改善肩袖相关肩部疼痛的特定运动模式：系统评价与荟萃分析
Specific modes of exercise to improve rotator cuff-related shoulder pain: systematic review and meta-analysis.
作者信息
Wu Dianxuan, Wen Zhicheng, Ke Haolin, Zhang Jiexin, Zhong Shaozi, Teng Jiachen, Xu Lan, Li Jintao, Shao Yan, Zeng Chun
机构信息
Department of Sports Medicine, Center for Orthopaedic Surgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.
Department of Orthopedics, Orthopedic Hospital of Guangdong Province, Academy of Orthopedics·Guangdong Province, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.
出版信息
Front Bioeng Biotechnol. 2025 Apr 8;13:1560597. doi: 10.3389/fbioe.2025.1560597. eCollection 2025.
OBJECTIVE
To investigate the effect of specific modes of exercise on rotator cuff-related shoulder pain (RCRSP) patients, aiming to provide a theoretical reference for conservative treatment and exercise prescription.
METHODS
Data sources included PubMed/MEDLINE, Web of Science, ScienceDirect, and CNKI, covering studies from database inception to June 2024. Study selection followed pre-set inclusion/exclusion criteria. Cochrane methods guided quality assessment and data extraction. Outcome measures included VAS, CMS, and DASH scores. Publication bias assessed via funnel plots; forest plots created using RevMan 5.4.
RESULTS
13 studies (n = 690) met inclusion criteria for RCRSP exercise interventions. It is indicated that: (1) specific exercises led to modest improvements in performance of pain (SMD = -0.31, 95% CI: 0.46 to -0.16, P < 0.0001) and function, with enhancements in CMS (SMD = 0.59, 95% CI: 0.44 to 0.74, P < 0.00001) and DASH (SMD = -0.60, 95% CI: 0.80 to -0.39, P < 0.00001). (2) Interventions lasting less than 2 months were slightly more effective than those lasting 2 months or longer, observed in VAS (SMD = -0.35, 95% CI: 0.56 to -0.15, P = 0.0007), CMS (SMD = 0.71, 95% CI: 0.47 to 0.96, P < 0.00001), and DASH (SMD = -0.71, 95% CI: 0.99 to -0.43, P < 0.00001). (3) Subgroup analyses revealed that handgrip strength exercises enhanced shoulder pain relief, shoulder mobilization/stretching improved both function and pain levels over 2 months, scapular stabilization exercise improved pain and DASH performance over 2 months, eccentric exercises boosted CMS and DASH performance over 2 months, while proprioceptive exercises showed no significant improvement in pain or CMS performance.
CONCLUSION
Compared to non-specific exercises, specific exercise programs moderately alleviate RCRSP symptoms, with shorter interventions (<2 months) demonstrating marginally superior outcomes. Efficacy varies by exercise type, emphasizing the need for individualized prescriptions.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (CRD42024550602).
目的
探讨特定运动模式对肩袖相关肩部疼痛（RCRSP）患者的影响，旨在为保守治疗和运动处方提供理论参考。
方法
数据来源包括PubMed/MEDLINE、Web of Science、ScienceDirect和CNKI，涵盖从数据库建立至2024年6月的研究。研究选择遵循预设的纳入/排除标准。采用Cochrane方法进行质量评估和数据提取。结局指标包括视觉模拟评分法（VAS）、Constant-Murley肩关节功能评分（CMS）和上肢功能障碍评分（DASH）。通过漏斗图评估发表偏倚；使用RevMan 5.4绘制森林图。
结果
13项研究（n = 690）符合RCRSP运动干预的纳入标准。结果表明：（1）特定运动使疼痛表现（标准化均数差[SMD]= -0.31，95%置信区间[CI]：-0.46至-0.16，P < 0.0001）和功能有适度改善，CMS（SMD = 0.59，95% CI：0.44至0.74，P < 0.00001）和DASH（SMD = -0.60，95% CI：-0.80至-0.39，P < 0.00001）得到提高。（2）持续时间少于2个月的干预在VAS（SMD = -0.35，95% CI：-0.56至-0.15，P = 0.0007）、CMS（SMD = 0.71，95% CI：0.47至0.96，P < 0.00001）和DASH（SMD = -0.71，95% CI：-0.99至-0.43，P < 0.00001）方面比持续2个月或更长时间的干预稍有效。（3）亚组分析显示，握力训练可增强肩部疼痛缓解，肩部活动度/拉伸在2个月以上可改善功能和疼痛水平，肩胛稳定训练在2个月以上可改善疼痛和DASH表现，离心训练在2个月以上可提高CMS和DASH表现，而本体感觉训练在疼痛或CMS表现方面无显著改善。
结论
与非特定运动相比，特定运动方案可适度减轻RCRSP症状，较短时间（<2个月）的干预效果略优。疗效因运动类型而异，强调需要个性化处方。
系统评价注册
PROSPERO（CRD42024550602）
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