PDF(Pubmed)
Abstract：
BACKGROUND: Myofascial tissue plays a critical role in shoulder joint mobility disorders. Myofascial release therapy (MFR) is frequently utilized to restore the extensibility of fascial tissue and is considered beneficial for various clinical conditions such as low back pain and ankle injuries. However, no studies have yet evaluated the effects of MFR on periscapular muscles activation and shoulder mobility in patients with subacromial pain syndrome(SAPS).
OBJECTIVE: The purpose of this study was to compare the effectiveness of MFR combined with supervised exercise(SE) and SE alone in patients with SAPS.
METHODS: Assessor-blinded randomized controlled trial.
METHODS: Sir Run Run Shaw Hospital, Zhejiang University School of Medicine.
METHODS: Subacromial pain syndrome patients.
METHODS: Fifty participants were divided into two groups: SE group and MFR + SE group, each group 25 cases. Both treatment methods were performed 5 times a week for 4 weeks.
METHODS: Shoulder pain severity was assessed by visual analog scale (VAS); shoulder range of motion (ROM) by a goniometer; functionality by shoulder Pain and Disability Index (SPADI); and periscapular muscles activation by sEMG. All measurements were evaluated both pre- and post-treatment.
RESULTS: An ANOVA analysis indicated no significant group by time interactions for flexion ROM and resting VAS (p > 0.05). However, significant group by time interactions were found for SPADI, abduction and external rotation ROM, and activity VAS (p < 0.05). Post-hoc tests revealed significant improvements in SPADI, abduction and external rotation ROM, and activity VAS in both groups compared to pre-treatment (p < 0.05). Additionally, there were significant group by time interactions for the sEMG values of the upper trapezius and serratus anterior (p < 0.05). Post-hoc tests showed that compared to pre-treatment, the MFR + SE group had decreased upper trapezius sEMG values and increased serratus anterior sEMG values(p < 0.05), while the SE group showed increased serratus anterior sEMG values(p < 0.05). After the 4-week intervention, there were significant between-group differences in SPADI, abduction and external rotation ROM, activity VAS, and sEMG values of the upper trapezius and serratus anterior(p < 0.05).
CONCLUSIONS: Four weeks of MFR combined with SE can increase shoulder ROM, improve pain, and thus enhancing functional activities in patients with SAPS. Additionally, it can further improve the balance between the upper trapezius and serratus anterior to improve the dynamics of the periscapular muscles.
UNASSIGNED: ChiCTR2200061054. Date of registration 15/06/2022.
OBJECTIVE: The purpose of this study was to compare the effectiveness of MFR combined with supervised exercise(SE) and SE alone in patients with SAPS.
METHODS: Assessor-blinded randomized controlled trial.
METHODS: Sir Run Run Shaw Hospital, Zhejiang University School of Medicine.
METHODS: Subacromial pain syndrome patients.
METHODS: Fifty participants were divided into two groups: SE group and MFR + SE group, each group 25 cases. Both treatment methods were performed 5 times a week for 4 weeks.
METHODS: Shoulder pain severity was assessed by visual analog scale (VAS); shoulder range of motion (ROM) by a goniometer; functionality by shoulder Pain and Disability Index (SPADI); and periscapular muscles activation by sEMG. All measurements were evaluated both pre- and post-treatment.
RESULTS: An ANOVA analysis indicated no significant group by time interactions for flexion ROM and resting VAS (p > 0.05). However, significant group by time interactions were found for SPADI, abduction and external rotation ROM, and activity VAS (p < 0.05). Post-hoc tests revealed significant improvements in SPADI, abduction and external rotation ROM, and activity VAS in both groups compared to pre-treatment (p < 0.05). Additionally, there were significant group by time interactions for the sEMG values of the upper trapezius and serratus anterior (p < 0.05). Post-hoc tests showed that compared to pre-treatment, the MFR + SE group had decreased upper trapezius sEMG values and increased serratus anterior sEMG values(p < 0.05), while the SE group showed increased serratus anterior sEMG values(p < 0.05). After the 4-week intervention, there were significant between-group differences in SPADI, abduction and external rotation ROM, activity VAS, and sEMG values of the upper trapezius and serratus anterior(p < 0.05).
CONCLUSIONS: Four weeks of MFR combined with SE can increase shoulder ROM, improve pain, and thus enhancing functional activities in patients with SAPS. Additionally, it can further improve the balance between the upper trapezius and serratus anterior to improve the dynamics of the periscapular muscles.
UNASSIGNED: ChiCTR2200061054. Date of registration 15/06/2022.
摘要：
背景：肌筋膜组织在肩关节活动障碍中起关键作用。肌筋膜释放疗法（MFR）经常用于恢复筋膜组织的延展性，并且被认为对各种临床疾病（例如下腰痛和踝关节损伤）有益。然而,尚未有研究评估MFR对肩峰下疼痛综合征(SAPS)患者肩胛骨周围肌肉激活和肩关节活动度的影响.
目的：本研究的目的是比较MFR联合监督运动（SE）和单独SE在SAPS患者中的有效性。
方法：评估方盲随机对照试验。
方法：邵逸夫医院，浙江大学医学院.
方法：肩峰下疼痛综合征患者。
方法：将50名参与者分为两组：SE组和MFR+SE组，每组25例。两种治疗方法均每周进行5次，共4周。
方法：通过视觉模拟量表（VAS）评估肩痛的严重程度；通过测角器评估肩关节活动范围（ROM）；通过肩痛和残疾指数（SPADI）评估功能；通过sEMG激活肩胛周围肌肉。在治疗前和治疗后评估所有测量值。
结果：ANOVA分析表明，屈曲ROM和静息VAS的时间相互作用没有显着差异（p>0.05）。然而,在SPADI中发现了显著的按时间分组的相互作用，外展和外部旋转ROM，和活性VAS(p<0.05)。事后测试显示SPADI有显著改善，外展和外部旋转ROM，与治疗前相比，两组的VAS活性（p<0.05）。此外,上斜方肌和前锯肌的sEMG值在时间上存在显着交互作用（p<0.05）。事后测试表明，与治疗前相比，MFR+SE组上斜方肌sEMG值降低，前锯肌sEMG值升高（p<0.05），SE组sEMG值升高（p<0.05）。经过4周的干预，SPADI有显著的组间差异，外展和外部旋转ROM，活动VAS,上斜方肌和前锯肌的sEMG值（p<0.05）。
结论：4周MFR联合SE可增加肩关节ROM，改善疼痛,从而增强SAPS患者的功能活动。此外,它可以进一步改善上斜方肌和前锯齿肌之间的平衡，以改善肩胛骨周围肌肉的动力学。
■ChiCTR2200061054。注册日期2022年6月15日。
目的：本研究的目的是比较MFR联合监督运动（SE）和单独SE在SAPS患者中的有效性。
方法：评估方盲随机对照试验。
方法：邵逸夫医院，浙江大学医学院.
方法：肩峰下疼痛综合征患者。
方法：将50名参与者分为两组：SE组和MFR+SE组，每组25例。两种治疗方法均每周进行5次，共4周。
方法：通过视觉模拟量表（VAS）评估肩痛的严重程度；通过测角器评估肩关节活动范围（ROM）；通过肩痛和残疾指数（SPADI）评估功能；通过sEMG激活肩胛周围肌肉。在治疗前和治疗后评估所有测量值。
结果：ANOVA分析表明，屈曲ROM和静息VAS的时间相互作用没有显着差异（p>0.05）。然而,在SPADI中发现了显著的按时间分组的相互作用，外展和外部旋转ROM，和活性VAS(p<0.05)。事后测试显示SPADI有显著改善，外展和外部旋转ROM，与治疗前相比，两组的VAS活性（p<0.05）。此外,上斜方肌和前锯肌的sEMG值在时间上存在显着交互作用（p<0.05）。事后测试表明，与治疗前相比，MFR+SE组上斜方肌sEMG值降低，前锯肌sEMG值升高（p<0.05），SE组sEMG值升高（p<0.05）。经过4周的干预，SPADI有显著的组间差异，外展和外部旋转ROM，活动VAS,上斜方肌和前锯肌的sEMG值（p<0.05）。
结论：4周MFR联合SE可增加肩关节ROM，改善疼痛,从而增强SAPS患者的功能活动。此外,它可以进一步改善上斜方肌和前锯齿肌之间的平衡，以改善肩胛骨周围肌肉的动力学。
■ChiCTR2200061054。注册日期2022年6月15日。
