Effectiveness of Kaltenborn Joint Mobilization Technique Versus Muscle Energy Technique on Pain and Disability in Patients with Shoulder Adhesive Capsulitis

The objective of this study was to compare the effectiveness of Kaltenborn joint mobilization techniques with muscle energy techniques in adhesive capsulitis.Study was conducted in population of Sargodha who is seeking physiotherapy treatment for adhesive capsulitis in physiotherapy rehabilitation departments and centers.The study design was randomized,controlled,and multicenter.Around 75 patients were selected by inclusion and exclusion criteria,and were divided into three groups by lottery method of randomization.Group 1 obtained Kaltenborn method of treatment,Group 2 obtained muscle energy technique,and Group 3 is control group that obtained conventional treatment in the form of heat and range of motion exercises.Duration of study was 6 months,and the interventions were performed for two weeks,with a total of 10 sessions.A baseline measurement was taken on shoulder pain and disability index(SPADI).A post intervention measurement was taken on same outcome measurement tools and was compared using ANOVA statistical analysis.The pre-intervention measurements on SPADI were 61.11±8.79,60.91±9.90,and 61.18±9.00 in control,Kaltenborn,and METs groups,respectively.The post intervention measurements were 49.33±9.95,39.09±9.45,and 27.69±11.97 in control,Kaltenborn,and METs groups,respectively.This study concluded that both techniques are effective in the treatment of adhesive capsulitis to decrease the pain and disability in experimental groups in comparison to control groups.METs is superior to Kaltenborn in pain and disability management when compared to each other.

Shoulder adhesive capsulitis in cancer patients undergoing positron emission tomography-computed tomography and the association with shoulder pain

BACKGROUND Adhesive capsulitis is a relatively common condition that can develop in cancer patients during treatment.Positron emission tomography-computed tomography(PET-CT)is routinely performed as a follow-up study in cancer patients after therapy.Being aware of PET-CT findings to suggest shoulder adhesive capsulitis may help to alert clinicians for the diagnosis of unsuspected shoulder capsulitis.AIM To assess the association of shoulder adhesive capsulitis with cancer/therapy type and symptoms in cancer patients undergoing PET-CT.METHODS Our prospective study received Institutional Review Board approval.Written informed consent was obtained from all patients,who answered a questionnaire regarding shoulder pain/stiffness at the time of PET-CT study,between March 2015 and April 2019.Patients with advanced glenohumeral arthrosis,metastatic disease or other mass in the shoulder,or shoulder arthroplasty were excluded.Patterns of shoulder capsule 18F-fluorodeoxyglucose(FDG)uptake were noted.Standard Uptake Value(SUV)max and SUVmean values were measured at rotator interval(RI)and deltoid muscle in bilateral shoulders.Normalized SUV(SUV of RI/SUV of deltoid muscle)was also calculated.We assessed if SUV values are different between symptomatic and asymptomatic patients in both shoulders.Covariates were age,gender,and therapy type(surgery,chemotherapy,radiation).Wilcoxon rank sum tests were used to compare unadjusted marginal differences for age,SUV measurements between symptomatic and asymptomatic patients.Multiple linear regression models were used to examine the relationship between right or left shoulder SUV measurements and symptom status,after adjusting for covariates.Statistical significance level was set at P<0.05.RESULTS Of 252 patients initially enrolled for the study(mean age 66 years,67 symptomatic),shoulder PET-CT data were obtained in 200 patients(52 were excluded due to exclusion criteria above).The most common cancer types were lymphoma(n=61),lung(n=54)and breast(n=53).No significant difference was noted between symptomatic and asymptomatic patients in terms of age,gender,proportion of patients who had surgical therapy and radiation therapy.A proportion of patients who received chemotherapy was higher in patients who were asymptomatic in the right shoulder compared to those symptomatic in the right shoulder(65%vs 48%,P=0.012).No such difference was seen for the left shoulder.In both shoulders,SUVmax and SUVmean were higher in symptomatic shoulders than asymptomatic shoulders(Left SUVmax 2.0 vs 1.6,SUVmean 1.6 vs 1.3,both P<0.002;Right SUVmax 2.2 vs 1.8,SUVmean 1.8 vs 1.5,both P<0.01).For lung cancer patients,bilateral RI SUVmax and SUVmean values were higher in symptomatic shoulders than asymptomatic shoulders.For other cancer patients,symptomatic patients had higher left RI SUVmax/mean than asymptomatic patients after adjustment.CONCLUSION In symptomatic patients metabolic activities in RI were higher than asymptomatic patients.Adhesive capsulitis should be considered in cancer patients with shoulder symptoms and positive FDG uptake in RI.

Frozen shoulder:A systematic review of therapeutic options

Frozen shoulder is a common disease which causes significant morbidity. Despite over a hundred years of treating this condition the definition, diagnosis, pathology and most efficacious treatments are still largely unclear. This systematic review of current treatments for frozen shoulder reviews the evidence base behind physiotherapy, both oral and intra articular steroid, hydrodilatation, manipulation under anaesthesia and arthroscopic capsular release. Key areas in which future research could be directed are identified, in particular with regard to the increasing role of arthroscopic capsular release as a treatment.

Atypical progress of frozen shoulder after COVID-19 vaccination:A case report

BACKGROUND After vaccination was mandated worldwide,various adverse effects associated with the coronavirus disease 2019(COVID-19)vaccination,including shoulder pain,have been reported.Here,we report a case of new-onset shoulder pain after BNT162b2(Comirnaty,Pfizer-BioNTech)mRNA vaccination.CASE SUMMARY A 50-year-old man visited our rehabilitation center with left shoulder range of motion(ROM)limitation that had persisted for more than 5 mo.The history included no specific noteworthy events,except vaccination.The pain in the patient’s left deltoid muscle appeared 1 day after the second BNT162b2 vaccination and intensified to severe pain.The patient self-administered aspirin,with which the pain subsided immediately,whereas ROM limitation persisted.At the first visit,the patient complained of dull pain and ROM restriction of the left shoulder(flexion 130°,abduction 110°,and external rotation 40°).Among the diagnostic studies conducted for the evaluation of the shoulder,magnetic resonance imaging showed a thickened coracohumeral ligament.Nerve conduction studies and needle electromyography showed no electrodiagnostic abnormalities.The patient received comprehensive rehabilitation for 7 mo and had an overall improvement in pain and ROM of the left shoulder.CONCLUSION In this case of severe shoulder pain after COVID-19 vaccination that subsided immediately with aspirin treatment,the exact cause and mechanism of pain are unclear.However,the clinical symptoms and diagnostic workups in our report suggest the possibility that the COVID-19 vaccination triggered an immunochemical response that resulted in shoulder pathology.

Pain management of hemiplegic shoulder pain post stroke in patients from Nanjing,China

We selected 106 hemiplegic patients with shoulder pain hospitalized after stroke from three hospi- tals in Nanjing, China between February 2007 and January 2012. All patients had complete clinical data sets and accounted for 45.5% of the inpatients because of stroke. Results showed that the number of patients with hemiplegic shoulder pain post stroke increased yearly, attacking mainly males 50-69 years of age. Of 106 patients, there were 60 cases （56.6%） of adhesive capsulitis, 19 （17.9%） of shoulder subluxation, 14 （13.2%） of complex regional pain syndrome, and 13 （12.6%） of central pain. The main symptoms were shoulder pain （100%）, limit of shoulder mobility （98.1%）, and adhesion of the scapula （56.6%）. MRI of the shoulder showed tendon and ligament lesions （57.1%） and rotator cuff tear （38.1%）. 53.8% of central pain was related to the thalamus, in addition to the basal ganglia, brain stem, and cerebellopontine angle. Shoulder pain, upper limb motor function, and function independence were significantly improved after comprehensive rehabilitation. In par- ticular, electroacupuncture based on basic physical therapy exhibited efficacy on shoulder subluxa- tion and complex regional pain syndrome. Multiple linear regression results showed a negative re- lationship of efficacy of pain management with the attack period of shoulder pain, involvement of the posterior limb of the internal capsule, and duration between onset and rehabilitation treatment, but a positive correlation with pain-related education, pain regression period, and pain diagnosis.

Arthroscopic Capsular Release for Frozen Shoulder—Time to Thaw the Delay?

Introduction: Frozen shoulder is a common condition that affects the working population. Current management regimes are variable nationwide and the evidence base on which to base these decisions is poor. The longevity and severity of symptoms often result in great economic burden, both to health services and in terms of absence from work. Early surgical intervention with arthroscopic capsular release may result in improved symptoms and earlier return to both work and leisure activities. Aims: The aim of our prospective cohort study was to investigate whether early intervention with arthroscopic capsular release resulted in improvement of symptoms and whether this would in turn provide overall economic benefit to society. Methods: Patients diagnosed with frozen shoulder at an elective orthopaedic specialist shoulder clinic were recruited prospectively. Data were gathered by way of questionnaire to ascertain the demographic information of the patient as well as their previous treatment in the primary care setting and absence from work. Initial Oxford Shoulder Score (OSS) was also calculated: Arthroscopic capsular release was then performed and further data gathered at four-week post-operative follow-up. Economic impact of delay to treatment and cost of intervention were calculated using government data from the national tariff which cost different forms of treatment. Statistical analysis was then performed on the results. Results: Twenty five patients were recruited. Mean results were: Age of patients: 53.5 years, duration of symptoms prior to intervention: 35.2 weeks, days absent from work: 31.5, number of previous physiotherapy sessions: 7.2, number of steroid injections: 1.3. Mean pre-operative OSS was 37.4 (range 27 - 58, SD 7.4). Mean post-operative OSS was 15.9 (range 12 - 22, SD 2.3), P 0.01. Mean improvement in OSS was 21.5 (range 12 - 38, SD 7.1). The cost of non-operative treatment per patient including absence from work to the point of surgical intervention was ￡3954. The overall cost of arthroscopic capsular release per patient was ￡1861, a difference of ￡2093. There were no surgical complications. Conclusion: Arthroscopic capsular release improved shoulder function on OSS within four weeks. This is significantly shorter than the natural history of frozen shoulder. The overall cost of arthroscopic capsular release is significantly less than the cost of treating the patients non-operatively up to the point of surgical intervention. Early surgical intervention may improve symptoms quickly and reduce economic burden of the disease. A randomised controlled trial comparing early with late intervention would further elucidate potential benefits.

Corticosteroid injection alone vs additional physiotherapy treatment in early stage frozen shoulders

AIM To investigate the additional value of physiotherapy after a corticosteroid injection in stage one or two idiopathic frozen shoulders(FSs).METHODS A two center, randomized controlled trial was done. Patients with a painful early stage idiopathic FS were eligible for inclusion. After written consent, patients were randomly allocated into two groups. All patients received an ultrasound-guided intra-articular corticosteroid injection. One group underwent additional physiotherapy treatment(PT) and the other group did not(non-PT). The primary outcome measure was the Shoulder Painand Disability Index(SPADI). Secondary outcomes were pain(numeric pain rating scale), range of motion(ROM), quality of life(RAND-36 score), and patient satisfaction. Follow-up was scheduled after 6, 12 and 26 wk.RESULTS Twenty-one patients were included, 11 patients in the non-PT and ten in the PT group, with a mean age of 52 years. Both treatment groups showed a significant improvement at 26 wk for SPADI score(non-PT: P = 0.05, PT: P = 0.03). At the 6 wk follow-up, median SPADI score was significant decreased in the PT group(14 IQR: 6-38) vs the non-PT group(63 IQR: 45-76)(P = 0.01). Pain decreased significantly in both groups but no differences were observed between both treatment groups at any time point, except for night pain at 6 wk in favor of the PT group(P = 0.02). Significant differences in all three ROM directions were observed after 6 wk in favor of the PT group(P ≤ 0.02 for all directions). A significantly greater improvement in abduction(P = 0.03) and external rotation(P = 0.04) was also present in favor of the PT group after 12 wk. RAND-36 scores showed no significant differences in health-related quality of life at all follow-up moments. At 26 wk, both groups did not differ significantly with respect to any of the outcome parameters. No complications were reported in both groups.CONCLUSION Additional physiotherapy after corticosteroid injection improves ROM and functional limitations in early-stage FSs up to the first three months.

Arthroscopic capsular release and manipulation under anaesthesia for frozen shoulders:A hot topic

A frozen shoulder is a common cause of shoulder pain and stiffness.The etiology and pathology of frozen shoulders is not fully understood yet.Frozen shoulderis characterized by a decrease in intra-articular volume and capsular compliance.This can lead to significant limitations in daily life.The majority of the patients can be treated conservatively,with functional recovery to be expected in two to three years.However,if conservative treatment fails,manipulation under anaesthesia and arthroscopic capsular release can both be considered as appropriate treatments.Manipulation is a traditionally well-established technique but in recent years it seems that arthroscopic capsular release has gained popularity.Manipulation is a relative time efficient and technically low-demanding procedure in which the glenohumeral joint is forced into different directions under general anaesthesia to release the capsular contracture,thereby increasing the range of motion of the joint.In arthroscopic capsular release the glenohumeral capsule can be released in a more controlled manner under direct vision.There are no prospective comparative trials available to display superiority of one procedure over the other.In addition,the optimal timing of both these interventions still has to be determined.An overview of the literature concerning this topic and a description of both procedures with its own advantages and disadvantages is provided.

Patients with Shoulder Dysfunction After Mastectomy Can Benefit from Nurse-Assisted Home-Based Range of Motion Exercises

Background:Shoulder dysfunction is very common after mastectomy,and there is also less follow-up for physiotherapy services among patients with mastectomy.Objective:A study was conducted to determine the role of nurse-assisted home-based range of motion(ROM)exercises in patients with shoulder dysfunction after mastectomy.Methods:A pre-and post-interventional study design was used to collect data from 30 post-mastectomy patients.The subjects were selected on a voluntary basis.Informed consent was obtained from post-mastectomy patients who were discharged from different oncology hospitals in Pakistan prior to their inclusion in this study.After obtaining a baseline measurement,the patients were supervised with nurse-assisted ROM exercises at home.The nurse-assisted home-based ROM exercise program was designed for such patients,and the patients were followed-up for up to 1 month.The total duration of the study was 1 year from August 2015 to August 2016.Post-intervention measurement was performed at the patients’home.The difference in terms of pain reduction and ROM improvement at the shoulder joint was recorded using goniometric measurements and the 100 mm visual analogue scale(VAS).Results:The mean age of the 30 subjects was 39.83±5.89.The mean ROM of shoulder flexion before the exercise program was 106.03°,which improved to 133.93°after 1 month of the exercise program.The mean ROM of shoulder abduction before treatment was 94.83°,which improved to 127.13°after 1 month of supervised exercise program.The mean ROM of shoulder rotation before the exercise program was 127.53°,which improved to 152.03°after 1 month of the exercise program.Conclusion:The nurse-assisted home-based shoulder ROM exercise program is effective in terms of improving the range of motion and reducing pain at the shoulder joint in post-mastectomy patients.

低剂量类固醇激素联合玻璃酸钠治疗粘连性肩关节囊炎的临床效果

目的比较低剂量类固醇激素、高剂量类固醇激素及低剂量类固醇激素联合玻璃酸钠治疗粘连性肩关节囊炎的效果。方法选取2020年12月至2021年12月我科收治的60例粘连性肩关节囊炎患者为研究对象,采用随机数字表法将其分为低剂量组、高剂量组和联合组,各20例。低剂量组给予关节腔内注射0.5 mL复方倍他米松注射液,高剂量组给予关节腔内注射1 mL复方倍他米松注射液,联合组给予关节腔内注射0.5 mL复方倍他米松注射液联合2.5 mL玻璃酸钠。比较三组的治疗效果。结果治疗后2、4、8、16周,三组的视觉模拟评分法(VAS)、肩关节疼痛与功能障碍指数(SPADI)评分低于治疗前(P<0.05);治疗后2、4、8、16周,联合组的VAS、SPADI评分低于低剂量组(P<0.05);治疗后2、4、8、16周,联合组和高剂量组的VAS、SPADI评分无明显差异(P>0.05)。治疗后2、4、8、16周,三组的肩关节外展活动度及肩关节外旋活动度大于治疗前(P<0.05);治疗后2、4、8、16周,三组的肩关节外展活动度及肩关节外旋活动度无明显差异(P>0.05)。结论低剂量类固醇激素联合玻璃酸钠可以缓解粘连性肩关节囊炎患者的疼痛,改善关节功能,其效果与高剂量类固醇激素相当,优于低剂量类固醇激素。

高频超声测量盂肱关节下方关节囊厚度

目的观察高频超声于腋下冠状切面与横切面所测盂肱关节下方关节囊厚度(ICT)有无差异。方法利用高频超声于腋下冠状切面及横切面对56例肩周炎患者(肩周炎组)及115名健康对照(HC组)测量ICT,比较组间超声所见及组内不同切面测量结果。结果高频超声显示,肩周炎组盂肱关节下方关节囊增厚,表现为边界欠清的低回声,内部回声减低且不均匀,有积液时可见无回声区,可伴点状血流信号;HC组盂肱关节下方关节囊呈边界清晰的中等回声,内部呈均匀低或等回声。2组组内于不同切面所测ICT值差异均无统计学意义(P均>0.05)。结论利用高频超声于腋下冠状切面及横切面所测ICT无明显差异。

超声在肩周炎诊疗中的应用进展

肩周炎是一种表现为肩关节疼痛,活动受限为主的疾病。肩周炎的诊断主要依赖病史及体格检查,目前无规范化的诊治标准,一定程度上影响了其疗效。近年来的研究发现,超声可提高肩周炎的诊治率。本文综述了肩周炎的致病机制、分类、分期、超声诊断及超声引导下的精准注射治疗。

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

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。

针灸联合关节松动术治疗粘连性肩周炎临床观察

目的:观察针灸联合关节松动术治疗粘连性肩周炎的效果。方法:81例分为两组,对照组40例予关节松动术治疗,试验组41例予针灸联合关节松动术治疗。结果:试验组总有效率比对照组高(P<0.05)。治疗后两组中医证候积分均下降,且试验组比对照组低(P<0.05)。治疗后两组Mallet量表评分均下降,且试验组比对照组低(P<0.05)。试验组并发症发生率比对照组低(P<0.05)。结论:针灸联合关节松动术治疗粘连性肩周炎可提高疗效,且安全。

“5+X点”注射联合红外光灸治疗粘连性肩关节囊炎

目的:探讨超声可视引导下“5+X”注射联合红外光灸治疗粘连性肩关节囊炎的临床观察。方法:71例粘连性肩关节囊炎患者分为对照组、实验组,2组均进行常规治疗,对照组在常规治疗方案上加用肩周注射治疗,实验组在常规治疗方案上加用肩周注射联合红外光灸治疗。2组患者治疗前后均进行红外热成像检查。结果:治疗2周后,2组患者与治疗前相比NRS评分均降低(P<0.05),肩关节功能评价量表评分均增加(P<0.05),且实验组评分均优于对照组(P<0.05);2组患者在肩周注射次数、住院期间静脉镇痛药物使用天数方面,实验组低于对照组(P<0.05);2组患者患肩皮温均降低(P<0.05),且实验组下降幅度高于对照组(P<0.05)。结论:超声引导下“5+X点”肩周注射联合红外光灸治疗粘连性肩关节囊炎疗效显著,节约医疗成本,值得临床进一步推广。

Frozen shoulder-A prospective randomized clinical trial

AIM To compare the results of arthroscopic capsular release with intra-articular steroid injections in patients of frozen shoulder.METHODS Fifty-six patients with frozen shoulder were randomised to one of two treatment groups: Group 1, complete 360 degree arthroscopic capsular release and group 2, intra-articular corticosteroid injection(40 mg methyl prednisolone acetate). Both groups were put on active and passive range of motion exercises following the intervention. The outcome parameters were visual analogue scale(VAS) score for pain, range of motion and Constant score which were measured at baseline, 4, 8, 12, 16 and 20 wk after intervention.RESULTS All the parameters improved in both the groups. The mean VAS score improved significantly more in the group 1 as compared to group 2 at 8 wk. This greater improvement was maintained at 20 wk with P value of 0.007 at 8 wk, 0.006 at 12 wk, 0.006 at 16 wk and 0.019 at 20 wk. The Constant score showed a more significant improvement in group 1 compared to group 2 at 4 wk, which was again maintained at 20 wk with P value of 0.01 at 4, 8, 12 and 16 wk. The gain in abduction movement was statistically significantly more in arthroscopy group with P value of 0.001 at 4, 8, 12, 16 wk and 0.005 at 20 wk. The gain in external rotation was statistically significantly more in arthroscopy group with P value of 0.007 at 4 wk, 0.001 at 8, 12, and 16 wk and 0.003 at 20 wk. There was no statistically significant difference in extension and internal rotation between the two groups at any time. CONCLUSION Arthroscopic capsular release provides subjective and objective improvement earlier than intra-articular steroid injection.

TREATMENT OF PERIARTHRITIS HUMEROSCAPULARIS WITH ACUPUNCTURE AND ACUPOINT BLOCKING

Periarthritis humeroscapularis is alsoknown as adhesive capsulitis of theshoulder,or commonly called frozen shoul-der;evidently it is related to seniledegenerative changes.It is usually due torupture of the rotator cuff,chronic inflam-mation of the periarticular muscles,the ten-dons,the synovial bursa or articular

关节镜下360°关节囊松解治疗黏连性肩关节囊炎

目的研究关节镜下360°关节囊松解治疗黏连性肩关节囊炎的临床疗效。方法回顾性研究分析2015年1月至2019年1月93例黏连性肩关节囊炎患者临床资料,男34例,女59例;年龄40~75岁,平均(56.5±3.5)岁,均应用关节镜下360°关节囊松解治疗。记录术前及末次随访时肩关节活动度和疼痛视觉模拟评分(visual analogue score,VAS)进行肩关节功能评价,以Likert量表评价患者肩关节恢复总体满意度。结果93例患者均按时完成随访,随访时间12~36个月,平均(18.3±4.3)个月。术前症状持续6~25个月,平均(9.2±3.5)个月。术后无神经损伤和感染等并发症,末次随访时肩关节主被动前屈(135.0±8.2)°,外展(128.0±4.5)°,外旋(63.2±6.4)°,内旋(63.5±7.8)°;平均VAS评分(0.9±0.3)分;肩关节恢复满意度为75.3%,均较术前明显改善(P<0.05)。结论关节镜下360°关节囊松解治疗黏连性肩关节囊炎有效、安全,能够减轻疼痛,改善肩关节活动度,对于黏连性肩关节囊炎是一种可供选择的手术松解方法,值得临床推广。

耳穴贴压联合塞来昔布胶囊治疗肩周炎临床研究

目的:观察耳穴贴压联合塞来昔布胶囊治疗肩周炎对患者短期疗效及肩关节功能的影响。方法:选取64例肩周炎患者为研究对象,采用随机数字表法分为西药组及中西结合组各32例。西药组给予塞来昔布胶囊治疗,中西结合组在西药组基础上联合耳穴贴压治疗,14 d为1个疗程。比较2组临床疗效及不良反应,比较2组治疗前、治疗1 d、7 d、14 d时视觉模拟评分法(VAS)评分、疼痛递质[β-内啡肽(β-EP)、前列腺素E2(PGE2)]水平,并比较2组治疗前后Constant-Murley肩关节功能活动量表(CMS)评分。结果:治疗14 d后,中西结合组总有效率93.75%,高于西药组75.00%(P<0.05)。治疗1 d、7 d、14 d,2组VAS评分均逐渐降低(P<0.05),且治疗7 d、14 d,中西结合组VAS评分低于同期西药组(P<0.05)。治疗1 d、7 d、14 d,2组血清β-EP水平均逐渐升高(P<0.05),PGE2水平均逐渐降低(P<0.05),且治疗7 d、14 d时中西结合组β-EP水平高于同期西药组(P<0.05),PGE2水平低于同期西药组(P<0.05)。治疗后,2组关节活动度、疼痛、日常生活CMS评分均升高(P<0.05),且中西结合组高于西药组(P<0.05)。2组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:耳穴贴压联合塞来昔布胶囊治疗肩周炎镇痛效果良好,可促进患者肩关节功能恢复。

盂肱关节下方关节囊厚度与治疗肩关节周围炎次数的相关性

目的探讨肩关节周围炎(肩周炎)患者盂肱关节下方关节囊厚度(ICT)与其接受超声引导下可视化精准治疗次数的相关性。方法纳入40例单侧肩周炎患者,以常规肌肉骨骼超声测量患侧ICT,完善临床评估后实施超声可视化精准治疗,以2周为周期直至痊愈,记录总治疗次数;采用Pearson相关分析观察患侧ICT与病程及治疗次数的相关性。结果40例病程15~90天,平均(49.8±25.0)天;均成功完成超声引导下可视化精准治疗,未见不良反应。超声显示患侧ICT为0.8~4.5 mm,平均(2.87±0.95)mm;治疗1~6次,平均(2.2±1.1)次;患侧ICT与病程及治疗次数均呈正相关(r=0.688、0.739,P均<0.001)。结论肩周炎病程越长,ICT越厚,则所需治疗次数越多。