低强度脉冲超声联合常规康复治疗肩关节挛缩的疗效分析

Effect analysis of low-intensity pulsed ultrasound combined with conventional rehabilitation in the treatment of shoulder joint contracture

摘要:

目的 观察低强度脉冲超声（LIPUS）联合常规康复治疗和单纯常规康复治疗对肩关节挛缩患者的疗效。方法 选取2024年1月—2024年12月于安徽医科大学第二附属医院接受治疗的肩关节挛缩患者59例。根据数字表法随机分为对照组30例和实验组29例，对照组采用单纯常规康复治疗，实验组采用常规康复治疗+ LIPUS治疗。评估两组患者治疗前后的患肩关节活动度、视觉模拟评估法（VAS）评分、Constant Murley肩关节评分（CMS）和患侧肩部三角肌表面积分肌电值（iEMG）。结果 实验组治疗前后前屈活动度、外展活动度和后伸活动评分的差值均高于对照组（P <0.05）。两组患者患侧肩关节治疗前后CMS评分差值比较，差异均有统计学意义（P <0.05）；实验组治疗前后疼痛程度、日常生活、肌力及肩关节活动度4项评分的差值均高于对照组。实验组治疗前后VAS评分的差值均高于对照组（P <0.05）。实验组治疗前后前屈iEMG值、外展iEMG值差值均高于对照组（P <0.05）。结论 LIPUS联合常规康复治疗能显著缓解肩关节疼痛和增加患侧肩关节活动范围，改善肩关节的综合功能，提高患侧三角肌iEMG值，其综合疗效优于单纯常规康复治疗。

Abstract:

Objective To observe the effect of low-intensity pulsed ultrasound (LIPUS) combined with conventional rehabilitation therapy versus conventional rehabilitation therapy alone on patients with shoulder contracture.Methods A total of 59 patients with shoulder contracture treated in our hospital from January 2024 to December 2024 were selected. Using a random number table, they were divided into control group (n = 30) and experimental group (n = 29). The control group received conventional rehabilitation therapy alone. The experimental group received low-intensity pulsed ultrasound (LIPUS) therapy in addition to conventional rehabilitation therapy. The range of motion (ROM) of the affected shoulder, Visual Analogue Scale (VAS) score, Constant-Murley shoulder score (CMS), and surface integrated electromyography (iEMG) of the deltoid muscle were evaluated before and after treatment.Results The experimental group demonstrated significantly greater improvements in flexion range of motion, abduction range of motion, and extension activity compared to the control group (P < 0.05). Statistically significant differences were observed in the Constant-Murley score (CMS) for the affected shoulder between the two groups before and after treatment (P < 0.05). Additionally, the experimental group exhibited higher improvements in pain intensity, daily living activities, muscle strength, and shoulder joint range of motion compared to the control group. The variations in Visual Analogue Scale (VAS) scores before and after treatment were significantly greater in the experimental group than in the control group (P < 0.05). Furthermore, the differences in anterior flexion integrated electromyography (iEMG) values and abduction iEMG values before and after treatment were also significantly greater in the experimental group compared to the control group (P < 0.05).Conclusion Low-intensity pulsed ultrasound (LIPUS) combined with conventional rehabilitation therapy can significantly relieve shoulder pain, increase the range of motion of the affected shoulder, improve shoulder joint function, increase the iEMG value of the deltoid muscle, and demonstrates superior comprehensive efficacy compared to conventional rehabilitation therapy alone.