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
DOI: 10.12677/ACM.2023.13102135, PDF,   
作者: 雍智杰*:上海览海康复医院,上海;谈 健:上海市闵行区华漕社区卫生服务中心,上海;陈激光:上海市武警总队医院骨科,上海;缪 芸#:上海交通大学医学院附属第一人民医院康复医学科,上海
关键词: 神经肌肉电刺激运动训练肩峰下撞击综合征随机对照试验Neuromuscular Electrical Stimulation Exercise Training Subacromial Impingement Syndrome Randomized Controlled Trial
摘要: 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。
Abstract: 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.
文章引用:雍智杰, 谈健, 陈激光, 缪芸. 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[J]. 临床医学进展, 2023, 13(10): 15261-15267. https://doi.org/10.12677/ACM.2023.13102135

参考文献

[1] 翟天军, 张增乔, 宋永嘉, 冯伟. 附着于喙突的肌肉和韧带对肩峰下撞击综合征的影响[J]. 中医正骨, 2022, 34(10): 53-57.
[2] 董大维, 郭靖, 管海生, 王洪光, 李廷. 肩峰下撞击综合征发病机制、诊断及治疗的研究进展[J]. 中国疗养医学 2022, 31(3): 258-260.
[3] Çelik, M.S., Sönmezer, E. and Acar, M. (2022) Effectiveness of Pro-prioceptive Neuromuscular Facilitation and Myofascial Release Techniques in Patients with Subacromial Impingement Syndrome. Somatosensory & Motor Research, 39, 97-105. [Google Scholar] [CrossRef] [PubMed]
[4] Garving, C., Jakob, S., Bauer, I., Nadjar, R. and Brunner, U.H. (2017) Impingement Syndrome of the Shoulder. DÄ International, 114, 765-776. [Google Scholar] [CrossRef] [PubMed]
[5] 崔卫国, 张志刚, 陈德生. 肩峰下撞击综合征的治疗进展[J]. 中国骨与关节杂志, 2011, 10(4): 397-401.
[6] Héctor, G., Sebastián, P., Oscar, S. and Felipe, A. (2023) Effectiveness of Scapular Mobilization in People with Subacromial Impingement Syndrome: A Randomized Controlled Trial. Annals of Physical and Rehabilitation Medicine, 66, Article ID: 101744. [Google Scholar] [CrossRef] [PubMed]
[7] Maffiuletti, N.A. (2010) Physiological and Methodological Con-siderations for the Use of Neuromuscular Electrical Stimulation. European Journal of Applied Physiology, 110, 223-234. [Google Scholar] [CrossRef] [PubMed]
[8] Bdaiwi, A.H., Mackenzie, T.A., Herrington, L., Horsley, I. and Cools, A.M. (2015) Acromiohumeral Distance during Neuromuscular Electrical Stimulation of the Lower Trapezius and Serratus Anterior Muscles in Healthy Participants. Journal of Athletic Training, 50, 713-718. [Google Scholar] [CrossRef] [PubMed]
[9] 元帅霄, 俞瑾, 刘晓华. 运动训练在肩峰下撞击综合征患者功能恢复中的应用[J]. 中国康复医学杂志, 2011, 26(9): 50-55.
[10] 席蕊, 周敬滨, 高奉, 钱驿, 李国平. 肩胛肌群康复训练对肩峰下撞击综合征患者肩关节功能和肩峰下间隙的影响[J]. 体育科学, 2022, 42(10): 71-76+97.
[11] Blume, C., Wang-Price, S., Trudelle-Jackson, E. and Ortiz, A. (2015) Comparison of Eccentric and Concentric Exercise Interventions in Adults with Subacromial Impingement Syndrome. International Journal of Sports Physical Therapy, 10, 441-455.
[12] Hanratty, C.E., McVeigh, J.G., Kerr, D.P., Basford, J.R., Finch, M.B., Pendleton, A. and Sim, J. (2012) The Effectiveness of Physiotherapy Exercises in Subacromial Impingement Syndrome: A System-atic Review and Meta-Analysis. Seminars in Arthritis and Rheumatism, 42, 297-316. [Google Scholar] [CrossRef] [PubMed]
[13] Bang, M.D. and Deyle, G.D. (2000) Comparison of Super-vised Exercise with and without Manual Physical Therapy for Patients with Shoulder Impingement Syndrome. Journal of Orthopaedic & Sports Physical Therapy, 30, 126-137. [Google Scholar] [CrossRef] [PubMed]
[14] Gunay Ucurum, S., Kaya, D.O., Kayali, Y., Askin, A. and Tekindal, M.A. (2018) Comparison of Different Electrotherapy Methods and Exercise Therapy in Shoulder Impingement Syndrome: A Prospective Randomized Controlled Trial. Acta Orthopaedica et Traumatologica Turcica, 52, 249-255. [Google Scholar] [CrossRef] [PubMed]
[15] Kroll, H.R. (2015) Exercise Therapy for Chronic Pain. Physical Medicine and Rehabilitation Clinics of North America, 26, 263-281. [Google Scholar] [CrossRef] [PubMed]
[16] Vinuesa-Montoya, S., Aguilar-Ferrándiz, M.E., Mata-rán-Peñarrocha, G.A., Fernández-Sánchez, M., Fernández-Espinar, E.M. and Castro-Sánchez, A.M. (2017) A Prelimi-nary Randomized Clinical Trial on the Effect of Cervicothoracic Manipulation plus Supervised Exercises vs a Home Ex-ercise Program for the Treatment of Shoulder Impingement. Journal of Chiropractic Medicine, 16, 85-93. [Google Scholar] [CrossRef] [PubMed]
[17] İğrek, S. and Çolak, T.K. (2022) Comparison of the Effectiveness of Proprioceptive Neuromuscular Facilitation Exercises and Shoulder Mobilization Patients with Subacromial Impinge-ment Syndrome: A Randomized Clinical Trial. Journal of Bodywork and Movement Therapies, 30, 42-52. [Google Scholar] [CrossRef] [PubMed]
[18] Xu, S., Chen, J.Y., Lie, H.M.E., Hao, Y. and Lie, D.T.T. (2020) Minimal Clinically Important Difference of Oxford, Constant, and UCLA Shoulder Score for Arthroscopic Rotator Cuff Repair. Journal of Orthopaedics, 19, 21-27. [Google Scholar] [CrossRef] [PubMed]