- 學位論文
體外震波對於項韌帶鈣化的療效
he Efficacy of Extracorporeal Shock Wave Treatment in Nuchal Ligament Calcification
摘要
研究背景及目的: 近幾年震波被廣泛應用於治療骨癒合、網球肘、足底筋膜炎及鈣化性肌腱炎等等。震波有助於骨折癒合及肌腱病變修復。在頸部不適的患者中常見有項韌帶鈣化現象。針對項韌帶鈣化一般傳統復健治療，包括物理治療、深層按摩及使用抗發炎藥物等等，但效果不彰。震波對於鈣化性肌腱炎有不錯的療效，因此本研究中將探討震波對於項韌帶鈣化的療效。 受試者: 由高醫附設醫院復健科門診收集30名於x光檢查中發現有項韌帶鈣化的患者，經同意後收錄進行研究。 研究方法: 受試者必須接受每次震波強度0.134mJ/mm2至0.403m J/mm2，頻率5 Hz，總計2000發的震波治療。一周一次，共計三周。治療前後及治療後三個月、六個月紀錄頸部活動度。治療前及治療後三個月、六個月紀錄下鈣化大小及neck disability index分數。 研究結果: 震波治療後頸部活動度有顯著改善，且改善效果可維持三個月。震波治療後三個月鈣化及neck disability index 分數有顯著減少。 結論: 震波可有效治療項韌帶鈣化，增加頸部活動度、減少疼痛，並療效可持續三個月。
並列摘要
BACKGROUND AND PURPOSE: Extracorporeal shock wave therapy (ESWT) has been used to treat conditions such as nonunion of fractures, lateral epicondylitis, plantar fasciitis, and calcific tendinitis of the shoulder in recent decade. It has been shown that it could promote fracture healing and repair of tendinopathies. Nuchal ligament calcification is common among patients with neck pain. The conservative methods of nuchal ligament calcification treatment included physical therapy, deep friction, local or systemic application of noninflammatory drugs, but the effects were limited. Therefore, our study aimed at evaluating the effects of ESWT on nuchal ligament calcification. Subjects: 30 patients were examined who had nuchal ligament calcification were recruited from outpatient department of rehabilitation Kaohsiung Medical University Hospital. The subjects were informed and consented. METHODS: ESWT were performed with 2000 shock wave at 5 Hz and energy level between0.134mJ/mm2 and 0.403mJ/mm2 per session, and once per week for 3 weeks. Rang of motion of neck and neck disability index were evaluated before and after treatment, and followed up 3 months and 6 months. Size of calcium deposits were also calculated. RESULTS : Significant improvement of neck ROM was seen just after treatment. Neck disability index was decreased just after treatment and 3 months later. Reduction of significant calcium deposits were found at 3 months follow-up. CONCLUSIONS : ESWT is safe and effective in treatment of nuchal ligament calcification. ESWT is effective to increase range of motion of neck, decreasing neck pain for at least 3 months.