肩袖损伤合并肩关节僵硬关节镜下修复术后早期主动助力/主动关节活动训练的临床观察  

The Effectiveness of Early Active-assisted/Active Range of Motion Exercise after Arthroscopic Repair of Rotator Ccuff Injury Combined with Shoulder Stiffness

作　　者：徐思维 王华建 项洁 XU Siwei;WANG Huajian;XIANG Jie(Department of Rehabilitation Medicine,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China)

机构地区：[1]徐州医科大学附属医院康复医学科,徐州221006

出　　处：《中国医药指南》2024年第6期19-23,共5页Guide of China Medicine

摘　　要：目的观察肩袖损伤合并肩关节僵硬关节镜下修复术后进行早期主动助力/主动关节活动训练的有效性和安全性。方法回顾性分析2017年1月至2018年6月肩袖损伤合并肩关节僵硬关节镜下修复术后22例患者的临床资料,根据术后开始主动助力关节活动训练的时间分成早期组和常规组,其中早期组11例(早期康复治疗方案),术后3~6周内进行可耐受的主动助力/主动关节活动训练,常规组11例(常规康复治疗方案),术后6周后开始主动助力/主动关节活动训练,观察指标包括术前、术后12周肩关节前屈、外展、外旋被动关节活动度(PROM),数字疼痛评分(NRS)及Constant-Murley肩关节功能评分(CMS)。结果术后12周早期组和常规组肩关节前屈PROM、外展PROM、外旋PROM、NRS、CMS分别与术前相比,差异均有统计学意义(P<0.05);术后12周早期组和常规组肩关节前屈PROM、外展PROM、外旋PROM、NRS、CMS相比,差异均无统计学意义(P>0.05),两组较术前的前屈PROM、外展PROM、NRS、CMS改善差值相比,差异均无统计学意义(P>0.05),两组较术前外旋的PROM改善差值相比,差异有统计学意义(P<0.05)。术后12周时,早期组和常规组均未发生康复治疗相关的不良反应,差异无统计学意义(P>0.05)。结论肩袖损伤合并肩关节僵硬关节镜下修复术后早期可耐受的主动助力/主动关节活动训练改善外旋PROM的短期效果更显著。Objective To observe the effectiveness and safety of early active-assisted or active range of motion exercise after arthroscopic repair of rotator cuff injury combined with shoulder stiffness.Methods The clinical data of 22 patients with rotator cuff injury combined with shoulder stiffness after arthroscopic repair from January 2017 to June 2018 were retrospectively analyzed.They were divided into early group and routine group according to the time of active joint mobility training after surgery,of which 11 cases were in the early group(early rehabilitation treatment program).The patients in the conventional group(11 cases)received tolerated active assistance/active joint mobility training within 3 to 6 weeks after surgery,and began active assistance/active joint mobility training 6 weeks after surgery.The passive range of motion(PROM)of shoulder flexion,abduction and external rotation,numerical rating scale(NRS),and Constant-Murley Score(CMS)were assessed before and 12 weeks after surgery.Results At 12 weeks after surgery,there were statistically significant differences in shoulder flexion,abduction,external rotation,NRS,CMS of both groups compared to before surgery(P<0.05)respectively.At 12 weeks after surgery,there were no group differences in flexion,abduction,external rotation,NRS,and CMS(P>0.05);At 12 weeks after surgery,there were no group differences in the level of improvement compared to preoperative in flexion,abduction,NRS,and CMS(P>0.05),the superiority of the early group was demonstrated in terms of the level of improvement compared to preoperative in external rotation(P<0.05).At 12 weeks after surgery,there were no treatment-related adverse reactions observed in both the early group and the routine group,and the difference was not statistically significant(P>0.05).Conclusions Activeassisted or active range of motion exercise within acceptable limits of symptoms within 3-6 weeks after surgery have a more significant effect on improving external rotation.

关 键 词：肩袖修复 早期康复 主动关节活动训练 主动助力关节活动训练 

分 类 号：R683[医药卫生—骨科学]