体外冲击波疗法对脑卒中后偏瘫肩痛患者疼痛管理的影响:一项前瞻性随机对照试验。

Effect of Extracorporeal Shockwave Therapy on Pain Management of Patients with Post-Stroke Hemiplegic Shoulder Pain: A Prospective Randomized Controlled Trial.

作者信息

Haghighat Shila, Khosravi Maryam, Saadatnia Mohammad, Hashemijaazi Maryamsadat

机构信息

Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Neurology, School of Medicine, Neurosciences Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Adv Biomed Res. 2023 Aug 31;12:216. doi: 10.4103/abr.abr_279_21. eCollection 2023.

Abstract

BACKGROUND

Post-stroke hemiplegic shoulder pain (HSP) is a common complication leading to significant activity limitation. Some approaches have been recommended for the management of HSP, and most of them have various adverse effects, while none were established to be effective. This study aimed to evaluate the effect of minimally invasive extracorporeal shockwave therapy (ESWT) on patients with HSP pain management.

MATERIALS AND METHODS

Using a single-blind, randomized clinical trial, 43 patients with HSP were randomly assigned to complete three focus ESWT sessions once a week and additional five radial ESWT sessions twice a week. Patients in the control arm received zero energy ESWT. Visual analog scale, passive range of motion (ROM), Fugl-Meyer upper extremity assessment (FMA-UE), and shoulder pain and disability scale (SPADI) were measured at baseline, at the end of the interventions, and within four and eight weeks' intervals to evaluate the pain, function, and ROM in the affected shoulder.

RESULT

Both groups showed an improvement in pain scores on the fourth and eighth weeks visits (-value <0.001). Intervention with ESWT could effectively lead to a less severe pain score compared to the control group (-value <0.001). In the intervention group, the ROM improved in both passive abduction and forward flexion (-value <0.05), but no significant change was observed in the control group (-value >0.05). FMA-UE and SPADI did not differ significantly between groups.

CONCLUSION

Based on the findings of this study, the combination of rESWT and focused ESWT can efficiently improve stroke-induced HSP.

摘要

背景

中风后偏瘫肩痛(HSP)是一种常见并发症,会导致严重的活动受限。已经推荐了一些方法来管理HSP,但大多数都有各种不良反应,且没有一种被证实有效。本研究旨在评估微创体外冲击波疗法(ESWT)对HSP患者疼痛管理的效果。

材料与方法

采用单盲随机临床试验,43例HSP患者被随机分配,每周进行一次共三次聚焦ESWT治疗,另外每周两次共五次桡骨ESWT治疗。对照组患者接受零能量ESWT治疗。在基线、干预结束时以及干预后四周和八周时测量视觉模拟量表、被动活动范围(ROM)、Fugl-Meyer上肢评估(FMA-UE)以及肩痛和功能障碍量表(SPADI),以评估患侧肩部的疼痛、功能和ROM。

结果

两组在第四周和第八周随访时疼痛评分均有所改善(P值<0.001)。与对照组相比,ESWT干预可有效降低疼痛评分(P值<0.001)。在干预组中,被动外展和前屈的ROM均有所改善(P值<0.05),而对照组未观察到显著变化(P值>0.05)。两组之间FMA-UE和SPADI无显著差异。

结论

基于本研究结果,径向ESWT和聚焦ESWT联合应用可有效改善中风引起的HSP。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fca3/10699219/46d6e91f3434/ABR-12-216-g001.jpg

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