三位一体牵伸技术联合Mulligan关节松动术治疗原发性冻结肩的疗效观察

Therapeutic efficacy of triple-treatment stretching combined with Mulligan Concept of Mobilization with Movement in primary frozen shoulder

摘要:

目的 探讨三位一体牵伸技术联合Mulligan关节松动术对原发性冻结肩功能恢复的影响。方法 选取2018年1月—2020年3月在丽水市第二人民医院诊治的原发性冻结肩患者96例。将患者随机分为治疗组和对照组，每组48例。对照组行Mulligan关节松动术治疗，治疗组行三位一体牵伸联合Mulligan关节松动术治疗，持续4周。比较两组疗效、疼痛［视觉模拟评分法（VAS）评分］、关节活动度（ROM）、功能［日本骨科学会（JOA）肩关节功能评分（以下简称JOA评分）］、日常生活活动能力［（ADL）评分］、安全性。结果 治疗组脱落2例，对照组脱落1例，最终治疗组46例，对照组47例完成治疗；治疗组总有效率（95.65%）高于对照组（78.72%）（P <0.05）；治疗组治疗前后ROM（外展、后伸、内旋、前屈、外旋）、JOA评分（疼痛、功能、活动度、X线评定、关节稳定性、总分）、VAS评分和ADL评分的差值均大于对照组（P <0.05）；治疗过程中所有患者未发生皮下出血、肌肉拉伤、关节脱位等不良事件。结论 三位一体牵伸技术联合Mulligan关节松动术治疗原发性冻结肩效果显著，可明显缓解疼痛，增加关节活动度，改善肩关节功能，提高患者活动能力，且安全可靠。

Abstract:

Objective To investigate the effect of the triple-treatment stretching combined with Mulligan Concept of Mobilization with Movement on the functional recovery of primary frozen shoulder.Methods A total of 96 patients with primary frozen shoulder treated in Lishui Second People's Hospital from January 2018 to March 2020 were randomly divided into treatment group (48 cases) and control group (48 cases). The control group underwent Mulligan Concept of Mobilization with Movement, and the treatment group underwent triple-treatment stretching combined with Mulligan Concept of Mobilization with Movement for 4 weeks. The therapeutic efficacy, pain of the shoulder joint assessed via Visual Analogue Scale (VAS) score, joint range of motion (ROM), function of the shoulder joint assessed via Japanese Orthopedic Association (JOA) score, Activities of Daily Living (ADL) score, and safety of the treatments were compared between the two groups.Results Two cases in the treatment group and one case in the control group were censored, and therefore 46 cases in the treatment group and 47 cases in the control group completed the treatment. The overall effective rate (95.65%) of the treatment group was higher than that of the control group (78.72%) (P < 0.05). The differences of ROM (abduction, extension, internal rotation, forward flexion, external rotation), JOA score (pain, function, range of movement, radiographic evaluation, stability, and total score), VAS score and ADL score before and after treatment in the treatment group were higher than those in the control group (P < 0.05). During the treatment, no patient developed adverse events such as subcutaneous hemorrhage, muscle strain, or joint dislocation.Conclusions Triple-treatment stretching combined with Mulligan Concept of Mobilization with Movement is effective in treating primary frozen shoulder. It is a safe and reliable approach to relieving pain, increasing joint mobility, improving shoulder joint function, and enhancing activity of daily living.