The Preliminary Results of Extracorporeal Shockwave Therapy in Patients with Piriformis Syndrome

體外震波治療於梨狀肌症候群之成效

黃靖雰(Ching-Fen Huang) ； 陳天文(Tien-Wen Chen) ； 李權峯(Cyuan-Fong Li) ； 蕭毓璇(Yu-Hsuan Hsiao) ； 陳嘉炘(Chia-Hsin Chen) ； 黃茂雄(Mao-Hsiung Huang)

《台灣復健醫學雜誌》 46卷1期 (2018/06) Pp. 37-45

https://doi.org/10.6315/TJPMR.201806-46(1).05

摘要

The study was designed to evaluate the therapeutic effect of extracorporeal shockwave therapy (ESWT) on the rehabilitation of patients with piriformis syndrome. Thirty-six patients diagnosed with unilateral piriformis syndrome were included and allocated randomly into three groups, Groups A-C, with twelve patients in each group. Patients in Groups A-C all received conventional physical modalities programs, including hot packs and interferential current therapy, three times weekly for six weeks. Patients in Group B received an extra twenty minutes of stretching exercise therapy after physical modalities therapy, and Group C received the same therapy as in Group B and extra shockwave therapy weekly for six weeks. The outcome measurements included the changes in the hip range of motion (ROM), visual analogue scale (VAS), Timed Up and Go test (TUG) and latency of H reflex. Each assessment was performed before and after the treatment, and follow-up three months later. The results showed that patients in both Group B and Group C yielded more improvement than did patients in Group A. Besides, Group C presented more significant improvement (p＜0.05) after treatment and at follow-up. Extra stretching exercise therapy had positive effects on pain reduction and functional improvement. Furthermore, extracorporeal shockwave therapy might provide additional benefit in managing the piriformis syndrome. In conclusion, conventional physical modalities therapy combined with stretching exercise therapy and ESWT will result in greater therapeutic effects.

關鍵字

piriformis syndrome ； stretch exercise therapy ； extracorporeal shockwave therapy

並列摘要

目的：梨狀肌症候群(piriformis syndrome)為臨床上診斷困難且治療不易突破、容易復發的疾病，體外震波治療(extracorporeal shockwave therapy)已廣泛應用於軟組織之發炎性鈣化，已被證實於足底肌膜炎、肩關節之旋轉肌鈣化有一定之療效；但目前對於慢性肌肉性病變之效應未明。本研究嘗試以體外震波治療應用於梨狀肌症候群之病人，並探討其治療效益。方法：本研究收集符合梨狀肌症候群診斷之受試者36位，隨機分配為三組，分別接受為期六週之復健計畫，包括傳統復健治療（熱敷及電療）、傳統復健治療及伸展運動治療、傳統復健治療及伸展運動治療和震波治療。結果評估包括髖關節活動度（range of motion）、疼痛指數（visual analogue scale）、起身行走測試（Timed Up and Go test）及H反射傳導潛期（latency of H reflex），分別於治療前、治療後及追蹤三個月評估。結果：接受伸展運動治療和震波治療的組別結果皆比傳統復健治療組別較好，其中接受伸展運動治療加上震波治療的組別有達到顯著差異（p＜0.05），顯示體外震波治療可改善髖關節之活動角度及疼痛，於神經電學檢查及下肢功能評估上亦有顯著進步。結論：體外震波治療於梨狀肌症候群病人能改善其疼痛並增加其功能性表現，可考慮作為臨床上治療選擇，此外，傳統復健治療合併伸展運動治療亦能有更好治療成效。

並列關鍵字

梨狀肌症候群(piriformis syndrome) ； 伸展運動治療(stretch exercise therapy) ； 體外震波治療(extracorporeal shockwave therapy)

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