What are the occupational treatment methods for scapulohumeral periarthritis?

(1) Purpose of treatment According to different stages of periarthritis of shoulder, the purpose of occupational therapy is different.

1. Patients in acute stage mainly show pain, and the dysfunction is mainly muscle spasm caused by pain. Therefore, the purpose of occupational therapy is to relieve pain, maintain the range of motion of shoulder joint and prevent joint dysfunction.

2. Patients in chronic stage are characterized by pain and limited joint activity, but most of them are functional disorders, and pain is often caused by joint activity disorders. Therefore, occupational therapy aims at restoring the function of joint movement.

3. Patients in convalescence mainly show joint movement disorder, and the pain is slight or not obvious. Therefore, the main purpose of occupational therapy is to continue to strengthen functional exercise, enhance muscle strength, restore or improve the disused scapular muscle, and restore the normal elasticity and contraction function of deltoid muscle, so as to achieve the purpose of comprehensive rehabilitation and prevent recurrence.

(2) Treatment method 1. The occupational therapy adopted in the acute stage should be mainly to relieve pain and make the shoulder joint get full rest.

(1) Avoid excessive use of the affected shoulder joint: In work or daily life, minimize the repeated use of the affected shoulder joint. If the affected shoulder joint is used for a long time, it should be used alternately with the healthy shoulder joint to reduce the overload of the affected shoulder joint and ensure that the affected shoulder joint has enough rest time.

(2) Activities of daily life: In daily life activities, the healthy upper limb should be used more to relieve the excessive fatigue of the affected shoulder joint. You can use the following methods: you can use healthy hands instead of combing your hair, or use some combs with long handles to comb your hair with affected hands; Washing your hair and face can be replaced by healthy hands; You can wear the affected hand first and then the healthy hand; You can wipe your back with a long towel when you take a shower. Put the healthy hand on one end of the towel on the shoulder, and the affected hand reaches the other end of the towel on the back, and then pull up the healthy hand (Figure 1 1-3- 1). You can also use a long-handled brush instead of a towel to clean your back; When cutting food, you can use a lighter knife to avoid aggravating shoulder pain due to gravity.

Figure 1 1-3- 1 The healthy hand (top) drives the affected hand (bottom).

(3) Maintain the range of motion of the shoulder joint: In the acute stage, it is necessary to maintain the range of motion of the shoulder joint as much as possible. Patients should be encouraged to move their shoulder joints without aggravating shoulder pain. Generally, you can take some self-active exercises to keep the shoulder joint moving. Or reduce the degree of joint movement limitation, such as climbing the wall with the affected arm (touching the height), pulling the affected arm, pulling the pulley to practice health care sticks, etc. (fig. 1 1-3-2~4). In addition, the patient can do the Codman as follows: Stand with legs apart, and the affected shoulder joint naturally droops, with the shoulder joint as the axis. Instantaneous acupuncture or counterclockwise rotation of the upper arm (Figure 1 1-3-5) can increase local blood circulation, relax muscles and reduce painful activities. According to the degree of pain you can bear, don't take heavy things in your hands and don't need too much action.

2. The occupational therapy used in chronic stage should be mainly to relieve adhesion, expand the range of motion of shoulder joint and restore normal joint function. Because the shoulder joint is the most flexible joint in the whole body and has the largest range of activities, there are also various movements. In principle, as long as the healthy shoulder joint can complete the action, it can be used as the treatment content of the affected shoulder joint.

(1) Shoulder flexion and extension operation therapy: for example, use sandpaper board to polish wood boards, saw wood, planed wood, hammered the table top, pushed the roller to wipe the table top, knitted on the knitting stand, played basketball and bowling, practiced on the shoulder ladder or climbed the wall, etc.

(2) Treatment of shoulder adduction-abduction: for example, painting, weaving, painting, playing the piano and writing big characters.

(3) Treatment of shoulder rotation: for example, playing table tennis, pitching, practicing carpentry (such as planing and sawing) and sanding.

(4) Holistic occupational therapy: for example, shoulder wheel movement, pulley movement, etc.

During the above operation, the shoulder joint should be moved to the maximum range or limited terminal as far as possible to achieve the purpose of traction.

3. The occupational therapy adopted in the recovery period should be based on exercises to increase shoulder joint activity, supplemented by muscle strength exercises.

Try to restore the normal elasticity and contraction function of disused muscles such as scapular girdle muscle and deltoid muscle, so as to achieve the purpose of comprehensive rehabilitation and prevent recurrence.

Joint movements can be swung with wooden sticks and dumbbells, using gymnastics sticks, shoulders, ladders, ribs, high pulleys and so on. It can also be done by shoulder external rotation and internal rotation, mainly deltoid muscle, pulling muscle strength, and using dumbbell tensioners and other instruments to carry out resistance movement or isokinetic movement. In daily life, we should make full use of the affected shoulder joint to complete various exercises so as not to cause obvious pain, and pay special attention to the abduction range of the shoulder joint and the muscle strength recovery of the deltoid muscle of the shoulder strap.

In addition to taking different treatment measures according to different course of disease, we should also consider the treatment measures according to the severity of the disease.

For example, according to the movement limitation and terminal feeling caused by pain in passive exercise test, judge the severity and guide the treatment. For example, in passive exercise, the patient's pain occurs before the shoulder joint moves to the restricted end, suggesting that scapulohumeral periarthritis is in the acute stage, and the range of activities at this time should not be too large; If the pain occurs at the end of the shoulder joint with limited activity, it means that the acute stage of scapulohumeral periarthritis has passed, and the active activity and range of activity can be appropriately increased; When there is no pain at the end of the shoulder joint and the activity is limited, active exercise can be increased.