力偶练习和肩肱节律调整对肩袖损伤保守治疗影响的临床研究  

Clinical study on the effect of coupling exercise and shoulder-brachial rhythm adjustment on conservative treatment of rotator cuff injury

作　　者：赵琛[1] 胡锐 周红[1] 王芳[1] 胡真[1] 文凡 Chen Zhao;Rui Hu;Hong Zhou;Fang Wang;Zhen Hu;Fan Weng(Department of Muscle Traumatology,Sichuan Orthopedic Hospital,Chengdu 610000,China)

机构地区：[1]四川省骨科医院筋伤科,成都610000

出　　处：《中华肩肘外科电子杂志》2022年第3期226-231,共6页Chinese Journal of Shoulder and Elbow(Electronic Edition)

摘　　要：目的对非手术治疗的肩袖损伤患者,采取结合肩胛骨周围肌肉平衡的力偶训练,同时对肩关节活动范围、肩部疼痛等指标做相应测定与分析,以期了解治疗效果,进而规范肩痛患者的治疗方案。方法选取肩关节疼痛患者共100例,随机分为两组,每组各50例,一组采取传统保守治疗方法(对照组);另一组采用力偶练习和调整肩胛骨节律(实验组)。记录两组患者治疗前、治疗3个月后、6个月后及12个月后患者的视觉模拟评分(visual analogue scale,VAS)、美国肩肘外科协会评分(American shoulder and elbow surgeons'form,ASES)、肩胛骨侧方移位实验(later scapular slide test,LSST)测试数据,并进行统计学比较。结果实验组与对照组在治疗后12个月,其VAS评分都较治疗前显著下降(P<0.05)。实验组的ASES功能评分在治疗后,相较治疗前有显著改善(P<0.05),而对照组无变化。实验组在三个姿势下的LSST测试,相较治疗前有显著改善(P<0.05),而对照组无变化。结论采用传统保守治疗及力偶练习和调整肩胛骨节律治疗均能显著缓解肩关节疼痛,但力偶练习和调整肩胛骨节律治疗能够更显著地改善肩关节功能,在此方面优于传统保守治疗。Background Shoulder pain and dysfunction are common problems in clinical practice.Many studies on other shoulder joint lesions and injuries have proved that rotator cuff injury,acromion impaction syndrome,shoulder instability,and other shoulder joint diseases are related to the shoulder blade's abnormal position and movement trajectory and abnormal changes in shoulder blade movement.Normal shoulder joint movement needs humerus joints,the acromioclavicular joints,the sternoclavicular joint,and the shoulder of the chest wall joint to coordinate with each other.When their interaction is abated,stamina and coordination become poor,weak muscle strength and stability of the shoulder blade less,poor posture and lack of core stability,and shoulder joint pain and injury on the probability increase.In rotator cuff injury,exercise therapy can also relieve pain and restore shoulder function for patients who do not meet the indications for surgery.Many studies have found that patients with rotator cuff injury have abnormal changes in scapular movement,mostly caused by force couple imbalance and shoulder-brachial rhythm disorder.The muscle groups around the shoulder joint in the shoulder joint lift,the formation of two directions of force,counterclockwise rotation of force including deltoid bundle,trapezius upper,middle,lower and serratus anterior muscle;The clockwise pair includes a posterior bundle of the deltoid,infraspinatus,teres minor,teres major,latissimus dorsi,rhomboid,etc.At the same time,they cooperate to form the shoulder-brachial rhythm and complete the 180°full radian abduction,which is produced by the 120°abduction of the glenohumeral joint and the 60°upward rotation of the scapulothoracic joint,with a motion ratio of approximately 2:1.Objective For patients with rotator cuff injury treated with non-surgical treatment,couples training combined with the balance of the muscles around the scapula was adopted.The range of motion of the shoulder joint,shoulder pain,and other indicators were measured and analyzed a

关 键 词：肩袖损伤 力偶练习 肩肱节律 

分 类 号：R687.4[医药卫生—骨科学]