingement symptoms.
One hundred and forty volunteers with shoulder pain were evaluated. Demographic information and variables related to the shoulder and neck were collected. Self-reported pain and disability of the shoulder and cervical spine were measured using the Shoulder Pain and Disability Index (SPADI) and Neck Disability Index (NDI) questionnaires, respectively. An NRS was used to measure pain in the shoulder and cervical spine. A purposeful modeling strategy was used to determine the best model to predict shoulder disability and shoulder pain (dependent variables). Multiple logistic regression analysis followed by receiver operating curve analysis was used to determine which variables better differentiated moderate to severe shoulder pain from mild shoulder pain.
Variables such as Neck Disability Index (NDI) score (β = 1.09, P = .00) and age (β = -0.19, P = .03) were associated with the total SPADI score. Neck pain was significantly associated with shoulder pain (β = 0.40, P = .00). The combination of variables predicting moderate to severe shoulder pain was total SPADI score (odds ratio [OR] = 1.15, P = .003), neck pain (OR = 3.20, P = .04), and age (OR = 1.01, P = .05).
Our results demonstrate the important connection between shoulder- and neck-related symptoms in individuals with subacromial impingement symptoms.
本研究旨在验证肩痛强度和与颈-脊柱功能障碍相关的变量与肩功能障碍之间的可能关系，并确定这些变量中哪些可以区分中重度肩痛（NRS 评分>4）与轻度肩痛（NRS 评分≤4）在患有肩峰下撞击症症状的个体中。
共评估了 140 名患有肩部疼痛的志愿者。收集了与肩部和颈部相关的人口统计学信息和变量。使用肩痛和残疾指数（SPADI）和颈痛残疾指数（NDI）问卷分别测量肩部和颈部的自我报告疼痛和残疾。使用 NRS 测量肩部和颈部疼痛。采用有目的的建模策略来确定预测肩部残疾和肩部疼痛（因变量）的最佳模型。采用多元逻辑回归分析和受试者工作特征曲线分析来确定哪些变量可以更好地区分中重度肩痛和轻度肩痛。
颈痛残疾指数（NDI）评分（β=1.09，P=0.00）和年龄（β=-0.19，P=0.03）等变量与 SPADI 总分相关。颈痛与肩痛显著相关（β=0.40，P=0.00）。预测中重度肩痛的变量组合是 SPADI 总分（优势比[OR]=1.15，P=0.003）、颈痛（OR=3.20，P=0.04）和年龄（OR=1.01，P=0.05）。
我们的研究结果表明，肩峰下撞击症患者的肩部和颈部相关症状之间存在重要联系。
