强化呼吸训练对慢性肩袖损伤患者上肢功能恢复的影响

关键词：肩袖损伤  呼吸训练  激励式腹式呼吸训练仪  胸围  腹围

Keywords:rotator cuff injury  respiratory training  motivational abdominal breathing device  chest circumference  abdominal circumference

摘要：

      摘要 目的：探讨强化呼吸训练对慢性肩袖损伤患者上肢功能的治疗效果。 方法：选取2018年3月—2018年8月本院康复科和疼痛科就诊的慢性肩袖损伤患者40例，按随机数字表法分为治疗组（n=20）和强化组（n=20），两组均给予常规的康复训练，包括：ROM训练、关节松动术、牵伸练习、肌力练习。强化组在此基础上增加激励式腹式呼吸练习，每周3—5次，共6周。治疗前及治疗6周后对两组分别使用美国肩肘外科协会(American Shoulder and Elbow Surgeons， ASES)评分，并分别测量吸气相末、呼气相末的胸围、腹围值。 结果：治疗前两组各项评价指标差异不具有显著性意义（P>0.05），治疗6周后，强化组和治疗组的胸围吸气末和呼气末变化度从治疗前的（4.17±2.02）和（-6.64±4.30）分别提升至（10.86±2.63）和（-11.74±2.55），强化组和治疗组的腹围吸气末和呼气末变化度从治疗前的(1.79±2.19）和（-3.26±1.49）分别提升至（13.19±1.65）和（-15.29±7.21），差异具有显著性意义（P<0.001），患者自评量表部分及治疗师评定部分，除了肩关节水平内收角度变化度在两组间没有差异，而其他指标强化组优于治疗组（P<0.05或P<0.001）。 结论：强化呼吸训练可以较单独应用常规康复训练更有效提高患者上肢功能，可作为有效的干预手段应用于临床。

Abstract:

      Abstract Objective: To study effects of enhanced respiratory training on upper limb function recovery for patients with chronic rotator cuff injury. Method: A total of 40 chronic rotator cuff injury patients，who underwent rehabilitation training between March 2018 and August 2018 in department of rehabilitation medicine and pain management， were randomly divided into treatment group (n=20) and intensive group(n=20).Both groups were given the conventional rehabilitation training including ROM training，mobilization， stretch training， muscle strength training. The intensive group received Motivational Abdominal Breathing training based on the conventional rehabilitation training.These exercises were given 3 to 5 times a week for 6 weeks. American Shoulder and Elbow Surgeons(ASES)，the chest circumference and abdominal circumference in the end of expiratory phase and inspiratory phase were measured before and after training. Result: Before the intervention， there were no significant difference between the two groups in the terms of any assessments（P>0.05）. The average changes of chest circumference in the end of inhalation and exhalation in the intensive group and treatment group were increased from (4.17±2.02) and (-6.64±4.30) to (10.86±2.63) and (-11.74±2.55)， respectively. The average changes of abdominal circumference in the end of inhalation and exhalation in the intensive group and treatment group were respectively increased from (1.79±2.19) and (-3.26±1.49) to (13.19±1.65) and (-15.29±7.21)，and were significantly larger than that before intervention (P<0.001). There was no difference in the degree of the shoulder horizontal adduction between the two groups for the patient self-report section and the section used by physicians had no difference，while the other indexes in the intensive group were significantly better than the treatment group(P<0.05 or P<0.001). Conclusion：The enhanced respiratory training could improve the upper limb function， which is better than the conventional rehabilitation training alone，and may be used as clinical effective intervention methods.