Efficacy and cost-effectiveness of physiotherapy following glenohumeral joint distension for adhesive capsulitis: A Randomized trial
Efficacy and cost-effectiveness of physiotherapy following glenohumeral joint distension for adhesive capsulitis: A Randomized trial
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DOI：
10.1002/art.22892
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发表时间：
2007-08-15
期刊：
影响因子：
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通讯作者：
Wright, Warwick J. L.
中科院分区：
文献类型：
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作者：
Buchbinder, Rachelle;Youd, Joanne M.;Wright, Warwick J. L.
Objective.确定关节造影关节扩张后的积极物理治疗是否对粘连性关节囊炎有额外的益处。我们进行了一项随机、安慰剂对照、参与者和单一评估者盲法试验。共有156名参与者进入研究，其中144名完成了研究，这些参与者主要在1个肩部疼痛和僵硬3个月，并且在>= 2个运动平面中被动运动受限> 30度。在关节扩张后，参与者被随机分配到手动治疗和定向运动或安慰剂（假超声），每周两次，持续2周，然后每周一次，持续4周。在基线、6周、12周和26周评估疼痛、功能、主动肩部运动、参与者感知的成功和生活质量。还收取了费用。两组均随时间推移而改善，在任何时间点，两组之间的疼痛、功能或生活质量改善均无显著差异。物理治疗组在所有主动肩部运动方面都有显著差异（例如，所有时间点组间肩关节外展平均变化的合并差异为10.6度，95%置信区间[95% CI] 3.1，18.1）和参与者感知的成功（合并相对风险1.49，95% CI 1.1，1.65;需要治疗的人数= 5）。6个月的物理治疗净成本为136.8澳元（95%CI-177.5，223.1）。关节扩张后的物理治疗在疼痛、功能或生活质量方面没有提供额外的益处，但导致持续更大的肩部活动范围和参与者感知的改善长达6个月。
Objective. To determine whether an active physiotherapy program following arthrographic joint distension for adhesive capsulitis provides additional benefits.Methods. We performed a randomized, placebo-controlled, participant and single assessor blinded trial. A total of 156 participants with pain and stiffness in predominantly 1 shoulder for :3 months and restriction of passive motion > 30 degrees in >= 2 planes of movement entered the study, and 144 completed the study. Following joint distension, participants were randomly assigned to either manual therapy and directed exercise or placebo (sham ultrasound), both administered twice weekly for 2 weeks then once weekly for 4 weeks. Pain, function, active shoulder movements, participant-perceived success, and quality of life were assessed at baseline, 6, 12, and 26 weeks. Costs were also collected.Results. Both groups improved over time with no significant differences in improvement between groups for pain, function, or quality of life at any time point. Significant differences favored the physiotherapy group for all active shoulder movements (e.g., pooled difference in mean change between groups across all time points for total shoulder abduction was 10.6 degrees, 95% confidence interval [95% CI] 3.1, 18.1) and participant-perceived success (pooled relative risk 1.49 95% CI 1.1, 1.65; number needed to treat = 5). Net cost of physiotherapy was $136.8 Australian (95% CI -177.5, 223.1) over the 6 months.Conclusion. Physiotherapy following joint distension provided no additional benefits in terms of pain, function, or quality of life but resulted in sustained greater active range of shoulder movement and participant-perceived improvement up to 6 months.