肩峰下撞击综合征术后采用同步热疗联合康复训练的疗效观察

Effect of simultaneous thermotherapy with rehabilitation training on postoperative subacromial impingement syndrome

目的探索同步热疗改善肩峰下撞击综合征患者术后肩关节功能的方法。方法选取2017年6月-2019年6月我院收治的82例肩峰下撞击综合征术后患者,随机分为三组:对照组A(n=27),采用传统热疗20 min后再进行康复训练40 min;对照组B(n=27),采用便携式温热肩部理疗仪热疗20 min后再进行康复训练40 min;实验组(n=28),采用便携式温热肩部理疗仪热疗同时康复训练40 min。在术前、术后6周、术后12周,采用视觉模拟评分(visual analog scale,VAS)、Constant-Murley肩关节功能评分(Constant-Murley score,CMS)进行评估,并记录不良反应。结果术前三组VAS评分及CMS评分无统计学差异(P均>0.05)。所有研究对象均随访至少12周。三组VAS及CMS评分在治疗过程中均显著改善(P均<0.05)。术后6周、术后12周随访时,实验组VAS评分显著优于对照组A和对照组B(6周:2.4±0.49 vs 3.9±0.50和3.4±0.52;12周:1.3±0.52 vs 1.5±0.47和1.6±0.51;P均<0.05);实验组CMS评分显著高于对照组A(6周:59.37±1.69 vs 57.35±2.22;12周:72.76±2.65 vs 73.44±3.01;P均<0.05),但与对照组B差异无统计学意义。结论在肩峰下撞击综合征术后的康复训练中采用同步热疗,较传统热疗后康复训练的效果更好。

Objective To explore the effect of simultaneous thermotherapy with rehabilitation training on shoulder joint function of patients with subacromial impingement syndrome.Methods From June 2017 to June 2019,a total of 82 patients with subacromial impingement syndrome admitted to our hospital who met the inclusion criteria after surgery were randomly divided into three groups:control group A(n=27),control group B(n=27)and experimental group(n=28).The control group A underwent rehabilitation training for 40 minutes after 20 minutes of traditional thermal therapy.The control group B received 20 minutes of thermal therapy by a Portable Thermal Shoulder Physiotherapy and then 40 minutes of rehabilitation training.In the experimental group,the patients underwent 40 minutes of rehabilitation and thermal therapy by a Portable Thermal Shoulder Physiotherapy at the same time.Visual analogue scale of pain(VAS)and Constant-Murley shoulder function scale(CMS)were recorded before and at 6 weeks,12 weeks after surgery,meanwhile adverse reactions were recorded(P>0.05).Results There was no significant difference in VAS score and CMS score between the three groups before surgery(P>0.05).After surgery,all subjects were followed up for at least 12 weeks.At 6 weeks and 12 weeks after operation,VAS score in the experimental group were superior to that in the control group A and control group B,with statistically significant differences(6-week:2.4±0.49 vs 3.9±0.50 and 3.4±0.52;12-week:1.3±0.52 vs 1.5±0.47 and 1.6±0.51;all P<0.05);CMS score was significantly higher in the experiment group than in the control group A(6-week:59.37±1.69 vs 57.35±2.22;12-week:72.76±2.65 vs 73.44±3.01;all P<0.05),but there was no significant difference between the experiment group and the control group B(P>0.05).Conclusion In the postoperative rehabilitation of subacromial impingement syndrome,simultaneous thermotherapy with rehabilitation training achieve more significant effect than sequential rehabilitation training following thermal therapy.