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肩胛上神经阻滞联合低强度激光治疗对肩周炎患者肩部疼痛、功能障碍、活动度及生活质量的评估

Evaluation of shoulder pain, disability, mobility, and quality of life in patients with adhesive capsulitis following suprascapular nerve block combined with low-intensity laser therapy.

作者信息

Abodonya A M, Alrawaili S M, Abdelbasset W K

机构信息

Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia.

出版信息

Eur Rev Med Pharmacol Sci. 2023 Feb;27(3):845-851. doi: 10.26355/eurrev_202302_31176.

Abstract

OBJECTIVE

Adhesive capsulitis is a common health concern affecting shoulder mobility, which targets around 5% of populations worldwide, consequently affecting their quality of life. The aim of this study was to ascertain the effects of combining suprascapular nerve block and low-power laser therapy on pain intensity, mobility, disability, and quality of life in adhesive capsulitis.

PATIENTS AND METHODS

Between December 2021 and June 2022, 60 patients with adhesive capsulitis were enrolled in the study. They were randomly allocated into three groups, 20 each. The first group was employed for laser therapy 3 sessions a week for 8 weeks (LT group). The second group was employed for nerve block one time (NB group). The third group was recruited for nerve block intervention one time in addition to laser therapy 3 sessions a week for 8 weeks (LT+NB group). VAS, SPADI, SF-36, and shoulder range of motion were assessed pre- and post-8-week intervention.

RESULTS

Of 60 patients that started the study, 55 patients have completed the study program. No significant differences were noticed between LT, NB, and LT+NB groups before intervention (VAS at rest, p = 0.818, VAS at motion, p = 0.878, SPADI, p = 0.919, SF-36 (PCS), p = 0.731, SF-36 (MCS), p = 0.936, shoulder flexion, p = 0.441, shoulder abduction, p = 0.722, shoulder internal rotation, p = 0.396, and shoulder external rotation, p = 0.263). However, noteworthy differences were identified between LT, NB, and LT+NB groups (VAS at rest, p < 0.001, VAS at motion, p < 0.001, SPADI, p = 0.011, SF-36 (PCS), p = 0.033, SF-36 (MCS), p = 0.007, shoulder flexion, p < 0.001, shoulder abduction, p < 0.001, shoulder internal rotation, p < 0.001, and shoulder external rotation, p < 0.001).

CONCLUSIONS

Both treatment modalities whether low-power laser therapy or suprascapular nerve block have beneficial effects in the treatment of adhesive capsulitis. The combination of both interventional modalities has beneficial effects in the treatment of adhesive capsulitis more than laser therapy or suprascapular nerve block alone. Accordingly, this combination should be recommended in pain management of musculoskeletal disorders, particularly adhesive capsulitis.

摘要

目的

粘连性肩周炎是一种影响肩关节活动度的常见健康问题,全球约5%的人口受其影响,进而影响他们的生活质量。本研究的目的是确定肩胛上神经阻滞联合低功率激光治疗对粘连性肩周炎患者疼痛强度、活动度、功能障碍及生活质量的影响。

患者与方法

2021年12月至2022年6月,60例粘连性肩周炎患者纳入本研究。他们被随机分为三组,每组20例。第一组接受激光治疗,每周3次,共8周(激光治疗组)。第二组接受一次神经阻滞(神经阻滞组)。第三组除接受每周3次、共8周的激光治疗外,还接受一次神经阻滞干预(激光治疗+神经阻滞组)。在8周干预前后评估视觉模拟评分法(VAS)、肩关节功能障碍指数(SPADI)、健康调查简表36(SF-36)及肩关节活动范围。

结果

开始研究的60例患者中,55例完成了研究方案。干预前,激光治疗组、神经阻滞组和激光治疗+神经阻滞组之间未观察到显著差异(静息时VAS,p = 0.818;活动时VAS,p = 0.878;SPADI,p = 0.919;SF-36生理功能量表(PCS),p = 0.731;SF-36心理功能量表(MCS),p = 0.936;肩关节前屈,p = 0.441;肩关节外展,p = 0.722;肩关节内旋,p = 0.396;肩关节外旋,p = 0.263)。然而,激光治疗组、神经阻滞组和激光治疗+神经阻滞组之间存在显著差异(静息时VAS,p < 0.001;活动时VAS,p < 0.001;SPADI,p = 0.011;SF-36(PCS),p = 0.033;SF-36(MCS),p = 0.007;肩关节前屈,p < 0.001;肩关节外展,p < 0.001;肩关节内旋,p < 0.001;肩关节外旋,p < 0.001)。

结论

低功率激光治疗和肩胛上神经阻滞这两种治疗方式在粘连性肩周炎治疗中均有有益效果。两种干预方式联合治疗粘连性肩周炎比单独使用激光治疗或肩胛上神经阻滞更具有益效果。因此,在肌肉骨骼疾病尤其是粘连性肩周炎的疼痛管理中,应推荐这种联合治疗方式。

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