背景:目前还没有报道证实人工干预如肱骨头稳定对改善功能和减轻疼痛时,积极的手动被动伸展对肩膀疼痛僵硬患者的影响。这项研究的目的是比较临床结果,例如运动范围,疼痛,和残疾分数,在应用积极的手动被动拉伸时,有或没有肱骨头稳定干预的肩膀疼痛僵硬的患者。
方法:招募了56例肩膀疼痛僵硬的患者(31例接受肱骨头稳定干预,25例未接受这种干预)。临床结果,如活动范围(A-ROM),疼痛,使用测角仪评估残疾评分;活动视觉模拟量表(A-VAS)的测量;和手臂残疾,肩和手(DASH)和肩痛和残疾指数(SPADI),分别。
结果:所有参数,A-ROM,A-VAS,干预前两组患者的残疾评分(DASH和SPADI)差异无统计学意义(P>0.05)。然而,干预之后,屈曲的A-ROM的平均差异,绑架,内外旋转为18(95%置信区间[CI],14.1-21.7),31(95%CI,24.9-37.4),17(95%CI,13.4-21.4),和16(95%CI,11.6-20.9),分别。DASH和SPADI的A-VAS和残疾评分的平均差异为-1(95%CI,-1.5至-0.8),-27(95%CI,32.3至-22.6),和-23(95%CI,-27.8至-18.3),分别。所有这些测量都有利于肱骨头稳定。
结论:在肩膀疼痛僵硬的患者积极的手动被动拉伸过程中,肱骨头稳定干预可能更有利于改善临床结果,如A-ROM,A-VAS疼痛水平,残疾分数。
BACKGROUND: No reports have been published verifying the effects of manual interventions such as humeral head stabilization on improving function and reducing pain when applying aggressive manual passive stretching in patients with painful stiff shoulders. The purpose of this study was to compare clinical outcomes, such as range of motion, pain, and disability scores, in patients with painful stiff shoulders with and without humeral head stabilization intervention while applying aggressive manual passive stretching.
METHODS: Fifty-six patients with painful stiff shoulders were recruited (31 with humeral head stabilization intervention and 25 without such intervention). Clinical outcomes such as active range of motion (A-ROM), pain, and disability scores were evaluated using a goniometer; measurement of activity visual analog scale (A-VAS); and Disabilities of the Arm, Shoulder and Hand (DASH) and Shoulder Pain and Disability Index (SPADI), respectively.
RESULTS: All the parameters, A-ROM, A-VAS, and disability scores (DASH and SPADI) were not significantly different between the 2 groups (P > .05) before the intervention. However, after the intervention, the mean difference in A-ROM for flexion, abduction, and external and internal rotation was 18 (95% confidence interval [CI], 14.1-21.7), 31 (95% CI, 24.9-37.4), 17 (95% CI, 13.4-21.4), and 16 (95% CI, 11.6-20.9), respectively. The mean difference in A-VAS and disability scores for DASH and SPADI was -1 (95% CI, -1.5 to -0.8), -27 (95% CI, 32.3 to -22.6), and -23 (95% CI, -27.8 to -18.3), respectively. All of these measurements favored humeral head stabilization.
CONCLUSIONS: During aggressive manual passive stretching in patients with painful stiff shoulders, humeral head stabilization intervention may be more beneficial in improving clinical outcomes such as A-ROM, A-VAS pain levels, and disability scores.