对比Spencer 7步技术和关节松动术(Maintland手法)治疗肩关节粘连性关节囊炎的疗效差异

Comparison of the therapeutic effects of Spencer 7-step technique and joint mobilization(Maintland maneuver)in the treatment of adhesive capsulitis of the shoulder joint

目的 对比Spencer 7步技术和关节松动术(Maintland手法)治疗肩关节粘连性关节囊炎的临床疗效差异。方法 45例肩关节粘连性关节囊炎患者,随机分为治疗组(23例)和对照组(22例)。治疗组有3例,对照组有2例未完成8周的治疗,退出统计。故治疗组和对照组各有20例患者进行对比治疗。治疗组采用常规的物理因子治疗和Spencer 7步技术,对照组应用常规的物理因子治疗和关节松动术(Maintland手法)。比较两组治疗前后的Constant-Murley肩关节功能评分及视觉模拟评分法(VAS)评分。结果 治疗后,两组Constant-Murley肩关节功能评分的日常生活、肩前曲、肩外展评分均高于本组治疗前,差异具有统计学意义(P<0.05);但组间治疗后比较差异没有统计学意义(P>0.05)。治疗后,两组Constant-Murley肩关节功能评分的肩外旋、肩内旋、肩外展肌力评分均高于本组治疗前,且治疗组肩外旋评分(8.20±1.28)分、肩内旋评分(7.60±1.67)分、肩外展肌力评分(17.75±2.55)分高于对照组的(6.60±1.31)、(6.00±1.30)、(15.00±2.81)分,差异具有统计学意义(P<0.05)。治疗后,两组VAS评分均低于本组治疗前,差异具有统计学意义(P<0.05);但组间治疗后比较差异没有统计学意义(P>0.05)。结论 在常规的物理因子治疗的基础上应用Spencer 7步技术和关节松动术(Maintland手法)治疗肩关节粘连性关节囊炎患者均可在疼痛和日常生活能力、关节活动度方面带来改善,但是对比肩外旋、肩内旋、肩外展肌力方面Spencer 7步技术结合常规的物理因子治疗比关节松动术(Maintland手法)具有更好的效果。

Objective To compare the clinical efficacy of Spencer 7-step technique and joint mobilization(Maintland maneuver)in the treatment of adhesive capsulitis of the shoulder joint.Methods 40 patients with adhesive capsulitis of the shoulder joint were randomly divided into a treatment group(23 cases)and a control group(22 cases).There were 3 cases in the treatment group and 2 cases in the control group who did not complete the 8-week treatment and withdrew from the statistics.Therefore,the treatment group and the control group each had 20 cases for comparison of treatment.The treatment group received conventional physical agents therapy and Spencer 7-step technique,and the control group received conventional physical agents therapy and joint mobilization(Maintland maneuver).The Constant-Murley shoulder joint function score and visual analogue scale(VAS)score before and after treatment were compared between the two groups.Results After treatment,the scores of daily activity,shoulder flexion and shoulder abduction abduction in both groups were higher than those before treatment,and the difference was statistically significant(P<0.05).However,there was no significant difference between groups after treatment(P>0.05).After treatment,the scores of shoulder external rotation,shoulder internal rotation and shoulder abduction muscle strength in both groups were higher than those before treatment;in the treatment group,the shoulder external rotation score was(8.20±1.28)points,the shoulder internal rotation score was(7.60±1.67)points and the shoulder abduction muscle strength score was(17.75±2.55)points,which were higher than(6.60±1.31),(6.00±1.30)and(15.00±2.81)points in the control group;the difference was statistically significant (P<0.05). After treatment, VAS score in both groups was lower than that before treatment, and the difference was statistically significant (P<0.05). However, there was no significant difference between the two groups after treatment (P>0.05). Conclusion The application of Spencer 7-step technique and joint mobilization (Maintland maneuver) on the basis of conventional physical agents therapy can improve the pain, daily living ability and joint range of motion in patients with adhesive capsulitis of the shoulder joint. However, the Spencer 7-step technique combined with conventional physical agents therapy has better results than joint mobilization (Maintland maneuver) in terms of shoulder external rotation, shoulder internal rotation, and shoulder abduction muscle strength.