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干针疗法对髋关节炎患者疼痛、髋部肌肉力量和身体功能的疗效:一项随机对照试验。

Effectiveness of Dry Needling Therapy on Pain, Hip Muscle Strength, and Physical Function in Patients With Hip Osteoarthritis: A Randomized Controlled Trial.

机构信息

Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy. Faculty of Health Sciences, University of Valladolid, Soria.

Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy. Faculty of Health Sciences, University of Valladolid, Soria.

出版信息

Arch Phys Med Rehabil. 2021 May;102(5):959-966. doi: 10.1016/j.apmr.2021.01.077. Epub 2021 Feb 7.

Abstract

OBJECTIVE

To investigate the short-term effects of dry needling (DN) on physical function, pain, and hip muscle strength in patients with hip osteoarthritis (OA).

DESIGN

A double-blind, placebo-control, randomized controlled trial.

SETTING

Private practice physiotherapy clinic.

PARTICIPANTS

Patients with unilateral hip OA (N=45) were randomly allocated to a DN group, sham DN group, or control group.

INTERVENTIONS

Patients in the DN and sham groups received 3 treatment sessions. Three active myofascial trigger points (MTrPs) were treated in each session with DN or a sham needle procedure. The treatment was applied in active MTrPs of the iliopsoas, rectus femoris, tensor fasciae latae, and gluteus minimus muscles.

MAIN OUTCOME MEASURES

Physical function was assessed with the Western Ontario and McMaster Universities (WOMAC) physical function subscale, the timed Up and Go test, and the 40-meter self-paced walk test. Intensity of hip pain related to physical function was evaluated using the visual analog scale and WOMAC pain subscale. The maximal isometric force of hip muscles was recorded with a handheld dynamometer.

RESULTS

Significant group by time interactions were shown for physical function, pain, and hip muscle force variables. Post hoc tests revealed a significant reduction in hip pain and significant improvements in physical function and hip muscle strength in the DN group compared with the sham and control groups. The DN group showed within- and between-groups large effect sizes (d>0.8).

CONCLUSIONS

DN therapy in active MTrPs of the hip muscles reduced pain and improved hip muscle strength and physical function in patients with hip OA. DN in active MTrPs of the hip muscles should be considered for the management of hip OA.

摘要

目的

探讨干针(DN)治疗对髋骨关节炎(OA)患者身体功能、疼痛和髋部肌肉力量的短期影响。

设计

双盲、安慰剂对照、随机对照试验。

地点

私人执业物理治疗诊所。

参与者

单侧髋骨 OA 患者(N=45)被随机分配到 DN 组、假 DN 组或对照组。

干预

DN 组和假 DN 组患者各接受 3 次治疗。每次治疗时,用 DN 或假针程序处理 3 个活跃的肌筋膜触发点(MTrP)。治疗应用于髂腰肌、股直肌、阔筋膜张肌和臀小肌的活跃 MTrP 中。

主要观察指标

使用西部安大略省和麦克马斯特大学(WOMAC)身体功能子量表、计时起立行走测试和 40 米自我步伐测试评估身体功能。使用视觉模拟量表和 WOMAC 疼痛子量表评估与身体功能相关的髋部疼痛强度。使用手持测力计记录髋部肌肉的最大等长力量。

结果

在身体功能、疼痛和髋部肌肉力量变量方面,均显示出显著的组间时间交互作用。事后检验显示,与假 DN 组和对照组相比,DN 组的髋部疼痛明显减轻,身体功能和髋部肌肉力量明显改善。DN 组在组内和组间均表现出较大的效应量(d>0.8)。

结论

DN 治疗髋部肌肉的活跃 MTrP 可减轻疼痛,改善髋骨 OA 患者的髋部肌肉力量和身体功能。DN 治疗髋部肌肉的活跃 MTrP 应考虑用于髋骨 OA 的管理。

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