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比较仪器辅助软组织松解术和体外冲击波疗法治疗肌筋膜疼痛综合征的疗效。

Comparison of the effectiveness of instrument-assisted soft tissue mobilization and extracorporeal shock wave therapy in myofascial pain syndrome.

机构信息

Department of Therapy and Rehabilitation, Kızılcahamam Vocational School of Health Services Ankara University, Ankara, Turkiye.

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkiye.

出版信息

Turk J Med Sci. 2023 Oct 16;53(6):1825-1839. doi: 10.55730/1300-0144.5753. eCollection 2023.

Abstract

BACKGROUND/AIM: To compare the effectiveness of instrument-assisted soft tissue mobilization (IASTM) and extracorporeal shock wave therapy (ESWT) used in myofascial pain syndrome (MPS) and to determine whether they are superior to conservative treatment (CT).

MATERIALS AND METHODS

A total of 42 female patients (aged 18-60 years) diagnosed with MPS were enrolled and randomly assigned to either the CT (n = 14), CT+IASTM (n = 14), or CT+ESWT group (n = 14). All of the groups received treatment for 3 weeks (CT: 5 sessions per week, 15 sessions in total, ESWT and IASTM: 2 sessions per week, 6 sessions in total). Neck stretching exercises were given to all of the patients as a home program. The pain intensity of the patients was determined using the visual analog scale (VAS). The pressure pain threshold (PPT) was measured with an algometer. Cervical joint range of motion (ROM) was measured with a cervical ROM (CROM) device. Pain, cervical disability, quality of life, and sleep disturbances were evaluated with the Neck Outcome Score (NOOS). Depression and anxiety parameters were evaluated with the Hospital Anxiety and Depression Scale (HADS). Evaluations were made before treatment and 3 days after the last treatment session.

RESULTS

The CT+IASTM group was more successful than the other groups in terms of pain intensity, PPT, and improvements in the ROM parameters (p < 0.05). No significant difference was found between the NOOS and HADS scores of the groups when the posttreatment changes were compared to pretreatment (p > 0.05).

CONCLUSIONS

All 3 of these treatments can be used to alleviate the negative effects of MPS. IASTM treatment can be preferred primarily in the creation of combined treatment programs for patients with ROM limitations and low PPTs.

摘要

背景/目的:比较肌筋膜疼痛综合征(MPS)中应用仪器辅助软组织松解(IASTM)和体外冲击波疗法(ESWT)的疗效,并确定它们是否优于保守治疗(CT)。

材料和方法

共纳入 42 名 18-60 岁女性 MPS 患者,随机分为 CT 组(n = 14)、CT+IASTM 组(n = 14)或 CT+ESWT 组(n = 14)。所有组均接受 3 周治疗(CT:每周 5 次,共 15 次;ESWT 和 IASTM:每周 2 次,共 6 次)。所有患者均接受颈部伸展运动作为家庭康复方案。使用视觉模拟量表(VAS)评估患者的疼痛强度,用压力测痛仪测量压力疼痛阈值(PPT),用颈椎活动度(CROM)装置测量颈椎活动度(ROM)。使用颈部结局评分(NOOS)评估疼痛、颈椎功能障碍、生活质量和睡眠障碍,使用医院焦虑和抑郁量表(HADS)评估抑郁和焦虑参数。在治疗前和最后一次治疗后 3 天进行评估。

结果

在疼痛强度、PPT 和 ROM 参数改善方面,CT+IASTM 组比其他组更成功(p < 0.05)。与治疗前相比,治疗后各组的 NOOS 和 HADS 评分无显著差异(p > 0.05)。

结论

这 3 种治疗方法均可减轻 MPS 的负面影响。IASTM 治疗可优先应用于 ROM 受限和 PPT 较低的患者的联合治疗方案中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbde/10760573/7385215786ac/turkjmedsci-53-6-1825f1.jpg

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