临床实践中肩袖损伤特殊检查的知识、应用及诊断适用性调查
Survey on Knowledge, Use, and Diagnostic Applicability of Special Tests for Rotator Cuff Involvement in Clinical Practice.
作者信息
Forbush Steven W, Bandy William D, Back-Kremers Gabrielle L, Renfroe Mollie, Downey Haley F
机构信息
Orthopedic Manual Therapy Instruction.
Department of Physical Therapy University of Central Arkansas.
出版信息
Int J Sports Phys Ther. 2023 Feb 1;18(1):199-207. doi: 10.26603/001c.67934. eCollection 2023.
BACKGROUND
Recently, researchers have commented that shoulder special tests cannot identify the structure causing rotator cuff symptoms and should only be considered pain provocation tests. Others have disagreed, reporting that special tests were able to accurately detect the presence of rotator cuff involvement.
PURPOSE
The purpose of this study was to determine the knowledge, use, and perceived effectiveness of 15 selected special tests utilized to examine patients with possible rotator cuff dysfunction.
STUDY DESIGN
Descriptive study using survey.
METHODS
An electronic survey was returned by 346 members of the Academies of Orthopedic and Sports Physical Therapy through list serves. Descriptions and pictures for 15 special tests of the shoulder were included in the survey. Information regarding years of clinical experience and American Board of Physical Therapy Specialties (ABPTS) specialist certification in Sports or Orthopedics was collected. Respondents were asked if they could and the special tests to evaluate dysfunction of the rotator cuff - and how confident they were in ability of the tests to dysfunction of the rotator cuff.
RESULTS
The four tests most readily by respondents included the empty can, drop arm, full can, and Gerber's tests, and the four tests regularly by the respondents included the infraspinatus, full can, supraspinatus, and champagne toast tests. The infraspinatus, champagne toast, external rotation lag (ERLS), and the belly-off tests were found to be the be most useful for establishing a of the muscle-tendon complex involved. Years of experience and clinical specialization was not relevant to knowledge or use or these tests.
CONCLUSIONS
This study will allow clinicians and educators to understand which special tests are easily identified, regularly used, and perceived as helpful for the diagnosis of muscles involved in a rotator cuff dysfunction.
LEVEL OF EVIDENCE
3b.
背景
最近，研究人员评论说，肩部特殊检查无法识别导致肩袖症状的结构，应仅将其视为疼痛激发试验。其他人则持不同意见，报告称特殊检查能够准确检测出肩袖受累情况。
目的
本研究的目的是确定用于检查可能存在肩袖功能障碍患者的15项选定特殊检查的知晓情况、使用情况和感知有效性。
研究设计
采用调查的描述性研究。
方法
通过邮件列表，346名骨科和运动物理治疗学会成员回复了电子调查问卷。调查问卷中包含了15项肩部特殊检查的描述和图片。收集了有关临床经验年限以及美国物理治疗专业委员会（ABPTS）运动或骨科专科认证的信息。受访者被问及他们是否能够执行以及执行这些特殊检查以评估肩袖功能障碍，以及他们对这些检查检测肩袖功能障碍能力的信心程度。
结果
受访者最容易执行的四项检查包括空罐试验、落臂试验、满罐试验和格伯试验，受访者最常执行的四项检查包括冈下肌试验、满罐试验、冈上肌试验和香槟祝酒试验。发现冈下肌试验、香槟祝酒试验、外旋滞后试验（ERLS）和腹部离开试验对于确定受累肌腱复合体的诊断最为有用。经验年限和临床专科与这些检查的知晓情况、使用情况无关。
结论
本研究将使临床医生和教育工作者了解哪些特殊检查易于识别、经常使用且被认为有助于诊断肩袖功能障碍中受累的肌肉。
证据级别
3b。
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