摘要
目的:观察比较哑铃操锻炼与徒手功能锻炼对肩周炎患者症状及功能改善的治疗效果。方法:于2004-03/05选择太钢集团临汾钢铁公司社区志愿参加调查的肩周炎患者54例,均符合《临床疼痛治疗学》肩关节周围炎的诊断标准,随机分为哑铃操锻炼组(26例)和徒手功能锻炼组(28例),分别进行哑铃操锻炼和传统徒手功能锻炼。哑铃操锻炼每日2～3次,每次5～10min,哑铃重量2～5kg不等,具体动作包括向前屈肘,外展内收,前后摆臂,向上推举,向前伸屈,外展推举,向后伸肩,外展屈肘,前伸屈肘及综合动作;徒手功能锻炼包括前后摆臂,旋转法,正面爬墙法,侧面爬墙法,后抻摸肩及前屈摸肩。均于锻炼3个月后对哑铃操锻炼组和徒手功能锻炼组改善肩周炎症状的治疗效果及患者肩关节活动度各指标(前屈、后伸、外展)改变幅度进行对比观察,疗效评定标准:优为疼痛消失,功能完全恢复正常(外展>80°,前屈上举>160°,屈肘内旋达TL9以上);良为活动稍痛,功能绝大部分恢复(外展>70°,前屈上举>140°,屈肘内旋达TL12以上);可为疼痛及压痛均减轻,关节活动范围有改善;差为疼痛及压痛均无明显改善,关节活动范围无改变。采用关节量角器测量肩关节活动度各指标(前屈、后伸、外展)的改变幅度。组间比较采用配对t检验和组间卡方检验。结果:按意向处理分析,纳入肩周炎患者54例,全部进入结果分析。①哑铃操锻炼和徒手功能锻炼对肩周炎治疗效果的比较:经3个月锻炼后,哑铃操锻炼组优24例,良2例(显效率86.7%),优秀率达92.3%,徒手功能锻炼组良5例,可16例,差7例(显效率48.6%),良好率17.8%。两组疗效比较差异有显著性(χ2=5.69,P<0.05)。②平均锻炼次数哑铃操锻炼组少于徒手功能锻炼组(13.1±2.1)次,(19.3±3.2)次,(t=2.805,P<0.05)。③哑铃操锻炼组和徒手功能锻炼组肩关节活动度各指标改变幅度的比较:哑铃操锻炼组的改变幅度均显著高于徒手功能锻炼组(92.46±17.14)°,(85.41±13.34)°,(31.42±15.21)°,(29.96±8.63)°,(96.63±29.49)°,(89.81±20.53)°,(P<0.05).结论:哑铃操锻炼对肩周炎症状的治疗效果优于徒手功能锻炼,平均锻炼次数少于徒手功能锻炼;锻炼后两组的肩关节活动度前屈、后伸、外展3项指标均有不同程度改善,但哑铃操锻炼组患者改变幅度均显著高于徒手功能锻炼组。
AIM： To observe the therapeutic effects of dumbbell gymnastics and barehanded exercise in ameliorating the symptoms of shoulder periarthritis. METHODS： Fifty-four patients with shoulder periarthritis from the Taigang Group Linfen Iron and Steel Company took part in the study voluntarily between March and May 2004. They all accorded with the standard of shoulder periarthritis diagnostics in “Clinical pain therapy”, and then they were randomly divided into dumbbell gymnastics group （n=26） and bare-handed exercise group （n=28）, Patients in the dumbbell gymnastics group exercised 2-3 times per day and 5-10 minutes for each time, the dumbbell weighed about 2-5 kg. After 3 months, the amelioration of the symptoms and the changed range of the indexes of shoulder＇s joint activity were compared in the two groups, the evaluation standards were that Excellent： The pain disappear and the function recover normal completely. Good, A little pain when action, also the function recover normal party. General： Both the pain and the press ache are relieving and the limit of joint is improved. Bad： The pain is almost patently improved as well as the press ache, including the limit of joint. The t test and chi-square test were used. RESULTS： According to intention-to-treat analysis, all the 54 patients were involved in the analysis of results. ① After 3-month exercise, the effect was excellent in 24 cases and good in 2 cases of the dumbbell gymnastics group （effective rate： 86.7%, excellent rate： 92.3%）, it was general in 16 cases and bad in 7 cases of the bare-handed exercise group （effective rate： 48.6%, excellent rate： 17.8%）, the effect was significantly different between the two groups （χ^2=5.69, P 〈 0,05）.②The average exercise, times were, fewer in the dumbbell gymnastics group than in the bare-handed exercise group [（13.1±2.1）, （19.3±3.2） times, t=2.805, P 〈 0.05]. ③ The changed ranges were significantly higher in the dumbbell gymnastics group than in the bare-handed exercise group [（92.46±17.14）°, （85.41±13.34）°; （31.42± 15.21）°, （29.96±8.63）°; （96.63±29.49）, （89.81 ±20.53）°, P 〈 0.05]. CONCLUSION： Dumbbell gymnastics exercise has a better effect than bare-handed exercise both in the intensity aspect and eurative effect aspect.
出处
《中国临床康复》
CSCD
北大核心
2005年第28期187-189,共3页
Chinese Journal of Clinical Rehabilitation
