神经肌肉电刺激治疗功能性肩峰下撞击综合征的疗效研究

The Therapeutic Effects of Neuromuscular Electrical Stimulation on Functional Subacromial Impingement Syndrome

目的:比较神经肌肉电刺激(NMES)联合运动训练(ET)与单纯运动训练对功能性肩峰下撞击综合征(SIS)患者肩部功能、疼痛、关节活动度和肌力的影响。方法:将符合纳入条件的患者随机分为NMES + ET组(25例)和ET组(25例)。分别在治疗前、治疗8周后应用Constant评分量表评定患者肩功能,视觉模拟评分(VAS)评估疼痛程度,测角器测量肩关节活动度,手持测力仪评定肌力。结果:治疗结束时两组患者的肩部功能、关节活动度和肌力均增加,而疼痛均减轻。与ET组相比,NMES + ET组患者活动时的疼痛缓解更明显,肩外旋活动度和肌力提高更显著。结论:在ET的基础上加用NMES并不能额外提高功能性SIS患者肩部功能,但在提高肩关节外旋活动度、肌力和减轻活动时疼痛方面效果更好,二者联合应用的长期疗效需后续研究进一步探索。

Objective: To compare the effects of neuromuscular electrical stimulation (NMES) combined with exercise training (ET) and exercise training onlyon shoulder function, pain, joint range of motion, and muscle strength in patients with functionalsubacromial impingement syndrome (SIS). Method: Patients who met the inclusion criteria were randomly divided into NMES + ET group (n = 25) and ET group (n = 25). Before treatment and 8 weeks after treatment, the patients’ shoulder function was assessed with Constant scale, the pain degree was assessed with visual analogue scale (VAS), the range of motion of shoulder joint was measured with goniometer, and the muscle strength was assessed with hand-held dynamometer. Result: At the end of treatment, the shoulder function, range of motion, and muscle strength of both groups of patients increased, while pain decreased. Compared with the ET group, the NMES + ET group showed more significant pain relief during ac-tivity, and more significant improvements in shoulder external rotation and muscle strength. Con-clusion: The addition of NMES to ET did not additionally improve the shoulder function of SIS pa-tients, but it is better in improving the range of shoulder external rotation, muscle strength and reducing pain during activity. The long-term efficacy of the combination of NMES and ET in the treatment of SIS need further exploration in the following study.