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肩峰下疼痛综合征患者肩峰下注射后经颅直流电刺激(a-tCDS):一项随机对照试验研究

Transcranial direct current stimulation (a-tCDS) after subacromial injections in patients with subacromial pain syndrome: a randomized controlled pilot study.

作者信息

Larrivée Samuel, Balg Frédéric, Léonard Guillaume, Bédard Sonia, Tousignant Michel, Boissy Patrick

机构信息

Research Center on Aging CIUSSS Estrie CHUS, Sherbrooke, QC, Canada.

Department of Surgery, Division of Orthopedics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.

出版信息

BMC Musculoskelet Disord. 2021 Mar 11;22(1):265. doi: 10.1186/s12891-021-04139-2.

Abstract

BACKGROUND

Subacromial pain syndrome (SAPS) is a common complaint in orthopaedics. Subacromial corticosteroid injections (CSI) can relieve pain in the short term. Anodal transcranial direct current stimulation (a-tDCS) has been used for symptomatic pain relief in a variety of chronic pain conditions. The aim of this pilot study was to assess whether the application a-tDCS could enhance the symptomatic relief provided by CSI in patients affected by SAPS.

METHODS

Thirty-eight participants (18 to 65-year-old) suffering from SAPS were recruited to have a CSI and randomly allocated to receive, 1 weeks post CSI, real a-tDCS (r-tDCS), sham tDCS (s-tDCS) or no intervention (Control). Upper limb function was measured 1 week prior to the CSI, at the 2- and 4-week follow-ups using self-administered questionnaires and physical measures. Self-reported pain and activity during each day were logged by the participants using visual analog scales (VAS). Differences between groups were tested using repeated-measures ANOVAs.

RESULTS

Pain VAS and the Single Assessment Numeric Evaluation scale (SANE) showed significant improvement from baseline 2 weeks and 4 weeks after CSI in all groups (p < 0.05). There were no significant group X time interaction 2 weeks following tDCS treatment in any of the variables.

CONCLUSION

All groups showed significant improvement in pain VAS and SANE scores following the CSI. One session of a-tDCS treatment 2 weeks following CSI did not result in any additive or potentializing effects when compared to a s-tDCS or a control group.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT03967574 . Registered 30 May 2019 - Retrospectively registered.

摘要

背景

肩峰下疼痛综合征(SAPS)是骨科常见的病症。肩峰下皮质类固醇注射(CSI)可在短期内缓解疼痛。阳极经颅直流电刺激(a-tDCS)已被用于多种慢性疼痛病症的症状性疼痛缓解。本初步研究的目的是评估应用a-tDCS是否能增强CSI对SAPS患者的症状缓解作用。

方法

招募38名年龄在18至65岁之间的SAPS患者接受CSI,并随机分配在CSI后1周接受真正的a-tDCS(r-tDCS)、假tDCS(s-tDCS)或不进行干预(对照组)。在CSI前1周、2周和4周随访时,使用自行填写的问卷和体格检查测量上肢功能。参与者使用视觉模拟量表(VAS)记录每天的自我报告疼痛和活动情况。使用重复测量方差分析检验组间差异。

结果

所有组在CSI后2周和4周时,疼痛VAS和单项评估数字评定量表(SANE)较基线均有显著改善(p < 0.05)。在任何变量中,tDCS治疗2周后均无显著的组×时间交互作用。

结论

所有组在CSI后疼痛VAS和SANE评分均有显著改善。与s-tDCS或对照组相比,CSI后2周进行一次a-tDCS治疗未产生任何叠加或增效作用。

试验注册

ClinicalTrials.gov,NCT03967574。2019年5月30日注册——回顾性注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afcc/7948354/473cde339aa6/12891_2021_4139_Fig1_HTML.jpg

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