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肩袖修复术后持续被动活动的早期结果:一项前瞻性、随机、双盲、对照研究。

Early results of continuous passive motion after rotator cuff repair: a prospective, randomized, blinded, controlled study.

作者信息

Raab M G, Rzeszutko D, O'Connor W, Greatting M D

机构信息

Hand and Upper Extremity Surgery Service, Dwight D. Eisenhower Army Medical Center, Ft. Gordon, Georgia, USA.

出版信息

Am J Orthop (Belle Mead NJ). 1996 Mar;25(3):214-20.

PMID:8775698
Abstract

PURPOSE

To determine the effect of continuous passive motion (CPM) on rotator cuff repair (RCR).

METHODS

A prospective, randomized, blinded, controlled study was performed on all patients undergoing primary RCR between December 1992 and January 1994. A preoperative "shoulder score" was calculated for each patient based on four scales: function (50%), pain (20%), muscle strength (15%), and range-of-motion (ROM) (15%). A standard questionnaire and single blinded physical therapist were employed. At the time of operation, patients were randomized into the control group (postoperative physical therapy [PT]) or the study group (PT plus CPM). Postoperative shoulder scores were then calculated by repeat questionnaires and physical examinations at 3-month follow-up.

RESULTS

Twenty-six patients (12 control, 14 study; 24/26 tears were full thickness) underwent RCR and completed 3-month follow-up. Both groups had similar age and sex distributions; the study group had larger tears than the control group. All patients underwent RCR and subacromial decompression. No statistically significant difference in shoulder score increases was seen between the two groups at follow-up. A statistically significant (P = 0.0138) increase in ROM subscore was seen in the study group. Other subscores showing improvement with CPM included pain relief in female patients (P = 0.0185), and pain relief in patients > or = 60 years of age (P = 0.0364).

CONCLUSIONS

CPM has no effect on overall shoulder score at 3-month follow-up. CPM has a beneficial effect on ROM for all patients, as well as on pain relief in female patients and patients > or = 60 years of age.

摘要

目的

确定持续被动运动(CPM)对肩袖修复术(RCR)的影响。

方法

对1992年12月至1994年1月期间接受初次RCR的所有患者进行了一项前瞻性、随机、双盲、对照研究。根据四个量表为每位患者计算术前“肩部评分”:功能(50%)、疼痛(20%)、肌肉力量(15%)和活动范围(ROM)(15%)。采用标准问卷和单盲物理治疗师。手术时,患者被随机分为对照组(术后物理治疗[PT])或研究组(PT加CPM)。然后在3个月随访时通过重复问卷调查和体格检查计算术后肩部评分。

结果

26例患者(12例对照,14例研究;24/26例撕裂为全层)接受了RCR并完成了3个月随访。两组年龄和性别分布相似;研究组的撕裂比对照组更大。所有患者均接受了RCR和肩峰下减压。随访时两组肩部评分增加无统计学显著差异。研究组ROM子评分有统计学显著增加(P = 0.0138)。显示CPM有改善的其他子评分包括女性患者的疼痛缓解(P = 0.0185)和年龄≥60岁患者的疼痛缓解(P = 0.0364)。

结论

在3个月随访时,CPM对总体肩部评分无影响。CPM对所有患者的ROM以及女性患者和年龄≥60岁患者的疼痛缓解有有益作用。

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