Mülkoğlu Cevriye, Tiftik Tülay, Deniz Ayşegül Berna, Taka İbrahim, Genç Hakan
Department of Physical Medicine and Rehabilitation, Health Sciences University, Ankara Training and Research Hospital, Ankara, Türkiye.
Turk J Phys Med Rehabil. 2023 Oct 12;69(4):520-525. doi: 10.5606/tftrd.2023.12660. eCollection 2023 Dec.
This study aimed to increase the awareness of clinicians about shoulder injury related to vaccine administration (SIRVA) by analyzing 21 patients with adhesive capsulitis that developed after COVID-19 (coronavirus disease 2019) vaccination.
In this observational study, 21 patients (11 males, 10 females; mean age: 60.7±7.3 years; range, 45 to 70 years) with incipient shoulder pain and limitation diagnosed with adhesive capsulitis due to SIRVA were evaluated between June 2021 and December 2022. Demographic and clinical data of the patients were recorded. Pain was evaluated with the Visual Analog Scale (VAS). The passive range of motion (ROM) of the affected shoulder was measured by a goniometer. The applied treatment methods (medical treatment, physical therapy, intraarticular steroid injection, hydrodilatation, and suprascapular nerve block) were recorded. The patients were called in for control two months later. Visual Analog Scale scores and passive shoulder ROMs were reevaluated.
Symptoms started after the second dose in nine (42.9%) patients. The mean time between vaccination and onset of complaints was 8.0±6.4 days. Sinovac vaccine was administered to eight patients, BioNTech vaccine was administered to five patients, and Sinovac+BioNTech vaccine was administered to eight patients. Baseline to control ROM angle changes were 128.8±30.4º to 155.0±20.6° for flexion, 117.1±37.8° to 147.1±26.4° for abduction, 45.9±17.8° to 61.9±12.6° for internal rotation, and 43.4±21.9° to 56.3±18.3° for external rotation, respectively. The mean VAS scores were 7.0±1.2 (5-9) at baseline and 2.7±1.0 (1-5) at the control. There was a statistically significant difference between the baseline and control (two months after treatment) in terms of VAS scores and ROM angles (p<0.001).
Clinicians should be aware of adhesive capsulitis following vaccine administration since a significant improvement can be obtained by proper treatment for SIRVA.
本研究旨在通过分析21例在接种2019冠状病毒病(COVID-19)疫苗后发生粘连性关节囊炎的患者,提高临床医生对疫苗接种相关肩部损伤(SIRVA)的认识。
在这项观察性研究中,于2021年6月至2022年12月期间对21例因SIRVA诊断为粘连性关节囊炎且有初期肩部疼痛和活动受限的患者(11例男性,10例女性;平均年龄:60.7±7.3岁;范围45至70岁)进行了评估。记录患者的人口统计学和临床数据。采用视觉模拟量表(VAS)评估疼痛情况。用角度计测量患侧肩部的被动活动范围(ROM)。记录所应用的治疗方法(药物治疗、物理治疗、关节内类固醇注射、液压扩张和肩胛上神经阻滞)。两个月后召集患者进行复查。重新评估视觉模拟量表评分和肩部被动ROM。
9例(42.9%)患者在接种第二剂疫苗后出现症状。接种疫苗至出现症状的平均时间为8.0±6.4天。8例患者接种了科兴疫苗,5例患者接种了辉瑞疫苗,8例患者接种了科兴+辉瑞疫苗。从基线到复查时,屈曲ROM角度变化分别为128.8±30.4°至|155.0±20.6°,外展为117.1±37.8°至147.1±26.4°,内旋为45.9±17.8°至61.9±12.6°,外旋为43.4±21.9°至56.3±18.3°。平均VAS评分在基线时为7.0±1.2(5 - 9),复查时为2.7±1.0(1 - 5)。在VAS评分和ROM角度方面,基线与复查时(治疗后两个月)存在统计学显著差异(p<0.001)。
临床医生应意识到接种疫苗后可能发生粘连性关节囊炎,因为对SIRVA进行适当治疗可取得显著改善。