- 學位論文
體外震波治療對於肩頸疼痛的治療效益
Effects of Extracorporeal Shock Wave Therapy on Shoulder and Neck Pain
摘要
研究背景: 體外震波治療(Extracorporeal Shock Wave Therapy, ESWT ) 已廣泛被應用在肌肉骨骼系統相關疾病；不僅可用來減輕疼痛，同時可改善治療區域的血液循環。然而目前較少研究在探討體外震波治療，且運用於非特異性肩頸疼痛的臨床效益。目的: 本研究主要目的為探討非特異性肩頸部疼痛患者，在接受體外震波治療後有何臨床效益。方法:本研究共計招募41位非特異性肩頸疼痛自願者，並隨機分配成兩組，分別為震波組(21人)與衛教組(20人)。震波組針對肩頸部上斜方肌與提肩胛肌緊繃帶(taut band)，接受能量強度1.5 bar，每次2000發，每週1次持續3週的治療。震波組與衛教組皆給予相同的居家衛教(home program)，包含進行頸部六個方向及上頸椎旋轉共八個主動動作介入。兩組分別於介入前及介入3週後，量測疼痛視覺類比量表(visual analogue scale, VAS )、頸部失能量表(neck disability index, NDI )、疼痛閾值(pressure threshold)及電磁場追蹤儀(electromagnetic tracking system) 以評估頸部運動學，並於第6週追蹤疼痛視覺類比量表與頸部失能量表。本研究數據分析係使用Two-ways repeated measured ANOVA進行統計分析不同時間及不同組別的治療效益。結果: 本研究結果顯示於時間因素中(介入前、介入3週後及追蹤第6週)，在震波組及衛教組疼痛視覺類比量表、疼痛閾值、頸部失能量表及頸部關節活動度皆有顯著地改善(p<0.05)。另震波組除可以減少疼痛外，更可顯著(p<0.05)改善頸部關節活動時的偶合動作(couple motion)。結論: 肩頸部疼痛患者不論是接受衛教介入或體外震波介入皆有明顯減緩疼痛症狀、改善日常生活之影響及長時間工作所產生的不適暨頸部關節活動度受限的問題；而體外震波治療配合衛教介入，除可減少疼痛外，更能有效改善頸部偶合動作。
並列摘要
Background: Extracorporeal shock wave therapy (ESWT) has been used to treat various musculoskeletal disorders. The beneficial effects included pain alleviation and improvement on blood circulation of shoulder and neck area. However, few studies have foucsed on the effects of the ESWT for subjects with shoulder and neck pain. Purpose: The objective of this study is to clarify the potential positive effect of ESWT on relieving the symptoms of non-specific shoulder and neck pain. The results derived from this study can be use as improve pain for further shoulder and neck area. Method: A total of 41 participants with non-specific shoulder and neck pain were randomly divided into the experimental (n=21) or education group (n=20) respectively. The ESWT was applied on upper trapezius muscle and levator scapulae muscle following parameters 1.5 bar per intervention 2000 impulse once a week for three weeks for the experimental group. Both groups were provided with home program containing neck movements at six directions and rotation to left and right in full cervical flexion. Moreover, the Visual analogue scale (VAS), neck disability index (NDI), the pain threshold, and the electromagnetic tracking system for cervical range of motion were measured before and after a third-week intervention for both groups, followed by the Visual analogue scale (VAS) and neck disability index (NDI) on the sixth week. Two-ways repeated measured ANOVA was used for statistical analysis and the time and group interaction effect was selected as an examination for the ESWT effectiveness. Results: After intervention, the both groups VAS and NDI are also demonstrated time factor (before and after three-week intervention as well as follow the intervention on the sixth week) have improved (p<0.05). The experimental group has significantly improved in neck couple motion (p<0.05). Conclusions: The result of this study showed that the ESWT and education group are useful in clinical application. They are non-invasive, safe and effective. These symptoms of pain, function status, symptoms induced by long-term work and ROM limitation in neck are relieved after intervention. The ESWT group decreased more coupled movements than education group.
參考文獻
延伸閱讀
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