肩關節活動受限患者之疼痛點分析

A STUDY ON TENDER POINT OVER THE PATIENTS WITH SHOULDER’S ROM LIMITATION

黃玉萍(Yu-ping Huang)

指導教授 ： 王鐘毅

大同大學/工程學院/生物工程學系所/碩士(2010年)

摘要

肩關節的疼痛病理機轉呈現多樣性，不易有效地實行物理電療。本論文的目的在於系統性的將病患的自覺性痛點、激痛點、壓痛點，與傳導痛間之酸、麻與痛感等之消長變化、動作代償進行分類，以期有助於精確的診斷，縮短治療時間。 本研究對象為被診斷為肩關節活動受限之62位患者，我們採同身寸方式，將等肩部細分為64區域，以數位疼痛閾值量測儀進行壓痛點檢查，並以視覺模擬評分量化疼痛程度。
根據這些實際量測的結果，可以發現：肩關節活動受限者之壓痛點分佈廣泛，以三角肌前部後部肱骨三角肌粗隆，和SITS肌肉之壓痛點最多，且壓痛明顯，常為激痛；其次為斜方肌。進一步細分，主要疼痛區為H2、H3、H5、G7、G8及E1等區域，次要疼痛區為D9、E9、C4、C5及C6。從病程而言，肩關節活動受限者於早期壓痛點明顯，集中肩峰下及等處。病程後期，壓痛點擴散，壓痛不明顯，但以小圓肌和棘下肌最常見。

關鍵字

肩關節 ； 肌筋膜痛點 ； 壓痛點

並列摘要

Pathological diagnosis of patients subjected to restricted range of motion (ROM) is often hampered by its subjectivity and pervasion in the pain locations. The purpose of this thesis is to systematically classify the location and progress of consciousness pain locations, including trigger points and tender points, for more effective rehabilitation treatment.
The research is based on records of 62 patients suffered from limited ROM in shoulders. The examinations were conducted with a pressure threshold meter to press on 64 points within an area defined by the normalized body-inch. The consciousness pain was assessed with visual analogue scale (VAS).
According to the records, the tender points are widespread on shoulder, especially in anterior deltoid, posterior deltoid, deltoid tuberosity and SITS, while trapezius is also common. Specifically, major pains are located in H2,H3,H5,G7,G8, and E1, while minor pains are located in D9,E9,C4,C5 and C6. Also, the patients normally suffer significant pains under the acromion at the early stage, while the spread of tender points becomes unapparent, usually in teres major and infraspinatus, at the later stage.

Keyword: Shoulder; Tender point; Myofascial pain syndrome.

並列關鍵字

Myofascial pain syndrome ； Tender point ； Shoulder

參考文獻

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