运动训练在肩峰下撞击综合征患者功能恢复中的应用

关键词：肩峰下撞击综合征  运动训练  物理治疗

Keywords:subacromial impingement syndrome  kinesiotherapy  physiotherapy

摘要：

      摘要 目的：探讨运动训练对肩峰下撞击综合征患者功能恢复的影响。 方法：将86例肩袖损伤为1度或2度的肩峰下撞击综合征患者随机分为包含运动训练的物理治疗组(试验组)和不包含运动训练的物理治疗组(对照组)。两组患者均采用常规的脉冲超短波、温热疗、冷疗等物理治疗，试验组同时按肩峰下撞击综合征患者运动训练计划进行康复治疗，两组患者均进行12周治疗，并于开始治疗前以及3个月、6个月、12个月随访时进行评估。采用Constant评分表和美国加州大学（UCLA）肩评分表评估其疗效。 结果：从入组到第3个月，从入组到第6个月，从入组到第12个月的三个阶段随访时，每个阶段的Constant总分和各分项的分数增加值，试验组与对照组比较，有显著性差异（P<0.05）；经过治疗，第3个月，第6个月，第12个月随访时，Constant总分分数，试验组与对照组比较，有显著性差异（P<0.05），UCLA肩关节功能各项评分，试验组与对照组比较，有显著性差异（P<0.05）；经过治疗，第3个月，第6个月，第12个月随访时，Constant总分分数，两组与各自治疗前后比较，有显著性差异（P<0.05），UCLA肩关节功能评分中，除对照组第3个月，第6个月随访时力量得分与治疗前无显著性差异（P>0.05），其余各项评分两组与各自治疗前后比较有显著性差异（P<0.05）。 结论：系统的、以运动生物力学及运动生理学为理论指导的运动训练同时结合其他物理治疗手段能更有效地治疗肩峰下撞击综合征，对肩关节功能恢复有明显的促进作用。

Abstract:

      Abstract Objective: To discuss the effects of kinesiotherapy on the recovery of function in patients with subacromial impingement syndrome. Method: Eighty-six patients with subacromial impingement syndrome of shoulder (rotator cuff injury Neer I and Ⅱ) were treated either by physiotherapy including kinesiotheray with a guided training program (trial group, n=44), or by physiotherapy not including kinesiotheray (control group, n=42). Patients of both groups received treatment for 12 weeks and were evaluated before the beginning of treatment and at the 3nd month, 6th month and 12th month of follow-up. Outcomes of shoulder function were measured by Constant scores， and the university at California at Los Angeles (UCLA) shoulder scores. Result: The mean Constant scores and UCLA shoulder scores, of both groups improved significantly after one year (P<0.05); the changes of Constant scores and subscores from baseline to the 3rd, 6th, and 12th month of follow up were significantly different between two groups (P<0.05); and the difference between two groups in Constant scores and the scores of UCLA at the 3rd, 6th, and 12th month of follow-up were significant (P<0.05). Conclusion: Physiotherapy including systematic kinesiotherapy based on biomechanics and kinetic-physiology is more effective in patients with subacromial impingement syndrome.