治疗环境对 RCRSP 疼痛、功能、自我效能和满意度的影响

实验性的：隔离治疗环境组（第 2 组）。

第2组将在安静的单人房间接受治疗。 房间里有人造光照明，窗帘关闭，病人看不到外面的景色。 患者将接受由患者教育、运动疗法和冷敷组成的治疗，每周3次，总共15次。 每节课持续约 60 分钟。 患者教育和运动治疗完成后，参与者将安静休息15分钟的冷敷。

行为的：患者教育

它包括对治疗过程和过去疗程的评估。 向患者解释了简单的肩部生物力学、功能以及造成损伤的原因。 为了提高患者对治疗的参与度，强调治疗的作用以及患者应配合才能治愈。 治疗期间指导患者调节日常生活活动，避免手臂过头、重复动作、提包重量超过2-3公斤等。 建议不要携带。 患者被告知其他睡眠姿势。

行为的：运动疗法

两组参与者都参加了由文献中推荐的练习组成的结构化锻炼计划。 该锻炼计划包括关节活动范围练习、伸展练习和强化练习，并在物理治疗师的监督下进行了6周。 关节活动范围和强化练习建议为3组，每组10次重复，伸展运动建议为5次重复，每次20秒。 物理治疗师选择适合患者临床状况和进展的运动并将其纳入计划中。

行为的：冷敷

每次运动治疗后，将进行冷敷 15 分钟。 在使用col-pack期间，第1组的患者会听我们选择的古典音乐，而第2组的患者会安静地休息。 我们的CD机上共有40首巴赫、莫扎特、贝多芬和安德烈·瑞欧的歌曲，患者有权利选择和收听自己想要的歌曲。

实验性的：The enriched therapeutic environment group (Group 1)

Group 1 will receive treatment in a physiotherapy unit which has following characteristics ; enlightened with sunlight, has a view of green trees and includes other participants exercising. This enviroment also had an intrumental music playing in the background. Patients will receive a treatment consisting of patient education, exercise therapy and cold application for a total of 15 sessions, 3 times a week. Each session will last approximately 60 minutes. After the patient education and exercise therapy is completed, the participants will rest for 15 minutes of cold application.

行为的：患者教育

它包括对治疗过程和过去疗程的评估。 向患者解释了简单的肩部生物力学、功能以及造成损伤的原因。 为了提高患者对治疗的参与度，强调治疗的作用以及患者应配合才能治愈。 治疗期间指导患者调节日常生活活动，避免手臂过头、重复动作、提包重量超过2-3公斤等。 建议不要携带。 患者被告知其他睡眠姿势。

行为的：运动疗法

两组参与者都参加了由文献中推荐的练习组成的结构化锻炼计划。 该锻炼计划包括关节活动范围练习、伸展练习和强化练习，并在物理治疗师的监督下进行了6周。 关节活动范围和强化练习建议为3组，每组10次重复，伸展运动建议为5次重复，每次20秒。 物理治疗师选择适合患者临床状况和进展的运动并将其纳入计划中。

行为的：冷敷

每次运动治疗后，将进行冷敷 15 分钟。 在使用col-pack期间，第1组的患者会听我们选择的古典音乐，而第2组的患者会安静地休息。 我们的CD机上共有40首巴赫、莫扎特、贝多芬和安德烈·瑞欧的歌曲，患者有权利选择和收听自己想要的歌曲。

数字疼痛评定量表 (NPRS)

使用 NPRS 测量参与者在休息、夜间和活动期间的疼痛。 NPRS 是一个 11 分制的量表，可以从 0 到 10 分。 零分 (0) 表示“无疼痛”，10 分表示分数定义“最严重的疼痛”。 患者将被要求在量表上标记肩部疼痛

Quick - The Disabilities of the Arm, Shoulder and Hand (Quick DASH) Questionnaire

Q-DASH is a questionnaire developed to assess upper extremity functioning and symptoms based on self-report of patients. The total score of the scale ranges from 0-100 points and similar to SPADI, a high score is considered as high functional disability.

Western Ontario Rotator Cuff (WORC) Index

WORC is a functional test which consists of 5 sections and a total of 21 questions assessing the physical symptoms, sports/leisure time activities, work, lifestyle, emotions that are affected by the shoulder problem. Each question is rated on a scale of 0-100 mm. Patients are scored between 0 and 2100 in total, with 2100 being the worst score.

Pain Self-Efficacy Questionnaire (PSEQ)

The Pain and Self-Efficacy questionnaire consists of 10 questions and it assesses multiple domains of self-efficacy related to social and physical functioning. Each item is rated on a 7-point Likert-type scale (0: I am not at all confident, 6: I am completely confident). The total score ranges from 0 to 60, with higher scores indicating greater self-efficacy for functioning despite pain.

Global Rating of Change, GRC

The Global Rating of Change (GRC) is specifically designed to determine the impact of an intervention in musculoskeletal problems, to chart the clinical course of a condition and to measure a patient's improvement or deterioration over time. When using the GRC scale, the patient being assessed must have a certain cognitive level because the patient's ability to recall and measure the pre-treatment state is required. In our study, a scale consisting of 5 levels will be used (-2: much worse, -1: worse, 0: same, 1: better, 2: much better).