肩旋轉肌袖斷裂術後復健護理

Rehabilitation Nursing Care after a Rotator Cuff Tear Repair

曲幗敏(Kuo-Min Chu) ； 許秀珠(Hsin-Chu Hsu) ； 林麗華(Li-Hwa Lin) ； 顧振玲(Chen-Ling Ku)

《源遠護理》 12卷1期 (2018/03) Pp. 17-25

https://doi.org/10.6530/YYN/2018.5.3

摘要

肩旋轉肌袖是一種常見導致肩膀疼痛與失能的疾病，其影響的人口群從年輕人到年長者都有，但在年長者較為常見，也是中老年人肩關節功能失調最常見的疾病之一，主要症狀為疼痛與手臂上舉困難，治療方法有保守治療與手術治療，當保守治療無效時醫師會建議病患接受手術治療。術後復健是治療成功與否的關鍵因素，復健運動的目的為減緩疼痛與恢復肩部功能，運動需恰當，過與不及都會影響治療成效，運動過多容易導致肌腱再度斷裂，不足則會產生沾黏情形。復健運動共分為四個階段，術後早期階段、保護和保護性主動運動階段、早期加強階段以及增強階段。接受復健的時機與運動型態除了須考量肌腱癒合之生物機轉外，也須考量肌腱斷裂大小、肌腱本身的條件、肌腱修復與術前肩膀僵硬狀況，每個人的狀況不同，因此臨床上需依據病人的個別性擬定復健計畫，並需與病人充分溝通以確保運動安全。

關鍵字

肩旋轉肌袖斷裂 ； 肩旋轉肌袖修補術 ； 術後復健 ； 護理

並列摘要

Rotator cuff tears (RCT) are the most common causes of shoulder pain and disability. RCT occur both in the young and in the elderly, but they are significantly more common in the elderly population. It is one of the most common causes of shoulder disability in the elderly. The most common symptoms of RCT include pain and difficulty with overhead activities. RCT treatment includes conservative and operative methods. Conservative treatment is the appropriate initial plan of care for RCT. Surgery is also considered for patients who have attempted conservative treatment and regardless continue have difficulty with their shoulder. If conservative treatments fail to relieve pain or the patient continues to have difficulty with activities of daily living or occupational duties, surgical referral is recommended. The postoperative rehabilitation program is critical for the success of surgical treatment of RCT. The goals of rehabilitation are to relieve pain and restore shoulder function. The rehabilitation exercises should be appropriate; if attempting to do too much will lead to a retear, doing too less may cause stiffness. A rotator cuff rehabilitation program is broken down into four stages: immediate postoperative stage, protection and protected active stage, early strengthening, advanced strengthening stage. In order to ensure a successful rehabilitation protocol, understanding the biomechanical factors of the repaired Rotator Cuff tendon is an essential component. It is also necessary to considerate the size of the RCT, the condition of the tendon itself, the condition of the tendon repair, and shoulder stiffness before surgery. Individual exercise programs should be designed according to the patient's condition, and it is necessary to communicate to the patient why these exercise are needed and how they should be performed, in order to ensure the safety of the exercise.

並列關鍵字

rotator cuff tear ； rotator cuff repair ； rehabilitation ； nursing

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