基于人体工效学的肩袖护具在肩袖损伤患者肩关节镜术后康复中的应用

陶爱萍; 贾曼; 王双双; 李琪琪; 王谊

doi:10.16766/j.cnki.issn.1674-4152.003818

基于人体工效学的肩袖护具在肩袖损伤患者肩关节镜术后康复中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003818

1.
温州医科大学附属第二医院创伤骨科，浙江温州 325026
2.
温州医科大学附属第二医院手外科
3.
温州医科大学附属第二医院护理部

基金项目:

浙江省医药卫生科技计划项目 2022480711

浙江省市县级科技计划项目 Y20210488

详细信息

通讯作者:
王谊，E-mail: wangyi2078@aliyun.com

中图分类号: R684.7
计量
- 文章访问数: 19
- HTML全文浏览量: 12
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2024-05-16
- 网络出版日期: 2025-01-20

Application of ergonomic rotator cuff protector in patients with rotator cuff injury after shoulder arthroscopy

1.
Department of Orthopedics Trauma, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325026, China

摘要

摘要: 目的探究基于人体工效学设计的肩袖护具对肩袖损伤患者肩关节镜术后疼痛、睡眠、锻炼依从性和肩关节功能恢复的影响。方法收集2022年1月—2023年6月于温州医科大学附属第二医院骨科择期进行肩关节镜修复术治疗的肩袖损伤患者共92例。利用Excel随机分组法分为对照组和护具组，各46例。对照组术后给予常规康复护理，护具组在康复护理基础上使用人体工效学肩袖护具，比较2组术后疼痛、睡眠质量、锻炼依从性、肩关节活动度以及肩关节功能情况。结果护具组干预2周后疼痛(VAS)评分为(3.02±0.45)分，低于对照组的(4.17±0.68)分(P＜0.05)。干预8周后多导睡眠指标中总睡眠时间、睡眠效率高于对照组(P＜0.05)，觉醒次数少于对照组(P＜0.05)；锻炼依从性评分为(65.73±5.10)分，高于对照组的(57.07±8.23)分(P＜0.05)；肩关节前屈、后伸、内旋以及外旋活动度均大于对照组(P＜0.05)；肩关节功能量表评分为(24.88±5.13)分，高于对照组的(18.09±4.12)分(P＜0.05)。结论使用人体工效学肩袖护具既可减轻肩袖损伤患者肩关节镜术后疼痛，改善睡眠质量，又可利于患者锻炼依从性的提高和肩关节功能的恢复。
- 肩袖损伤 /
- 肩袖护具 /
- 人体工效学 /
- 肩关节活动度 /
- 肩关节功能
Abstract: Objective To explore the effects of ergonomics-based rotator cuff protector on pain, sleep, exercise compliance, and shoulder function recovery in patients with rotator cuff injury after shoulder arthroscopy. Methods A total of 92 patients with rotator cuff injury were collected from January 2022 to June 2023 in Department of Orthopedics Trauma, the Second Affiliated Hospital of Wenzhou Medical University. They were divided into a control group and a protection group using the Excel random grouping method, with 46 cases in each group. The control group was given routine rehabilitation nursing after surgery, while the protection group was given an ergonomic rotator cuff protector on the basis of rehabilitation nursing. Postoperative pain, sleep quality, exercise compliance, shoulder motion, and shoulder function were compared between the two groups. Results After 2 weeks of intervention, the VAS score of the brace group was 3.02±0.45, which was lower than that of the control group (4.17±0.68, P<0.05). After 8 weeks of intervention, the total sleep time and sleep efficiency were higher than those of the control group (P<0.05), and the number of awakenings was lower than that of the control group (P<0.05). The exercise compliance score was (65.73±5.10) points, higher than that of the control group [(57.07±8.23) points, P<0.05]. The movements of shoulder flexion, extension, internal rotation, and external rotation were higher than those of the control group (P<0.05). The score of the shoulder joint function scale was 24.88±5.13, which was higher than that of the control group (18.09±4.12, P<0.05). Conclusion The use of ergonomic rotator cuff protector can not only reduce the pain of patients with rotator cuff injury after shoulder arthroscopy, improve sleep quality, but also improve their exercise compliance and restore shoulder joint function.
- Rotator cuff injury /
- Rotator cuff protector /
- Ergonomics /
- Shoulder range of motion /
- Shoulder function

HTML全文

图 1 肩袖护具示意图

Figure 1. Schematic diagram of rotator cuff protector

下载: 全尺寸图片幻灯片

表 1 2组肩袖损伤患者一般资料比较

Table 1. Comparison of general data between the two groups of patients with rotator cuff injury

组别	例数	性别 (男/女，例)	年龄 (x±s，岁)	患肩 (左侧/右侧，例)	病程 (x±s，月)	肩袖退缩程度Patte分型 (Ⅰ/Ⅱ/Ⅲ型，例)
对照组	46	22/24	43.23±9.12	20/26	4.24±1.11	16/21/9
护具组	46	27/19	43.07±7.34	17/29	4.37±0.98	19/22/5
统计量		1.092^a	0.092^b	0.407^a	0.595^b	1.211^c
P值		0.296	0.927	0.524	0.553	0.190
注：^a为χ²值，^b为t值，^c为Z值。

下载: 导出CSV

表 2 2组肩袖损伤患者干预前后患肩VAS评分比较(x±s，分)

Table 2. Comparison of the VAS scores between the two groups of patients with rotator cuff injury before and after intervention (x±s, points)

组别	例数	干预前	干预2周后
对照组	46	6.68±1.45	4.17±0.68^b
护具组	46	7.01±1.17	3.02±0.45^b
统计量		1.201^a	15.901^c
P值		0.233	＜0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP＜0.05。

下载: 导出CSV

表 3 2组肩袖损伤患者干预前后睡眠质量比较(x±s)

Table 3. Comparison of sleep quality between the two groups of patients with rotator cuff injury before and after intervention (x±s)

组别	例数	总睡眠时间(min)		睡眠效率(%)		觉醒次数(次)
组别	例数	干预前	干预8周后	干预前	干预8周后	干预前	干预8周后
对照组	46	258.98±11.34	290.88±14.37^b	69.09±6.23	74.12±4.77^b	7.23±1.21	5.11±1.14^b
护具组	46	260.34±20.95	351.23±16.23^b	70.17±7.24	85.23±5.67^b	7.65±1.32	3.45±0.67^b
统计量		0.387^a	26.341^c	0.767^a	23.451^c	1.591^a	18.231^c
P值		0.700	＜0.001	0.445	＜0.001	0.115	＜0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP＜0.05。

下载: 导出CSV

表 4 2组肩袖损伤患者干预前后锻炼依从性比较(x±s，分)

Table 4. Comparison of exercise compliance between the two groups of patients with rotator cuff injury before and after intervention (x±s, points)

组别	例数	心理方面		主动学习方面		身体方面		总分
组别	例数	干预前	干预8周后	干预前	干预8周后	干预前	干预8周后	干预前	干预8周后
对照组	46	25.89±5.12	29.77±7.12^b	13.77±3.11	15.67±3.66^b	9.09±2.44	11.63±2.12^b	48.75±5.66	57.07±8.23^b
护具组	46	25.76±6.71	34.23±8.41^b	14.02±3.45	17.94±3.12^b	9.17±2.71	13.56±3.41^b	48.95±9.34	65.73±5.10^b
统计量		0.104^a	26.121^c	0.365^a	18.909^c	0.149^a	18.054^c	0.124^a	23.102^c
P值		0.917	＜0.001	0.716	＜0.001	0.882	＜0.001	0.901	＜0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP＜0.05。

下载: 导出CSV

表 5 2组肩袖损伤患者干预前后肩关节活动度比较(x±s，°)

Table 5. Comparison of shoulder joint motion between the two groups of patients with rotator cuff injury before and after intervention (x±s, °)

组别	例数	前屈		后伸		内旋		外旋
组别	例数	干预前	干预8周后	干预前	干预8周后	干预前	干预8周后	干预前	干预8周后
对照组	46	32.45±5.12	68.23±6.12^b	33.45±6.21	71.23±5.61^b	17.89±3.12	38.23±5.21^b	20.09±3.66	60.12±7.25^b
护具组	46	33.11±6.88	88.67±5.67^b	33.19±7.24	89.23±8.01^b	18.02±3.41	60.23±6.14^b	20.45±4.51	79.23±8.24^b
统计量		0.522^a	27.841^c	0.185^a	20.091^c	0.191^a	35.231^c	0.420^a	23.562^c
P值		0.603	＜0.001	0.854	＜0.001	0.849	＜0.001	0.675	＜0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP＜0.05。

下载: 导出CSV

表 6 2组肩袖损伤患者干预前后UCLA评分比较(x±s，分)

Table 6. Comparison of UCLA scores between the two groups of patients with rotator cuff injury before and after intervention (x±s, points)

组别	例数	干预前	干预8周后
对照组	46	12.23±2.45	18.09±4.12^b
护具组	46	12.78±3.10	24.88±5.13^b
统计量		0.944^a	19.321^c
P值		0.348	＜0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP＜0.05。

下载: 导出CSV

参考文献(17)

[1]	王佳, 程少文, 孙广晓. 快速康复护理模式在肩关节镜下肩袖损伤修补术术后患者中的应用效果[J]. 中华全科医学, 2020, 18(7): 1230-1233. doi: 10.16766/j.cnki.issn.1674-4152.001472 WANG J, CHENG S W, SUN G X. Study on the effect of rapid rehabilitation nursing mode in patients after repair of rotator cuff injury under arthroscope[J]. Chinese Journal of General Practice, 2020, 18(7): 1230-1233. doi: 10.16766/j.cnki.issn.1674-4152.001472
[2]	ZHANG M, ZHOU J, ZHANG Y, et al. Influence of scapula training exercises on shoulder joint function after surgery for rotator cuff Injury[J]. Med Sci Monit, 2020, 29(26): e925758. DOI: 10.12659/MSM.925758.
[3]	李锦芳. 疼痛控制结合临床护理路径对创伤性骨折患者康复锻炼依从性及睡眠质量的影响[J]. 世界睡眠医学杂志, 2023, 10(5): 1136-1138, 1141. LI J F. Effect of pain control combined with clinical nursing path on rehabilitation exercise compliance and sleep quality of patients with traumatic fracture[J]. World Journal of Sleep Medicine, 2023, 10(5): 1136-1138, 1141.
[4]	谭媛媛, 和晖, 杨秀贤, 等. 骨科患者功能锻炼依从性量表的编制及信度效度检验[J]. 中国护理管理, 2019, 19(11): 1626-1631. TAN Y Y, HE H, YANG X X, et al. Development and reliability and validity test of the compliance scale of functional exercise for orthopedic patients[J]. Chinese Nursing Management, 2019, 19(11): 1626-1631.
[5]	邢月蒙, 王亚楠, 段怡帆, 等. 腕踝针疗法对关节镜下肩袖修补术后肩关节功能恢复的影响[J]. 广州中医药大学学报, 2023, 40(7): 1723-1728. XING Y M, WANG Y N, DUAN Y F, et al. Effect of wrist-Ankle acupuncture on functional recovery of the shoulder joint after arthroscopic rotator cuff repair[J]. Journal of Guangzhou University of Traditional Chinese Medicine, 2023, 40(7): 1723-1728.
[6]	ZHAO W L, YANG J W, KANG Y H, et al. Animal models of rotator cuff injury and repair: a systematic review[J]. Tissue Eng Part B Rev, 2022, 28(6): 1258-1273. doi: 10.1089/ten.teb.2022.0034
[7]	CASTRO-CONTRERAS E, VALDEZ-PARDO M E. Rotator cuff injuries with nighttime pain and sleep quality before and after treatment[J]. Acta Ortop Mex, 2022, 36(1): 33-38. doi: 10.35366/106757
[8]	刘旭, 李晓乐, 张晋, 等. 关节镜下肩袖修复手术后早期锻炼与支具固定对其疗效的影响比较: 一项meta分析[J]. 山东医药, 2021, 61(16): 84-88. LIU X, LI X L, ZHANG J, et al. Comparison of the effect of early exercise and brace fixation after arthroscopic rotator cuff repair: a meta-analysis[J]. Shandong Medical Journal, 2021, 61(16): 84-88.
[9]	张健, 徐凯忆, 赵崧灵, 等. 基于二维照片的青年男性颈肩部形态分类与识别[J]. 纺织学报, 2022, 43(5): 143-149. ZHANG J, XU K Y, ZHAO S L, et al. Classification and recognition of young males ' neck-shoulder shape based on 2-D photos[J]. Journal of Textile Research, 2022, 43(5): 143-149.
[10]	李芹, 王家友, 周娟, 等. 基于护理团队策略下的疼痛干预对胃癌术后患者疼痛管理、睡眠质量及生活质量的影响[J]. 中国医药导报, 2023, 20(1): 166-169. LI Q, WANG J Y, ZHOU J, et al. Effects of pain intervention based on nursing team strategy on pain management, sleep quality, and quality of life of postoperative patients with gastric cancer[J]. China Medical Herald, 2023, 20(1): 166-169.
[11]	陶静怡, 王雨彤, 张达颖, 等. 原发性三叉神经痛病人睡眠质量与疼痛信念的相关性分析[J]. 护理研究, 2022, 36(10): 1861-1864. TAO J Y, WANG Y T, ZHANG D Y, et al. Correlation analysis between sleep quality and pain beliefs in patients with primary trigeminal neuralgia[J]. Chinese Nursing Research, 2022, 36(10): 1861-1864.
[12]	文珂, 陈佩娟, 何玉. 成人鼻咽癌放疗病人张口锻炼依从性影响因素及与自我管理效能的关系[J]. 护理研究, 2021, 35(24): 4419-4423. WEN K, CHEN P J, HE Y. Influencing factors of mouth-opening exercise compliance and its relationship with self-management efficacy in adult patients with nasopharyngeal carcinoma undergoing radiotherapy[J]. Chinese Nursing Research, 2021, 35(24): 4419-4423.
[13]	白佳瑶, 廖宗峰, 李玲, 等. 帕金森病患者功能锻炼的依从性现状及影响因素分析[J]. 护士进修杂志, 2023, 38(6): 491-495, 501. BAI J Y, LIAO Z F, LI L, et al. Compliance status of functional exercise in patients with Parkinson ' s disease and its influencing factors[J]. Journal of Nurses Training, 2023, 38(6): 491-495, 501.
[14]	刘会子, 张敏, 陈娟, 等. 骨质疏松性椎体压缩性骨折病人术后早期功能锻炼依从性的影响因素[J]. 循证护理, 2023, 9(20): 3754-3757. LIU H Z, ZHANG M, CHEN J, et al. Analysis of influencing factors on early postoperative functional exercise compliance in patients with osteoporotic vertebral compression fractures[J]. Chinese Evidence-Based Nursing, 2023, 9(20): 3754-3757.
[15]	景晶, 巨娣, 田利红, 等. 产后压力性尿失禁女性行盆底肌功能锻炼依从性影响因素分析[J]. 中国计划生育学杂志, 2023, 31(2): 251-256. JING J, JU D, TIAN L H, et al. Analysis of the influencing factors of the compliance of women with postpartum stress urinary incontinence for the pelvic floor muscle functional exercise[J]. Chinese Journal of Family Planning, 2023, 31(2): 251-256.
[16]	马敏. 初产妇剖宫产术后盆底肌功能锻炼依从性的影响因素[J]. 河南医学研究, 2020, 29(23): 4280-4282. MA M. Factors influencing compliance of pelvic floor muscle function exercise in primipara after cesarean section[J]. Henan Medical Research, 2020, 29(23): 4280-4282.
[17]	纽晓丹, 肖涛, 王保平, 等. 基于脑电响应分析睡眠剥夺对运动表现的影响[J]. 陕西师范大学学报(自然科学版), 2022, 50(6): 104-112. NIU X D, XIAO T, WANG B P, et al. The EEG response analysis of sleep deprivation to performance of exercise[J]. Journal of Shaanxi Normal University: Natural Science Edition, 2022, 50(6): 104-112.