背景:肩袖肌腱病(RCT)是一种广泛的肌肉骨骼疾病,是肩痛和功能受限的主要原因。由此产生的疼痛和有限的功能对整体生活质量具有不利影响。这项研究的目的是对体外冲击波疗法(ESWT)对RCT的影响进行系统评价。
方法:从开始到2024年2月20日,对以下数据库进行了文献检索:PubMed,WebofScience,Cochrane图书馆,Scopus,MEDLINE,EMBASE,EBSCO,和中国国家知识基础设施(CNKI)进行了检查,以确定探索ESWT治疗肩袖肌腱病(钙化或非钙化)的潜在研究,对照组为假,其他治疗(包括安慰剂),没有日期限制,语言。两名研究人员独立筛选文献,提取的数据,评估了纳入研究中的偏倚风险,并使用RevMan5.3软件进行荟萃分析。
结果:共纳入16个RCTs,共1093例患者。结果表明,与对照组相比,ESWT用于疼痛评分视觉模拟评分/评分(VAS)(SMD=-1.95,95%CI-2.47,-1.41,P<0.00001),功能评分Constant-Murley评分(CMS)(SMD=1.30,95%CI0.67,1.92,P<0.00001),加州大学洛杉矶分校(UCLA)评分(SMD=2.69,95%CI1.64,3.74,P<0.00001),美国肩肘外科医师形态(ASES)(SMD=1.29,95%CI0.93,1.65,P<0.00001),运动范围(ROM)外部旋转(SMD=1.00,95%CI0.29,1.72,P=0.02),总有效率(TER)(OR=3.64,95%CI1.85,7.14,P=0.0002),以上结果的差异有统计学意义。但ROM-外展(SMD=0.72,95%CI-0.22,1.66,P=0.13),差异无统计学意义。
结论:目前有限的证据表明,与对照组相比,ESWT可以提供更好的疼痛缓解,功能恢复,和RCT患者功能的维持。
BACKGROUND: Rotator cuff tendinopathy (RCT) is a widespread musculoskeletal disorder and a primary cause of shoulder pain and limited function. The resulting pain and limited functionality have a detrimental impact on the overall quality of life. The purpose of this study was to perform a systematic
review of the effects of extracorporeal shock wave therapy (ESWT) for RCT.
METHODS: The literature search was conducted on the following databases from inception to February 20, 2024: PubMed, Web of Science, the Cochrane Library, Scopus, MEDLINE, EMBASE, EBSCO, and China National Knowledge Infrastructure (CNKI) were checked to identify the potential studies exploring the effect of ESWT for the treatment of Rotator cuff tendinopathy (Calcification or non-calcification), control group for sham, other treatments (including placebo), without restriction of date, language. Two researchers independently screened literature, extracted data, evaluated the risk of bias in the included studies, and performed meta-analysis using RevMan 5.3 software.
RESULTS: A total of 16 RCTs with 1093 patients were included. The results showed that compared with the control group, ESWT for pain score Visual Analogue Scale/Score (VAS) (SMD = -1.95, 95% CI -2.47, -1.41, P < 0.00001), function score Constant-Murley score (CMS) (SMD = 1.30, 95% CI 0.67, 1.92, P < 0.00001), University of California Los Angeles score (UCLA) (SMD = 2.69, 95% CI 1.64, 3.74, P < 0.00001), American Shoulder and Elbow Surgeons form (ASES) (SMD = 1.29, 95% CI 0.93, 1.65, P < 0.00001), Range of motion (ROM) External rotation (SMD = 1.00, 95% CI 0.29, 1.72, P = 0.02), Total effective rate (TER) (OR = 3.64, 95% CI 1.85, 7.14, P = 0.0002), the differences in the above results were statistically significant. But ROM-Abduction (SMD = 0.72, 95% CI -0.22, 1.66, P = 0.13), the difference was not statistically significant.
CONCLUSIONS: Currently limited evidence suggests that, compared with the control group, ESWT can provide better pain relief, functional recovery, and maintenance of function in patients with RCT.