系统康复治疗对年轻肩关节脱位患者肩关节稳定性的作用

Effects of systematic rehabilitation treatment on the stability of shoulder in the young patients with shoulder dislocation

目的对年轻患者肩关节脱位进行系统的康复治疗,以检验系统康复疗法疗效优于单纯固定的假设。方法根据所采用的治疗方法,将43例40岁以下的急性肩关节脱位患者分成实验组23例,对照组20例。实验组患者进行包括关节活动范围锻炼、发展肩胛骨周围肌的肌力训练、发展肩袖肌的肌力、适度的外展、外旋锻炼及耐力训练在内的系统康复治疗。对照组只进行单纯固定后未经系统康复治疗。对两组患者的临床效果进行比较。结果实验组复发率为17%(4/23),对照组复发率为45%(9/20),两组复发率比较差异有显著性意义(χ2=3.866,P<0.05);随访结果显示肩关节ASES评分实验组为90.9±4.87,对照组为75.4±4.94,两组差异有非常显著性意义(t=9.94,P=2.99×10-12<0.01)。结论肩关节脱位年轻患者进行系统的康复锻炼,可以提高患肩的稳定性。

Aim To assay the hypothesis of systematic rehabilitation therapy better than simple fixation therapy by treating shoulder dislocation of the young patients with the systematic rehabilitation therapy.Methods Twenty three acute shoulder dislocation patients,19 mles and 4 females,aged >40,accepted systematic rehabilitation therapy,including mobile range of joint, muscle power training, abduction exercise,external rotation exercise and endurance training, in comparison with twenty acute shoulder dislocation patients as controls, 13males and 7females, aged < 40,only accepting simple fixation.The experimental group was followed up for 8-13 months as well as 10-14 months in the control group.Results The recurrence rates were 17.4%(4/23) in the experimental group and 45%(9/20) in the control group respectively, with a significant difference between the two groups(χ2=3.866,P< 0.05).During the post treatment follow up, the scores of American Shoulder And Elbow Surgeons (ASES) were (90.9±4.87) and (75.4±4.94) in the two groups respectively, with a significant difference between the two group(t=9.94,P=2.99×10-2).Conclusion Systematic physical therapy improves the stability of the shoulder in the young patients.