Boyles et al.38
demonstrated that thoracic manipulation resulted in a statistically
significant decrease in self-reported pain and disability in patients
with shoulder impingement syndrome at 48 hours follow-up. Finally,
Mintken et al.39
were able to develop a CPR for patients with a primary complaint of
shoulder pain who demonstrated rapid improvement in pain and disability
following cervical and thoracic spine manipulation. The prospective
single-arm trial found if three out of five prognostic variables were
present
1. Pain-free Shoulder flexion <127°
2. Shoulder internal rotation
<53° at 90° of abduction
3. Negative Neer test
4. No medication use for
their shoulder pain
5. Symptoms <90 days),
The chance of
experiencing rapid improvement following manipulation improved from 61
to 89% (positive likelihood ratio = 5.3).39
PT Rextify
Sunday, April 16, 2017
Acromial Types 各種形狀的 Acromion
Reference 本文出處: https://radiopaedia.org/articles/acromial-types
The shape of the acromion had been initially divided into three types (which was known as the Bigliani classification) 3, to which a fourth has been added 2. They are useful as a standardised way of describing the acromion, as well as predicting to a degree the incidence of impingement.Acromion其實一開始有分三種型式,後來才加上了第四種。如此的分類在臨床上的使用,使其是能夠將之標準化後,變得在看 Impingement syndromes 能夠更有效地去推測。
分類
Classification
This
classification was initially proposed by Bigliani et al in 1986 on
outlet view radiographs, and later modified by Kitay et al 7 and Vanarthos et al in 1995, which remains the most widely accepted classification at time of writing (July 2016).Acromion morphology (types) are based on sagittal oblique MRI:
如此的分類方法一開始是由 Bigliani 於1986年所提出的。之後也曾經在1995年被Kitay et al 7 and Vanarthos 等學者重新修訂過,也是最廣泛被使用且接受的。Acromion 的形體學是要在MRI 的sagittal oblique 的角度之下才看得出來。
- flat inferiorly (12%) 6
-
curved (56%)
- parallel to the humeral head with a concave undersurface
- considered most common type 3
-
hooked (29%)
- the most anterior portion of the acromion has a hooked shape
- associated with increased incidence of shoulder impingement
-
convex (upturned) (3%)
- most recent classification of acromion process shape
- the undersurface of the acromion is convex near the distal end 4
- no convincing correlation between a type 4 acromion and impingement syndrome exists 4, 5
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