超声波疗法结合肌肉失衡调整训练对黏连性肩关节囊炎患者的疗效

doi:10.3969/j.issn.1006-5725.2025.02.008

Abstract

Abstract:

Objective To explore the short and long term efficacy of ultrasound therapy combined with muscle imbalance adjustment training in patients with adhesive capsulitis（AC） ofthe shoulder. Methods A total of 60 AC patients were divided into an observation group and a control group， both each consisting of 30 cases. The observation group underwentultrasound therapy along with muscle imbalance adjustment training， while the control group received acupuncture treatment， both for a duration of 20 days. The Visual Analogue Scale（VAS）， goniometer for ROM， Manual Muscle Testing（MMT），Constant-Murley Shoulder Score， and modified Barthel index were used to access shoulder jointpain level， range of motion （ROM）， peripheral muscle strength， shoulder joint function， and daily living abilities， respectively. The Hamilton Anxiety Scale （HAMA） and Hamilton Depression Scale （HAMD） were utilized to evaluate the levels of anxiety and depression.All the assessments were conducted and compared between the two groups before treatment， at the end of treatment， and at 6 and 12 months after treatment. Results Both groups showed varying degrees of improvement in ROM， MMT， VAS， Constant-Murley score， modified Barthel index， and emotional status compared to pre-treatment. The observation group demonstrated superior outcomes in posterior shoulder extension strength， VAS， Constant-Murley score， modified Barthel index， HAMA， and HAMD scores at the end of treatment （P < 0.05）. At 6 months post-treatment， the observation group showed better shoulder joint flexion， extension， abduction， and adduction ROM， as well as muscle strength in flexion， external rotation， and internal rotation， VAS， Constant-Murley score， modified Barthel index， HAMA， and HAMD scores. At 12 months after treatment， the observation group continued to show superior outcomes in all the aforementioned indexes （P < 0.05）. Conclusion The combination of ultrasound therapy and muscle imbalance adjustment training can effectively reduce shoulder joint pain， improve ROM， enhance muscle strength around the shoulder joint， improve shoulder joint function， alleviate anxiety and depression， and ultimately enhance the quality of life for patients with AC.

Key words: ultrasound therapy, muscle imbalance, adhesive capsulitis of the shoulder

CLC Number:

R493

Runhong CUI,Yan CHI,Di ZHANG,Hexiao GAO,Xue. JIANG. Efficacy of ultrasound therapy combined with muscle imbalance adjustment training in patients with adhesive capsulitis oftheshoulder[J]. The Journal of Practical Medicine, 2025, 41(2): 208-214.

Figures/Tables 7

Tab.1

Comparison of general information of patients between the two groups"

组别	例数	性别		年龄（ $x ˉ$ ± s）/岁	病程（ $x ˉ$ ± s）/个月	利手		患侧
组别	例数	男	女	年龄（ $x ˉ$ ± s）/岁	病程（ $x ˉ$ ± s）/个月	左	右	左	右
对照组	30	10	20	50.87 ± 3.15	9.18 ± 1.84	2	28	17	13
观察组	30	11	19	50.50 ± 3.17	9.28 ± 1.86	1	29	16	14
t/χ²值		0.07		0.45	0.78	0.35		0.07
P值		0.79		0.65	0.44	0.55		0.80

Tab.1

Tab.2

Tab.3

Tab.4

Tab.5

Tab.6

Tab.7

References 26

1	MILLAR N L， MEAKINS A， STRUYF F， et al. Frozen shoulder［J］. Nat Rev Dis Primers， 2022， 8（1）： 59. doi:10.1038/s41572-022-00386-2 doi: 10.1038/s41572-022-00386-2
2	PATTNAIK S， KUMAR P， SARKAR B， et al. Comparison of kaltenborn mobilization technique and muscle energy technique on range of motion， pain and function in subjects with chronic shoulder adhesive capsulitis［J］. Hong Kong Physiother J， 2023， 43（2）： 149-159. doi:10.1142/s1013702523500166 doi: 10.1142/s1013702523500166
3	KIM W M， SEO Y G， PARK Y J， et al. Effects of different types of contraction exercises on shoulder function and muscle strength in patients with adhesive capsulitis［J］. Int J Environ Res Public Health， 2021， 18（24）： 13078. doi:10.3390/ijerph182413078 doi: 10.3390/ijerph182413078
4	KORKOMAN A J， ALAMMARI A S， ALQAHTANI N H， et al. The incidence of adhesive capsulitis and covid-19 pandemic effect［J］. JSES Int， 2023， 7（6）： 2406-2409. doi:10.1016/j.jseint.2023.07.007 doi: 10.1016/j.jseint.2023.07.007
5	KIRKER K， O'CONNELL M， BRADLEY L， et al. Manual therapy and exercise for adhesive capsulitis： A systematic review with meta-analysis［J］. J Man Manip Ther， 2023， 31（5）： 311-327. doi:10.1080/10669817.2023.2180702 doi: 10.1080/10669817.2023.2180702
6	VITA F， PEDERIVA D， TEDESCHI R， et al. Adhesive capsulitis： The importance of early diagnosis and treatment［J］. J Ultrasound， 2024， 27（3）： 579-587.
7	CHO C H， BAE K， CKIM D H. Treatment strategy for frozen shoulder［J］. Clin Orthop Surg， 2019， 11（3）： 249-257. doi:10.4055/cios.2019.11.3.249 doi: 10.4055/cios.2019.11.3.249
8	CHALLOUMAS D， BIDDLE M， MCLEAN M， et al. Comparison of treatments for frozen shoulder： A systematic review and meta-analysis［J］. JAMA Netw Open， 2020， 3（12）： e2029581. doi:10.1001/jamanetworkopen.2020.29581 doi: 10.1001/jamanetworkopen.2020.29581
9	GRIGGS S M， AGREEN A AHN. Idiopathic adhesive capsulitis. A prospective functional outcome study of nonoperative treatment［J］. J Bone Joint Surg Am， 2000， 82（10）： 1398-1407. doi:10.2106/00004623-200010000-00005 doi: 10.2106/00004623-200010000-00005
10	RUSSELL S， JARIWALA A， CONLON R， et al. A blinded， randomized， controlled trial assessing conservative management strategies for frozen shoulder［J］. J Shoulder Elbow Surg， 2014， 23（4）： 500-507. doi:10.1016/j.jse.2013.12.026 doi: 10.1016/j.jse.2013.12.026
11	陈薇. 超声波疗法联合白脉软膏治疗肱骨外上髁炎临床观察［J］. 中西医结合研究， 2023， 15（6）： 391-393.
12	SALLOUM K， KARKOUTLY M， HADDAD I， et al. Effectiveness of ultrasound therapy， therabite device， masticatory muscle exercises， and stabilization splint for the treatment of masticatory myofascial pain： A randomized controlled trial［J］. Clin Exp Dent Res， 2024， 10（4）： e921. doi:10.1002/cre2.921 doi: 10.1002/cre2.921
13	刘露，邓秋兰. 超声波疗法配合康复训练在肩周炎患者中的应用［J］. 齐鲁护理杂志， 2013， 19（7）： 38-40.
14	陈锡娇，陈玉蓓. 超声波疗法配合康复训练在肩周炎患者中的效果观察［J］. 中国卫生标准管理， 2021， 12（10）： 131-134
15	RAMIREZ J. Adhesive capsulitis： Diagnosis and management［J］. Am Fam Physician， 2019， 99（5）： 297-300.
16	MCKEAN D， YOONG P， BROOKS R， et al. Shoulder manipulation under targeted ultrasound-guided rotator interval block for adhesive capsulitis［J］. Skeletal Radiol， 2019， 48（8）： 1269-1274. doi:10.1007/s00256-018-3105-3 doi: 10.1007/s00256-018-3105-3
17	CONSTANT C R， GERBER C， EMERY R J H， et al. A review of the constant score： Modifications and guidelines for its use［J］. J Shoulder Elbow Surg， 2008， 17（2）： 355-361. doi:10.1016/j.jse.2007.06.022 doi: 10.1016/j.jse.2007.06.022
18	ÖZEKLI MISIRLIOĞLU T， EREN İ， ÖZYEMIŞÇI TAŞKIRAN Ö， et al. Turkish version of the patient-based constant-murley score： Its cross-cultural adaptation， validity， reliability and comparison with the clinician-based version［J］. Turk J Phys Med Rehabil， 2022， 68（3）： 336-347. doi:10.5606/tftrd.2022.8520 doi: 10.5606/tftrd.2022.8520
19	REDLER L HDENNIS E R. Treatment of adhesive capsulitis of the shoulder［J］. J Am Acad Orthop Surg， 2019， 27（12）： e544-e554. doi:10.5435/jaaos-d-17-00606 doi: 10.5435/jaaos-d-17-00606
20	WONG C K， LEVINE W N， DEO K， et al. Natural history of frozen shoulder： Fact or fiction？ A systematic review［J］. Physiotherapy， 2017， 103（1）： 40-47. doi:10.1016/j.physio.2016.05.009 doi: 10.1016/j.physio.2016.05.009
21	KELLEY M J， SHAFFER M A， KUHN J E， et al. Shoulder pain and mobility deficits： Adhesive capsulitis［J］. J Orthop Sports Phys Ther， 2013， 43（5）： A1-31. doi:10.2519/jospt.2013.0302 doi: 10.2519/jospt.2013.0302
22	LOWRY V， LAVIGNE P， ZIDAROV D， et al. A systematic review of clinical practice guidelines on the diagnosis and management of various shoulder disorders［J］. Arch Phys Med Rehabil， 2024， 105（2）： 411-426. doi:10.1016/j.apmr.2023.09.022 doi: 10.1016/j.apmr.2023.09.022
23	刘英桃，王德军，王伟，等. 透压针刀对冻结期肩周炎肩关节活动度及远期疗效［J］. 实用医学杂志， 2023， 39（2）： 230-235. doi:10.3969/j.issn.1006-5725.2023.02.018 doi: 10.3969/j.issn.1006-5725.2023.02.018
24	王勤俭，李泊泊，董良杰，等. 臂丛麻醉下大手法松解术联合小针刀治疗肩周炎的临床观察［J］. 实用医学杂志， 2021， 37 （14）： 1887-1891.
25	周晓平. 温针灸对肩周炎的镇痛作用研究［J］. 实用医学杂志， 2007， 23（1）： 127-128.
26	朱广玮，朱纯生. 温针灸联合推拿拔伸松动术治疗粘连期肩周炎疗效观察［J］. 实用中医药杂志， 2024， 40（8）： 1635-1636.

组别	治疗前	疗程结束时	治疗后6个月	治疗后12个月
对照组	6.33 ± 1.83	3.27 ± 1.23	5.27 ± 1.40	4.15 ± 1.54
观察组	6.63 ± 2.11	2.17 ± 1.09	1.47 ± 1.04	0.77 ± 0.63
P1值	0.56	< 0.001	< 0.001	< 0.001
P2值	-	< 0.001	< 0.05	< 0.001
P3值	-	< 0.001	< 0.001	< 0.001

组别	时间	前屈	后伸	外展	内收	外旋	内旋
对照组	治疗前	114.5 ± 35.77	37.90 ± 7.04	80.93 ± 36.35	42.37 ± 2.19	65.65 ± 5.66	68.41 ± 6.64
	治疗结束	146.13 ± 19.67^?	42.50 ± 3.88^?	123.93 ± 24.23^?	44.13 ± 1.81^?	62.00 ± 14.90	67.00 ± 13.04
	6个月	123.85 ± 27.11^#	40.12 ± 4.38	101.08 ± 27.60^?#	42.15 ± 2.38^#	64.44 ± 10.74	69.11 ± 8.34
	12个月	137.96 ± 20.41^?	41.85 ± 3.26^?	114.54 ± 23.67^?	43.04 ± 2.39	64.17 ± 12.42	69.3. ± 10.70
观察组	治疗前	97.93 ± 46.38	36.70 ± 7.89	76.37 ± 39.44	42.10 ± 2.92	65.88 ± 4.15	69.76 ± 3.93
	治疗结束	141.33 ± 14.90^?	42.17 ± 3.64^?	118.83 ± 29.56^?	43.87 ± 1.98^?	62.62 ± 12.33	66.65 ± 12.21
	6个月	148.23 ± 15.76^?	43.00 ± 3.11^?	123.90 ± 31.56^?	44.30 ± 1.64^?	67.43 ± 10.68	71.52 ± 10.38
	12个月	155.89 ± 15.31^?	43.75 ± 2.59^?	144.21 ± 63.42^?	44.43 ± 1.48^?	66.96 ± 9.85	72.52 ± 8.33
P1值		0.13	0.54	0.64	0.65	0.89	0.48
P2值		0.29	0.73	0.47	0.59	0.87	0.92
P3值		< 0.001	0.006	0.006	< 0.001	0.38	0.43
P4值		< 0.001	0.02	0.03	0.012	0.38	0.24

组别	时间	前屈	后伸	外展	外旋	内旋
对照组	治疗前	4.24 ± 0.44	4.86 ± 0.36	3.95 ± 0.22	3.95 ± 0.22	3.90 ± 0.30
	治疗结束	4.70 ± 0.47^?	4.70 ± 0.47	3.93 ± 0.37	4.67 ± 0.48^?	4.50 ± 0.51^?
	治疗后6个月	4.38 ± 0.50	4.95 ± 0.22	4.00 ± 0.00	4.57 ± 0.51^?	4.19 ± 0.40
	治疗后12个月	4.54 ± 0.51	4.81 ± 0.40	4.04 ± 0.20	4.58 ± 0.50^?	4.23 ± 0.43
观察组	治疗前	4.26 ± 0.45	4.74 ± 0.45	3.89 ± 0.32	3.84 ± 0.37	3.89 ± 0.32
	治疗结束	4.90 ± 0.31^?	4.90 ± 0.31	4.07 ± 0.37	4.77 ± 0.43^?	4.73 ± 0.45^?
	治疗后6个月	4.97 ± 0.18^?	5.00 ± 0.00	4.13 ± 0.35^?	4.90 ± 0.31^?	4.90 ± 0.31^?
	治疗后12个月	5.00 ± 0.00^?	5.00 ± 0.00	4.86 ± 0.36^?	4.86 ± 0.36^?	4.82 ± 0.39^?
P1值		0.86	0.36	0.5	0.26	0.92
P2值		0.054	0.02	0.16	0.4	0.06
P3值		< 0.001	0.24	0.08	0.006	< 0.001
P4值		< 0.001	0.014	< 0.001	0.02	< 0.001

组别	治疗前	疗程结束时	治疗后6个月	治疗后12个月
对照组	62.47 ± 17.57	87.57 ± 10.35	70.96 ± 14.30	80.73 ± 11.71
观察组	59.90 ± 19.81	85.87 ± 3.54	96.50 ± 5.14	99.18 ± 0.67
P1值	0.60	< 0.005	< 0.001	< 0.001
P2值	-	< 0.001	< 0.11	< 0.001
P3值	-	< 0.001	< 0.001	< 0.001

组别	治疗前	疗程结束时	治疗后6个月	治疗后12个月
对照组	93.73 ± 3.77	97.97 ± 1.83	95.04 ± 2.20	96.50 ± 1.45
观察组	93.37 ± 3.85	98.87 ± 0.97	99.23 ± 1.01	99.71 ± 0.46
P1值	0.71	0.02	< 0.001	< 0.001
P2值	-	< 0.001	< 0.22	< 0.001
P3值	-	< 0.001	< 0.001	< 0.001

Efficacy of ultrasound therapy combined with muscle imbalance adjustment training in patients with adhesive capsulitis oftheshoulder

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 7

References 26

Related Articles 9

Recommended Articles

Metrics

Comments

组别	时间	HAMA	HAMD
对照组	治疗前	10.57 ± 4.12	9.60 ± 2.90
	治疗结束	4.50 ± 2.80^?	5.60 ± 2.92^?
	6个月	7.54 ± 3.54^?#	7.92 ± 2.71^#
	12个月	6.04 ± 3.14^?	6.73 ± 1.99^?
观察组	治疗前	11.13 ± 4.83	10.40 ± 4.05
	治疗结束	2.77 ± 1.81^?	3.87 ± 2.43^?
	6个月	2.03 ± 1.63^?	2.30 ± 1.74^?
	12个月	0.86 ± 0.76^?#	1.21 ± 0.74^?#
P1值	-	0.63	0.38
P2值	-	< 0.01	0.02
P3值	-	< 0.001	< 0.001
P4值	-	< 0.001	< 0.001

[1]	Shuaidi ZHANG,Jianyun ZHANG,Jingjing LI,Changyu GU,Jian GUO,Ruiqing LI. Research progress of musculoskeletal ultrasound technique in the evaluation of limb spasticity after stroke [J]. The Journal of Practical Medicine, 2025, 41(1): 134-140.
[2]	Liangwen SUN,Chunxia WEI,Miao LIU,Min LU,Shaojun GAO,Bo WANG,Qiang DUAN,Wei LI,Xiaoqun HUANG. Effects of whole body vibration training combined with blood flow restriction on motor function and community activity in elderly stroke patients with hemiplegia [J]. The Journal of Practical Medicine, 2024, 40(20): 2874-2879.
[3]	Lingling ZHU,Yanchun CHEN,Liang FANG,Chengyan CAI,Ting. LIU. Clinical effectiveness of dynamic joint mobilization combined with core stability training for nonspecific low back pain treatment [J]. The Journal of Practical Medicine, 2024, 40(18): 2602-2606.
[4]	Luoyi DENG,Yan CHEN,Ni ZENG,Pu HUANG,Xing ZHANG,Kangjie HU,Peng ZHENG,Shuang. WU. Effect of contralesional cerebellar iTBS combined with routine rehabilitation on lower limb walking function in stroke patients [J]. The Journal of Practical Medicine, 2024, 40(13): 1797-1802.
[5]	Jia YUAN,Wenfeng FENG,Yunxiang DOU,Xuanjun CHEN,Zhihong ZHANG. Effective of repeated peripheral magnetic stimulation treatment over patients with lumbar disc herniation was observed based on neuroelectrophysiological examination [J]. The Journal of Practical Medicine, 2024, 40(12): 1665-1670.
[6]	Yue REN,Ting TIAN,Guangsheng WEI,Ming ZHANG,Hong YU,Jie LI,Tingting DONG,Yinmei FENG,Hongchao CUI,Jiao. ZHANG. Effect of stage I comprehensive cardiac rehabilitation in patients with acute ST elevation myocardial infarctionafter emergency percutaneous coronary intervention [J]. The Journal of Practical Medicine, 2024, 40(5): 682-687.
[7]	Qiu ZHANG,Jihua YU,Weiping LI,Yunqi LING,Jianxiong WANG,Fangyuan XU. Effects on different frequencies of whole body vibration on gross motor function and walking function in children with dyskinetic cerebral palsy [J]. The Journal of Practical Medicine, 2024, 40(3): 353-359.
[8]	Rui CAO,Yu DING,Zhengcao LU,Yiwei. DING. Clinical efficacy of perioperative precision rehabilitation of total endoscopic spinal decompression for lumbar spinal stenosis [J]. The Journal of Practical Medicine, 2023, 39(22): 2946-2952.
[9]	Suzhen YE,Xiaoyang WANG,Hongzhao BAI,Xuezhen ZHOU,Haiyan LI. Clinical efficacy and influencing factor of Remote Ischemic Postconditioning in Patients with Post Stroke Fatigue [J]. The Journal of Practical Medicine, 2023, 39(21): 2812-2816.