Delgado-Gil José A, Prado-Robles Eva, Rodrigues-de-Souza Daiana P, Cleland Joshua A, Fernández-de-las-Peñas César, Alburquerque-Sendín Francisco
Physical Therapist, Primary Care Service Area, León, Spain.
Occupational Therapist, General Hospital, León, Spain.
J Manipulative Physiol Ther. 2015 May;38(4):245-52. doi: 10.1016/j.jmpt.2014.12.008. Epub 2015 Apr 30.
The purpose of this study was to compare the immediate effects of mobilization with movement (MWM) to a sham technique in patients with shoulder impingement syndrome.
A randomized controlled trial was performed. Forty-two patients (mean ± SD age, 55 ± 9 years; 81% female) satisfied eligibility criteria, agreed to participate, and were randomized into an MWM group (n = 21) or sham manual contact (n = 21). The primary outcome measures including pain intensity, pain during active range of motion, and maximal active range of motion were assessed by a clinician blinded to group allocation. Outcomes were captured at baseline and after 2 weeks of MWM treatment or sham intervention. The primary analysis was the group × time interaction.
The 2×2 analysis of variance revealed a significant group × time interaction for pain intensity during shoulder flexion (F = 7.054; P = .011), pain-free shoulder flexion (F = 32.853; P < .001), maximum shoulder flexion (F = 18.791; P < .01), and shoulder external rotation (F = 7.950; P < .01) in favor of the MWM group. No other significant differences were found.
Patients with shoulder impingement syndrome who received 4 sessions of MWM exhibited significantly better outcomes for pain during shoulder flexion, pain-free range of shoulder flexion, maximal shoulder flexion, and maximal external rotation than those patients who were in the sham group.
本研究旨在比较活动中松动术(MWM)与假手法对肩峰撞击综合征患者的即时效果。
进行了一项随机对照试验。42例患者(平均年龄±标准差,55±9岁;81%为女性)符合入选标准,同意参与研究,并被随机分为MWM组(n = 21)或假手法接触组(n = 21)。主要结局指标包括疼痛强度、主动活动范围时的疼痛以及最大主动活动范围,由对分组情况不知情的临床医生进行评估。在基线以及MWM治疗或假干预2周后记录结局。主要分析为组×时间交互作用。
二因素方差分析显示,在肩屈曲时的疼痛强度(F = 7.054;P = .011)、无痛肩屈曲(F = 32.853;P < .001)、最大肩屈曲(F = 18.791;P < .01)和肩外旋(F = 7.950;P < .01)方面存在显著的组×时间交互作用,支持MWM组。未发现其他显著差异。
接受4次MWM治疗的肩峰撞击综合征患者在肩屈曲时的疼痛情况、无痛肩屈曲范围、最大肩屈曲和最大外旋方面,比假手术组患者的结局显著更好。