| Objective:Rotator cuff injury often causes shoulder pain,in the non-acute stage is mostly caused by the lack of blood circulation at the lesion site,and the commonly used conservative treatment for moderate injury mainly includes manipulation and fixation,closed injection,ultrasound physiotherapy,medical exercises,etc.Extracorporeal shock wave is a mechanical wave with the characteristics of acousto-optic mechanics,which causes a micro-damage to the local area through the cavitation of mechanical wave,which has a good effect on the damaged tissue of ischemia and hypoxia,can improve local blood circulation,and is used in musculoskeletal diseases and other fields.In recent years,floating needle,as a relatively new treatment,has been used in the treatment of various diseases such as tennis elbow by sweeping away the "flashlight" effect of superficial fascia,changing the ion channels of cells and promoting blood circulation.There are few studies of application in rotator cuff injuries.This study mainly studied the therapeutic effect of floating needle therapy and shock wave therapy in subjects with moderate rotator cuff injury in college students in sports colleges,compared the efficacy evaluation of floating needle therapy and shock wave therapy on moderate rotator cuff injury,the effect of daily living ability,etc.,to provide suggestions for the conservative treatment of moderate rotator cuff injury,and provide evidence-based evidence clinically.Methods:According to the inclusion and exclusion criteria,45 patients with rotator cuff injury among the students of Xi’an Institute of Physical Education were selected as the study subjects.According to the morning and evening of inclusion,the random number method was used to evenly divide the subjects into 15 cases in the floating needle group,the extracorporeal shock wave group and the blank control group,and a randomized controlled trial was conducted.In the floating needle group,the main trigger points of the affected area were selected,and the corresponding responsible muscles were found around the trigger points,and the needle entry points were generally in the muscles and abdomen of the affected muscles,and the needle entry points(1-3)were selected,3 times/week as a course of treatment,a total of two courses of treatment;The shock wave group selected the affected area(1-3)as the central position for treatment,2 times/week,4 times as a course of treatment,a total of two courses of treatment;The blank control group did not apply additional intervention according to their usual living habits.The treatment effect of patients was analyzed by indicators such as treatment efficacy,VAS(Visual Analogue Scale)visual simulation score,shoulder range of motion,shoulder muscle strength,Y-Balance(UQ)comprehensive value and CMS(constant-murley score)shoulder function score,and the corresponding indicators were scored and observed before treatment,after 1treatment,after treatment 2W and after 4W treatment,and compared between and within groups.Results:(1)In the end,a total of 37 patients completed all treatment and evaluation,including 13 cases in the floating needle group,13 cases in the shock wave group,and11 cases in the blank control group.Before the intervention,there were no significant differences in the evaluation indicators of the three groups(P>0.05).(2)After the end of treatment,the total effective rate of the floating needle group after the end of treatment was 92.3%,and the apparent effective rate was 84.6%.The total response rate of the shock wave group was 76.9% and the apparent effective rate was 38.5% after the end of treatment.There was no statistical difference in the effective rate between the two groups(P>0.05),and the apparent efficiency of the floating needle group was greater than that of the shock wave group(P<0.05).(3)VAS score:(1)Compared with before treatment,the VAS score of the floating needle group and the shock wave group was significantly reduced(P<0.05)immediately after treatment,2W and 4W after treatment.(2)Compared between groups,immediately after treatment,after 2W and 4W,the VAS score in the floating needle group was lower than that in the shock wave group(P<0.05).(4)CMS shoulder function score:(1)Compared with before treatment,after 2W treatment and 4W treatment,floating needle and shock wave treatment had obvious effects on the improvement of rotator cuff injury function score(P<0.05).(2)Compared between groups,after treatment of 2W and 4W,the score of the floating needle group was significantly higher than that of the shock wave group,with a statistical difference(P<0.05).(3)The four aspects of CMS shoulder score(pain,daily living ability,range of motion,muscle strength)were analyzed and processed,and after the treatment of 2W,the scores of the floating needle group were higher than those of the shock wave group(P<0.05)in all four aspects;after the treatment of 4W,the CMS pain score,CMS daily score and CMS muscle strength score of the floating needle group were significantly higher than those in the shock wave group(P<0.05),and there was no significant difference between the CMS mobility score and the shock wave(P>0.05).(5)Shoulder range of motion:(1)Compared with before treatment,the floating needle group had significantly improved the range of motion in all directions after treatment of 2W and 4W(P<0.05).(2)Compared with before treatment,there was no significant difference in the range of motion in all directions(P>0.05)in the shock wave group after 2W treatment;after treatment of 4W,there was a significant increase in forward flexion,internal rotation and external rotation(P<0.05),and there was no significant difference in posterior extension and abduction(P>0.05).(3)Compared between groups,after treatment of 2W,the mobility of the floating needle group was significantly higher than that of the shock wave group(P<0.05),and there was no significant difference between the abduction activity and the shock wave group(P>0.05),after the treatment of 4W,the range of motion of the floating needle group was significantly higher than that of the shock wave group(P<0.05),and there was no significant difference between the range of activity of forward flexion,abduction,internal rotation and external rotation and the shock wave(P>0.05).(6)Shoulder joint stability:(1)Compared with before treatment,after treatment of 2W and 4W,the comprehensive value of Y-Balance(UQ)in the floating needle group and the shock wave group was significantly improved(P<0.05).(2)In between-group comparison,there was no significant difference between Y-Balance(UQ)scores in the floating needle group and the shock wave group after treatment of2 W and 4W.(7)Shoulder muscle strength: Compared with before treatment,the six directions of forward flexion,posterior extension,adduction,abduction,internal rotation and external rotation had different degrees of improvement in muscle strength in all directions after treatment of 4W,but there was no statistical difference(P>0.05).Conclusion:(1)Floating needle treatment and shock wave therapy have immediate effects on reducing pain in patients with rotator cuff injury,and the immediate effect of floating needle is better than that of shock wave therapy.(2)After the treatment of 2W,floating needle treatment and shock wave therapy were effective in relieving pain,increasing shoulder joint function and stability.The floating needle group was superior to the shock wave group in terms of pain relief,increased shoulder function,and increased range of motion(forward flexion,posterior extension,internal rotation,external rotation).(3)After the treatment of 4W,the floating needle group was superior to the shock wave group in terms of pain relief,increased shoulder joint function,and increased range of motion(posterior extension). |
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