Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.
Department of Medicine, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.
Braz J Phys Ther. 2022 May-Jun;26(3):100403. doi: 10.1016/j.bjpt.2022.100403. Epub 2022 Mar 31.
Rotator cuff related shoulder pain (RCRSP) is the main diagnosis for shoulder pain. A painful arc during active arm elevation is a common finding in RCRSP. The angular onset of pain during arm elevation may play an important role on functioning of the upper extremities.
This study aimed to: 1) determine and characterize the association between the angular onset of pain during arm elevation and upper-limb self-reported functioning, 2) verify whether demographic and clinical characteristics contribute to this association, and 3) investigate whether these characteristics differ considering distinct ranges of angular onset of pain in individuals with RCRSP.
252 individuals with RCRSP were divided in 3 groups based on the angular onset of pain during arm elevation in the sagittal plane: <60°, 60°-120°, and >120°. The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used to assess functioning of the upper limbs. Demographic and clinical characteristics were selected for the multivariable analysis.
Individuals with an angular onset of pain above 120° of arm elevation presented lower DASH score (lesser disability) than individuals with an angular onset of pain between 60°- 120°. Male sex, age, dominance of the side affected, duration of symptoms, and the angular onset of pain during arm elevation explained 31% of the DASH score variance.
Individuals with RCRSP and angular onset of pain above 120° of arm elevation present better functioning than individuals with onset of pain between 60°-120°, and similar functioning as those with pain below 60°. Male sex, lower age, non-dominant side being affected and longer duration of symptoms are also associated to better functioning as assessed by the DASH questionnaire.
肩袖相关的肩部疼痛（RCRSP）是肩部疼痛的主要诊断。主动抬高手臂时出现疼痛弧是 RCRSP 的常见表现。手臂抬高时疼痛的起始角度可能对上肢功能发挥着重要作用。
本研究旨在：1）确定并描述手臂抬高时疼痛起始角度与上肢自我报告功能之间的关系，2）验证人口统计学和临床特征是否对此关系有影响，3）研究在 RCRSP 患者中，考虑到不同的疼痛起始角度范围，这些特征是否存在差异。
根据在矢状面手臂抬高时疼痛的起始角度，将 252 名 RCRSP 患者分为 3 组：<60°、60°-120°和>120°。使用上肢残疾问卷（DASH）评估上肢功能。选择人口统计学和临床特征进行多变量分析。
手臂抬高起始角度大于 120°的患者的 DASH 评分（残疾程度较低）低于起始角度在 60°-120°之间的患者。男性、年龄、患侧优势、症状持续时间以及手臂抬高时疼痛的起始角度解释了 DASH 评分变异的 31%。
手臂抬高起始角度大于 120°的 RCRSP 患者的上肢功能比起始角度在 60°-120°之间的患者更好，与起始角度小于 60°的患者相似。男性、年龄较小、非优势侧受累以及症状持续时间较长也与 DASH 问卷评估的更好功能相关。
