Şahin Onat Şule, Biçer Seda, Şahin Zehra, Küçükali Türkyilmaz Ayşegül, Kara Murat, Özbudak Demir Sibel
From the Ankara Physical and Rehabilitation Medicine Training and Research Hospital, Ankara (ŞŞO, SB, ZŞ, MK, SÖD); and Department of Physical and Rehabilitation Medicine, Recep Tayyip Erdogan University Medical School, Rize, Turkey (AKT).
Am J Phys Med Rehabil. 2016 Aug;95(8):553-60. doi: 10.1097/PHM.0000000000000492.
The aim of this study was to investigate whether kinesiotaping or subacromial corticosteroid injection provides additional benefit when used with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with shoulder impingement syndrome.
Patients with shoulder impingement syndrome were divided into 3 groups as follows: NSAID group (n = 33), kinesiotaping group (kinesiotaping + NSAID) (n = 33), and injection group (subacromial corticosteroid injection + NSAID) (n = 33). Outcome measures including visual analog scale, shoulder ranges of motion, Shoulder Disability Questionnaire, and University of California-Los Angeles (UCLA) scale were evaluated before and after the treatment (fourth week).
A total of 99 patients (21 male and 78 female patients) were enrolled in this study. Demographic and baseline clinical characteristics of the groups (except for body mass index and visual analog scale at night, both P = 0.05) were similar between the groups (all P > 0.05). Clinical parameters were found to have improved in the 3 groups (all P < 0.001). While the kinesiotaping and injection groups showed similar improvements (all P > 0.05), each group had better outcome than did the NSAID group as regards pain (activity visual analog scale), ranges of motion, and Shoulder Disability Questionnaire and UCLA scale scores (all P < 0.05).
Addition of kinesiotaping or subacromial corticosteroid injection to NSAID treatment seems to have better/similar effectiveness in patients with shoulder impingement syndrome. Therefore, kinesiotaping might serve as an alternative treatment in case (injection of) corticosteroids are contraindicated.
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this article, the reader should be able to: (1) Delineate appropriate treatment options for shoulder impingement syndrome; (2) Identify treatment benefits of kinesiotaping and corticosteroid injections in shoulder impingement syndrome; and (3) Incorporate kinesiotaping and corticosteroid injections into the treatment plan for patients with shoulder impingement syndrome.
Advanced
: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this activity for amaximumof 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
本研究旨在调查在肩部撞击综合征患者中,与非甾体抗炎药(NSAIDs)联合使用时,肌内效贴布或肩峰下皮质类固醇注射是否能带来额外益处。
将肩部撞击综合征患者分为以下3组:NSAIDs组(n = 33)、肌内效贴布组(肌内效贴布 + NSAIDs)(n = 33)和注射组(肩峰下皮质类固醇注射 + NSAIDs)(n = 33)。在治疗前及治疗后(第4周)评估包括视觉模拟量表、肩部活动范围、肩部功能障碍问卷以及加利福尼亚大学洛杉矶分校(UCLA)量表等结果指标。
本研究共纳入99例患者(21例男性和78例女性患者)。各组间的人口统计学和基线临床特征相似(除体重指数和夜间视觉模拟量表外,两者P = 0.05)(所有P > 0.05)。发现3组的临床参数均有改善(所有P < 0.001)。虽然肌内效贴布组和注射组显示出相似的改善(所有P > 0.05),但在疼痛(活动视觉模拟量表)、活动范围以及肩部功能障碍问卷和UCLA量表评分方面,每组的结果均优于NSAIDs组(所有P < 0.05)。
在NSAIDs治疗基础上添加肌内效贴布或肩峰下皮质类固醇注射,对于肩部撞击综合征患者似乎具有更好/相似的疗效。因此,在皮质类固醇(注射)禁忌的情况下,肌内效贴布可能是一种替代治疗方法。
高级
学术物理医学与康复医师协会经继续医学教育认证委员会认可,可为医生提供继续医学教育。学术物理医学与康复医师协会指定该活动最多授予1.5个美国医学协会(AMA)PRA第1类学分™。医生应仅根据其参与活动的程度申领相应学分。