Tombak Yasemin, Karaahmet Ozgur Zeliha, Tombak Aysegul, Gurcay Eda
Physical Medicine and Rehabilitation, Ankara Etlik City Hospital, Varlik Mah, Halil Sezai Erkut Cad No. 5, 06170, Yenimahalle, Ankara, Turkey.
Physical Medicine and Rehabilitation, Ankara Etlik City Hospital, Ankara, Turkey.
Wien Klin Wochenschr. 2024 Sep 5. doi: 10.1007/s00508-024-02437-y.
Rotator cuff calcific tendinitis (RCCT) is a benign but incapacitating condition and in some patients it is the cause of chronic debilitating pain and functional disability. We aimed to reveal the short-term effects of low-level laser therapy (LLLT) on clinical and sonographic parameters in patients with symptomatic RCCT.
This prospective randomized controlled study analyzed 76 painful shoulders of 68 patients aged 18-75 years, with over 3 months of shoulder pain and where RCCT was confirmed sonographically. Patients in the LLLT group (received 5 LLLT sessions per week and home exercises for 5 days/week for 3 weeks) and the control group (received home exercises, 5 days/week for 3 weeks) were assessed clinically and sonographically just before and after treatment, recording pain intensity, range of motion (ROM), shoulder functional status, location (supraspinatus/infraspinatus, subscapularis), number and degree of calcification. Degree of calcification was determined with ultrasound and classified by the Bianchi-Martinoli classification. The LLLT was applied to the calcified areas marked under ultrasound guidance.
Both groups showed statistically significant improvements in ROM, pain intensity, shoulder pain and disability index (SPADI) pain/disability/total, and degree of calcification after treatment. No significant change was achieved for calcification in the control group. Considering the change values, improvements in abduction, extension, pain intensity, SPADI pain/disability/total, calcification number, and calcification degree parameters were found to be statistically significantly better in the LLLT group than in the control group.
Adding LLLT to the home program in treatment of symptomatic RCCT outperformed the home program alone, reducing the number and severity of calcifications, improving pain and disability.
肩袖钙化性肌腱炎(RCCT)是一种良性但使人丧失能力的病症,在一些患者中,它是导致慢性衰弱性疼痛和功能障碍的原因。我们旨在揭示低强度激光疗法(LLLT)对有症状的RCCT患者临床和超声参数的短期影响。
这项前瞻性随机对照研究分析了68例年龄在18 - 75岁之间、肩部疼痛超过3个月且经超声证实患有RCCT的患者的76个疼痛肩部。LLLT组(每周接受5次LLLT治疗,并每周进行5天家庭锻炼,持续3周)和对照组(每周进行5天家庭锻炼,持续3周)在治疗前后进行临床和超声评估,记录疼痛强度、活动范围(ROM)、肩部功能状态、钙化位置(冈上肌/冈下肌、肩胛下肌)、钙化数量和程度。钙化程度通过超声测定,并根据比安奇 - 马蒂诺利分类法进行分类。LLLT应用于超声引导下标记的钙化区域。
两组在治疗后ROM、疼痛强度、肩部疼痛和残疾指数(SPADI)疼痛/残疾/总分以及钙化程度方面均显示出统计学上的显著改善。对照组的钙化情况无显著变化。考虑变化值,发现LLLT组在外展、伸展、疼痛强度、SPADI疼痛/残疾/总分、钙化数量和钙化程度参数方面的改善在统计学上显著优于对照组。
在有症状的RCCT治疗中,在家庭锻炼方案基础上加用LLLT比单纯的家庭锻炼方案效果更好,可减少钙化的数量和严重程度,改善疼痛和残疾状况。