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肩袖修复术后监督康复与家庭康复对肩部运动、疼痛及功能早期恢复的短期比较

Short-term Comparison of Supervised Rehabilitation and Home-based Rehabilitation for Earlier Recovery of Shoulder Motion, Pain, and Function after Rotator Cuff Repair.

作者信息

Song Si-Jung, Jeong Tae-Ho, Moon Jung-Wha, Park Han-Vit, Lee Si Yung, Koh Kyoung-Hwan

机构信息

Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea.

出版信息

Clin Shoulder Elb. 2018 Mar 1;21(1):15-21. doi: 10.5397/cise.2018.21.1.15. eCollection 2018 Mar.

Abstract

BACKGROUND

This study was undertaken to compare the outcome of supervised and home exercises with respect to range of motion (ROM), pain, and Single Assessment Numeric Evaluation (SANE). We further correlated the ROM recovery and pain reduction as well.

METHODS

The study included 49 patients who underwent arthroscopic rotator cuff repair. Rehabilitation was initiated after 4 weeks of immobilization. A total of 29 patients performed supervised exercise 3 times a week. Standardized education and brochures for review were provided to the remaining 20 patients who insisted on home rehabilitation. Statistical analysis was performed for comparing pain Numerical Rating Scale (NRS), SANE, and ROM. In addition, we also evaluated the correlation between pain and ROM.

RESULTS

Comparison of the two groups revealed no significant differences in forward flexion, internal rotation, abduction, and pain NRS. However, SANE at the 9th week (63.8 vs. 55.0, =0.038) and improvement of external rotation from the 5th to the 9th week (17.6 vs. 9.3, =0.018) were significantly higher in the supervised exercise group as compared to the home exercise group. Correlation of pain NRS with forward flexion, external rotation, internal rotation and abduction were statistically not significant (correlation coefficient=0.032 [=0.828], -0.255 [=0.077], 0.068 [=0.642], and -0.188 [=0.196], respectively).

CONCLUSIONS

The supervised rehabilitation after arthroscopic rotator cuff repair showed better improvement in external rotation and higher SANE score after 4 weeks of rehabilitation exercise. However, no statistically significant correlation was observed between the recovery of ROM and short-term pain relief.

摘要

背景

本研究旨在比较监督下锻炼和家庭锻炼在活动范围(ROM)、疼痛及单项评估数值评定(SANE)方面的结果。我们还对ROM恢复情况与疼痛减轻情况进行了相关性分析。

方法

本研究纳入了49例行关节镜下肩袖修补术的患者。固定4周后开始康复治疗。总共29例患者每周进行3次监督下锻炼。为其余坚持家庭康复的20例患者提供了标准化教育内容及复习手册。对疼痛数字评定量表(NRS)、SANE及ROM进行统计学分析比较。此外,我们还评估了疼痛与ROM之间的相关性。

结果

两组比较显示,前屈、内旋、外展及疼痛NRS方面无显著差异。然而,与家庭锻炼组相比,监督下锻炼组在第9周时的SANE评分(63.8对55.0,P=0.038)以及第5至9周外旋的改善情况(17.6对9.3,P=0.018)显著更高。疼痛NRS与前屈、外旋、内旋及外展之间的相关性在统计学上无显著意义(相关系数分别为0.032[P=0.828]、-0.255[P=0.077]、0.068[P=0.642]及-0.188[P=0.196])。

结论

关节镜下肩袖修补术后的监督康复在康复锻炼4周后,外旋改善情况更好,SANE评分更高。然而,ROM恢复与短期疼痛缓解之间未观察到统计学上的显著相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfd8/7726373/a9643795f421/cise-2018-21-1-15f1.jpg

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