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肩袖修复术后康复。对当前(2020 年)意大利临床实践的调查。

Post-surgery rehabilitation following rotator cuff repair. A survey of current (2020) Italian clinical practice.

机构信息

Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy.

Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy.

出版信息

Disabil Rehabil. 2022 Aug;44(17):4689-4699. doi: 10.1080/09638288.2021.1916628. Epub 2021 May 4.

Abstract

AIMS

To analyse the clinical practice of Italian physiotherapists within the framework of postoperative rehabilitation of rotator cuff (RC) surgery patients, and to compare it with similar studies carried out in other countries.

METHODS

A web-based, voluntary, cross-sectional survey with 27 closed multiple-choice questions was developed and submitted to Italian-based physiotherapists in order to assess their clinical practice.

RESULTS

Data from 1160 questionnaires were then analysed. Thirty-five percent of respondents ( = 413/1160) reported that they commence passive range of motion from the first postoperative week, while 49.2% ( = 571/1160) start during the second or third week. The majority of respondents ( = 603/1160, 52.0%) introduce active mobilisation between the fourth and the sixth week after surgery and 41.1% ( = 477/1160) introduce overhead movements between the fourth and the sixth week after surgery.

DISCUSSION AND CONCLUSIONS

When managing the postoperative rehabilitation of RC surgery patients, Italian physiotherapists' practice is congruent with the guidelines published by American Society of Shoulder and Elbow Therapists (ASSET) and also with other UK surveys. However, while Italian physiotherapists manage immobilisation periods, active and passive mobilisation and the return to sport activities, according to evidence-based best practice guidelines, there is less consistency with respect to physical exercise, patient follow-up and referral.IMPLICATIONS FOR REHABILITATIONItalian physiotherapists' practice with patients following rotator cuff (RC) repair complies with evidence-based practice guidelines regarding immobilisation periods, passive and active mobilisation, and return to sport activities.There is less consistency between reported/declared practice and available evidence concerning physical exercise, patient follow-up, and referral.Physiotherapist with Orthopaedic Manipulative Physical Therapy (OMPT) training is more aligned with the current literature compared to physiotherapists without specific training, in terms of managing rehabilitation programmes, period of immobilisation and therapeutic exercise.More careful adherence to the international guidelines is recommended, in order to manage patients following RC repair in accordance with the evidence and to achieve the best possible outcomes.

摘要

目的

分析意大利物理治疗师在肩袖(RC)手术后康复框架内的临床实践,并将其与在其他国家进行的类似研究进行比较。

方法

开发了一项基于网络的、自愿的、横断面调查,其中包含 27 个封闭式多项选择题,并提交给意大利的物理治疗师,以评估他们的临床实践。

结果

然后对 1160 份问卷的数据进行了分析。35%的受访者(=413/1160)报告他们从术后第一周开始进行被动活动范围,而 49.2%(=571/1160)在第二或第三周开始。大多数受访者(=603/1160,52.0%)在手术后第四至第六周开始进行主动活动,41.1%(=477/1160)在手术后第四至第六周开始进行过头活动。

讨论和结论

在管理 RC 手术后患者的康复时,意大利物理治疗师的实践与美国肩肘治疗协会(ASSET)发布的指南以及其他英国调查结果一致。然而,尽管意大利物理治疗师在管理固定期、主动和被动活动以及恢复运动活动方面遵循基于证据的最佳实践指南,但在体育锻炼、患者随访和转介方面一致性较差。

康复意义

意大利物理治疗师对肩袖(RC)修复后患者的治疗实践符合关于固定期、被动和主动活动以及重返运动活动的基于证据的实践指南。在体育锻炼、患者随访和转介方面,报告/声明的实践与现有证据之间的一致性较差。接受过骨科手法物理治疗(OMPT)培训的物理治疗师在管理康复方案、固定期和治疗性运动方面与没有特定培训的物理治疗师相比,更符合当前文献。建议更严格地遵守国际指南,以便根据证据管理 RC 修复后的患者,并实现最佳的结果。

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