目的:经皮神经电刺激(PENS)似乎是治疗肌肉骨骼疼痛的有效方法。这项试验的目的是研究对残疾和疼痛的影响,以及在肩峰下疼痛综合征患者的运动计划中添加PENS的心理方面。方法:随机,我们进行了平行组临床试验.60例肩峰下疼痛患者被分配到单独运动中(n=20),运动加PENS(n=20),或运动加安慰剂PENS(n=20)组。所有组的患者每天两次进行锻炼计划,持续3周。分配给PENS组的患者还接受了四次针对腋窝和肩胛骨上神经的超声引导PENS。分配给运动加安慰剂PENS的患者接受了假PENS申请。主要结果是相关残疾(手臂残疾,肩膀,手,DASH)。次要结果包括平均疼痛,焦虑程度,抑郁症状,和睡眠质量。他们在基线时进行评估,一周后,一个月和三个月后。使用混合模型ANCOVA的意向治疗进行分析。结果:结果显示大多数结果没有组间差异(相关残疾:F=0.292,p=0.748,n2p=0.011;焦虑:F=0.780,p=0.463,n2p=0.027;抑郁症状:F=0.559,p=0.575,n2p=0.02;或睡眠质量:F=0.294,p=0.747,n2p=0.01;两组在整个研究过程中经历了与运动组(Δ-1.2,95CI-2.3至-0.1)或安慰剂组(Δ-1.3,95CI-2.5至-0.1)相比,接受运动加PENS的患者在一个月时肩痛的改善更大。结论:在我们的肩峰下疼痛综合征患者样本中,在治疗后1个月和3个月,将针对腋窝和肩胛骨上神经的四个超声引导下PENS纳入锻炼计划并没有带来更好的结果。
Objective: Percutaneous electrical nerve stimulation (PENS) appears to be effective for the treatment of musculoskeletal pain. The aim of this
trial was to investigate the effects on disability and pain, as well as on the psychological aspects of adding PENS into an exercise program in patients with subacromial pain syndrome. Methods: A randomized, parallel-group clinical
trial was conducted. Sixty patients with subacromial pain were allocated into exercise alone (n = 20), exercise plus PENS (n = 20), or exercise plus placebo PENS (n = 20) groups. Patients in all groups performed an exercise program twice daily for 3 weeks. Patients allocated to the PENS group also received four sessions of ultrasound-guided PENS targeting the axillar and suprascapular nerves. Patients allocated to the exercise plus placebo PENS received a sham PENS application. The primary outcome was related disability (Disabilities of the Arm, Shoulder, and Hand, DASH). Secondary outcomes included mean pain, anxiety levels, depressive symptoms, and sleep quality. They were assessed at baseline, one week after, and one and three months after. An analysis was performed using intention-to-treat with mixed-models ANCOVAs. Results: The results revealed no between-group differences for most outcomes (related disability: F = 0.292, p = 0.748, n2p = 0.011; anxiety: F = 0.780, p = 0.463, n2p = 0.027; depressive symptoms: F = 0.559, p = 0.575, n2p = 0.02; or sleep quality: F = 0.294, p = 0.747, n2p = 0.01); both groups experienced similar changes throughout the course of this
study. Patients receiving exercise plus PENS exhibited greater improvement in shoulder pain at one month than those in the exercise (Δ -1.2, 95%CI -2.3 to -0.1) or the placebo (Δ -1.3, 95%CI -2.5 to -0.1) groups. Conclusions: The inclusion of four sessions of ultrasound-guided PENS targeting the axillar and suprascapular nerves into an exercise program did not result in better outcomes in our sample of patients with subacromial pain syndrome at one and three months after treatment.