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Objective:To investigate the clinical efficacy of radial extracorporeal shockwave therapy(ESWT)for scapulohumeral periarthritis in the elderly.Methods:A total of 82 patients diagnosed with scapulohumeral periarthritis at the rehabilitation medicine department of our hospital from July 2016 to January 2019 were retrospectively analyzed.The visual analogue score(VAS), Constant-Murley score(CMS), range of motion(ROM), adverse reactions, curative effectiveness and survival analysis were examined before treatment and at several time points within 6 months of treatment.Results:Compared with pre-treatment, the VAS, CMS, ROM, curative effects and survival analysis of patients with primary and secondary scapulohumeral periarthritis improved after treatment in both the conventional rehabilitation therapy group and the conventional rehabilitation therapy combined with ESWT group(all P<0.05). The short-term effects(2 weeks and 1 month after treatment)were better in the conventional rehabilitation therapy combined with ESWT group than in the conventional rehabilitation therapy group( P<0.05). There was no significant difference in long-term effects(2, 4 and 6 months after treatment)between the two groups( P>0.05). For patients with primary scapulohumeral periarthritis, conventional rehabilitation therapy combined with ESWT had advantages over conventional rehabilitation therapy in reducing the VAS score and improving shoulder function(CMS score and ROM)( P<0.05). For patients with secondary scapulohumeral periarthritis, conventional rehabilitation therapy combined with ESWT was better in reducing VAS than conventional rehabilitation therapy( P<0.05), while there was no significant difference in shoulder function improvement between the two groups(all P>0.05). Conclusions:Conventional rehabilitation combined with ESWT can relieve shoulder pain, improve range of motion and has a good safety profile in the treatment of scapulohumeral periarthritis in the elderly, but there is no significant difference in long-term efficacy between conventional rehabilitation therapy and conventional rehabilitation therapy combined with ESWT.
ABSTRACT
Objective To establish a model of knee joint extension contracture in New Zealand white rab-bits, and to lay the experimental foundation for further studies on the pathogenesis and treatment of joint contractures. Methods Thirty male New Zealand white rabbits with mature bones were randomly divided into 6 groups. The left knee joints of the immobilization groups ( 5 groups of 5 rats each) were fixed in extension for 1, 2, 4, 6 or 8 weeks. There was also a control group. At the end of each period the plaster was demolished and the level of transforming growth factor-β1 ( TGF-β1) in joint cavities, the degree of total contracture, myogenic contracture, arthrogenic con-tracture, and the thickness of the posterior joint capsules were measured. The significance of the differences between the immobilized groups and the control group was compared using one-way analysis. Results The level of TGF-β1 in the joint fluid differed significantly among the 6 groups. The differences in the degree of total contracture among the control group, one-week, two-week and four-week groups were also significant. The average degree of the myogenic contracture in the one-week group was significantly different from the other 5 groups' averages. The average myogenic contracture was also of significantly different between the two-week group and the control group. The degree of arthro-genic contracture was significantly different among the groups except for between the 6-week and 8-week groups. The average joint capsule thickness was significantly different among all of the groups except for between the control group and the one-week group. Conclusion This technique for modeling knee extending contracture using New Zealand white rabbits is simple and practical. It provides a better animal model for studying the mechanism of knee joint con-tracture and related treatment strategies and can be used for further exploration of the occurrence and recovery of knee contractures.
ABSTRACT
Joint contracture is currently one of the very common diseases in rehabilitation medicine department.Once it occurs,it likely leads to such functional disturbances in the patients as restricted joint activities,decreased muscle strength around a joint and abnormal gait,seriously affecting the quality of life of the patients.Studies on its pathogenesis can help doctors better understand and treat the disease.In this paper,pathogenesis of the disease and progress in its therapy are summarized.