Cevriye Mülkoğlu, Tülay Tiftik, A Berna Deniz, Habibe Kandaşoğlu, Hakan Genç
{"title":"粘连性关节囊炎患者在接受肩胛上神经阻断术的同时接受盂肱关节水扩张术的叠加效应。","authors":"Cevriye Mülkoğlu, Tülay Tiftik, A Berna Deniz, Habibe Kandaşoğlu, Hakan Genç","doi":"10.1186/s12891-024-08082-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>We aimed to investigate the efficacy of shoulder hydrodilatation (HD) applied in addition to suprascapular nerve blockage (SSNB) on severity of pain, shoulder joint range of motion (ROM), functional status, handgrip (HG) strength in patients with adhesive capsulitis (AC).</p><p><strong>Methods: </strong>Forty-eight patients who were diagnosed with AC based on physical examination findings included in the study. The patients were randomized into two groups as combination of SSNB + HD and SSNB alone. Injections were performed under ultrasonography guidance. Shoulder ROM angles were measured with a goniometer. Pain intensity was evaluated with visual analog scale. Functional status was evaluated with Quick Disability of Arm, Shoulder, and Hand (QDASH). HG strength was measured by a Jamar dynometer. After the injection, a home-based exercise program was given to all patients. Patients were evaluated at baseline, 1st and 3rd month.</p><p><strong>Results: </strong>Abduction and external rotation ROM angles were statistically significantly limited in SSNB group, at baseline (p = 0.020, p = 0.018, respectively). In terms of other parameters, both groups were similar at baseline (p > 0.05). At comparison of baseline-1st month, a significant improvement was observed in VAS score, abduction and flexion ROM and QDASH score, in both groups (p < 0.05), however, there was no statistically significant difference between the groups. There is a statistically significant decrease in VAS score in both groups, at all times, but, no significant difference between the groups. At the comparison of baseline-3rd month measurements, it was observed that all of the parameters significantly improved in both groups, and there was no statistically significant difference between the groups except for abduction and external rotation ROM (p > 0.05). Abduction ROM and external rotation ROM were significantly higher in the SSNB group than SSNB + HD group at 3rd month.</p><p><strong>Conclusions: </strong>Both SSNB + HD and SSNB alone provide significant improvement clinically especially in shoulder pain. HD added to SSNB does not seem to provide any additional benefit. 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The patients were randomized into two groups as combination of SSNB + HD and SSNB alone. Injections were performed under ultrasonography guidance. Shoulder ROM angles were measured with a goniometer. Pain intensity was evaluated with visual analog scale. Functional status was evaluated with Quick Disability of Arm, Shoulder, and Hand (QDASH). HG strength was measured by a Jamar dynometer. After the injection, a home-based exercise program was given to all patients. Patients were evaluated at baseline, 1st and 3rd month.</p><p><strong>Results: </strong>Abduction and external rotation ROM angles were statistically significantly limited in SSNB group, at baseline (p = 0.020, p = 0.018, respectively). In terms of other parameters, both groups were similar at baseline (p > 0.05). At comparison of baseline-1st month, a significant improvement was observed in VAS score, abduction and flexion ROM and QDASH score, in both groups (p < 0.05), however, there was no statistically significant difference between the groups. There is a statistically significant decrease in VAS score in both groups, at all times, but, no significant difference between the groups. At the comparison of baseline-3rd month measurements, it was observed that all of the parameters significantly improved in both groups, and there was no statistically significant difference between the groups except for abduction and external rotation ROM (p > 0.05). Abduction ROM and external rotation ROM were significantly higher in the SSNB group than SSNB + HD group at 3rd month.</p><p><strong>Conclusions: </strong>Both SSNB + HD and SSNB alone provide significant improvement clinically especially in shoulder pain. HD added to SSNB does not seem to provide any additional benefit. 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引用次数: 0
摘要
背景:我们的目的是研究在肩胛上神经阻滞术(SSNB)基础上应用肩关节水扩张术(HD)对粘连性肩关节囊炎(AC)患者的疼痛严重程度、肩关节活动范围(ROM)、功能状态、手握力(HG)的疗效:研究对象包括 48 名根据体格检查结果确诊为粘连性肩关节囊炎的患者。这些患者被随机分为两组,即联合使用 SSNB + HD 组和单独使用 SSNB 组。注射在超声引导下进行。用动态关节角度计测量肩关节的ROM角度。疼痛强度用视觉模拟量表进行评估。功能状态用手臂、肩部和手部快速残疾指数(QDASH)进行评估。用 Jamar 测力计测量 HG 力量。注射后,所有患者都将接受家庭锻炼计划。在基线、第1个月和第3个月对患者进行评估:结果:在统计学上,SSNB 组的外展和外旋 ROM 角度在基线时明显受限(分别为 p = 0.020 和 p = 0.018)。在其他参数方面,两组基线值相似(p > 0.05)。在基线-第 1 个月的比较中,两组的 VAS 评分、外展和屈曲 ROM 以及 QDASH 评分均有显著改善(P 0.05)。第 3 个月时,SSNB 组的外展 ROM 和外旋 ROM 明显高于 SSNB + HD 组:结论:SSNB + HD 和单用 SSNB 都能明显改善临床症状,尤其是肩部疼痛。在 SSNB 的基础上加用 HD 似乎不会带来额外的益处。对于肩关节外展和外旋受限的 AC 患者,SSNB 是一种有效的治疗方案,最长可持续 3 个月。
Additive effect of glenohumeral joint hydrodilatation applied in addition to suprascapular nerve blockage in patients with adhesive capsulitis.
Background: We aimed to investigate the efficacy of shoulder hydrodilatation (HD) applied in addition to suprascapular nerve blockage (SSNB) on severity of pain, shoulder joint range of motion (ROM), functional status, handgrip (HG) strength in patients with adhesive capsulitis (AC).
Methods: Forty-eight patients who were diagnosed with AC based on physical examination findings included in the study. The patients were randomized into two groups as combination of SSNB + HD and SSNB alone. Injections were performed under ultrasonography guidance. Shoulder ROM angles were measured with a goniometer. Pain intensity was evaluated with visual analog scale. Functional status was evaluated with Quick Disability of Arm, Shoulder, and Hand (QDASH). HG strength was measured by a Jamar dynometer. After the injection, a home-based exercise program was given to all patients. Patients were evaluated at baseline, 1st and 3rd month.
Results: Abduction and external rotation ROM angles were statistically significantly limited in SSNB group, at baseline (p = 0.020, p = 0.018, respectively). In terms of other parameters, both groups were similar at baseline (p > 0.05). At comparison of baseline-1st month, a significant improvement was observed in VAS score, abduction and flexion ROM and QDASH score, in both groups (p < 0.05), however, there was no statistically significant difference between the groups. There is a statistically significant decrease in VAS score in both groups, at all times, but, no significant difference between the groups. At the comparison of baseline-3rd month measurements, it was observed that all of the parameters significantly improved in both groups, and there was no statistically significant difference between the groups except for abduction and external rotation ROM (p > 0.05). Abduction ROM and external rotation ROM were significantly higher in the SSNB group than SSNB + HD group at 3rd month.
Conclusions: Both SSNB + HD and SSNB alone provide significant improvement clinically especially in shoulder pain. HD added to SSNB does not seem to provide any additional benefit. SSNB is an effective treatment option for up to 3 months in patients with AC, mainly in abduction and external rotation limitation.
期刊介绍:
BMC Musculoskeletal Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of musculoskeletal disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
The scope of the Journal covers research into rheumatic diseases where the primary focus relates specifically to a component(s) of the musculoskeletal system.