早期与晚期康复训练方法对肩袖修补术后患者肩关节功能的影响

Effect of Early versus Delayed Rehabilitation Training Methods on Shoulder Joint Function in Patients after Rotator Cuff Repair

摘要: 目的：探讨早期与晚期康复训练对肩袖修补术后患者关节活动度及功能的影响。方法：回顾性分析2021年9月至2022年8月新疆维吾尔自治区人民医院住院的43例肩袖撕裂患者。其中男21，女22，年龄45~63，右肩18例，左肩25例。早期康复组为术后第2周开始康复训练；晚期康复组患者术后第6周开始康复。比较两组患者术后6周，3个月，6个月疼痛视觉模拟评分(visual analogue scale, VAS)，constant评分，简明肩关节功能测试(simple shoulder test, SST)，前屈及外旋活动度。术后6个月进行MRI检查判断术后愈合情况。结果：比较两组患者术后6周，3个月VAS评分，constant评分，SST评分，前屈及外旋活动度存在显著差异，P < 0.05。两组患者术后6个月愈合率之间及其他观察指标之间无明显差异，P > 0.05。结论：肩袖修补术后，早期积极康复训练不影响愈合的同时对患者术后早期关节活动度，关节功能恢复和疼痛的改善有促进作用。尽管患者早期训练对关节早期活动有明显的影响但后期各组之间未见明显的差异。因此鉴于本研究和其他相关研究的结果，临床上我们需考虑患者具体病情，服从情况并且选择适合的康复训练方式，有效提高患者肩关节活动及功能恢复。

Abstract: Objective: To investigate the effects of early versus late rehabilitation on joint mobility and function in patients after rotator cuff repair. Methods: A retrospective analysis of 43 patients with rotator cuff tears hospitalized in the People’s Hospital of Xinjiang Uygur Autonomous Region from Septem-ber 2021 to August 2022. Among them, 21 were male and 22 were female, aged 45~63, 18 cases were right shoulder and 25 cases were left shoulder. The early rehabilitation group started rehabil-itation training at the 2rd postoperative week; the patients in the late rehabilitation group started rehabilitation at the 6th postoperative week. The visual analogue scale (VAS), constant score, sim-ple shoulder test (SST), anterior flexion and external rotation mobility were compared between the two groups at 6 weeks, 3 months and 6 months postoperatively. MRI was performed at 6 months postoperatively to determine the postoperative healing status. Result: There were significant dif-ferences in VAS scores, constant scores, SST scores, anterior flexion and external rotation mobility between the two groups at 6 weeks and 3 months postoperatively, P < 0.05. There were no signifi-cant differences between the healing rates and other observed indexes between the two groups at 6 months postoperatively, P > 0.05. Conclusion: After rotator cuff repair, early active rehabilitation training did not affect healing while promoting early postoperative joint mobility, recovery of joint function, and improvement of pain in patients. Although there was a significant effect of early training on early joint motion, no significant differences were seen between the groups in the later stages. Therefore, in view of the results of this study and other related studies, we need to consider the patient’s specific condition, obey the situation and choose a suitable rehabilitation training method to effectively improve the patient’s shoulder joint movement and functional recovery.