Güneş Musa, Yana Metehan, Kütükçü Beril, Ergişi Yılmaz, Daşar Uygar
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karabuk University, Karabuk, Türkiye.
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karabuk University, Karabuk, Türkiye.
J Shoulder Elbow Surg. 2025 May 22. doi: 10.1016/j.jse.2025.04.010.
After arthroscopic rotator cuff repair (RCR), rehabilitation focuses on pain, range of motion (ROM), and function. Instrument-assisted soft tissue mobilization (IASTM) is also widely used to improve these functions. However, its effectiveness after arthroscopic RCR is unknown. This study aimed to investigate the short-term effects of IASTM on pain, ROM, functional level, and kinesiophobia in patients following arthroscopic RCR.
A randomized, controlled, double-blind study was conducted with 33 patients 4 weeks after arthroscopic RCR. Patients were randomly assigned to an IASTM group (n = 17) or a control (n = 16) group. While the control group received conventional physiotherapy, the IASTM group received IASTM 3 sessions per week for 4 weeks, in addition to conventional physiotherapy. Pain intensity (visual analog scale [VAS]), ROM, functional level (Shoulder Pain and Disability Index), and kinesiophobia (Tampa Scale for Kinesiophobia) were evaluated before and after 4 weeks of treatment.
The baseline characteristics of the groups were similar. After treatment, the improvement in VAS rest (mean difference [MD]: -2.6 vs. -2.1, P = .004), VAS activity (MD: -4.2 vs. -2.6, P = .009), VAS night (MD: -4.2 vs. -2.7, P = .024), and Shoulder Pain and Disability Index total (MD: -30.5 vs. -20.0, P = .004) scores was statistically greater in the IASTM group compared to the control group. After treatment, both active and passive shoulder ROM angles improved statistically significantly within groups (P < .001), with significantly greater improvements in the IASTM group than those in the control group (P < .05). Tampa Scale for Kinesiophobia scores improved significantly within groups (P < .001). However, there was no statistical difference between groups (P = .089).
IASTM effectively improved pain, ROM, upper extremity function, and kinesiophobia in the short term after arthroscopic RCR. Therefore, adding IASTM to rehabilitation programs after arthroscopic RCR may obtain more effective results.
关节镜下肩袖修复术(RCR)后,康复重点在于疼痛、活动范围(ROM)和功能。器械辅助软组织松动术(IASTM)也被广泛用于改善这些功能。然而,其在关节镜下RCR后的有效性尚不清楚。本研究旨在探讨IASTM对关节镜下RCR术后患者疼痛、ROM、功能水平和运动恐惧的短期影响。
对33例关节镜下RCR术后4周的患者进行了一项随机、对照、双盲研究。患者被随机分为IASTM组(n = 17)或对照组(n = 16)。对照组接受常规物理治疗,IASTM组除常规物理治疗外,每周接受3次IASTM治疗,共4周。在治疗4周前后评估疼痛强度(视觉模拟量表[VAS])、ROM、功能水平(肩痛和残疾指数)和运动恐惧(坦帕运动恐惧量表)。
两组的基线特征相似。治疗后,IASTM组VAS静息(平均差值[MD]:-2.6 vs. -2.1,P = .004)、VAS活动(MD:-4.2 vs. -2.6,P = .009)、VAS夜间(MD:-4.2 vs. -2.7,P = .024)以及肩痛和残疾指数总分(MD:-30.5 vs. -20.0,P = .004)评分的改善在统计学上显著高于对照组。治疗后,两组内主动和被动肩部ROM角度均有统计学意义的显著改善(P < .001),IASTM组的改善显著大于对照组(P < .05)。坦帕运动恐惧量表评分在组内有显著改善(P < .001)。然而,两组之间无统计学差异(P = .089)。
IASTM在关节镜下RCR术后短期内有效改善了疼痛、ROM、上肢功能和运动恐惧。因此,在关节镜下RCR术后的康复计划中加入IASTM可能会获得更有效的结果。