高强度家庭拉伸装置与传统物理疗法治疗粘连性肩关节囊炎的非手术治疗效果比较：一项前瞻性、随机对照试验。
Efficacy of a high-intensity home stretching device and traditional physical therapy in non-operative management of adhesive capsulitis - a prospective, randomized control trial.
机构信息
Foundation for Orthopaedic Research and Education, Tampa, FL, USA.
Florida Orthopaedic Institute, 13020 Telecom Parkway North, Temple Terrace, Tampa, FL, 33637, USA.
出版信息
BMC Musculoskelet Disord. 2024 Apr 20;25(1):305. doi: 10.1186/s12891-024-07448-4.
BACKGROUND
Historically, in-person physical therapy serves as a foundational component of nonoperative treatment of adhesive capsulitis (AC). This study compares the effectiveness of an at-home high-intensity stretch (HIS) device to traditional physical therapy (PT) and to PT in combination with the HIS device. We hypothesize that the HIS device will be as effective as PT alone or as combination therapy in the first-line treatment of AC and use of the HIS device will exhibit improvement at higher rate.
METHODS
Thirty-four patients with idiopathic adhesive capsulitis and a minimum of 12 months follow-up were included in this study. Patients were randomized into one of the three groups: HIS device, PT alone, or HIS device + PT. Passive range of motion (ROM), American Shoulder and Elbow Surgeons (ASES), and Simple Shoulder Test (SST) scores were measured. Additionally, patient satisfaction, compliance and complications were recorded. Paired t-test, ANOVA and Chi-squared tests were used in analysis.
RESULTS
Final ROM in all planes improved for all groups compared to baseline (p < 0.001), with only HIS device group able to restore > 95% of contralateral ROM in all planes at final follow-up. Patients with PT alone were on average slowest to improve ROM from baseline, at 3 months, 6 months, and 1 year in all planes except internal rotation. ASES and SST scores improved for all groups when compared to baseline (p < 0.001). Use of HIS-device resulted in greater improvement in SST and ASES Total scores compared to PT alone (p = 0.045, and p = 0.048, respectively).
CONCLUSIONS
Use of an at-home high-intensity stretching device for conservative treatment of idiopathic adhesive capsulitis improves outcomes in ROM and in ASES and SST scores both when used as an adjunct to physical therapy and when used alone.
TRIAL REGISTRATION
The study protocol was registered at www.
CLINICALTRIALS
gov (20/05/2022, NCT05384093).
背景
在过去，物理治疗师的当面治疗是粘连性肩关节囊炎（AC）非手术治疗的基础组成部分。本研究比较了家庭用高强度伸展（HIS）设备与传统物理治疗（PT）以及 PT 与 HIS 设备联合应用的效果。我们假设 HIS 设备在粘连性肩关节囊炎的一线治疗中与单独使用 PT 或联合治疗一样有效，并且 HIS 设备的使用将以更高的速度显示出改善。
方法
这项研究纳入了 34 名患有特发性粘连性肩关节囊炎且随访至少 12 个月的患者。患者被随机分为三组：HIS 设备组、单独 PT 组或 HIS 设备+PT 组。测量被动活动范围（ROM）、美国肩肘外科医生（ASES）和简易肩部测试（SST）评分。此外，还记录了患者满意度、依从性和并发症。采用配对 t 检验、方差分析和卡方检验进行分析。
结果
与基线相比，所有组的所有平面的最终 ROM 均有改善（p<0.001），只有 HIS 设备组在最终随访时能够恢复所有平面的对侧 ROM>95%。单独接受 PT 的患者在所有平面的 ROM 改善方面速度最慢，在 3 个月、6 个月和 1 年时均如此，除了内旋。与基线相比，所有组的 ASES 和 SST 评分均有改善（p<0.001）。与单独接受 PT 相比，使用 HIS 设备可使 SST 和 ASES 总分的改善更为显著（p=0.045 和 p=0.048）。
结论
在粘连性肩关节囊炎的保守治疗中，家庭用高强度伸展设备的使用可改善 ROM 以及 ASES 和 SST 评分，无论是作为物理治疗的辅助手段还是单独使用。
试验注册
研究方案在 www.clinicaltrials.gov 上注册（2022 年 5 月 20 日，NCT05384093）。
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