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肱二头肌长头腱鞘炎患者行干针治疗后疼痛、功能和腱鞘内积液的改善:一项单盲随机临床试验。

Pain, function and peritendinous effusion improvement after dry needling in patients with long head of biceps brachii tendinopathy: a single-blind randomized clinical trial.

机构信息

Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan.

Department of Physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung, Taiwan.

出版信息

Ann Med. 2024 Dec;56(1):2391528. doi: 10.1080/07853890.2024.2391528. Epub 2024 Aug 14.

Abstract

INTRODUCTION

Long head of biceps brachii tendinopathy, a frequent source of anterior shoulder pain, may lead to discomfort and diminished function. The objective of this study is to assess the efficacy of dry needling and transcutaneous electrical nerve stimulation in these patients.

PATIENTS AND METHODS

Thirty patients were randomized into dry needling and transcutaneous electrical nerve stimulation groups and assessed before treatment, 8 and 15 days after treatment using a visual analogue scale, shoulder pain and disability index, pressure pain threshold, tissue hardness, and biceps peritendinous effusion.

RESULTS

Both treatments significantly reduced the visual analogue scale in immediate ( < 0.001), short-term ( < 0.01), and medium-term effects ( < 0.01). Dry needling outperformed transcutaneous electrical nerve stimulation for the pain ( < 0.01) and disability ( < 0.03) subscales of the shoulder pain and disability index in the short-term and medium-term effects, respectively. Pressure pain threshold increased after both treatments but didn't last beyond 8 days. Neither treatment showed any improvements in tissue hardness of the long head of biceps brachii muscle. Notably, only the dry needling group significantly reduced biceps peritendinous effusion in both short-term and medium-term effects ( < 0.01).

CONCLUSIONS

Dry needling showed non-inferior results to transcutaneous electrical nerve stimulation in reducing pain and disability and demonstrated even superior results in reducing biceps peritendinous effusion (see Graphical Abstract).

TRIAL REGISTRATION

The Institutional Review Board of the China Medical University Hospital (CMUH107-REC2-101) approved this study, and it was registered with Identifier NCT03639454 on ClinicalTrials.gov.

摘要

简介

肱二头肌长头腱鞘炎是引起肩部前侧疼痛的常见原因,可能导致不适和功能受限。本研究旨在评估干针和经皮神经电刺激对此类患者的疗效。

患者和方法

30 名患者随机分为干针和经皮神经电刺激组,在治疗前、治疗后 8 天和 15 天使用视觉模拟量表、肩痛和残疾指数、压力疼痛阈值、组织硬度和肱二头肌腱周积液进行评估。

结果

两种治疗方法均能显著降低即时( < 0.001)、短期( < 0.01)和中期( < 0.01)的视觉模拟量表评分。干针治疗在短期和中期效应中,在疼痛( < 0.01)和残疾( < 0.03)亚量表上的效果优于经皮神经电刺激。两种治疗方法均可提高压力疼痛阈值,但在 8 天后不再持续。两种治疗方法均未改善肱二头肌长头肌肉的组织硬度。值得注意的是,只有干针组在短期和中期效应中均显著减少肱二头肌腱周积液( < 0.01)。

结论

干针在减轻疼痛和残疾方面与经皮神经电刺激效果相当,在减少肱二头肌腱周积液方面效果甚至更好(见图)。

试验注册

中国医科大学附属医院机构审查委员会(CMUH107-REC2-101)批准了这项研究,并在 ClinicalTrials.gov 上以标识符 NCT03639454 进行了注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2290/11328602/29e1851ff758/IANN_A_2391528_UF0001_C.jpg

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