J Orthop Sports Phys Ther. 2018 Jul;48(7):541-551. doi: 10.2519/jospt.2018.7871. Epub 2018 May 10.
Background Anodal transcranial direct-current stimulation (a-tDCS) has been shown to enhance the effects of sensorimotor training in neurological populations. Sensorimotor training leads to reduced pain and increased function in the treatment of rotator cuff tendinopathy. The addition of a-tDCS during a rehabilitation program centered on sensorimotor training may improve treatment outcomes in individuals with rotator cuff tendinopathy. Objective To compare 2 groups of individuals with rotator cuff tendinopathy, one receiving a rehabilitation program centered on sensorimotor training with a-tDCS and the other receiving the same rehabilitation program with sham a-tDCS. Methods In this triple-blind, parallel-group randomized controlled trial, 40 adults with rotator cuff tendinopathy participated in a 6-week rehabilitation program (8 treatments with home exercises and including sensorimotor training, patient education, and strengthening). They were randomly assigned to 1 of 2 groups to receive either real a-tDCS (stimulation, 1.5 mA for 30 minutes) or sham a-tDCS during the first 5 treatments. Symptoms and functional limitations (Disabilities of the Arm, Shoulder and Hand questionnaire, Western Ontario Rotator Cuff index) of all participants were evaluated at baseline and at 3, 6, and 12 weeks. Acromiohumeral distances (ultrasonographic measurement at 0°, 45°, and 60° of arm elevation) were assessed at baseline and 6 weeks. Two-way or 3-way repeated-measures analyses of variance were used for statistical analyses. Results Both groups showed statistically significant improvement in Disabilities of the Arm, Shoulder and Hand questionnaire and Western Ontario Rotator Cuff index scores at 3, 6, and 12 weeks, and in acromiohumeral distance at 45° and 60° at 6 weeks (P<.05). No significant group-by-time interaction was observed for all outcomes (P>.43). Conclusion Results do not demonstrate any improved treatment outcomes from the addition of a-tDCS during a rehabilitation program for individuals with rotator cuff tendinopathy. Level of Evidence Therapy, level 1b. J Orthop Sports Phys Ther 2018;48(7):541-551. Epub 10 May 2018. doi:10.2519/jospt.2018.7871.
阳极经颅直流电刺激（a-tDCS）已被证明可以增强神经人群中感觉运动训练的效果。感觉运动训练可减轻肩袖肌腱病的疼痛并提高功能。在以感觉运动训练为中心的康复计划中添加 a-tDCS，可能会改善肩袖肌腱病患者的治疗效果。目的：比较 2 组肩袖肌腱病患者，一组接受以感觉运动训练为中心的康复计划加 a-tDCS 治疗，另一组接受相同的康复计划加 sham a-tDCS 治疗。方法：在这项三盲、平行组随机对照试验中，40 名肩袖肌腱病患者参加了 6 周的康复计划（8 次治疗，包括家庭锻炼以及感觉运动训练、患者教育和强化训练）。他们被随机分配到 2 组中的 1 组，在最初的 5 次治疗中接受真实 a-tDCS（刺激，1.5 mA 持续 30 分钟）或 sham a-tDCS。所有参与者的症状和功能限制（上肢功能障碍问卷、Western Ontario 肩袖指数）均在基线和 3、6 和 12 周进行评估。在基线和 6 周时评估肩峰肱骨关节距离（超声测量 0°、45°和 60°手臂抬高）。采用双向或三向重复测量方差分析进行统计分析。结果：两组患者在 3、6 和 12 周时上肢功能障碍问卷和 Western Ontario 肩袖指数评分以及 6 周时 45°和 60°肩峰肱骨关节距离均有统计学意义的改善（P<.05）。所有结果均未观察到组间时间交互作用（P>.43）。结论：结果表明，在肩袖肌腱病患者的康复计划中添加 a-tDCS 并不能提高治疗效果。证据水平：治疗，1b 级。《美国骨科运动医学杂志》2018 年；48（7）：541-551。2018 年 5 月 10 日在线发表。doi：10.2519/jospt.2018.7871.
