局部震動伸展訓練對五十肩患者的立即療效

Abstract

目的：瞭解局部震動伸展訓練對五十肩患者肩關節活動度及疼痛的立即效果，並探討其作用機轉。方法：本實驗收集15位罹患五十肩的受試者(平均年齡48.56±5.48歲；平均罹病時間5.50±3.41個月)，在肩屈曲、外展、外旋、內旋最大角度接受局部震動伸展訓練，頻率設在40Hz，每個角度震動1分鐘休息20秒重複三次，共12分鐘的震動訓練。比較震動前後肩關節活動度及自覺疼痛量表的差別，並探討患側肩及健側肩的肌肉張力及本體感覺差異。結果：震動後患側肩的肩屈曲、外展、及被動外旋角度都有顯著進步，休息時及動作時疼痛皆顯著降低，然而肩周圍肌肉張力及本體感覺無顯著差異。介入前健側肩與患側肩的肩周圍肌肉張力及本體感覺無顯著差異。結論：局部震動伸展訓練可以快速有效的改善五十肩患者的肩關節活動度及疼痛，其增加角度的機轉主要經由提高疼痛閾值所致。Purpose: To investigate the acute effect of local vibration training on shoulder range of motion (ROM) and pain (visual analog scale, VAS) in patients with frozen shoulder. Methods: Fifteen participants were included to receive local vibration training (40Hz) while stretching to tolerable end range of shoulder flexion, abduction, external rotation, and internal rotation. The vibration was performed 1 minute followed by 20 seconds of rest, repeated 3 times of each shoulder motion (12 minutes total). Pre- and post-test ROM, VAS, shoulder muscle stiffness, and proprioception were compared. The muscle stiffness and proprioception in both side were analyzed. Results: After local vibration, the shoulder ROM and VAS were significantly improved. As for muscle stiffness and proprioception, there was no significant difference between pre- and post-test and between affected shoulder and sound side. Conclusion: Local vibration with stretching could immediately increase shoulder ROM and decrease pain. The mechanism may through alter pain threshold.