清宫正骨肩关节手法对肩袖修补术后患者摸背活动受限的疗效观察

doi:10.3969/j.issn.1006-5725.2026.03.003

Abstract

Abstract:

Objective To assess the efficacy and safety of Qing Gong′s orthopaedic manipulation （QGOM） for the shoulder on hand-behind-back （HBB） restriction after rotator cuff repair （RCR）. Methods Forty-two patients with post-RCR HBB restriction were randomised into two groups （n = 21 each）： one performing shoulder exercises （control）， and the other receiving thrice-weekly QGOM treatment for 6 weeks （observation）. Results At 6 weeks， the median HBB score increased by 5 （2， 6） in the observation group compared to a 2 （2， 2） in the control group （Z = -3.678， P < 0.001）. The median visual analogue scale score decreased by 3 （2， 4） in the observation group， while it decreased by 1 （1， 2）（Z = -3.652， P < 0.001） in the control group. The mean Constant?Murley score increased by 28.76 and 15.90 in the observation and control groups， respectively. The difference between the two groups was 12.86 （95% confidence interval （CI）： 7.26 ~ 18.45， P < 0.001）. At 6 weeks， active forward flexion （Z = -3.663， P < 0.001）， abduction （t = -4.579， P < 0.001）， extension （Z = -2.281，P = 0.023） and external rotation （t = -2.757， P = 0.009） were significantly greater in the observation group than those in the control group. Shoulder forward flexion and abduction in the observation group increased significantly in the observation group （Z= -2.055， P = 0.041） than those in the control group （Z = -2.450， P = 0.013）. The observation group showed significantly greater improvement than the control group in forward flexion （Z = -3.059， P = 0.002）， abduction （Z = -3.700， P < 0.001）， extension （Z = -2.194， P = 0.028）， and external rotation （Z = -3.003， P = 0.003）. Conclusions QGOM for the shoulder was effective， safe and more beneficial than shoulder exercise alone in improving HBB after RCR.

Key words: rotator cuff repair, post-operative stiffness, manual therapy, traditional Chinese medicine, hand-behind-back movement

CLC Number:

Wanxi DENG,Abudushalamu ADILIJIANG,Yingyu HU,Minli LIANG,Haiyun CHEN,Jun LIU. Effect of Qing Gong′s orthopaedic manipulation for the shoulder on hand-behind-back restriction after rotator cuff repair： A randomised controlled clinical trial[J]. The Journal of Practical Medicine, 2026, 42(3): 371-378.

Figures/Tables 6

Tab. 1

Tab.2

Fig.1

Tab.3

Tab. 4

Fig.2

References 31

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位置	得分/分
手背只摸到同侧大腿外侧	0
手背摸到臀部	2
手背摸到腰骶结合部	4
手背摸到腰部第3腰椎高度	6
手背摸到第12胸椎高度	8
手背摸到肩胛间区（第7胸椎高度）	10

特征	观察组（n = 21）	对照组（n = 21）	t/Z/χ² 值	P值
性别/［例（%）］			0.000	1.000
女	17（80.95）	18（85.71）
男	4（19.05）	3（14.29）
年龄/岁	59.19 ± 10.56	57.05 ± 12.32	0.605	0.548
摸背活动评分/分	4.05 ± 2.16	3.90 ± 2.05	-0.052	0.958
VAS疼痛评分/分	4.14 ± 1.06	4.33 ± 0.92	-0.491	0.624
患肩主动活动度/°
前屈	103.76 ± 25.96	97.81 ± 24.45	-1.083	0.279
外展	96.19 ± 26.87	90.24 ± 21.83	-0.788	0.435
后伸	32.57 ± 8.89	32.57 ± 5.62	-0.469	0.639
外旋	26.48 ± 12.47	24.24 ± 14.66	-0.533	0.597
Constant?Murley评分/分	54.71 ± 11.67	51.67 ± 8.62	-0.963	0.341
肩袖撕裂范围大小/［例（%）］			0.000	0.850
< 1 cm	1（4.76）	2（9.52）
1 ~ < 3 cm	16（76.19）	17（80.95）
3 ~ 5 cm	4（19.05）	2（9.52）
缝合方式/［例（%）］			0.525	0.469
单排	4（19.50）	6（28.57）
双排	17（80.95）	15（71.43）
行肩峰成形术/［例（%）］			0.000	1.000
是	20（95.24）	20（95.24）
否	1（4.76）	1（4.76）
行术中松解操作/［例（%）］			0.194	0.659
是	2（9.52）	4（19.05）
否	19（90.45）	17（80.95）

结局指标	观察组（n = 21）	对照组（n = 21）	t/z值	P值
摸背活动评分/分	8.0（8.00，9.50）	6.0（4.00，8.00）	-4.137	< 0.001
VAS疼痛评分/分	1.0（0.50，2.00）	3.0（2.00，3.00）	-3.889	< 0.001
Constant?Murley评分（x ± s）/分	83.48 ± 6.82	67.57 ± 10.17	-5.955	< 0.001
主动活动度
前屈/°	138.00（130.00，155.00）	116.00（107.50，126.50）	-3.663	< 0.001
外展（x ± s）/°	138.67 ± 20.58	106.24 ± 25.09	-4.579	< 0.001
后伸/°	42.00（38.50，50.50）	38.00（34.00，44.50）	-2.281	0.023
外旋（x ± s）/°	42.24 ± 12.08	31.62 ± 12.87	-2.757	0.009

结局指标	观察组变化量	对照组变化量	t/Z值	P值
摸背活动评分/分	5.00（2.00，6.00）	2.0（2.00，2.00）	-3.678	< 0.001
VAS疼痛评分/分	3.00（2.00，4.00）	1.0（1.00，2.00）	-3.652	< 0.001
Constant–Murley评分（x ± s）/分	28.76 ± 11.03	15.90 ± 6.28	-4.644	< 0.001
主动活动度/°
前屈	31.00（19.50，44.50）	16.00（9.50，23.50）	-3.059	0.002
外展	35.00（27.50，58.50）	14.00（9.50，18.50）	-3.700	< 0.001
后伸	10.00（5.50，20.00）	5.00（2.00，12.50）	-2.194	0.028
外旋	15.00（8.00，21.00）	6.00（2.50，10.00）	-3.003	0.003

Effect of Qing Gong′s orthopaedic manipulation for the shoulder on hand-behind-back restriction after rotator cuff repair： A randomised controlled clinical trial

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