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血流限制下的低负荷阻力训练对治疗外侧肘肌腱病有效:一项随机、假对照试验。

Low-Load Resistance Training With Blood Flow Restriction Is Effective for Managing Lateral Elbow Tendinopathy: A Randomized, Sham-Controlled Trial.

作者信息

Karanasios Stefanos, Korakakis Vasileios, Moutzouri Maria, Xergia Sofia A, Tsepis Elias, Gioftsos George

出版信息

J Orthop Sports Phys Ther. 2022 Dec;52(12):803-825. doi: 10.2519/jospt.2022.11211. Epub 2022 Sep 13.

Abstract

To evaluate the effect of low-load resistance training with blood flow restriction (LLRT-BFR) when compared to LLRT with sham-BFR in patients with lateral elbow tendinopathy (LET). Randomized controlled trial. Forty-six patients with LET were randomly assigned to a LLRT-BFR or a LLRT with sham-BFR treatment group. All patients received soft tissue massage, supervised exercises with BFR or sham intervention (twice a week for 6 weeks), advice, and a home exercise program. The primary outcome measures were pain intensity, patient-rated tennis elbow evaluation (PRTEE) score, pain-free grip strength, and global rating of change, measured at baseline, 6 weeks, and 12 weeks. Between-group differences were evaluated using mixed-effects models with participant-specific random effects for continuous data. Global rating of change was analyzed using logistic regression. Statistically significant between-group differences were found in favor of LLRT-BFR compared to LLRT with sham-BFR in pain intensity at 12-week follow-up (-1.54, 95% CI: -2.89 to -0.18; = .026), pain-free grip strength ratio at 6-week follow-up (0.20, 95% CI: 0.06 to 0.34; = .005), and PRTEE at 6- and 12-week follow-up (-11.92, 95% CI: -20.26 to -3.59; = .006, and -15.23, 95% CI: -23.57 to -6.9; <.001, respectively). At 6- and 12-weeks, patients in the LLRT-BFR group had greater odds of reporting complete recovery or significant improvement (OR = 6.0, OR = 4.09, respectively). Low-load resistance training with blood flow restriction produced significantly better results compared to the LLRT with sham-BFR for all primary outcomes. Considering the clinically significant between-group improvement in function (>11 points in PRTEE) and the better success rates in the LLRT-BFR group, this intervention may improve recovery in LET. .

摘要

为评估与采用假血流限制的低负荷抗阻训练(LLRT-假BFR)相比,血流限制下的低负荷抗阻训练(LLRT-BFR)对外侧肘肌腱病(LET)患者的疗效。随机对照试验。46例LET患者被随机分配至LLRT-BFR组或LLRT-假BFR治疗组。所有患者均接受软组织按摩、有BFR或假干预的监督锻炼(每周两次,共6周)、建议及家庭锻炼计划。主要结局指标为疼痛强度、患者自评网球肘评估(PRTEE)评分、无痛握力及总体变化评级,在基线、6周和12周时进行测量。对于连续数据,使用具有参与者特定随机效应的混合效应模型评估组间差异。使用逻辑回归分析总体变化评级。在12周随访时,与LLRT-假BFR相比,LLRT-BFR在疼痛强度方面有显著的组间差异(-1.54,95%CI:-2.89至-0.18;P = 0.026),在6周随访时无痛握力比方面(0.20,95%CI:0.06至0.34;P = 0.005),以及在6周和12周随访时PRTEE方面(-11.92,95%CI:-20.26至-3.59;P = 0.006,以及-15.23,95%CI:-23.57至-6.9;P均<0.001)。在6周和12周时,LLRT-BFR组患者报告完全恢复或显著改善的几率更高(OR分别为6.0和4.09)。与LLRT-假BFR相比,血流限制下的低负荷抗阻训练在所有主要结局方面均产生了显著更好的结果。考虑到临床上有意义的组间功能改善(PRTEE中>11分)以及LLRT-BFR组更高的成功率,这种干预可能会改善LET的恢复情况。

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