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富血小板血浆治疗偏瘫肩痛的疗效

Efficacy of platelet-rich plasma in the treatment of hemiplegic shoulder pain.

作者信息

Uzdu Asude, Kirazlı Yeşim, Karapolat Hale, Unlu Burcu, Tanıgör Göksel, Çalış Funda Atamaz

机构信息

Department of Physical Medicine and Rehabilitation, Ege University Faculty of Medicine, Bornova, Izmir, Turkey.

出版信息

Neurol Sci. 2021 May;42(5):1977-1986. doi: 10.1007/s10072-020-04710-0. Epub 2020 Sep 29.

Abstract

OBJECTIVE

The aim of this study was to examine the effects of platelet-rich plasma (PRP) on pain and functional outcomes in patients with hemiplegic shoulder pain. We compared the effects of PRP against saline solution by designing a double blind, randomized, prospective study.

DESIGN

Forty-four patients with hemiplegia were included in this study. All patients received a total of 3 injections, 1 week apart. The first group received PRP injections while the second group received placebo injections. After 3 months of follow-up, 40 patients completed the trial. Primary outcome measure was movement-induced pain score (VAS), and secondary outcome measures were spontaneous pain score, shoulder passive range of motion (ROM), functional independence measure score, and the amount of paracetamol used. All subjects were evaluated at baseline, 1 week, 1 month, and 3 months after the completion of the last injection.

RESULTS

Both groups showed an improvement in spontaneous and movement-related pain scores and shoulder passive ROM values on 1st and 3rd month visits (p < 0.05). No significance difference was detected between groups (p > 0.05). Similarly, FIM scores improved significantly in both groups (p < 0.05) but no difference was found between groups. Paracetamol use did not differ significantly between groups.

CONCLUSION

The PRP injections were found not to be superior to placebo. Improvements in both groups can be attributed to the use of rehabilitation techniques and exercises in all patients. There is still need for further research to show whether PRP is a treatment option in the course of hemiplegic shoulder pain.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03931824.

摘要

目的

本研究旨在探讨富血小板血浆(PRP)对偏瘫肩痛患者疼痛及功能结局的影响。我们通过设计一项双盲、随机、前瞻性研究,比较了PRP与生理盐水的效果。

设计

本研究纳入了44例偏瘫患者。所有患者共接受3次注射,每次间隔1周。第一组接受PRP注射,而第二组接受安慰剂注射。经过3个月的随访,40例患者完成了试验。主要结局指标为运动诱发疼痛评分(视觉模拟量表[VAS]),次要结局指标为自发疼痛评分、肩部被动活动范围(ROM)、功能独立性测量评分以及对乙酰氨基酚的使用量。所有受试者在最后一次注射完成后的基线、1周、1个月和3个月时进行评估。

结果

在第1个月和第3个月的随访中,两组患者的自发疼痛评分、与运动相关的疼痛评分以及肩部被动ROM值均有所改善(p < 0.05)。两组之间未检测到显著差异(p > 0.05)。同样,两组的功能独立性测量(FIM)评分均显著改善(p < 0.05),但组间无差异。两组对乙酰氨基酚的使用量无显著差异。

结论

发现PRP注射并不优于安慰剂。两组的改善可能归因于所有患者均采用了康复技术和锻炼。仍需要进一步研究以表明PRP是否为偏瘫肩痛病程中的一种治疗选择。

试验注册

ClinicalTrials.gov标识符:NCT03931824。

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