确定肩上活动所需的盂肱运动范围:一项观察研究。

IF 2.1 Q1 REHABILITATION Archives of physiotherapy Pub Date : 2024-08-26 eCollection Date: 2024-01-01 DOI:10.33393/aop.2024.3015
Linda Dyer, Jaap Swanenburg, Hermann Schwameder, Samy Bouaicha
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引用次数: 0

摘要

背景:肩部手术后高举活动度的恢复非常耗时,而且对患者的满意度非常重要。肩胛胸关节和盂肱关节(GH)的高举伸展和活动是常见的治疗干预措施。在临床环境中,肩关节整体屈曲120°以上所需的屈曲、外展和外旋的孤立GH活动范围(ROM)仍不明确。本研究明确了高举活动所需的GH ROM:方法:分析了肩部手术后患者肩部 ROM 的及时发展情况。从术后6周开始至治疗结束,每隔2周使用动态关节角度计和目测法测量被动肩关节整体屈曲、GH屈曲、外展和外旋ROM。使用接收者操作特征曲线来确定GH ROM的临界值,使其能够进行高举活动:共有21名患者(平均年龄49岁,76%为男性)接受了肩袖修复术(71%)、Latarjet肩关节稳定术(19%)和关节镜下肱二头肌腱切开术(10%)。能准确实现头顶活动度的ROM临界值为GH屈曲和外展83°,曲线下面积(AUC)范围为0.90至0.93(P < 0.001)。GH外旋的临界值为对侧活动量的53%(AUC为0.87,P < 0.001):结论:120°以上的肩关节整体屈曲需要几乎完全的GH屈曲和外展才能实现。只要外旋 ROM 达到对侧的 53% 以上,外旋 ROM 似乎就不那么重要了。
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Defining the glenohumeral range of motion required for overhead shoulder mobility: an observational study.

Background: Recovery of overhead mobility after shoulder surgery is time-consuming and important for patient satisfaction. Overhead stretching and mobilization of the scapulothoracic and glenohumeral (GH) joints are common treatment interventions. The isolated GH range of motion (ROM) of flexion, abduction, and external rotation required to move above 120° of global shoulder flexion in the clinical setting remains unclear. This study clarified the GH ROM needed for overhead mobility.

Methods: The timely development of shoulder ROM in patients after shoulder surgery was analyzed. Passive global shoulder flexion, GH flexion, abduction, and external rotation ROM were measured using goniometry and visually at 2-week intervals starting 6-week postsurgery until the end of treatment. Receiver operating characteristic curves were used to identify the GH ROM cutoff values allowing overhead mobility.

Results: A total of 21 patients (mean age 49 years; 76% men) after rotator cuff repair (71%), Latarjet shoulder stabilization (19%), and arthroscopic biceps tenotomy (10%) were included. The ROM cutoff value that accurately allowed overhead mobility was 83° for GH flexion and abduction with the area under the curve (AUC) ranging from 0.90 to 0.93 (p < 0.001). The cutoff value for GH external rotation was 53% of the amount of movement on the opposite side (AUC 0.87, p < 0.001).

Conclusions: Global shoulder flexion above 120° needs almost full GH flexion and abduction to be executable. External rotation ROM seems less important as long as it reaches over 53% of the opposite side.

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CiteScore
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审稿时长
10 weeks
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