Wilk K E, Andrews J R, Arrigo C A
HealthSouth Rehabilitation Corporation, Birmingham, AL, USA.
J Orthop Sports Phys Ther. 1997 Jun;25(6):380-9. doi: 10.2519/jospt.1997.25.6.380.
Thorough descriptions of specific physical examination tests used to determine glenohumeral instability are lacking in the scientific literature. The purpose of this paper was to discuss the importance of the subjective history and illustrate the physical examination of the glenohumeral joint. Additionally, the authors will illustrate specific stability assessment for the glenohumeral joint based on current basic science and clinical research. The physical examination of a patient whose history suggests subtle glenohumeral joint instability may be extremely difficult for the clinician due to the normal amount of capsular laxity commonly present in most individuals. An essential component of the physical examination is a through and meticulous subjective history which includes the mechanisms of injury and/or dysfunction, chief complaint, level of disability, and aggravating movements. The physical examination must include an assessment of motion, static stability testing, muscle testing, and a neurologic assessment. A comprehensive understanding of various stability testing maneuvers is important for the clinician to appreciate. The evaluation techniques discussed in this paper should assist the clinician in determining the passive stability of the glenohumeral joint.
科学文献中缺乏对用于确定肩肱关节不稳定的特定体格检查测试的详尽描述。本文的目的是讨论主观病史的重要性，并阐述肩肱关节的体格检查。此外，作者将基于当前的基础科学和临床研究，阐述肩肱关节的特定稳定性评估。对于临床医生而言，对病史提示存在轻微肩肱关节不稳定的患者进行体格检查可能极具难度，因为大多数人通常都存在一定程度的关节囊松弛。体格检查的一个重要组成部分是全面且细致的主观病史，其中包括损伤和/或功能障碍的机制、主要症状、残疾程度以及加重症状的动作。体格检查必须包括对活动度的评估、静态稳定性测试、肌肉测试以及神经学评估。临床医生全面理解各种稳定性测试手法非常重要。本文所讨论的评估技术应有助于临床医生确定肩肱关节的被动稳定性。
