| 尹朱丹,钟琦,包倪荣,刘云.肩袖修补术后早期锻炼与保守锻炼效果的Meta分析[J].中国康复,2020,35(8):421-427 |
| 肩袖修补术后早期锻炼与保守锻炼效果的Meta分析 |
| A Meta Analysis of Early Exercise and Conservative Exercise after Rotator Cuff Repair |
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| DOI： |
| 中文关键词: 肩袖损伤 康复 Meta分析 |
| 英文关键词: rotator cuff injury rehabilitation Meta analysis |
| 基金项目:社会发展-面上项目（BE2017723） |
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| 摘要点击次数: 6307 |
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| 中文摘要: |
| 目的：系统评价关节镜肩袖修补后早期与保守功能锻炼的疗效差异。方法：计算机检索多个中英文数据库，搜集符合纳排标准的随机对照试验，检索时间截止至2019年12月15日，进行文献质量评价后，采用REVMAN5.2软件对提取的数据进行分析。结果：共纳入9篇随机对照试验，包括901例患者，其中474例为早期活动组，427例为保守活动组。在肩关节功能评分方面，快速康复组术后4个月、6个月及1年时的肩关节功能测试（SST）评分较保守组更高；在活动度方面，与保守康复组相比，快速康复组术后6个月时的前屈活动度及术后6周时的外展活动度恢复更好，内外旋活动度在两组间未见显著差异；另外本研究发现在术后疼痛及肩袖愈合完整性方面，两组间也均无显著性差异。结论：早期康复可以促进肩关节早中期的前屈及外展活动度，而其长期疗效和其他指标方面，早期锻炼与保守锻炼两种方式并无显著差异。受纳入研究的质量限制，上述结论尚需开展更多高质量的随机对照试验加以验证。 |
| 英文摘要: |
| Objective: To systematically evaluate the differences between early and conservative functional exercise after arthroscopic rotator cuff repair. Methods: A number of Chinese and English databases were retrieved until 15th December 2019, and randomized controlled trials meeting the inclusion and exclusion criteria were collected. After literature quality evaluation, the extracted data were analyzed with REVMAN5.2 software. Results: A total of 9 randomized controlled trials were included, including 901 patients, of whom 474 were in the early activity group and 427 were in the conservative activity group. In terms of the score of shoulder joint function, the SST score in the early rehabilitation group was higher than that in the conservative group at the 4th month, 6th month and 1st year after surgery. In terms of mobility, flexion motion at 6th month and abduction activity at 6th week after operation recovered better in the early rehabilitation group than in the conservative rehabilitation group, and there was no significant difference in internal and external rotation activity between the two groups. In addition, there was no significant difference in postoperative pain and rotator cuff healing integrity between the two groups. Conclusion: Early rehabilitation can promote forward flexion and abduction activity in the early and middle stages of the recovery, but there is no significant difference between early and conservative rehabilitation in its long term efficacy and other indicators. Due to the limited quality of the included studies, the above conclusions need to be verified by more high quality randomized controlled trials. |
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