Hajivandi Shaahin, Dachek Atousa, Salimi Amirhossein, Mamaghani Hesan Jelodari, Mirghaderi Seyed Peyman, Dehghani Javad, Borazjani Roham, Babaniamansour Amirmohammad, Sarallah Rojin, Javanshir Salar, Salimi Maryam
Department of Orthopedic Surgery, Dezful University of Medical Sciences, Dezful, Iran.
Student Research Committee, Dezful University of Medical Sciences, Dezful, Iran.
Adv Orthop. 2021 Oct 25;2021:6789453. doi: 10.1155/2021/6789453. eCollection 2021.
Surgical treatment and conservative treatment is the options to improve pain, function, and range of motion following rotator cuff tear. In this study, we aimed to compare the effects of physiotherapy and corticosteroid injections on the function, pain, and range of motion in patients with full-thickness rotator cuff tearing separately and simultaneously.
A total of 96 patients were randomly assigned to the study and divided into 3 groups of 32 patients. DASH questionnaire and VAS criterion were completed by all three groups, and the range of motions of all groups was measured by a goniometer. Then, the first group underwent 12 sessions of physiotherapy twice a week for 6 weeks; the second group received 80 mg of methylprednisolone and 1 ml of lidocaine 2% in two stages, 21 days apart; and the third group received 80 mg of methylprednisolone and 1 ml of lidocaine 2%, and after 2 days, 6 sessions of physiotherapy twice a week for 3 weeks were prescribed. In the end, the questionnaire was filled out by the patient, and the range of emotions was assessed with a goniometer.
More than 80% of patients in each group were female. There was no significant difference between the gender and age distribution of the groups. The mean age in physiotherapy, steroid, and physiotherapy + steroid groups was 51.78 ± 7.37, 52.37 ± 6.61, and 50.87 ± 5.65, respectively. The combination of physiotherapy + steroid intervention was more effective in reducing VAS and DASH scores than physiotherapy or steroid injection alone. Goniometric findings showed that treatments that included the steroid injection approach (steroid injection and steroid + physiotherapy) had a more dramatic effect on improving the patients' range of motion than physiotherapy alone.
Among the conservative approaches of treating full-thickness rotator cuff tear, a combination of steroid injection and physiotherapy is more effective significantly in comparison with either treatment alone. This trial is registered with IRCT20200102045987N1.
手术治疗和保守治疗是改善肩袖撕裂后疼痛、功能及活动范围的选择。在本研究中，我们旨在比较物理治疗和皮质类固醇注射分别及同时对全层肩袖撕裂患者功能、疼痛及活动范围的影响。
共96例患者被随机纳入研究并分为3组，每组32例。三组均完成DASH问卷和VAS标准评估，且用角度计测量所有组的活动范围。然后，第一组每周进行2次共12节物理治疗，持续6周；第二组分两个阶段接受80mg甲泼尼龙和1ml 2%利多卡因注射，间隔21天；第三组接受80mg甲泼尼龙和1ml 2%利多卡因注射，2天后每周进行2次共6节物理治疗，持续3周。最后，由患者填写问卷，并用角度计评估活动范围。
每组超过80%的患者为女性。各组间性别和年龄分布无显著差异。物理治疗组、类固醇组和物理治疗+类固醇组的平均年龄分别为51.78±7.37、52.37±6.61和50.87±5.65。物理治疗+类固醇联合干预在降低VAS和DASH评分方面比单独的物理治疗或类固醇注射更有效。角度测量结果显示，包括类固醇注射方法（类固醇注射和类固醇+物理治疗）的治疗在改善患者活动范围方面比单独的物理治疗有更显著的效果。
在全层肩袖撕裂的保守治疗方法中，与单独任何一种治疗相比，类固醇注射和物理治疗相结合的方法显著更有效。本试验已在IRCT20200102045987N1注册。
