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改良技术体外冲击波治疗膝骨关节炎肌腱和韧带的随机对照试验

Extracorporeal Shockwave Therapy With a Modified Technique on Tendon and Ligament for Knee Osteoarthritis: A Randomized Controlled Trial.

作者信息

Ho Kun-Dong, Yang Chia-Ling, Lo Huei-Yu, Yeh Huan-Jui

机构信息

From the Department of Physical Medicine and Rehabilitation, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan (K-DH, C-LY, H-YL, H-JY); Department of Chemistry, Chung Yuan Christian University, Chung Li, Taiwan (H-YL); and Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan (H-JY).

出版信息

Am J Phys Med Rehabil. 2022 Jan 1;101(1):11-17. doi: 10.1097/PHM.0000000000001730.

Abstract

BACKGROUND

There have been no definitive guidelines on the treatment method and specific points in the body.

PURPOSE

The aim of the study was to investigate the effects of extracorporeal shockwave therapy on treating the main tendons and ligaments of knee osteoarthritis.

METHOD

A total of 36 patients with knee osteoarthritis were enrolled in trial and organized into two groups: 3-wk extracorporeal shockwave therapy for the intervention group and 3-wk sham extracorporeal shockwave therapy for control group. Both groups received the same physical therapies: (1) transcutaneous electrical nerve stimulation, (2) magnetic field treatment, and (3) quadricep muscle strength training. Evaluation was performed before the start of treatment, at third week after the start of treatment, and 1 wk after the end of treatment. The study used randomized controlled trials (level of evidence, 1).

RESULT

Eextracorporeal shockwave therapy group had significant improvement in WOMAC pain score, physical function, and total score (mean difference = -2.8, P < 0.001; -5.1, P = 0.02; -8.3, P = 0.004, respectively), Visual Analog Scale score (mean difference = -2.3, P < 0.001), and the distance of 6-min walk test (mean difference = 28.7, P = 0.01) in the 1 wk after the end of treatment. Statistical significance in WOMAC pain, physical function, and total scores (mean difference = -3.0, P = 0.001; -5.6, P = 0.02; -9.3, P = 0.004, respectively) and Visual Analog Scale score (mean difference = -1.2, P = 0.027) was observed between the extracorporeal shockwave therapy group and control group.

CONCLUSIONS

Extracorporeal shockwave therapy for the tendons and ligaments has clinical benefits for pain and physical function improvement in knee osteoarthritis. In addition, improvement in physical performance was observed in the short-term follow-up.

摘要

背景

目前对于治疗方法及身体的特定部位尚无明确的指导方针。

目的

本研究旨在探讨体外冲击波疗法对治疗膝骨关节炎主要肌腱和韧带的效果。

方法

共纳入36例膝骨关节炎患者并分为两组:干预组接受为期3周的体外冲击波治疗,对照组接受为期3周的体外冲击波假治疗。两组均接受相同的物理治疗:(1)经皮电刺激神经疗法,(2)磁场治疗,以及(3)股四头肌力量训练。在治疗开始前、治疗开始后第3周以及治疗结束后1周进行评估。本研究采用随机对照试验(证据级别,1级)。

结果

体外冲击波治疗组在治疗结束后1周时,西安大略和麦克马斯特大学骨关节炎指数(WOMAC)疼痛评分、身体功能及总分(平均差值分别为=-2.8,P<0.001;=-5.1,P=0.02;=-8.3,P=0.004)、视觉模拟评分量表(VAS)评分(平均差值=-2.3,P<0.001)以及6分钟步行试验距离(平均差值=28.7,P=0.01)均有显著改善。体外冲击波治疗组与对照组在WOMAC疼痛、身体功能及总分(平均差值分别为=-3.0,P=0.001;=-5.6,P=0.02;=-9.3,P=0.004)以及VAS评分(平均差值=-1.2,P=0.027)方面存在统计学差异。

结论

体外冲击波疗法治疗肌腱和韧带对改善膝骨关节炎的疼痛和身体功能具有临床益处。此外,在短期随访中观察到身体性能有所改善。

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