Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden. E-mail:
J Rehabil Med. 2021 May 11;53(5):jrm00190. doi: 10.2340/16501977-2806.
Graded resistance training is the recommended treatment for patients with subacromial pain syndrome. It is debated whether adding joint mobilization will improve the outcome. The aim of this study was to evaluate the clinical outcome of guided exercises with or without joint mobilization, compared with controls who did not receive any treatment.
A 3-armed controlled trial in a primary care setting. A total of 120 patients, with clinically diagnosed subacromial pain syndrome, were randomized into guided exercise groups with and without additional joint mobilization, and a control group that did not receive any treatment. Data were analysed at baseline, 6 weeks, 12 weeks and 6 months. Primary outcome was the Constant-Murley score, and secondary outcomes were pain and active range of motion.
Shoulder function improved in all groups, as measured with the Constant-Murley score. At 12 weeks and 6 months the exercise groups improved significantly compared with the control group (p ≤ 0.05). Add-on joint mobilization resulted in decreased pain in active range of motion at 6 and 12 weeks compared with guided exercise or no treatment (p ≤ 0.05). Range of motion increased over time in all 3 groups.
In patients with subacromial pain syndrome guided exercises improved shoulder function compared with no treatment. Add-on joint mobilization decreased pain in the short-term compared with exercise alone or no treatment.
分级阻力训练是治疗肩峰下疼痛综合征患者的推荐治疗方法。目前还存在争议，即是否添加关节松动术会改善治疗效果。本研究旨在评估在初级保健环境中，与未接受任何治疗的对照组相比，指导运动加或不加关节松动术的临床疗效。
在初级保健环境中进行的三臂对照试验。共有 120 名患者被诊断为肩峰下疼痛综合征，随机分为指导运动组（联合或不联合附加关节松动术）和对照组（未接受任何治疗）。在基线、6 周、12 周和 6 个月时进行数据分析。主要结局指标是 Constant-Murley 评分，次要结局指标是疼痛和主动活动范围。
所有组的肩部功能均得到改善，以 Constant-Murley 评分衡量。在 12 周和 6 个月时，运动组与对照组相比（p≤0.05）有显著改善。与指导运动或不治疗相比，附加关节松动术在 6 周和 12 周时可降低主动活动范围的疼痛（p≤0.05）。在所有 3 组中，活动范围随时间增加。
在肩峰下疼痛综合征患者中，指导运动与不治疗相比可改善肩部功能。与单独运动或不治疗相比，附加关节松动术可在短期内减轻疼痛。
