综合康复疗法在肩袖损伤职业康复中的应用

目的 探讨医学训练疗法(medical training therapy,MTT)配合以超声波理疗(ultrasonic therapy)及关节松动术(joint loosening therapy)的综合康复疗法(ULM)对肩袖损伤的疗效。 方法 采用MTT配合超声波理疗及关节松动术为主的综合方法治疗59例肩袖损伤病人,于治疗前、治疗6周后分别评价其肩关节疼痛、日常生活能力、肌力、关节活动度及医患满意度等指标,分析疗效。 结果 57例肩伤患者完成6周的康复治疗,2例患者因疗效不佳中转关节镜手术治疗。完成治疗患者的肩关节日间痛可视化疼痛评分(visual analogue scale,VAS评分)由治疗前的(5.89 ±1.53)分降低至治疗后的(2.26 ±1.28)分,夜间痛VAS评分由治疗前的(7.30 ±1.70)分降低至治疗后的(2.67 ±1.66)分,两者在治疗前后比较,差异均有统计学意义(t=13.739、14.712,P<0.01)。肩关节功能综合评分由治疗前的(32.47 ±11.96)分提高到治疗后的(91.75 ±3.34)分,两者比较,差异有统计学意义(t=35.995,P<0.01)。 结论 以MTT配合超声波理疗及关节松动术为主的综合康复疗法对肩袖损伤的疗效较好,能全面促进患者肩关节功能康复。

Application of general rehabilitation therapy in occupational rehabilitation treatment of rotator cuff injuries

Objective To study the therapeutic effect of the general rehabilitation therapy （ULM）,including medical training therapy,ultrasonic therapy and joint loosening therapy,for rotator cuff injuries. Methods A total of 59 cases were received this general rehabilitation therapy. The evaluation of effectiveness was done after 6 weeks of rehabilitation. Pain （daylight pain and night pain）and function were assessed by VAS （Visual Analogue Scale）and Fudan University Shoulder Score （FDSS）. The shoulder joint＇s pain symptom, activities of daily living（ADL）,myodynamia（M ）, range of motion（ROM ）and satisfaction were also evaluated after 6 weeks. Results Except 2 patients treated with arthroseopie surgery during the treatment period,57 cases received a full cycle treatment. Those patients＇daylight pain VAS score decreased from （5.89 ± 1.53）at the beginning to （2.26 ± 1.28）after 6 weeks＇treatment,while the night pain VAS score decreased from （7.30 ±1.70） to （2.67 ±1.66）. The effectiveness of pain relief was obvious （t = 13.739 or 14.712,both P 〈 0.01 ）. Their total FDSS scores increased from （32.47 ±11.96） to （91.75 ±3.34）. The shoulder functional grades was obviously improved after 6 weeks treatment （t = 35.995,P 〈 0.001 ）. Conclusion The therapeutic effect of the general rehabilitation therapy （ULM）for rotator cuff injuries was effective significantly. It＇s important to promote the overall recovery of the shoulder function and the occupational rehabilitation of the patients.