Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia.
Faculty of Medicine and Health, Department of Exercise and Sports Sciences, School of Health Sciences, University of Sydney, New South Wales, Australia.
PLoS One. 2023 Feb 13;18(2):e0281206. doi: 10.1371/journal.pone.0281206. eCollection 2023.
BACKGROUND: The knowledge about the effective implementation of corticosteroid injection (CS) with deep transverse friction massage (DTFM) and Mill's manipulation (MM) on clinical and radiological changes (Magnetic resonance imaging-MRI and Ultra sound) in lateral epicondylalgia (LE) is lacking. Therefore, the objective of this study is proposed to find and compare the effects of corticosteroid injection (CS) DTFM and Mill's manipulation on clinical and radiological changes in lateral epicondylalgia. DESIGN, SETTING, PARTICIPANTS: Randomized, single-blinded, controlled study was conducted on 60 LE participants at university hospital. The active MM group (n = 30) received corticosteroid injection with DTFM and active Mill's manipulation (MM) three sessions a week for 4 weeks and the sham MM group received corticosteroid injection with sham manipulation. The primary outcome was pain intensity, measured with the visual analog scale. The other outcome measures were percentage of injury measured by MRI and ultrasound, functional disability, handgrip strength, patient perception, kinesiophobia, depression status and quality of life which were measured at 4 weeks, 8weeks and at 6 months follow up. RESULTS: The between-group difference in pain intensity at 4 weeks was 1.6 (CI 95% 0.97 to 2.22), which shows improvement in the active group than sham group. The similar effects have been noted after 8 weeks and at 6 months 2.0 (CI 95% 1.66 to 2.33) follow up in pain intensity. Similar improvements were also found on percentage of injury, functional disability, handgrip strength, patient perception, kinesiophobia, depression status and quality of life (p = 0.001). CONCLUSION: Corticosteroid injection with DTFM and Mill's manipulation was superior to sham group for improving pain, percentage of injury, functional disability, handgrip strength, patient perception, kinesiophobia, depression status and quality of life in people with lateral epicondylalgia. TRIAL REGISTRATION: Clinical trial registration: CTRI/2020/05/025135 trial registered prospectively on 12/05/2020. https://trialsearch.who.int/Trial2.aspx?TrialID=CTRI/2020/05/025135.
背景：关于在外侧肱骨上髁炎（LE）中使用皮质类固醇注射（CS）联合深层横断摩擦按摩（DTFM）和米尔手法（MM）进行临床和影像学变化（磁共振成像-MRI 和超声）的有效实施的知识尚不清楚。因此，本研究的目的是发现并比较皮质类固醇注射（CS）DTFM 和米尔手法对 LE 患者临床和影像学变化的影响。
设计、地点、参与者：在大学医院对 60 名 LE 参与者进行了随机、单盲、对照研究。主动 MM 组（n = 30）每周接受 3 次皮质类固醇注射联合 DTFM 和主动 MM，持续 4 周，而假 MM 组则接受皮质类固醇注射联合假手法。主要结局指标是疼痛强度，采用视觉模拟评分法测量。其他结局指标包括 MRI 和超声测量的损伤百分比、功能障碍、握力、患者感知、运动恐惧、抑郁状态和生活质量，这些指标在 4 周、8 周和 6 个月随访时进行测量。
结果：4 周时组间疼痛强度差异为 1.6（CI 95% 0.97 至 2.22），表明主动组的疼痛改善优于假组。8 周和 6 个月随访时，疼痛强度的差异相似，分别为 2.0（CI 95% 1.66 至 2.33）。在损伤百分比、功能障碍、握力、患者感知、运动恐惧、抑郁状态和生活质量方面也发现了类似的改善（p = 0.001）。
结论：皮质类固醇注射联合 DTFM 和 MM 对改善外侧肱骨上髁炎患者的疼痛、损伤百分比、功能障碍、握力、患者感知、运动恐惧、抑郁状态和生活质量优于假手法组。
试验注册：临床试验注册：CTRI/2020/05/025135 于 2020 年 5 月 12 日前瞻性注册于临床试验搜索网站。
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