常规功能训练结合肩胛骨松动训练对冻结肩术后早期康复的影响

Effect of Routine Functional Training Combined with Scapula Mobilization Training on Early Recovery after Frozen Shoulder Postoperative Rehabilitation

目的:通过观察两种康复训练方式治疗冻结肩松解术后的临床疗效,比较分析两组训练方式治疗后的临床康复指标,探讨肩胛骨松动训练促进冻结肩松解术后康复机制,为冻结肩松解术后的康复治疗探寻一种高效的方法。方法:纳入50例冻结肩松解术后患者,时间为2019年3月—12月,因丢失随访终止实验7人,实验数据最终共计43人;年龄为50~65岁;病程最长为14个月,最短为3个月。将其随机分为对照组(常规功能训练)和实验组(常规功能训练+肩胛骨松动治疗)。对治疗前后共12周进行测试评估,测试指标包括疼痛指标、功能指标及CT检查等。观察治疗前后患者的主观症状、肩关节的功能、肩关节活动范围以及肩关节骨性结构相对位置的变化,以及两组的治疗效果是否存在差异,并对得到的数据进行统计学分析。结果:1)实验组的治疗效果优于对照组,肩关节的疼痛评分显著降低(P<0.05),肌力评分及日常生活能力评分显著升高(P<0.05);2)肩关节活动范围的改善效果实验组明显优于对照组,肩关节活动范围显著增大(P<0.05);3)两组肱骨头扭转角、肱骨头倾斜角、肩胛盂扭转角等骨性结构无统计学差异(P>0.05),肩胛盂倾斜角、头顶肩峰距、结节肩峰距、肩峰喙突距等骨性结构相比,实验组优于对照组,具有显著性差异(P<0.05)。结论:两种康复训练方式均对冻结肩松解术后患者具有良好的治疗效果,增加肩胛骨松动训练比单纯常规功能训练改善效果更加明显,常规功能训练结合肩胛骨松动训练可改变肩关节骨性结构的相对位置,进而改善肩关节活动范围,有效促进术后康复。

Objective:To investigate the mechanism of scapula mobilization training promoting postoperative recovery of frozen shoulder arthroscopic release by comparing the clinical rehabilitation indexes of the frozen shoulder patients after the treatment of routine functional training or routine functional training combined with scapula mobilization training,and to explore an effective treatment method for rehabilitation after frozen shoulder recovery.Methods:In this experiment,50 patients with frozen shoulder release were included,the inclusion period was from March to December in 2019.During the period shutdown of its experiments 7 subjects,the final data of the experiment was 43 people.The patients were 50 to 65 years old.The course of disease was 14 months and the shortest was 3 months.43 frozen shoulder patients were randomly divided into control group(routine functional training)and experimental group(routine functional training+scapula mobilization training).The data of sore index,functional index and spiral CT scan were obtained and analyzed before and at 12 weeks after treatment.Results:1)The pain score was significantly lower in than control group(P<0.05),and the muscle strength score and daily life ability score were higher in experimental group(P<0.05);2)the motion range of shoulder was significantly higher in experimental group than that of control group(P<0.05);3)no significant difference was observed in the version angle of humeral head,inclination angle of humeral head,and version angle of glenoid(P>0.05).The experimental group was better in the inclination angle of glenoid,head to acromion distance,tuberosity to acromion distance,acromion to coracoid distance than control group(P<0.05).Conclusion:The two different rehabilitation training methods are effective for the rehabilitation of the patients after frozen shoulder patients arthroscopic release.In addition,the routine functional training combined with scapula mobilization training is more effective in changing the relative position of the bony structure and improving the range of motion of the shoulder joint,so as to promote the postoperative recovery of patients with frozen shoulder.