Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
J Manipulative Physiol Ther. 2023 Feb;46(2):98-108. doi: 10.1016/j.jmpt.2023.06.002. Epub 2023 Sep 29.
The purpose of this study was to compare the effects of manual therapy to therapeutic exercise on shoulder pain, disability, and range of motion (ROM) in patients with subacromial impingement syndrome (SAIS).
Sixty patients with SAIS were randomly assigned into the manual therapy (MT) and therapeutic exercise (TE) groups. Patients in the MT group were treated with joint mobilization, which was applied to the glenohumeral, acromioclavicular, sternoclavicular and scapulothoracic joints, and trigger point (TrP) inactivation using ischemic compression. Patients in the TE group performed therapeutic exercises. Shoulder pain, disability and active ROM (elevation, external rotation, and internal rotation) were assessed by the visual analog scale, the Shoulder Pain and Disability Index, and a goniometer, respectively. The outcomes were measured at baseline, after the intervention, and 1 month after the intervention.
After the treatment, both groups had significant improvements in shoulder pain, disability, and ROM (P < .05). The MT group experienced a greater reduction in shoulder pain than the TE group (P < .001). However, in disability and ROM, both groups exhibited similar improvements in post-treatment and follow-up periods.
Both MT and TE were effective in improving shoulder pain, disability, and ROM in patients with SAIS. Greater improvement in shoulder pain was observed in the MT group.
本研究旨在比较手法治疗与运动疗法对肩峰下撞击综合征(SAIS)患者肩部疼痛、功能障碍和活动度(ROM)的影响。
将 60 例 SAIS 患者随机分为手法治疗(MT)组和运动疗法(TE)组。MT 组采用关节松动术治疗,包括盂肱关节、肩锁关节、胸锁关节和肩胛胸壁关节,并采用缺血性压迫法治疗扳机点(TrP)。TE 组进行运动疗法。采用视觉模拟评分法、肩关节疼痛和功能障碍指数以及量角器分别评估肩部疼痛、功能障碍和主动 ROM(抬高、外旋和内旋)。在基线、干预后和干预后 1 个月测量结果。
治疗后,两组肩部疼痛、功能障碍和 ROM 均显著改善(P<0.05)。MT 组肩部疼痛的缓解程度明显大于 TE 组(P<0.001)。然而,在功能障碍和 ROM 方面,两组在治疗后和随访期间均表现出相似的改善。
MT 和 TE 均能有效改善 SAIS 患者的肩部疼痛、功能障碍和 ROM,MT 组在肩部疼痛方面的改善更为显著。