Neuromusculoskeletal Research Centre, Firoozgar Hospital.
Neuromusculoskeletal Research Centre, Iran University of Medical Sciences, Tehran, Iran.
Pain Med. 2019 Sep 1;20(9):1745-1749. doi: 10.1093/pm/pny303.
The aim of this study was to compare the efficacy of prolotherapy with hypertonic dextrose and radial shock wave therapy in chronic lateral epicondilosis.
Prospective single-blind randomized clinical trial.
Physical medicine and rehabilitation clinic.
Thirty-three patients with at least three months of signs and symptoms of lateral epicondilosis, as well as failure of at least one of the conservative treatments, randomly allocated into two groups.
Sixteen patients received three sessions of shock wave therapy, and 17 received one session prolotherapy. Severity of pain via visual analog scale (VAS), grip strength via Baseline Pneumatic Dynamometer, pressure pain threshold (PPT) by algometer and Disabilities of Arm, Shoulder, and Hand quick questionnaire (Quick DASH) were assessed at baseline, four weeks, and eight weeks after the intervention.
Within-group analysis showed that in both groups, differences between all of the outcome measures were significant after four and also eight weeks. Between-group analysis after four and eight weeks showed that the VAS and Quick DASH had significantly more improvement in the shock wave group. However, the two groups were similar regarding grip strength and PPT. No complication was observed in the two groups.
Based on the results of this study, a regiment of three sessions (weekly) of radial extracorporeal shock wave therapy is significantly more effective than one session of prolotherapy with 20% dextrose regarding pain and function in the management of chronic lateral epicondylosis in short-term follow-up.
本研究旨在比较增生疗法与高渗葡萄糖和径向冲击波疗法治疗慢性肱骨外上髁炎的疗效。
前瞻性单盲随机临床试验。
物理医学与康复诊所。
33 名患者至少有三个月的肱骨外上髁炎症状和体征,以及至少一种保守治疗失败,随机分为两组。
16 名患者接受 3 次冲击波治疗,17 名患者接受 1 次增生治疗。通过视觉模拟量表(VAS)评估疼痛严重程度,通过基线气动测力计评估握力,通过压力疼痛阈值(PPT)测量仪评估压力疼痛阈值(PPT),通过手臂、肩部和手快速问卷(Quick DASH)评估残疾程度。在干预后 4 周和 8 周时评估所有结果。
组内分析显示,两组患者在干预后 4 周和 8 周时,所有结果测量值的差异均有统计学意义。在 4 周和 8 周的组间分析中,冲击波组的 VAS 和 Quick DASH 有明显更多的改善。然而,两组在握力和 PPT 方面相似。两组均未观察到并发症。
根据本研究的结果,三组(每周一次)的径向体外冲击波疗法比单次 20%葡萄糖增生疗法在短期随访中对慢性肱骨外上髁炎的疼痛和功能管理更有效。