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评估两种不同的肌内效贴扎技术对关节活动过度型埃勒斯-当洛综合征患者肩部疼痛和功能的影响。

Evaluating the effects of two different kinesiology taping techniques on shoulder pain and function in patients with hypermobile Ehlers-Danlos syndrome.

作者信息

Tudini Frank, Levine David, Healy Michael, Jordon Max, Chui Kevin

机构信息

Department of Physical Therapy, The University of Tennessee at Chattanooga, Chattanooga, TN, United States.

Healy Physical Therapy and Sports Medicine, East Providence, RI, United States.

出版信息

Front Pain Res (Lausanne). 2023 Jan 16;4:1089748. doi: 10.3389/fpain.2023.1089748. eCollection 2023.

Abstract

BACKGROUND

Ehlers-Danlos Syndrome (EDS) is a group of inherited connective tissue disorders which predominantly affects women and has a prevalence as high as 1 in 5,000 individuals. Hypermobile EDS (hEDS) is the most common subtype of EDS and is characterized by multi-joint pain, particularly in large joints such as the shoulder. Physical therapy is often utilized to address the pain, physical impairments, and functional loss in patients with EDS. Kinesiology Tape (KT) is an intervention commonly used by physical therapists for treating shoulder pain and dysfunction. Studies related to the effectiveness of KT in patients with shoulder pain is equivocal and there are a lack of studies specifically studying the effects of KT in an EDS population.

PURPOSE

The purpose of this study was to assess the efficacy and short-term effects of two different KT techniques on shoulder pain and function in individuals with hEDS and shoulder pain.

METHODS

Participants were recruited from EDS support groups in the New England area of the United States; were diagnosed with hEDS by their physician; and had shoulder pain. Baseline demographic information was obtained for each participant followed by completion of 4 patient reported outcome (PRO) measures: the Upper Extremity Functional Index, QuickDASH (Disabilities of the Arm, Shoulder, & Hand), Shoulder Pain and Disability Index, and the Western Ontario Shoulder Instability Index. Current pain level, average pain over the past 24 h, and worst pain over the past 24 h were recorded using the numeric pain rating scale (NPRS). Subjects were randomly assigned to receive either an experimental shoulder KT procedure or a control shoulder taping. Immediately after taping, the NPRS was reassessed. Subjects then returned 48 h later to repeat the NPRS and PRO measures.

RESULTS

There was no significant difference between the experimental and control tape groups for any outcome measure. There was a significant improvement from pre-taping to 48-hours post taping for each of the 4 PRO measures with large effect sizes ( < 0.001;  = .517-.719). Likewise, average, and worst pain over the last 24 h significantly improved with large effect sizes over the same period ( = 0.005;  = .225 and  < 0.001;  = .382, respectively). Current NPRS levels significantly improved from pre-tape to immediately post-tape ( = .023,  = .131) and was maintained through the 48-hour follow up, although no further improvement was seen.

CONCLUSION

KT is an inexpensive and relatively safe intervention that is easy to apply and can offer temporary improvements in pain and function for patients with EDS and shoulder pain.

摘要

背景

埃勒斯-当洛综合征(EDS)是一组遗传性结缔组织疾病,主要影响女性,患病率高达五千分之一。活动度过高型EDS(hEDS)是EDS最常见的亚型,其特征为多关节疼痛,尤其是在肩部等大关节。物理治疗常用于缓解EDS患者的疼痛、身体损伤和功能丧失。肌内效贴布(KT)是物理治疗师治疗肩痛和功能障碍常用的一种干预手段。关于KT对肩痛患者有效性的研究尚无定论,且缺乏专门针对hEDS人群中KT效果的研究。

目的

本研究旨在评估两种不同的KT技术对hEDS伴肩痛患者的肩痛和功能的疗效及短期影响。

方法

从美国新英格兰地区的EDS支持小组招募参与者;由医生诊断为hEDS;且有肩痛症状。获取每位参与者的基线人口统计学信息,随后完成4项患者报告结局(PRO)指标:上肢功能指数、QuickDASH(手臂、肩部和手部功能障碍)、肩痛和残疾指数以及西安大略肩不稳定指数。使用数字疼痛评分量表(NPRS)记录当前疼痛水平、过去24小时的平均疼痛以及过去24小时的最严重疼痛。受试者被随机分配接受实验性肩部KT操作或对照肩部贴扎。贴扎后立即重新评估NPRS。受试者在48小时后返回重复NPRS和PRO指标测量。

结果

在任何结局指标上,实验组和对照组之间均无显著差异。4项PRO指标从贴扎前到贴扎后48小时均有显著改善,效应量较大(<0.001;=0.517 - 0.719)。同样,在同一时期,过去24小时的平均疼痛和最严重疼痛也有显著改善,效应量较大(=0.005;=0.225和<0.001;=0.382)。当前NPRS水平从贴扎前到贴扎后立即显著改善(=0.023;=0.131),并在48小时随访中保持,尽管未见进一步改善。

结论

KT是一种廉价且相对安全的干预措施,易于应用,可为EDS伴肩痛患者的疼痛和功能提供暂时改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d23b/9885497/29ab96406370/fpain-04-1089748-g001.jpg

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