融入高频超声技术的冻结肩早期康复程序应用效果观察  

Observation on the application effect of early rehabilitation procedure of frozen shoulder incorporating high-frequency ultrasound technology

作　　者：陈祢[1] 王宝兰[1] 武恒敏 麻全喜 张铁成[1] 刘玲[1] 李超[2] CHEN Mi;WANG Baolan;WU Hengmin;MA Quanxi;ZHANG Tiecheng;LIU Ling;LI Chao(Department of Rehabilitation Medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,P.R.China;Department of Critical Care Medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,P.R.China)

机构地区：[1]新疆医科大学第一附属医院康复医学科,乌鲁木齐830054 [2]新疆医科大学第一附属医院呼吸重症医学科,乌鲁木齐830054

出　　处：《华西医学》2022年第5期710-716,共7页West China Medical Journal

基　　金：新疆维吾尔自治区自然科学基金(2020D01C246)。

摘　　要：目的 探讨自行设计的融入高频超声技术的冻结肩早期康复程序在早期冻结肩患者门诊治疗中的应用效果。方法 选择2018年1月-2021年5月在新疆医科大学第一附属医院康复医学科门诊的冻结肩患者182例,随机分为试验组和对照组各91例。试验组患者接受冻结肩早期康复程序,对照组患者接受常规物理治疗。对比观察两组在治疗前(第0周)和开始治疗后第4、8周肩关节疼痛的视觉模拟评分(Visual Analogue Scale,VAS)(静息痛VAS评分、主动运动中VAS评分)、肩关节主动活动范围(外旋、前屈、外展)、肩关节疼痛与功能障碍指数(Shoulder Pain and Disability Index,SPADI)(疼痛亚量表得分、功能障碍亚量表得分及总得分)。结果 共143例(试验组74例,对照组69例)患者完成研究。第0周两组患者各项评估指标差异均无统计学意义(P>0.05)。治疗后组内比较结果显示,第4、8周试验组和对照组的静息痛VAS评分(F=44.359,P<0.001)、主动运动中VAS评分(F=158.458,P<0.001),肩关节前屈活动度(F=123.334,P<0.001)、外展活动度(F=117.539,P<0.001),SPADI总分(F=133.814,P<0.001)、疼痛亚量表得分(F=74.093,P<0.001)及功能障碍亚量表得分(F=145.336,P<0.001)均优于第0周,第8周评估结果优于第4周(P<0.05);对照组患者治疗后第4周的肩关节外旋活动度与第0周相比差异无统计学意义(P=0.599),至第8周外旋活动度才较第0周有明显改善(P<0.001),而试验组治疗后第4、8周的肩关节外旋活动度均较第0周明显改善(P<0.001)。治疗后组间比较结果显示,治疗后第4、8周两组间肩关节静息痛VAS评分(F=93.712,P<0.001)、主动运动中VAS评分(F=103.565,P<0.001),肩关节外旋活动度(F=13.388,P<0.001)、前屈活动度(F=66.375,P<0.001)及外展活动度(F=110.253,P<0.001),SPADI总分(F=7.917,P=0.006)及疼痛亚量表得分(F=39.091,P<0.001)对比差异均有统计学意义;第4周试验组SPADI功能障碍亚量表得分低于对照组(P=0.002),Objective To explore the effect of self-designed early rehabilitation procedure of frozen shoulder incorporating high-frequency ultrasound technology in the outpatient treatment of patients with early frozen shoulder.Methods One hundred and eighty-two consecutive patients who attended the outpatient clinic of the Department of Rehabilitation Medicine of the First Affiliated Hospital of Xinjiang Medical University and were diagnosed with frozen shoulder between January 2018 and May 2021 were selected and randomly divided into the trial group and the control group,with 91 patients in each group.Patients in the trial group received early rehabilitation procedures for frozen shoulder,and patients in the control group received conventional physiotherapy.The Visual Analogue Scale(VAS)(including VAS score for resting pain and VAS score for active motion),active range of motion of the shoulder joint(external rotation,forward flexion,and abduction),Shoulder Pain and Dysfunction Index(SPADI)(including pain subscale score,dysfunction subscale score,and total score) were compared between the two groups before treatment(Week 0) and 4 and 8 weeks after the start of treatment(Week 4 and 8).Results A total of 143 patients(74 in the trial group and 69 in the control group) completed the study.There was no significant difference in any assessment index between the two groups in Week 0(P>0.05).The results of the within-group comparison after treatment showed that the VAS score for resting pain(F=44.359,P<0.001),VAS score for active motion(F=158.458,P<0.001),anterior shoulder flexion(F=123.334,P<0.001),abduction mobility(F=117.539,P<0.001),total SPADI score(F=133.814,P<0.001),SPADI pain subscale score(F=74.093,P<0.001),and SPADI dysfunction subscale score(F=145.336,P<0.001) in Week 4 and8 were better than those in Week 0,and the assessments in Week 8 were better than those in Week 4 in each group(P<0.05);in the control group,there was no statistically significant difference in the external rotation mobility of the shoulder in Week 4

关 键 词：冻结肩 高频超声 早期康复 康复程序 

分 类 号：R686[医药卫生—骨科学]