冲击波联合表面肌电生物反馈训练对创伤后肘关节僵硬的疗效

Effect of extracorporeal shock wave therapy combined with surface EMG biofeedback on post⁃traumatic stiffness of the elbow

目的观察冲击波联合表面肌电生物反馈训练对创伤后肘关节僵硬的治疗效果。方法选取2021年1-12月在杭州市富阳中医骨伤医院康复科收治的创伤后肘关节僵硬患者80例,采用抽签法随机分配至对照组和治疗组,每组40例。对照组采用常规康复治疗(软组织松解、关节松动术、关节连续被动运动和冷疗),治疗组在常规康复治疗后采用冲击波疗法联合表面肌电生物反馈训练。两组患者每天训练1次,每周5 d,持续8周。比较两组患者治疗前后的视觉模拟疼痛评分(visual analogue scale,VAS)、肘关节主动活动度(active range of motion,AROM)、Mayo肘关节功能评分情况。结果经过8周治疗,两组患者的VAS疼痛评分、AROM、Mayo肘关节功能评分均较治疗前好转(P<0.001),治疗组在治疗后的VAS评分、AROM、Mayo肘关节功能评分改善值均优于对照组(P<0.05,P<0.001,P<0.001),两组患者治疗后均未出现不适症状。结论冲击波配合表面肌电生物反馈训练可以有效缓解创伤后肘关节僵硬患者的疼痛,改善肘关节的功能,并提高肘关节的主动关节活动度。

Objective To observe the therapeutic effect of extracorporeal shock wave therapy combined withsurface electromyography biofeedback training(ESW-sEMGBF)on post-traumatic elbow joint stiffness.Methods A total of 80 patients with post-traumatic elbow stiffness admitted to the Rehabilitation Department of Hangzhou Fuyang Hospital of Orthopedics of Traditional Chinese Medicine from January 2021 to December 2021 were randomly assigned into control group(n=40)and treatment group(n=40)using a lottery method.The control group received conventional rehabilitation treatment(including soft tissue release,joint mobilization,continuous passive motion and cold therapy),and the treatment group received conventional treatment combined with ESW-sEMGBF.Both groups underwent training once daily for five days a week over eight weeks.The visual analogue scale(VAS),active range of motion(AROM)of the elbow joint,and Mayo Elbow Performance Score(MEPS)were evaluated before and after treatment.Results After 8 weeks of treatment,significant improvements were observed in all outcomes for both groups.The treatment group showed better improvements in VAS scores,AROM,and MEPS after treatment compared with the control group(P<0.05,P<0.001,P<0.001).No side effects or adverse reactions were observed in either group after treatment.Conclusion Extracorporeal shock wave therapy combined with surface electromyography biofeedback training effectively alleviated pain in patients with post-traumatic elbow joint stiffness,improved elbow joint function,and increased active range of motion of the elbow joint.