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高强度激光治疗粘连性肩关节囊炎的疗效:一项假对照随机对照试验。

Efficacy of high-intensity laser therapy in patients with adhesive capsulitis: a sham-controlled randomized controlled trial.

机构信息

Department of Physical Medicine and Rehabilitation, Gaziler Physical Therapy and Rehabilitation Education and Research Hospital, Ankara, Turkey.

Department of Physical Medicine and Rehabilitation, Health Sciences University Sultan Abdulhamid Han Training and Research Hospital, Selimiye, Tıbbiye Caddesi, 34668, Uskudar, İstanbul, Turkey.

出版信息

Lasers Med Sci. 2021 Feb;36(1):207-217. doi: 10.1007/s10103-020-03121-z. Epub 2020 Aug 18.

Abstract

Adhesive capsulitis is an idiopathic condition characterized by painful shoulder stiffness, impairs quality of life, and causes disability. The purpose of the study is to evaluate the effects of high-intensity laser therapy (HILT) on pain, disability, and quality of life in patients with adhesive capsulitis. The study was designed as a prospective, double-blinded, and sham-controlled randomized trial. Thirty-six patients diagnosed with adhesive capsulitis were randomized into HILT plus therapeutic exercises, sham-laser plus therapeutic exercises, and control-therapeutic exercises only groups. All groups received 25 min of exercises to the shoulder joint supervised by a physiotherapist. Patients in both the HILT and the sham-laser group were blinded to their group randomization. The interventions were performed five times a week for 3 weeks (a total of 15 sessions). The primary outcome measure was the visual analogue scale for pain (Visual Analog Scale for pain (VAS)-pain). The secondary outcome measures were shoulder pain and disability index (SPADI), short-form health survey-36 (SF-36), and range of motion (ROM) of the shoulder joint. Assessments were performed at pre-intervention, post-intervention, and 12-week follow-up by an investigator who was blinded. Thirty-one participants completed the study. HILT plus therapeutic exercises showed significant differences in VAS-pain, SPADI-pain, and SF-36 (subgroups of energy/fatigue, pain, and general health) scores (all P < 0.05). All groups provided comparable improvements in SPADI-disability and ROM of shoulder joint after the interventions and during the follow-up (all P < 0.05). Fifteen sessions of HILT are superior to improve pain and quality of life but not superior in terms of disability or function in patients with adhesive capsulitis. Clinical trial registration number: The study was registered at the US National Institutes of Health ( ClinicalTrials.gov ) (NCT03929276) and available at https://clinicaltrials.gov/ct2/show/NCT03929276?term=tu%C4%9Fba+atan&draw=2&rank=3.

摘要

粘连性肩关节囊炎是一种特发性疾病,其特征为肩部疼痛和僵硬,降低生活质量,并导致残疾。本研究旨在评估高强度激光治疗(HILT)对粘连性肩关节囊炎患者疼痛、残疾和生活质量的影响。该研究设计为前瞻性、双盲、假对照随机试验。36 例粘连性肩关节囊炎患者随机分为 HILT 加治疗性运动、假激光加治疗性运动和仅治疗性运动对照组。所有组均接受 25 分钟的肩部关节治疗性运动,由物理治疗师监督。HILT 组和假激光组的患者对其分组均不知情。每周进行 5 次治疗,共 3 周(共 15 次)。主要观察指标为视觉模拟评分法疼痛评分(VAS-pain)。次要观察指标包括肩关节疼痛和残疾指数(SPADI)、健康调查简表 36(SF-36)和肩关节活动范围(ROM)。由一位不知分组情况的研究者在干预前、干预后和 12 周随访时进行评估。31 名参与者完成了研究。HILT 加治疗性运动在 VAS-pain、SPADI-pain 和 SF-36(能量/疲劳、疼痛和一般健康亚组)评分方面差异具有统计学意义(均 P < 0.05)。所有组在干预后和随访期间在 SPADI 残疾和肩关节 ROM 方面均提供了可比的改善(均 P < 0.05)。15 次 HILT 优于改善疼痛和生活质量,但在粘连性肩关节囊炎患者的残疾或功能方面并无优势。临床试验注册号:该研究在美国国立卫生研究院(ClinicalTrials.gov)注册(NCT03929276),网址为:https://clinicaltrials.gov/ct2/show/NCT03929276?term=tu%C4%9Fba+atan&draw=2&rank=3。

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