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使用和不使用关节内皮质类固醇进行肩周炎手法治疗的疗效比较。

A Comparison of the Treatment Outcomes With and Without the Use of Intra-articular Corticosteroids for Frozen Shoulder Manipulation.

作者信息

Kayaokay Kemal, Arslan Yurtlu Derya

机构信息

Department of Orthopaedics and Traumatology, Izmir Katip Çelebi University, Izmir, TUR.

Department of Anaesthesiology and Reanimation, Izmir Katip Çelebi University, Ataturk Training and Research Hospital, Izmir, TUR.

出版信息

Cureus. 2023 Aug 31;15(8):e44427. doi: 10.7759/cureus.44427. eCollection 2023 Aug.

Abstract

Background Manipulation under anesthesia is known to be an effective treatment method for a frozen shoulder. However, this process is painful and causes difficulty in early physiotherapy. Intra-articular corticosteroids may relieve pain after manipulation. This study compared patients who underwent manipulation under anesthesia with those who only underwent physiotherapy and those who received intra-articular corticosteroid administration and physiotherapy. Methodology A total of 33 patients presenting with frozen shoulders were included in this study. Those who underwent manipulation after anesthesia were determined as group 1 (16 patients) and those who received intra-articular corticosteroids in addition to manipulation under anesthesia were determined as group 2 (17 patients). Pain was evaluated using the Visual Analog Scale (VAS) scores. Functional outcomes were assessed using the University of California-Los Angeles (UCLA) scores and shoulder range of motion (ROM). Results VAS and UCLA scores of both groups were similar at 12 weeks and six months. ROM improved significantly after manipulation in both group 1 and group 2 (p < 0.05). There was no significant difference between the ROM in the two groups after manipulation and physiotherapy. Only the external rotation ROM value was better in group 2 (p = 0.032) Conclusions Physiotherapy after manipulation is a successful treatment method for frozen shoulder patients. It reduces pain in the early period compared to patients who are not administered intra-articular corticosteroids. However, it has no functional superiority.

摘要

背景

已知麻醉下手法治疗是肩周炎的一种有效治疗方法。然而,这个过程很痛苦,并且会给早期物理治疗带来困难。关节内注射皮质类固醇可能会减轻手法治疗后的疼痛。本研究比较了接受麻醉下手法治疗的患者、仅接受物理治疗的患者以及接受关节内注射皮质类固醇并进行物理治疗的患者。

方法

本研究共纳入33例肩周炎患者。将麻醉后接受手法治疗的患者确定为第1组(16例患者),将除麻醉下手法治疗外还接受关节内注射皮质类固醇的患者确定为第2组(17例患者)。使用视觉模拟评分法(VAS)对疼痛进行评估。使用加利福尼亚大学洛杉矶分校(UCLA)评分和肩关节活动范围(ROM)评估功能结果。

结果

两组的VAS和UCLA评分在12周和6个月时相似。第1组和第2组手法治疗后ROM均显著改善(p < 0.05)。手法治疗和物理治疗后两组的ROM无显著差异。仅第2组的外旋ROM值更好(p = 0.032)

结论

手法治疗后进行物理治疗是肩周炎患者的一种成功治疗方法。与未接受关节内注射皮质类固醇的患者相比,它在早期可减轻疼痛。然而,它在功能上并无优势。

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