持续平移性关节内活动技术结合肩袖肌群牵伸治疗肩袖损伤后肩关节功能障碍疗效观察

Effect of Sustained Translatory Joint-play Techniques Combined with Stretching Technique on Shoulder Dysfunction after Rotator Cuff Injury

目的:探讨持续平移性关节内活动技术结合肩袖肌群牵伸对肩袖损伤患者肩关节功能的作用。方法:将36例患者按照随机数字表法分为对照组和干预组各18例。对照组接受常规康复治疗,包括磁场温热振动治疗、低功率氦氖激光、Maitland关节松动术、肩关节活动范围训练、肩周肌群肌力训练、肩袖肌群力量训练及冷疗,每周6次,连续治疗4周。干预组在常规康复治疗基础上增加持续平移性关节内活动技术和肩袖肌群"保持-放松"牵伸,每次30 min,每日1次,每周6次,连续治疗4周。肩关节持续平移性关节内活动技术针对胸锁关节、肩锁关节、盂肱关节、肩胛胸壁关节进行。肩袖肌群牵伸包括肩胛下肌牵伸,冈下肌和小圆肌牵伸以及冈上肌牵伸。2组在治疗前及治疗4周后分别采用主动关节活动范围(ROM)及Constant-Murley肩关节功能评分量表(CMS)进行评估。结果:在治疗4周后,2组主动关节活动度较治疗前改善(P<0.01),干预组的改善程度明显优于对照组(P<0.01);2组CMS各项评分均较治疗前显著提高(P<0.01),干预组疼痛、日常活动、活动范围等项目评分均优于对照组(P<0.01)。结论:持续平移性关节内活动技术结合肩袖肌群牵伸能显著增加肩袖损伤患者的肩关节活动范围,减轻疼痛,促进肩关节运动功能恢复。

Objective：To investigate effects of sustained translatory joint-play techniques combined with stretching technique on the patients with shoulder dysfunction after rotator cuff injury. Methods：Thirty-six patients with shoulder dysfunction after rotator cuff injury were divided into control group and treatment group according to the random number table, with 18 cases in each group. The control group accepted converser treatment including tepid magnetic vibration therapy, lower power He-Ne laser therapy, range of motion exercise, shoulder muscle strengthen exercise, rotator cuff muscle strengthen exercise, Maitland joint mobilization and cold therapy,once a day, 6 days per week, lasted for four weeks. The treatment group added the sustained translatory joint-play techniques and rotator cuff muscle hold-relax stretching, for 30 minutes, once a day, 6 days per week, lasted for four weeks. The sustained translatory joint-play techniques focused on sternoclavicular joint, acromioclavicular joint, glenohumeral ioint and scapula-chest joint. Cuff muscle stretching included stretch of subscapularis, supraspintus, teres minor and infraspintus. In both groups, patients were assessed respectively by the range of motion（ROM） and Constant-Murley shoulder function score scale（CMS） before and after treatment. Results：The scores of CMS in both groups were significantly increased（P〈0.01） after treatment. Compared with the control group, the scores including pain, daily activities and activities items in the treatment group were much better（P〈0.01）. ROM of patients in both groups were significantly improved after treatment（P〈0.01）. Compared with the control group, ROM in the treatment group were much better（P〈0.01）. Conclusion：The sustained translatory joint-play techniques combined with stretching technique can significantly increase the range of shoulder joint activity in patients with shoulder cuff injury, relieve pain and promote the recovery of shoulder joint movement function.