在一般实践中,皮质类固醇注射与运动治疗治疗肩部疼痛的有效性 (SIX-Shoulder Study):一项随机对照试验
A H C Versloot1, D Schiphof1, R P G Ottenheijm2
1Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.
Musculoskeletal science & practice
|January 14, 2026
概括
与12个月的皮质类固醇注射相比,理疗师主导的运动治疗显示出更好的长期肩部疼痛和功能结果. 虽然注射提供了短期的缓解,但运动疗法在肩膀疼痛和残疾指数 (SPADI) 得分中提供了持续的改善.
科学领域:
- 整形外科 整形外科 整形外科
- 肌肉骨健康 肌肉骨健康
- 物理疗法物理治疗
背景情况:
- 目前的指导方针建议在初级保健肩部疼痛中注射皮质类固醇或进行运动治疗.
- 这些治疗方法之间的长期比较数据有限.
- 为了弥补这一差距,进行了一项务实的随机对照试验.
研究的目的:
- 为了比较12个月内皮质类固醇注射与物理治疗师主导的肩部疼痛运动治疗的有效性.
- 用肩膀疼痛和残疾指数 (SPADI) 评估疼痛和功能.
主要方法:
- 一项实用随机对照试验包括了新出现肩部疼痛的患者.
- 参与者被随机分配,接受皮质类固醇注射或12次运动治疗.
- 肩部疼痛和残疾指数 (SPADI) 用于在多个时间点评估结果,长达12个月.
主要成果:
- 与注射相比,运动疗法在6,9和12个月后在SPADI得分上显示出统计学上显著的更大改善.
- 皮质类固醇注射组在6周的随访中显示出明显更好的SPADI得分.
- 在运动治疗组 (25%) 比注射组 (7%) 更频繁地报告了副作用.
结论:
- 运动治疗似乎在12个月内产生了统计学上显著的更好的长期肩部疼痛和功能结果 (SPADI分数).
- 对效应估计的置信区间很宽,这表明有一定的不确定性.
- 可能需要进一步的研究来证实这些发现,并完善治疗建议.
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