Chen Chih-Yu, Hu Chia-Chian, Weng Pei-Wei, Huang Yu-Ming, Chiang Chang-Jung, Chen Chia-Hsien, Tsuang Yang-Hwei, Yang Rong-Sen, Sun Jui-Sheng, Cheng Cheng-Kung
Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan; Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
J Shoulder Elbow Surg. 2014 Dec;23(12):1843-1851. doi: 10.1016/j.jse.2014.08.010.
The treatment of adhesive capsulitis is a dilemma for orthopaedic rehabilitation specialists. In this study, we assessed whether extracorporeal shockwave therapy (ESWT) improves the functional outcome of primary shoulder adhesive capsulitis.
In this prospective, randomized, controlled, single-blind clinical trial, we enrolled 40 patients with primary adhesive capsulitis to assess whether ESWT can improve the functional outcome of primary adhesive capsulitis better than oral steroid therapy. Patients were allocated to the oral steroid group or ESWT group with randomization. Functional outcome evaluations were performed using the Constant Shoulder Score (CSS) and Oxford Shoulder Score.
Both groups showed significant improvement in the Oxford Shoulder Score evaluation throughout the study period. In the ESWT group, the total CSS and range of motion (ROM) parameter of the CSS in the ESWT group showed significant improvement from the fourth week that was better than that in the steroid group; the activities–of–daily living (ADL) parameter of the CSS achieved significance and was better than that in the steroid group at the sixth week. For the steroid group, pain was significantly reduced from baseline to the fourth week of the study; ADL and ROM improved at the fourth to 12th week. For the ESWT group, ADL and ROM improvements were significant from baseline to the sixth week.
Our results showed that ESWT can be an alternative treatment, at least in the short-term, for primary adhesive capsulitis of the shoulder. In addition, all of the side effects of ESWT were transient and tolerable.
粘连性关节囊炎的治疗对骨科康复专家来说是个难题。在本研究中,我们评估了体外冲击波疗法(ESWT)是否能改善原发性肩部粘连性关节囊炎的功能结局。
在这项前瞻性、随机、对照、单盲临床试验中,我们纳入了40例原发性粘连性关节囊炎患者,以评估ESWT是否比口服类固醇疗法能更好地改善原发性粘连性关节囊炎的功能结局。患者通过随机分组被分配至口服类固醇组或ESWT组。使用Constant肩关节评分(CSS)和牛津肩关节评分进行功能结局评估。
在整个研究期间,两组在牛津肩关节评分评估中均显示出显著改善。在ESWT组,从第四周起,ESWT组的CSS总分和CSS中的活动范围(ROM)参数显示出显著改善,优于类固醇组;CSS中的日常生活活动(ADL)参数在第六周达到显著水平,且优于类固醇组。对于类固醇组,从研究基线到第四周疼痛显著减轻;在第四至十二周ADL和ROM有所改善。对于ESWT组,从基线到第六周ADL和ROM的改善显著。
我们的结果表明,至少在短期内,ESWT可作为肩部原发性粘连性关节囊炎的一种替代治疗方法。此外,ESWT的所有副作用都是短暂且可耐受的。