School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia.
Research Unit of Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark.
Sci Rep. 2020 Nov 26;10(1):20611. doi: 10.1038/s41598-020-76704-z.
To determine whether subacromial space (i.e. acromiohumeral distance; AHD, and/or occupation ratio percentage) differs between people with subacromial pain syndrome (SAPS) and those without. To investigate whether there is a correlation between subacromial space and pain or disability in adults with SAPS and whether temporal changes in pain or disability are accompanied by changes in subacromial space. Systematic review and meta-analysis. Fifteen studies with a total of 775 participants were included. Twelve studies were of high quality and three studies were of moderate quality using the modified Black and Downs checklist. There was no between group difference in AHD in neutral shoulder position (mean difference [95% CI] 0.28 [-0.13 to 0.69] mm), shoulder abduction at 45° (-0.02 [-0.99 to 0.96] mm) or 60° (-0.20 [-0.61 to 0.20] mm). Compared to the control group, a greater occupation ratio in neutral shoulder position was demonstrated in participants with SAPS (5.14 [1.87 to 8.4] %). There was no consistent pattern regarding the correlation between AHD and pain or disability in participants with SAPS, and no consistent increase in subacromial space with improvement in pain or disability over time. The results suggest that surgical (e.g. sub-acromial decompression) and non-surgical (e.g. manual therapy, taping, stretching and strengthening) management of subacromial pain syndrome should not focus solely on addressing a potential decrease in subacromial space, but also on the importance of other biopsychosocial factors.
确定患有肩峰下疼痛综合征（SAPS）和无肩峰下疼痛综合征的人群之间的肩峰下空间（即肩肱距离；AHD 和/或占有率百分比）是否存在差异。调查成人 SAPS 患者的肩峰下空间与疼痛或残疾之间是否存在相关性，以及疼痛或残疾的时间变化是否伴有肩峰下空间的变化。系统评价和荟萃分析。共纳入 15 项研究，总计 775 名参与者。12 项研究质量较高，3 项研究使用改良 Black 和 Downs 清单评估为中度质量。中立位肩 AHD（平均差异 [95%CI] 0.28 [-0.13 至 0.69] 毫米）、肩外展 45°（-0.02 [-0.99 至 0.96] 毫米）或 60°（-0.20 [-0.61 至 0.20] 毫米）在两组间无差异。与对照组相比，SAPS 患者中立位的占有率更大（5.14 [1.87 至 8.4] %）。在 SAPS 患者中，AHD 与疼痛或残疾之间的相关性没有一致的模式，随着时间的推移，疼痛或残疾的改善并没有伴随着肩峰下空间的一致增加。结果表明，肩峰下疼痛综合征的手术（例如肩峰下减压术）和非手术（例如手法治疗、贴扎、拉伸和强化）治疗不应仅关注潜在的肩峰下空间减小，还应关注其他生物心理社会因素的重要性。
