肩峰下撞击综合征：意大利物理治疗师和骨科医生关于诊断策略和治疗方式的调查
Subacromial impingement syndrome: a survey of Italian physiotherapists and orthopaedics on diagnostic strategies and management modalities.
作者信息
Brindisino Fabrizio, Ristori Diego, Lorusso Mariangela, Miele Simone, Pellicciari Leonardo, Rossettini Giacomo, Bonetti Francesca, Heick John Duane, Testa Marco
机构信息
Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise C/da Tappino c/o Cardarelli Hospital, 86100 Campobasso, Italy.
Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy.
出版信息
Arch Physiother. 2020 Sep 2;10:16. doi: 10.1186/s40945-020-00087-7. eCollection 2020.
BACKGROUND AND AIM
The subacromial impingement syndrome (SIS) represents a common cause of disability in approximately 74% of patients with Shoulder Pain (SP). Even if contemporary research suggests that this mechanism is not (always) the dominant driver in SP, SIS is still a source of debate among scholars and clinicians. From a clinical point of view, evidence has suggested that clinicians can use both medical and physiotherapy approaches as effective methods to treat SIS.This survey aims to investigate models of management of patients with SIS in a sample of Italian physiotherapist specialists (Orthopaedic Manipulative Physical Therapists, -OMPTs-) and orthopaedic surgeons.
MATERIALS AND METHODS
An online survey with 29-item questionnaire was administered to assess the knowledge of OMPTs and orthopaedic surgeons about: a) strategies of clinical examination; b) the role of imaging in the diagnostic process; c) the physiotherapy management; and d) the pharmacological and surgical management in patients with SIS.
RESULTS
Six-hundred and twenty-nine respondents completed the survey (511 OMPTs (79.97%) and 128 orthopaedic surgeons (20.03%)). Ninety-two percent ( = 470) of the OMPTs and 80.5% ( = 103) of orthopaedic surgeons stated that in patients with SIS, a combination of diagnostic tests produced better accuracy ( = < 0.001). Twenty point seven % of OMPTs ( = 106) and 4.7% of orthopaedic surgeon ( = 6) stated that the Lift off was the most specific test ( = < 0.001). Four-hundred-and-twenty-four OMPTs (83%) and 40 orthopaedic surgeons (31.3%) answered that the gold standard for diagnosis of a patient with SIS are history and clinical examination ( < 0.001).
CONCLUSION
OMPTs and orthopaedic surgeons approach patients with SIS differently during both the assessment and the treatment. OMPTs appear to be appropriate in planning and managing clinical examination and therapeutic strategies to use with patients with SIS.
背景与目的
肩峰下撞击综合征（SIS）是导致约74%的肩痛（SP）患者残疾的常见原因。尽管当代研究表明这种机制并非（总是）肩痛的主要驱动因素，但SIS仍是学者和临床医生争论的焦点。从临床角度来看，有证据表明临床医生可以采用医学和物理治疗方法作为治疗SIS的有效手段。本次调查旨在研究意大利物理治疗专家（骨科手法物理治疗师，即OMPTs）和骨科医生样本中SIS患者的管理模式。
材料与方法
进行了一项包含29个项目问卷的在线调查，以评估OMPTs和骨科医生关于以下方面的知识：a）临床检查策略；b）影像学在诊断过程中的作用；c）物理治疗管理；d）SIS患者的药物和手术管理。
结果
629名受访者完成了调查（511名OMPTs（79.97%）和128名骨科医生（20.03%））。92%（=470）的OMPTs和80.5%（=103）的骨科医生表示，对于SIS患者，联合诊断测试能产生更高准确性（= < 0.001）。20.7%的OMPTs（=106）和4.7%的骨科医生（=6）表示，抬离试验是最具特异性的测试（= < 0.001）。424名OMPTs（83%）和40名骨科医生（31.3%）回答，SIS患者诊断的金标准是病史和临床检查（< 0.001）。
结论
OMPTs和骨科医生在评估和治疗SIS患者时采用不同方法。OMPTs似乎适合规划和管理与SIS患者一起使用的临床检查和治疗策略。
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