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超声引导下颈神经根阻滞推拿技术对肩周炎肩关节活动度的影响:一项回顾性研究

Effect of manipulation technique using ultrasound-guided cervical nerve root block on range of motion at the shoulder joint in frozen shoulder: a retrospective study.

作者信息

Park Kieun, Matsuzaki Masashi, Okamoto Mitsuji, Sakaki Akihiro, Ikuta Futoshi

机构信息

PAKU Painclinic, Gitex Ascent Building 5F, 6-1-20 Miyuki-dori, Chuo-ku, Kobe, Hyogo, 651-0087, Japan.

Sonic Japan Holdings Co., Ltd, 26-11 Maruyama-cho, Hachioji, Tokyo, 192-0021, Japan.

出版信息

J Exp Orthop. 2022 Jul 6;9(1):63. doi: 10.1186/s40634-022-00500-z.

DOI:10.1186/s40634-022-00500-z
PMID:35792941
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9259775/
Abstract

PURPOSE

The aim of this study was to evaluate the range of motion (ROM) at the shoulder joint before and after silent manipulation.

METHODS

This retrospective study included all patients who underwent silent manipulation at our institution between January 2013 and December 2017. In total, 1,665 shoulders in 1,610 patients (519 men, 1,146 women; mean age 55.4 ± 8.8 years) were treated during the study period. The mean symptom duration was 6.6 ± 7.1 months. ROM at the shoulder joint was measured in flexion, abduction, and external rotation before silent manipulation and at 1 week and 1, 2, and 3 months after the procedure.

RESULTS

Mean ROM at the shoulder was 98.8° (95% confidence interval [CI] 97.9-99.8) before silent manipulation and 155.5° (154.1-156.8) after 3 months in flexion (p = 0.0000), 75.6° (74.5-76.8) and 152.9° (151.0-154.9), respectively, in abduction (p = 0.0000), and 12.7° (12.0-13.4) and 45.9° (44.4-47.4) in external rotation (p = 0.0000). All ROM values were significantly increased at all time points after the procedure. There were no unanticipated adverse events or serious adverse reactions.

CONCLUSIONS

This study reports on the efficacy and safety of manipulation using conduction anesthesia for shoulder contractures in a large group of patients. Silent manipulation can increase ROM at the shoulder safely and effectively.

摘要

目的

本研究旨在评估在进行无痛手法治疗前后肩关节的活动范围(ROM)。

方法

这项回顾性研究纳入了2013年1月至2017年12月期间在本机构接受无痛手法治疗的所有患者。在研究期间,共治疗了1610例患者的1665个肩部(男性519例,女性1146例;平均年龄55.4±8.8岁)。平均症状持续时间为6.6±7.1个月。在无痛手法治疗前以及治疗后1周、1个月、2个月和3个月测量肩关节在屈曲、外展和外旋时的ROM。

结果

在屈曲方面,无痛手法治疗前肩关节的平均ROM为98.8°(95%置信区间[CI]97.9 - 99.8),3个月后为155.5°(154.1 - 156.8)(p = 0.0000);在外展方面,分别为75.6°(74.5 - 76.8)和152.9°(151.0 - 154.9)(p = 0.0000);在外旋方面,分别为12.7°(12.0 - 13.4)和45.9°(44.4 - 47.4)(p = 0.0000)。治疗后所有时间点的所有ROM值均显著增加。未发生意外不良事件或严重不良反应。

结论

本研究报告了在一大群患者中使用传导麻醉进行手法治疗肩部挛缩的有效性和安全性。无痛手法治疗可安全有效地增加肩关节的ROM。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76d1/9259775/b0dc5d587be0/40634_2022_500_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76d1/9259775/83816d0a7aee/40634_2022_500_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76d1/9259775/b0dc5d587be0/40634_2022_500_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76d1/9259775/83816d0a7aee/40634_2022_500_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76d1/9259775/b0dc5d587be0/40634_2022_500_Fig4_HTML.jpg

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本文引用的文献

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Ultrasound-Guided Hydrodilatation With Triamcinolone Acetonide for Adhesive Capsulitis: A Randomized Controlled Trial Comparing the Posterior Glenohumeral Recess and the Rotator Cuff Interval Approaches.超声引导下曲安奈德水扩张治疗粘连性肩周炎:比较肩胛下隐窝和肩袖间隙入路的随机对照试验
Front Pharmacol. 2021 May 7;12:686139. doi: 10.3389/fphar.2021.686139. eCollection 2021.
3
Clinical Guidelines in the Management of Frozen Shoulder: An Update!肩周炎管理临床指南:最新版!
Indian J Orthop. 2021 Feb 1;55(2):299-309. doi: 10.1007/s43465-021-00351-3. eCollection 2021 Apr.
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Hydrodilatation with corticosteroids is the most effective conservative management for frozen shoulder.水扩张联合皮质类固醇激素是治疗冻结肩最有效的保守治疗方法。
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