体外冲击波联合肩胛动力训练对肩关节周围炎疗效的影响

关键词：肩胛动力训练  体外冲击波疗法  表面肌电  肩关节周围炎

Keywords:scapular dynamic training  extracorporeal shock wave therapy  surface electromyography  scapulohumeral periarthritis

摘要：

      摘要 目的：探讨体外冲击波联合肩胛动力训练对肩关节周围炎的临床疗效。 方法：将就诊于安徽医科大学第二附属医院康复医学科的60例肩关节周围炎患者，随机分为对照组和试验组，每组30例。对照组采用常规康复治疗，试验组在对照组的基础上增加体外冲击波联合肩胛动力训练，共治疗2周。评估两组患者的疼痛视觉模拟评分（VAS）、匹兹堡睡眠量表评分（PSQI）、Constant-Murley肩关节功能评分，以及患侧肱二头肌、三角肌中束、上斜方肌的表面肌电均方根值（RMS）和中位频率值（MF），并测定30°/s时肩前屈和外展的峰力矩值。 结果：①治疗前，两组患者疼痛评分、匹兹堡睡眠量表评分、肩关节功能评分、前屈动作中肱二头肌和上斜方肌的RMS值及MF值、外展动作中三角肌和上斜方肌的RMS值及MF值组间差异均无显著性意义（P>0.05）；②治疗2周后，两组患者在前屈与外展动作中上斜方肌的RMS值与治疗前无显著变化（P>0.05），其余各项评估指标均较治疗前显著改善（P<0.05）；试验组在VAS评分、PSQI评分、Constant-Murley评分、肱二头肌与三角肌的RMS及MF值、上斜方肌MF值，以及肩前屈与外展的峰力矩显著优于对照组（P<0.05）。 结论：体外冲击波联合肩胛动力训练能有效改善肩关节周围炎患者的疼痛与肩关节功能，疗效优于常规康复治疗。

Abstract:

      Abstract Objective： To investigate the clinical efficacy of extracorporeal shock wave therapy (ESWT) combined with scapular dynamic training in the treatment of scapulohumeral periarthritis. Method： A total of 60 patients with scapulohumeral periarthritis who were treated in the Department of Rehabilitation Medicine， the Second Affiliated Hospital of Anhui Medical University， were randomly divided into a control group and an experimental group， with 30 cases in each group. The control group received conventional rehabilitation treatment， while the experimental group received ESWT combined with scapular dynamic training in addition to the conventional treatment. Both groups were treated for two weeks. The following parameters were evaluated in both groups： the visual analog scale （VAS） score，, the Pittsburgh sleep quality index （PSQI） score，, the Constant-Murley shoulder function score， and the root mean square （RMS） and median frequency （MF） values of surface electromyography of the affected biceps brachii， middle deltoid， and upper trapezius. The peak torque of shoulder flexion and abduction at 30°/s was also measured. Result： ①Before treatment， there were no significant differences between the two groups in the VAS score, PSQI score, shoulder function score, or the RMS and MF values of the biceps brachii and upper trapezius during flexion， and of the deltoid and upper trapezius during abduction (all P>0.05). ②After two weeks of treatment， the RMS values of the upper trapezius during flexion and abduction showed no significant change from the pre-treatment values in either group （P>0.05）， while all other assessment indicators improved significantly compared with the pre-treatment values (P<0.05). The experimental group showed significantly better outcomes than the control group in the VAS score， PSQI score， Constant-Murley score， RMS and MF values of the biceps brachii and deltoid， MF value of the upper trapezius， and peak torque of shoulder flexion and abduction (all P<0.05). Conclusion： ESWT combined with scapular dynamic training effectively relieves pain and improves shoulder function in patients with scapulohumeral periarthritis， and its efficacy is superior to that of conventional rehabilitation therapy.