目的:观察强化肩胛胸壁关节运动训练对治疗卒中后偏瘫患者肩痛及肩关节功能障碍的疗效。方法:选取60例脑卒中后偏瘫伴有肩痛及肩关节功能障碍的患者,应用随机数字表法分为治疗组和对照组,每组各30例。2组均予以脑卒中后偏瘫肩痛及肩关...目的:观察强化肩胛胸壁关节运动训练对治疗卒中后偏瘫患者肩痛及肩关节功能障碍的疗效。方法:选取60例脑卒中后偏瘫伴有肩痛及肩关节功能障碍的患者,应用随机数字表法分为治疗组和对照组,每组各30例。2组均予以脑卒中后偏瘫肩痛及肩关节功能障碍的常规康复方法治疗,治疗组在常规治疗的同时再予以8周的强化肩胛胸壁关节运动训练。运用Constant-Murley肩关节功能评分量表(Constant-Murley Shoulder Function Score Scale,CMS)、基本概念视觉模拟疼痛评分法(Visual Analogue Scale,VA S)、Fugl-Meyer Motor A ssessment简式Fugl-meyer上肢运动功能评分量表(Fugl-Meyer Motor A ssessment Fugl-meyer Simple Upper Limb Motor Function Score,FMA-UE)对患者情况进行评估。评估时间分别是治疗前、治疗4周后、治疗8周后。结果:治疗4周后与治疗前相比,两组在CMS评定量表中5个方面都有好转(P<0.05),VAS疼痛得分明显降低(P<0.05),FMA-UE上肢功能评定也有显著好转(P<0.05);治疗8周后,治疗组和对照组CMS 5个方面,VAS,FMA-UE都有显著好转,且与治疗4周后相比,两组各方面也都有明显好转(P<0.05)。治疗4周后,只有VAS疼痛得分治疗组明显低于对照组(P<0.05);治疗8周后,两组CMS评分除却力量测试上无明显区别(P>0.05)外,其他4个方面以及FMA-UE上肢功能评定、VA S疼痛得分上都存在明显区别(P<0.05),并且治疗组优于对照组。结论:对于卒中后偏瘫患者的肩痛及肩关节功能障碍,常规综合康复治疗方法以及强化肩胛胸壁关节运动训练都有着不错的治疗效果,然而强化肩胛胸壁关节运动训练对缓解肩痛及改善肩关节功能障碍的疗效更为显著。展开更多
The shoulder complex presents unique challenges for measuring motion as the scapula,unlike any other bony segment in the body,glides and rotates underneath layers of soft tissue and skin.The ability for clinicians and...The shoulder complex presents unique challenges for measuring motion as the scapula,unlike any other bony segment in the body,glides and rotates underneath layers of soft tissue and skin.The ability for clinicians and researchers to collect meaningful kinematic data is dependent on the reliability and validity of the instrumentation utilized.The aim of this study was to review the relevant literature pertaining to the reliability and validity of electromagnetic tracking systems(ETS) and digital inclinometers for assessing shoulder complex motion.Advances in technology have led to the development of biomechanical instrumentation,like ETS,that allow for the collection of threedimensional kinematic data.The existing evidence has demonstrated that ETS are reliable and valid instruments for collecting static and dynamic kinematic data of the shoulder complex.Similarly,digital inclinometers have become increasingly popular among clinicians due to their cost effectiveness and practical use in the clinical setting.The existing evidence supports the use of digital inclinometers for the collection of shoulder complex kinematics as these instruments have been demonstrated to yield acceptable reliability and validity.While digital inclinometers pose a disadvantage to ETS regarding accuracy,precision,and are limited to twodimensional and static measurements,this instrument provides clinically meaningful data that allow clinicians and researchers the ability to measure,monitor,and compare shoulder complex kinematics.展开更多
Scapulothoracic dissociation is a rare and complex injury pattern with varied presentation.Here we describe a case of a 32-year-old male who presented with scapulothoracic dissociation associated with brachial plexus ...Scapulothoracic dissociation is a rare and complex injury pattern with varied presentation.Here we describe a case of a 32-year-old male who presented with scapulothoracic dissociation associated with brachial plexus injury,along with scapholunate dissociation.We also propose an injury mechanism that might link the two injury patterns,suggesting that the association might be more than by chance.The patient was managed according to established trauma care and resuscitation protocols followed by open reduction and internal fixation of the clavicle fracture,and fixation of scapholunate dissociation and had a successful outcome at follow-up.展开更多
文摘目的:观察强化肩胛胸壁关节运动训练对治疗卒中后偏瘫患者肩痛及肩关节功能障碍的疗效。方法:选取60例脑卒中后偏瘫伴有肩痛及肩关节功能障碍的患者,应用随机数字表法分为治疗组和对照组,每组各30例。2组均予以脑卒中后偏瘫肩痛及肩关节功能障碍的常规康复方法治疗,治疗组在常规治疗的同时再予以8周的强化肩胛胸壁关节运动训练。运用Constant-Murley肩关节功能评分量表(Constant-Murley Shoulder Function Score Scale,CMS)、基本概念视觉模拟疼痛评分法(Visual Analogue Scale,VA S)、Fugl-Meyer Motor A ssessment简式Fugl-meyer上肢运动功能评分量表(Fugl-Meyer Motor A ssessment Fugl-meyer Simple Upper Limb Motor Function Score,FMA-UE)对患者情况进行评估。评估时间分别是治疗前、治疗4周后、治疗8周后。结果:治疗4周后与治疗前相比,两组在CMS评定量表中5个方面都有好转(P<0.05),VAS疼痛得分明显降低(P<0.05),FMA-UE上肢功能评定也有显著好转(P<0.05);治疗8周后,治疗组和对照组CMS 5个方面,VAS,FMA-UE都有显著好转,且与治疗4周后相比,两组各方面也都有明显好转(P<0.05)。治疗4周后,只有VAS疼痛得分治疗组明显低于对照组(P<0.05);治疗8周后,两组CMS评分除却力量测试上无明显区别(P>0.05)外,其他4个方面以及FMA-UE上肢功能评定、VA S疼痛得分上都存在明显区别(P<0.05),并且治疗组优于对照组。结论:对于卒中后偏瘫患者的肩痛及肩关节功能障碍,常规综合康复治疗方法以及强化肩胛胸壁关节运动训练都有着不错的治疗效果,然而强化肩胛胸壁关节运动训练对缓解肩痛及改善肩关节功能障碍的疗效更为显著。
文摘The shoulder complex presents unique challenges for measuring motion as the scapula,unlike any other bony segment in the body,glides and rotates underneath layers of soft tissue and skin.The ability for clinicians and researchers to collect meaningful kinematic data is dependent on the reliability and validity of the instrumentation utilized.The aim of this study was to review the relevant literature pertaining to the reliability and validity of electromagnetic tracking systems(ETS) and digital inclinometers for assessing shoulder complex motion.Advances in technology have led to the development of biomechanical instrumentation,like ETS,that allow for the collection of threedimensional kinematic data.The existing evidence has demonstrated that ETS are reliable and valid instruments for collecting static and dynamic kinematic data of the shoulder complex.Similarly,digital inclinometers have become increasingly popular among clinicians due to their cost effectiveness and practical use in the clinical setting.The existing evidence supports the use of digital inclinometers for the collection of shoulder complex kinematics as these instruments have been demonstrated to yield acceptable reliability and validity.While digital inclinometers pose a disadvantage to ETS regarding accuracy,precision,and are limited to twodimensional and static measurements,this instrument provides clinically meaningful data that allow clinicians and researchers the ability to measure,monitor,and compare shoulder complex kinematics.
文摘Scapulothoracic dissociation is a rare and complex injury pattern with varied presentation.Here we describe a case of a 32-year-old male who presented with scapulothoracic dissociation associated with brachial plexus injury,along with scapholunate dissociation.We also propose an injury mechanism that might link the two injury patterns,suggesting that the association might be more than by chance.The patient was managed according to established trauma care and resuscitation protocols followed by open reduction and internal fixation of the clavicle fracture,and fixation of scapholunate dissociation and had a successful outcome at follow-up.
