持续低水平热裹疗法对治疗手腕疼痛有效。

Continuous low-level heat wrap therapy is effective for treating wrist pain.

作者信息

Michlovitz Susan, Hun Larysa, Erasala Geetha N, Hengehold David A, Weingand Kurt W

机构信息

Department of Physical Therapy, Temple University, Philadelphia, PA 19140, USA.

出版信息

Arch Phys Med Rehabil. 2004 Sep;85(9):1409-16. doi: 10.1016/j.apmr.2003.10.016.

DOI:10.1016/j.apmr.2003.10.016

PMID:15375809

Abstract

OBJECTIVE

To evaluate the efficacy of continuous low-level heat wrap therapy for the treatment of various sources of wrist pain including strain and sprain (SS), tendinosis (T), osteoarthritis (OA), and carpal tunnel syndrome (CTS).

DESIGN

Prospective, randomized, parallel, single-blind (investigator), placebo-controlled, multicenter clinical trial.

SETTING

Two community-based research facilities.

PARTICIPANTS

Ninety-three patients (age range, 18-65 y) with wrist pain.

INTERVENTION

Subjects with moderate or greater wrist pain were randomized and stratified to 1 of the following treatments: efficacy evaluation (heat wrap, n=39; oral placebo, n=42) or blinding (oral acetaminophen, n=6; unheated wrap, n=6). Data were recorded over 3 days of treatment and 2 days of follow-up.

MAIN OUTCOME MEASURES

The primary comparison was between the heat wrap and the oral placebo group among SS/T/OA subjects for pain relief. Outcome measures included pain relief (0-5 scale), joint stiffness (101-point numeric rating scale), grip strength measured by dynamometry, and perceived pain and disability (Patient Rated Wrist Evaluation [PRWE]); subjects with CTS also completed the Symptom Severity Scale and Functional Status Scale.

RESULTS

Heat wrap therapy showed significant benefits in day 1 to 3 mean pain relief (P=.045) and increased day 3 grip strength (P=.02) versus oral placebo for the SS/T/OA group. However, joint stiffness and PRWE results were comparable between the 2 treatments. For the CTS group, heat wraps provided greater day 1 to 3/hour 0 to 8 mean pain relief (P=.001), day 1 to 3 mean joint stiffness reduction (P=.004), increased day 3 grip strength (P=.003), reduced PRWE scores (P=.0015), reduced symptom severity (P=.001), and improved functional status (P=.04). In addition, the heat wrap showed significant extended benefits through follow-up (day 5) in the CTS group.

CONCLUSIONS

Continuous low-level heat wrap therapy was efficacious for the treatment of common conditions causing wrist pain and impairment.

摘要

目的

评估持续低水平热裹疗法对治疗各种原因引起的腕部疼痛的疗效，这些原因包括拉伤和扭伤（SS）、肌腱病（T）、骨关节炎（OA）和腕管综合征（CTS）。

设计

前瞻性、随机、平行、单盲（研究者）、安慰剂对照、多中心临床试验。

地点

两个社区研究机构。

参与者

93例腕部疼痛患者（年龄范围18 - 65岁）。

干预

中度或更严重腕部疼痛的受试者被随机分组并分层接受以下治疗之一：疗效评估（热裹，n = 39；口服安慰剂，n = 42）或盲法（口服对乙酰氨基酚，n = 6；未加热裹，n = 6）。在3天治疗期和2天随访期记录数据。

主要观察指标

主要比较SS/T/OA受试者中热裹组和口服安慰剂组的疼痛缓解情况。观察指标包括疼痛缓解（0 - 5级）、关节僵硬（101点数字评分量表）、通过测力计测量的握力以及感知疼痛和功能障碍（患者腕部评估量表[PRWE]）；患有CTS的受试者还完成了症状严重程度量表和功能状态量表。

结果

对于SS/T/OA组，与口服安慰剂相比，热裹疗法在第1至3天的平均疼痛缓解方面显示出显著益处（P = 0.045），并且在第3天握力增加（P = 0.02）。然而，两种治疗方法在关节僵硬和PRWE结果方面相当。对于CTS组，热裹在第1至3天/第0至8小时的平均疼痛缓解方面更大（P = 0.001），第1至3天平均关节僵硬减轻（P = 0.004），第3天握力增加（P = 0.003），PRWE评分降低（P = 0.0015），症状严重程度降低（P = 0.001），功能状态改善（P = 0.04）。此外，热裹在CTS组随访期（第5天）显示出显著的持续益处。