目的观察肩袖撕裂合并冻结肩行手法松解后的关节镜下表现,并分析其影响因素。方法回顾性分析2017年9月至2019年9月收治的68例肩袖撕裂合并冻结肩病人的病例资料,其中,男35例,女33例,年龄为(52.68±6.54)岁,均行一期麻醉后手法松解...目的观察肩袖撕裂合并冻结肩行手法松解后的关节镜下表现,并分析其影响因素。方法回顾性分析2017年9月至2019年9月收治的68例肩袖撕裂合并冻结肩病人的病例资料,其中,男35例,女33例,年龄为(52.68±6.54)岁,均行一期麻醉后手法松解联合关节镜检查并肩袖修复术,观察手法松解后的关节镜下表现,比较松解损伤病人和未损伤病人之间的性别、患侧、肩袖撕裂程度差异,分析患肩关节疼痛时间、肩关节活动受限病程和实施手法松解时间与手法松解损伤的相关性。收集病人的数字分级法(numerical rating scale,NRS)疼痛评分、美国肩肘外科医师学会(American Shoulder and Elbow Surgeons,ASES)评分、Constant⁃Murley评分及丹麦健康与医疗管理局(Danish Health and Medicine Author⁃ity)满意度评分。结果共16例(23.53%)发生手法松解损伤,其中单一损伤者12例,两种及以上损伤者4例,损伤类型为前关节囊撕裂(3例,18.75%)、下关节囊撕裂(6例,37.50%)、盂肱中韧带撕裂(7例,43.75%)、盂肱下韧带肱骨端撕裂(humeral avulsion of the glenohumeral ligament,HAGL)(3例,18.75%)、前盂唇撕裂(2例,12.50%)。松解损伤病人和未损伤病人之间的年龄(P=0.431)、性别(P=0.893)、患侧(P=0.673)、肩袖撕裂程度(P=0.723)、患肩关节疼痛时间(P=0.813)、肩关节活动受限病程(P=0.250)、实施手法松解时间(P=0.125)均未见显著差异。松解损伤组和松解无损伤组术后NRS评分均较术前明显降低,肩关节功能评分较术前明显改善(P均<0.05);手术前后的NRS评分、肩关节功能ASES评分、Constant⁃Murley评分、病人满意度评分比较,差异均无统计学意义(P均>0.05)。结论肩袖撕裂合并冻结肩行麻醉后肩关节手法松解联合关节镜下肩袖修复术可能导致单一或合并的镜下损伤表现,年龄、性别、患侧、肩袖撕裂程度、患肩关节疼痛时间、肩关节活动受限病程、实施手法松解时间等因素展开更多
Manual Therapy is a rehabilitative approach based on the use of therapeutic procedures that includes several techniques, but this paper focuses on what is known as Positional Release (PR), a therapeutic model that inc...Manual Therapy is a rehabilitative approach based on the use of therapeutic procedures that includes several techniques, but this paper focuses on what is known as Positional Release (PR), a therapeutic model that includes a series of manoeuvres that are mainly used for the treatment of soft tissue. A deeper understanding of this type of therapeutic approach, especially its well known and widespread variant, Strain-Counterstrain, could, through controlled trials and systematic reviews, confirm its effectiveness, definitively explain the neurophysiological mechanism, and therefore make Positional Release another indispensable option in the professional expertise of the physiotherapist.展开更多
文摘目的观察肩袖撕裂合并冻结肩行手法松解后的关节镜下表现,并分析其影响因素。方法回顾性分析2017年9月至2019年9月收治的68例肩袖撕裂合并冻结肩病人的病例资料,其中,男35例,女33例,年龄为(52.68±6.54)岁,均行一期麻醉后手法松解联合关节镜检查并肩袖修复术,观察手法松解后的关节镜下表现,比较松解损伤病人和未损伤病人之间的性别、患侧、肩袖撕裂程度差异,分析患肩关节疼痛时间、肩关节活动受限病程和实施手法松解时间与手法松解损伤的相关性。收集病人的数字分级法(numerical rating scale,NRS)疼痛评分、美国肩肘外科医师学会(American Shoulder and Elbow Surgeons,ASES)评分、Constant⁃Murley评分及丹麦健康与医疗管理局(Danish Health and Medicine Author⁃ity)满意度评分。结果共16例(23.53%)发生手法松解损伤,其中单一损伤者12例,两种及以上损伤者4例,损伤类型为前关节囊撕裂(3例,18.75%)、下关节囊撕裂(6例,37.50%)、盂肱中韧带撕裂(7例,43.75%)、盂肱下韧带肱骨端撕裂(humeral avulsion of the glenohumeral ligament,HAGL)(3例,18.75%)、前盂唇撕裂(2例,12.50%)。松解损伤病人和未损伤病人之间的年龄(P=0.431)、性别(P=0.893)、患侧(P=0.673)、肩袖撕裂程度(P=0.723)、患肩关节疼痛时间(P=0.813)、肩关节活动受限病程(P=0.250)、实施手法松解时间(P=0.125)均未见显著差异。松解损伤组和松解无损伤组术后NRS评分均较术前明显降低,肩关节功能评分较术前明显改善(P均<0.05);手术前后的NRS评分、肩关节功能ASES评分、Constant⁃Murley评分、病人满意度评分比较,差异均无统计学意义(P均>0.05)。结论肩袖撕裂合并冻结肩行麻醉后肩关节手法松解联合关节镜下肩袖修复术可能导致单一或合并的镜下损伤表现,年龄、性别、患侧、肩袖撕裂程度、患肩关节疼痛时间、肩关节活动受限病程、实施手法松解时间等因素
文摘Manual Therapy is a rehabilitative approach based on the use of therapeutic procedures that includes several techniques, but this paper focuses on what is known as Positional Release (PR), a therapeutic model that includes a series of manoeuvres that are mainly used for the treatment of soft tissue. A deeper understanding of this type of therapeutic approach, especially its well known and widespread variant, Strain-Counterstrain, could, through controlled trials and systematic reviews, confirm its effectiveness, definitively explain the neurophysiological mechanism, and therefore make Positional Release another indispensable option in the professional expertise of the physiotherapist.
