目的:这项研究的目的是评估将电干针刺和推力操作添加到多模式运动程序中的效果,动员,肘部外侧肌腱病的超声检查。
方法:随机化,单盲,多中心,平行组试验。
方法:美国9个不同州的13个门诊物理治疗诊所。
方法:对104名患有肘部外侧肌腱病的参与者(n=143)进行随机分组。
方法:颈椎手法,四肢操纵,和经皮肌腱电干针加多模式物理治疗(n=73)或多模式物理治疗(n=70)。
方法:主要结果是通过基线时患者评定的网球肘评估测量的肘部疼痛强度和残疾,1周,4周,和3个月。次要结局包括数字疼痛评定量表,网球肘功能量表,全球变化评级,和药物摄入量。
结果:2×4协方差分析表明,接受电干刺和推力操纵加多模式物理治疗的肘部外侧肌腱病患者的残疾改善显着(患者额定网球肘评估:F=19.675;P<0.001),肘部疼痛强度(数字疼痛评分:F=22.769;P<0.001),和功能(网球肘功能量表:F=13.269;P<0.001)比接受多模式物理治疗的患者在3个月时。疼痛和残疾的组间效应大小较大(患者额定网球肘评估:标准化平均差=1.13;95%置信区间:0.78,1.48),有利于电干针刺和推力操作组。
结论:将经皮肌腱电干针刺和推力操作纳入多模式锻炼计划,对于肘部外侧肌腱病患者,动员和超声治疗比单独进行多模式物理治疗更有效.试用注册:www。clinicaltrials.govNCT031677102017年5月30日。
OBJECTIVE: The purpose of this study was to assess the effects of adding electrical dry needling and thrust manipulation into a multimodal program of exercise, mobilization, and ultrasound in patients with lateral elbow tendinopathy.
METHODS: Randomized, single-blinded, multicenter, parallel-group trial.
METHODS: Thirteen outpatient physical therapy clinics in nine different US states.
METHODS: One hundred and forty-three participants (n = 143) with lateral elbow tendinopathy were randomized.
METHODS: Cervical spine manipulation, extremity manipulation, and percutaneous tendon electrical dry needling plus multimodal physical therapy (n = 73) or multimodal physical therapy (n = 70) alone.
METHODS: The primary outcome was elbow pain intensity and disability as measured by the Patient-Rated Tennis Elbow Evaluation at baseline, 1 week, 4 weeks, and 3 months. Secondary outcomes included the Numeric Pain Rating Scale, Tennis Elbow Functional Scale, Global Rating of Change, and medication intake.
RESULTS: The 2 × 4 analysis of covariance demonstrated that individuals with lateral elbow tendinopathy receiving electrical dry needling and thrust manipulation plus multimodal physical therapy experienced significantly greater improvements in disability (Patient-Rated Tennis Elbow Evaluation: F = 19.675; P < 0.001), elbow pain intensity (Numeric Pain Rating Scale: F = 22.769; P < 0.001), and function (Tennis Elbow Function Scale: F = 13.269; P < 0.001) than those receiving multimodal physical therapy alone at 3 months. The between-group effect size was large for pain and disability (Patient-Rated Tennis Elbow Evaluation: standardized mean difference = 1.13; 95% confidence interval: 0.78, 1.48) in favor of the electrical dry needling and thrust manipulation group.
CONCLUSIONS: The inclusion of percutaneous tendon electrical dry needling and thrust manipulation into a multimodal program of exercise, mobilization and ultrasound was more effective than multimodal physical therapy alone in individuals with lateral elbow tendinopathy.Trial Registration: www.clinicaltrials.gov NCT03167710 May 30, 2017.