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肩袖钙化性肌腱病:关节腔灌洗术与冲击波治疗:对照临床试验方案(BOTCH)

Calcifying Tendinopathy of the Rotator Cuff: Barbotage vs. Shock Waves: Controlled Clinical Trial Protocol (BOTCH).

作者信息

Muñoz-Paz Javier, Piaggio-Muente Fiorella Liz, Acosta-Salvador Sebastián, Gómez-Flores Diego A, Jiménez-Jiménez Ana Belén, Muñoz-Alcaraz María Nieves, Mayordomo-Riera Fernando Jesús

机构信息

Interlevel Clinical Management Unit of Physical Medicine and Rehabilitation, Reina Sofía University Hospital, Córdoba and Guadalquivir Health District, 14011 Córdoba, Spain.

Maimónides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Córdoba, 14004 Córdoba, Spain.

出版信息

Healthcare (Basel). 2024 Dec 24;13(1):14. doi: 10.3390/healthcare13010014.

Abstract

: Shoulder pain is a very common health issue among adults, being 8% due to calcifying tendinopathies (CT) of the shoulder. The evolutionary process of this lesion can be classified according to Bianchi Martinoli, depending on the ultrasound appearance. In 50% of cases, with first-line treatments, they resolve spontaneously. However, in the remaining 50%, they become chronic, requiring other lines of treatment, such as shock waves (ESWT) or ultrasound-guided barbotage (US-PICT). : The objective focuses on comparing the improvement in pain using the visual analgesic scale (VAS) and shoulder joint balance (ROM) in patients with CT based on the treatment received, stratifying according to the characteristics of the injury, with the aim of protocolizing said treatment. : Randomized analytical controlled clinical trial in blocks with two arms according to the Bianchi Martinolli classification (I or II/III) in 56 patients affected by chronic pain by CT. The decision to treat will be made randomly 1:1, based on the treatment assigned to the previous patient. Results will be evaluated in three moments (1, 3, and 6 months). The following variables will be collected: VAS, Lattinen test, ROM (flexion, abduction, external and internal rotation), patient global improvement impression scale (PGI-I), global improvement impression scale (CGI-C). : The use of ESWT or US-PICT as treatments is a widely used practice in the daily life of this pathology. However, despite knowing that both treatments are useful in chronic CT, there are no known data or protocols by which one therapy is chosen over another, much less the influence that the evolutionary stage can have of the injury in the results obtained.

摘要

肩部疼痛是成年人中非常常见的健康问题,其中8%是由肩部钙化性肌腱病(CT)引起的。根据比安奇·马蒂诺利的分类,这种病变的演变过程可根据超声表现进行分类。在50%的病例中,通过一线治疗,病情会自发缓解。然而,在其余50%的病例中,病情会转为慢性,需要其他治疗方法,如冲击波(ESWT)或超声引导下注射(US-PICT)。:目的是根据所接受的治疗,比较使用视觉镇痛量表(VAS)和肩关节平衡(ROM)来评估CT患者疼痛改善情况,并根据损伤特征进行分层,以便将该治疗方案化。:对56例受CT慢性疼痛影响的患者,根据比安奇·马蒂诺利分类(I或II/III)进行双臂随机分析对照临床试验。治疗决策将基于前一位患者所分配的治疗方案,以1:1的比例随机进行。结果将在三个时间点(1、3和6个月)进行评估。将收集以下变量:VAS、拉蒂宁试验、ROM(屈曲、外展、外旋和内旋)、患者总体改善印象量表(PGI-I)、总体改善印象量表(CGI-C)。:在这种疾病的日常治疗中,使用ESWT或US-PICT作为治疗方法是一种广泛应用的做法。然而,尽管知道这两种治疗方法对慢性CT都有用,但尚无已知数据或方案可据此选择一种治疗方法而非另一种,更不用说损伤的演变阶段对所获结果可能产生的影响了。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/924b/11719880/12480949b78d/healthcare-13-00014-g001.jpg

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