CAJ | 학술논문

背景：目前关节镜肩袖修补后延期功能锻炼是否能提高肌腱的愈合率尚不清楚。关于肩袖修补后的功能锻炼时机仍无定论，且无相关系统评价发表。 　　目的：系统评价关节镜肩袖修补后早期与延期功能锻炼的疗效差异。 　　方法：检索Pubmed, EMBASE，Cochrane对照实验中心注册数据库，以及中国生物医学文献数据库、万方数据库、清华同方数据库、重庆维普数据库。英文检索词为“arthroscopy，rotator cuff，rehabilitation”，中文检索词为“肩关节镜，肩袖，康复”。对入选文献的参考文献进行二次检索。检索截止日期为2012-08-15。要求纳入文献均为关节镜肩袖修补后早期与延期功能锻炼的随机对照研究，进行方法学质量评价、筛选和异质性检验，采用REVMAN5.1软件对提取的数据进行分析。 　　结果与结论：共纳入3个随机对照试验，共包括237例患者，119例为早期活动组，118例为延期活动组。分析显示2组在术后1年随访时关节活动度、疼痛程度、美国肩肘外科医生评分、简明肩关节功能测试评分、肩袖再撕裂率差异均无显著性意义。提示与延期功能锻炼相比，关节镜肩袖修补后早期功能锻炼在关节功能及活动度的改善方面并无优势，但也不增加修补肩袖的再撕裂率。肩袖修补后康复方案可根据患者的实际情况进行制定。
배경：목전관절경견수수보후연기공능단련시부능제고기건적유합솔상불청초。관우견수수보후적공능단련시궤잉무정론，차무상관계통평개발표。 　　목적：계통평개관절경견수수보후조기여연기공능단련적료효차이。 　　방법：검색Pubmed, EMBASE，Cochrane대조실험중심주책수거고，이급중국생물의학문헌수거고、만방수거고、청화동방수거고、중경유보수거고。영문검색사위“arthroscopy，rotator cuff，rehabilitation”，중문검색사위“견관절경，견수，강복”。대입선문헌적삼고문헌진행이차검색。검색절지일기위2012-08-15。요구납입문헌균위관절경견수수보후조기여연기공능단련적수궤대조연구，진행방법학질량평개、사선화이질성검험，채용REVMAN5.1연건대제취적수거진행분석。 　　결과여결론：공납입3개수궤대조시험，공포괄237례환자，119례위조기활동조，118례위연기활동조。분석현시2조재술후1년수방시관절활동도、동통정도、미국견주외과의생평분、간명견관절공능측시평분、견수재시렬솔차이균무현저성의의。제시여연기공능단련상비，관절경견수수보후조기공능단련재관절공능급활동도적개선방면병무우세，단야불증가수보견수적재시렬솔。견수수보후강복방안가근거환자적실제정황진행제정。
BACKGROUND:At present, it remains unclear whether delayed functional exercises after arthroscopic rotator cuff repairs could elevate the healing rate of tendon. The opportunity of functional exercises after rotator cuff repairs is stil controversial, and there is no relevant system evaluation. OBJECTIVE:To systematical y evaluate the differences in curative effects of early and delayed functional exercises after arthroscopic rotator cuff repairs. METHODS:We searched the Pubmed, EMBASE, Cochrane Central Register of Control ed Clinical Trials, Chinese Biomedical Literature Database, Wanfang Data, China National Knowledge Infrastructure, and Chongqing VIP Database. The key words were“arthroscopy, rotator cuff, rehabilitation”. The references of the included literatures were re-retrieved. The deadline of retrieval was August 15, 2012. The included literatures were randomized control ed trials on early and delayed functional exercises after arthroscopic rotator cuff repairs. Methodological quality evaluation, screening and heterogeneous test were conducted. REVMAN5.1 software was utilized to analyze the extracted data. RESULTS AND CONCLUSION:We included three randomized control ed trials, including 237 patients:119 in the early movement group and 118 in the delayed movement group. During fol ow-up at 1 year after operation, no significant differences in range of motion, pain degree, American Shoulder and Elbow Surgeons Scale, Simple Should Test scores and re-tear rate of rotator cuff were detected between the two groups. Results confirmed that compared with delayed functional exercises, early functional exercises after arthroscopic rotator cuff repair did not have advantages on the improvement of joint function and range of motion, but also did not negatively affect cuff healing. Postoperative rehabilitation can be modified to ensure patient’s compliance.