Santamato Andrea, Panza Francesco, Notarnicola Angela, Cassatella Gennaro, Fortunato Francesca, de Sanctis Jula Laura, Valeno Giovanni, Kehoe Patrick G, Seripa Davide, Logroscino Giancarlo, Fiore Pietro, Ranieri Maurizio
J Orthop Sports Phys Ther. 2016 Sep;46(9):714-25. doi: 10.2519/jospt.2016.4629. Epub 2016 Jul 31.
Study Design Single-blind randomized trial. Background Extracorporeal shockwave therapy (ESWT) has been shown to produce good results in the treatment of subacromial impingement syndrome (SAIS). The efficacy of a combined administration of ESWT and isokinetic exercise (IE) has not yet been studied. Objectives To evaluate the efficacy of focused ESWT combined with IE for the rotator cuff versus focused ESWT alone in the treatment of SAIS. The secondary objective was to assess the isokinetic torque recovery (external rotation at 210°/s, 180°/s, and 120°/s). Methods Thirty participants with SAIS were randomly assigned to a focused-ESWT group or focused ESWT-plus-IE group. Subjects of both groups received 3 treatment sessions of focused ESWT over a period of 10 days. Participants in the second group also received IE for 10 therapy sessions. Outcome measures were the Constant-Murley score (CMS), the visual analog scale (VAS), and isokinetic parameters (peak torque and total work calculated from 5 repetitions) measured with the isokinetic test. Subjects were assessed at baseline, 10 days after the last treatment session with focused ESWT, and after 2 months of follow-up. Results At 2 months posttreatment, participants in the focused ESWT-plus-IE group showed significantly less pain (focused-ESWT VAS, 3.4 ± 0.8 versus focused ESWT-plus-IE VAS, 1.5 ± 0.5; P<.001) and greater improvement in functionality (focused-ESWT CMS, 75.9 ± 6.7 versus focused ESWT-plus-IE CMS, 92.1 ± 6.3; P<.001) and muscle endurance than the subjects in the focused-ESWT group. Conclusion In subjects with SAIS, combined administration of focused ESWT and IE for the rotator cuff resulted in greater reduction of pain, as well as superior functional recovery and muscle endurance in the short to medium term, compared with ESWT alone. Level of evidence Therapy, 2b.
unregistered 2011 trial. J Orthop Sports Phys Ther 2016;46(9):714-725. Epub 5 Aug 2016. doi:10.2519/jospt.2016.4629.
研究设计为单盲随机试验。背景：体外冲击波疗法（ESWT）已被证明在治疗肩峰下撞击综合征（SAIS）方面效果良好。ESWT与等速运动（IE）联合应用的疗效尚未得到研究。目的：评估聚焦式ESWT联合IE治疗肩袖损伤相对于单纯聚焦式ESWT治疗SAIS的疗效。次要目的是评估等速扭矩恢复情况（210°/秒、180°/秒和120°/秒时的外旋）。方法：30例SAIS患者被随机分配至聚焦式ESWT组或聚焦式ESWT加IE组。两组受试者均在10天内接受3次聚焦式ESWT治疗。第二组参与者还接受了10次IE治疗。结果指标为采用等速测试测量的Constant-Murley评分（CMS）、视觉模拟量表（VAS）和等速参数（5次重复的峰值扭矩和总功）。在基线、最后一次聚焦式ESWT治疗后10天以及随访2个月时对受试者进行评估。结果：治疗后2个月，聚焦式ESWT加IE组的参与者疼痛明显减轻（聚焦式ESWT组VAS为3.4±0.8，聚焦式ESWT加IE组VAS为1.5±0.5；P<0.001），功能改善更大（聚焦式ESWT组CMS为75.9±6.7，聚焦式ESWT加IE组CMS为92.1±6.3；P<0.001），且肌肉耐力优于聚焦式ESWT组的受试者。结论：在SAIS患者中，与单纯ESWT相比，聚焦式ESWT与肩袖损伤的IE联合应用在短期至中期可更大程度地减轻疼痛，实现更好的功能恢复和肌肉耐力。证据水平：治疗，2b级。
2011年未注册试验。《矫形与运动物理治疗杂志》2016年；46(9):714 - 725。2016年8月5日在线发表。doi:10.2519/jospt.2016.4629 。
