| Objective:To investigate the clinical effects of extracorporeal shock wave therapy and silver needle conduction therapy on pain relief and improvement of shoulder mobility in diabetic patients suffering from adhesive capsulitis,and to further investigate the safety and superiority of the combination of the two methods in improving the efficacy of the treatment in diabetic patients.Methods:Seventy-two diabetic patients with adhesive capsulitis were divided into three groups of 24 cases each according to the random number method,including the extracorporeal shock wave group(Group A,treated with extracorporeal shock wave),the silver needle group(Group B,treated with silver needle)and the combined treatment group(Group C,treated with silver needle conduction therapy within 1-2 days after extracorporeal shock wave),all patients underwent guided home shoulder functional exercises,and received no other treatments during treatment and follow-up.All patients were evaluated before(T0)and 1 week(T1),4 weeks(T2),8 weeks(T3)and 12 weeks(T4)after the first treatment,and their shoulder pain and dysfunction index score(SPADI),shoulder mobility(ROM)and the occurrence of adverse events during treatment were recorded.Results:1.Comparison of SPADI scores between the three groups of patientsThe SPADI scores of patients in both groups A and C changed significantly at all time points after treatment compared with those before treatment(P < 0.05);the functional impairment scores of patients in group B did not improve significantly at T1(P > 0.05),and the SPADI scores changed significantly at all other time points compared with those before treatment(P < 0.05).pain scores of patients in group B improved insignificantly compared with those in group A at T2(P > Patients in group B had no significant improvement in pain scores compared to group A at T2(P > 0.05),and group B had significant improvement in pain scores compared to group A at T4(P < 0.05);group C had more significant improvement in pain scores at T2,T3 and T4 compared to groups A and B(P < 0.05).patients in group B had significant improvement in functional impairment scores compared to group A at T4(P < 0.05);group C had more significant change in functional impairment scores at all time points compared to groups A and B(P< 0.05).The change in functional impairment scores was more significant in Group C than in Groups A and B at all time points(P < 0.05).2.Comparison of ROM scores between the three groups of patientsGroup B showed no significant change in abduction at T1 compared to before treatment(P > 0.05),while the rest of the ROM at all time points improved significantly compared to before treatment(P < 0.05);patients in groups A and C showed significant changes in ROM at all time points after treatment compared to before treatment(P <0.05).patients in group A showed more significant improvement in mobility of the four joints at T1 compared to group B,and internal rotation and The patients in Group A had more significant changes in all four joint mobility at T1 and more significant changes in internal and external rotation mobility at T2 than those in Group B(P < 0.05);the patients in Group C had more significant changes in external rotation and forward flexion mobility at all time points after treatment than those in Groups A and B,and more significant changes in abduction and internal rotation mobility at T2,T3 and T4 than those in Groups A and B(P < 0.05).3.Adverse reactions during treatment in the three groups of patientsTwelve of the patients in Group A experienced soreness and swelling of the shoulder,numbness of the skin,and pain that was worse than before treatment;five of the patients in Group B experienced redness and swelling at the entry point of the needle without subcutaneous haematoma,bruising,infection or pneumothorax,and four of the patients in Group C experienced similar conditions to those in Group A without subcutaneous haematoma,bruising,infection or pneumothorax,and one of the patients in Group C experienced dizziness and sweating,One patient in Group C developed dizziness,sweating,pallor and dyspnea during treatment.No other serious complications were seen in any of the three groups.Conclusion:1.Both extracorporeal shock wave therapy and silver needle conduction therapy have been shown to relieve pain and promote restoration of shoulder mobility and function in the treatment of cases of adhesive capsulitis in diabetic patients.2.The combination of the two treatments combines their respective advantages to improve the efficacy of the treatment of adhesive capsulitis in diabetic patients and to minimize the adverse effects of the treatment on diabetes mellitus,which is suitable for diabetic patients and deserves further study and application in clinical practice. |
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