河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (4): 390-394.doi: 10.3969/j.issn.1007-3205.2021.04.005

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电磁式体外冲击波治疗肩袖退行性变关节镜修补术后肩关节功能障碍的随机对照临床研究

  

  1. 1.徐州医科大学徐州临床学院,徐州市中心医院康复医学科,江苏 徐州 221009;2.徐州医科大学附属徐州康复医院康复科,江苏 徐州 221006
  • 出版日期:2021-04-25 发布日期:2021-04-28
  • 作者简介:朱伟伟(1990-),男,江苏东海人,徐州医科大学徐州临床学院初级治疗师,医学硕士研究生,从事康复诊疗研究。
  • 基金资助:
    徐州市医学青年后备人才工程(2016015);江苏省青年医学人才工程(QNRC2016376);徐州市临床技术骨干研修计划项目(2018GG011)

A randomized controlled clinical study of electromagnetic extracorporeal shock wave on shoulder dysfunction after arthroscopic repair of rotator cuff degeneration

  1. 1.Xuzhou Clinical College of Xuzhou Medical University, Department of Rehabilitation Medicine, Xuzhou 
    Central Hospital, Jiangsu Province, Xuzhou  221009, China; 2.Department of Physiatry, 
    Xuzhou Rehabilitation Hospital Affiliated to Xuzhou Medical University, 
    Jiangsu Province, Xuzhou 221006, China
  • Online:2021-04-25 Published:2021-04-28

摘要: 目的  观察电磁式体外冲击波对肩袖退行性变关节镜修补术后肩关节功能障碍的临床研究。
方法  将行退行性损伤肩关节镜修补术后的患者40例,随机分成两组,每组20例。从术后6~8周开始康复功能锻炼,2组均进行常规康复治疗方案,观察组在常规康复治疗的基础上增加电磁式体外冲击波治疗。分别在治疗前、治疗后3周、治疗后6周采用Constant-Murley肩关节功能评分量表、加州大学肩关节评分(the university of California at Los Angeles shoulder rating scale,UCLA)、目测类比评分法(visual analogue scale,VAS)疼痛评分以及关节活动范围(range of motor,ROM)进行评估。
结果  2组CMS评分在治疗前后均呈现升高趋势,且观察组高于对照组,日常生活活动、主动活动范围评分的组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.05),疼痛评分的组间、时点间差异有统计学意义(P<0.05),肌力的时点间、组间·时点间交互作用差异有统计学意义(P<0.05)。2组UCLA评分在治疗前后均呈现升高趋势,且观察组高于对照组,所有评分的时点间差异有统计学意义(P<0.05),疼痛评分的组间差异有统计学意义(P<0.05),疼痛、向前屈曲活动评分的组间·时点间交互作用差异有统计学意义(P<0.05)。2组VAS评分在治疗前后均呈现降低趋势,且观察组低于对照组,功能、向前屈曲活动度、前屈力量、满意度评分均呈现升高趋势,且观察组高于对照组,所有评分的时点间、组间·时点间交互作用差异有统计学意义(P<0.05),疼痛、功能、前屈力量、满意度评分组间差异有统计学意义(P<0.05)。
结论  于肩袖退行性损伤修补术后的患者,电磁式体外冲击波能够显著缓解术后疼痛,对肩关节功能改善具有显著作用。


关键词: 肩痛, 体外冲击波, 肩袖损伤

Abstract: Objective  To observe the clinical effect of electromagnetic extracorporeal shock wave on shoulder dysfunction after arthroscopic repair of rotator cuff degeneration. 
Methods  A total of 40 patients with degenerative rotator cuff injury who underwent arthroscopic repair were randomly divided into two groups, with 20 patients in each group. Rehabilitation exercise was performed at 6-8 weeks after operation. Both groups were treated with conventional exercise methods. The observation group was supplemented with electromagnetic extracorporeal shock wave therapy on the basis of conventional rehabilitation exercises. The Constant-Murley Shoulder Function Score Scale(CMS), the university of California at Los Angeles shoulder rating scale(UCLA), visual analogue scale(VAS) pain score and ioint range of motion(ROM) were used for evaluation before treatment, at 3 weeks and 6 weeks after treatment. 
Results  The CMS score of the two groups showed an increasing trend before and after treatment, and the score was higher in the observation group than in the control group; the difference of interaction between groups, time points and time points between groups were statistically significant with respect to activities of daily living and active ROM scores(P<0.05). There were significant differences between groups and time points with respect to pain score(P<0.05), between time points and time points between groups with respect to muscle strength(P<0.05). The UCLA score of the two groups showed an increasing trend before and after treatment, and the score was higher in the observation group than in the control group; there was significant difference between time points in all scores(P<0.05). The difference was statistically significant between groups with respect to pain score(P<0.05). There were significant differences between groups and time points with respect to pain score and forward flexion score. VAS score of the two groups before and after treatment showed a decreasing trend, which was lower in the observation group than in the control group, while the scores of function, range of forward flexion, forward flexion strength and satisfaction showed an increasing trend, which were higher in the observation group than in the control group, suggesting significant differences between time points and time points between groups(P<0.05). There were significant differences in pain, function, forward flexion strength and satisfaction between groups(P<0.05). 
Conclusion  After degenerative rotator cuff injury repair, electromagnetic extracorporeal shock waves can significantly relieve postoperative pain of the patient and have a significant effect on improving shoulder joint function.


Key words: extracorporeal shock wave, rotator cuff injury, functional exercise, shoulder pain