肌肉能量技术联合肌内效贴治疗跟腱病的疗效观察

Effect of muscle energy technique combined with intramuscular patch on the treatment of Achilles tendinopathy

目的评估肌肉能量技术联合肌内效贴治疗跟腱病的临床疗效。方法收集2021年4月至2021年12月烟台市烟台山医院足踝外科门诊诊治的跟腱病患者61例,按照随机数字表法分成观察组A(止点腱病)18例、观察组B(中段腱病)13例、对照组C(止点腱病)18例、对照组D(中段腱病)12例。对照组进行肌肉能量技术治疗,观察组进行肌肉能量技术联合肌内效贴治疗,分别在治疗前及治疗后即刻、1、4、12周时采用维多利亚运动评估研究所跟腱评估表(VISA-A)评分标准评价,并在治疗后12周时采用6点Likert评分法评价患者主观满意度。结果观察组治疗后各时点VISA-A评分A组(82±7、62±11、68±11、83±8)分,B组(65±10、58±10、70±10、89±4)分,均较同组治疗前的(53±11,54±10)分明显改善(P均<0.05)。对照组治疗后即刻VISA-A评分C组(54±13)、D组(54±8)与同组治疗前的(52±13和54±8)分比较差异无统计学意义(P>0.05),其余各时点C组(57±13、63±14、69±14),D组(57±8、65±7、79±3)与同组治疗前比较明显改善(P<0.05)。治疗后12周观察组VISA-A评分高于对照组(P<0.05)。6点Likert评分:满意率A组83.3%(15/18例)、B组100.0%(13/13例)、C组66.7%(12/18例)、D组83.3%(10/12例)。结论肌肉能量技术联合肌内效贴治疗跟腱病能够改善症状,提高患者满意度;治疗中段腱病的疗效优于治疗止点腱病。

Objective To evaluate the clinical efficacy of muscle energy technique combined with intramuscular patch(Kinesio taping)in the treatment of Achilles tendinopathy.Methods Sixty-one patients with Achilles tendinopathy,in the Department of Foot and Ankle Surgery,Yantaishan Hospital from April 2021 to December 2021,were collected,and randomly divided into observation group A(insertion tendinopathy,n=18),observation group B(mid-portion tendinopathy,n=13),control group C(insertion tendinopathy,n=18)and control group D(mid-portion tendinopathy,n=12).The patients received muscle energy technology in the control groups,and received muscle energy technique combined with intramuscular patch in the observation groups.The effects were assessed by VISA-A score table before and after the treatment(immediately,1 week,4 weeks and 12 weeks respectively).Patients'satisfaction was assessed by six-point Likert scale after 12 weeks treatment.Results The VISA-A score were(82±7,62±11,70±10,83±8)in group A and(65±10,58±10,70±10,89±4)in group B,which significantly improved after the treatment than that before the treatment at each time point(P<0.05).The immediately VISA-A score in group C(52±13)and group D(54±8)after the treatment in group C(54±13)and group D(54±8)had no significant difference(P>0.05)and significantly improved than that at other time points(P<0.05)in the control groups.The VISA-A score of the observation group was higher than that of the control group at 12 weeks after the treatment.Satisfaction rate was 83.3%(15/18 cases)in group A,100.0%(13/13 cases)in group B,66.7%(12/18 cases)in group C and 83.3%(10/12 cases)in group D,respectively.Conclusion The muscle energy technique combined with intramuscular patch can improve symptoms and patient's satisfaction in patients with Achilles tendinopathy,and the mid-portion tendinopathy is better than that in the insertion tendinopathy.