脑卒中患者躯干上部异常姿势与肩峰撞击综合征的相关性分析

目的 脑卒中患者常合并头前倾和胸椎后凸等异常姿势,通过颅颈角和上胸椎角测量,观察其与肩痛是否有相关性。 方法 将102例脑卒中患者分为肩痛组和对照组,肩痛组为脑卒中合并有肩峰撞击综合征且有肩痛症状的患者,对照组为物理检查阴性且无肩痛的脑卒中患者。通过坐位下矢状位头颈部及上胸部照片,分别进行颅颈角和上胸椎角测量,比较两组之间数据是否具有统计学意义。 结果 肩痛组患者颅颈角较对照组小,上胸椎角较对照组大,差异均有统计学意义（P<0.05）。经Speraman相关性分析,颅颈角与肩痛呈负相关（r=-0.29,P=0.04）,上胸椎角与肩痛呈正相关（r=0.58,P<0.01）。 结论 颅颈角及上胸椎角度可作为脑卒中后肩峰撞击综合征的一个预测因子,脑卒中患者合并有头前倾及胸椎后凸时应积极进行康复治疗。

The clinical relevance of abnormal upper trunk posture for predicting shoulder impingement syndrome among stroke survivors

Objective To explore the relevance of abnormal posture to the development of shoulder pain among stroke survivors. Methods A total of 102 stroke survivors were studied. Those with shoulder impingement syndrome or shoulder pain formed a shoulder pain group, while those without shoulder pain served as controls. The upper trunk sagittal sitting postures of all of the subjects were quantified using the thoracic and craniovertebral angles measured from photographs. Results The average craniovertebral angle of the shoulder pain group was significantly smaller than that of the control group, while the average thoracic angle of the former was significantly larger. The craniovertebral angles were negatively correlated with shoulder pain, while a large thoracic angle was positively correlated. Conclusion Thoracic and craniovertebral angles can be used as a predictor of shoulder impingement syndrome among stroke survivors. Stroke patients with thoracic kyphosis and forward head posture should undergo active rehabilitation.