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| Study on the orthogonal design of the optimal choice on scapulohumeral periarthritis with physical therapy, manipulative therapy and acupuncture therapy |
| LIU Xifang1 WANG Jin2 YANG Minyi1 SONG Yixin1 JIANG Yuan1 LIANG Dongsheng1 ZHAO Congzhe1 HAN Weihua1 |
1.Ward Two, Department of TCM Orthopedics, Xi′an Honghui Hospital, Xi′an Jiaotong University, Shaanxi Province, Xi′an 710054, China;
2.Department of Encephalopathy, Shaanxi Hospital of Traditional Chinese Medicine, Shaanxi Province, Xi′an 710003, China |
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Abstract Objective To study the effect of different combinations of physical therapy, manipulation and acupuncture on patients with periarthritis of shoulder, and to explore the optimal treatment protocol by using orthogonal design. Methods A total of 80 patients with scapulohumeral periarthritis who met the inclusion criteria were selected from Outpatient and Inpatient Department in Ward Two of Department of TCM Orthopedics and Ward of Sports Injury Shoulder Elbow, Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University from January 2016 to December 2017. They were divided into eight groups according to the orthogonal design of L8(27) tables with 10 cases in each group by random block method. Three factors including A (physical therapy), B (manipulation therapy), C (acupuncture therapy) and the corresponding 2 levels ( infrared ray therapy and extracorporeal shock wave therapy, joint mobilization therapy and manipulation therapy, ordinary acupuncture therapy and warm needle penetration therapy) were used for treatment, shoulder joint pain and function were observed by intuitive analysis and variance analysis. Results Compared with before treatment, different combinations of physical therapy, manipulation therapy and acupuncture therapy all reduced the visual analogue scale (VAS) score and improved the shoulder joint function score of patients with scapulohumeral periarthritis, and the differences were statistically significant (P ＜ 0.05). Physical therapy, manipulation and acupuncture therapy were the significant factors to improve shoulder joint pain and function through visual analysis and variance analysis of shoulder pain VAS score and functional score (P ＜ 0.05). Physical therapy was the best, followed by manipulation therapy, while acupuncture therapy was the least (RA＞RB＞RC, rA＞rB＞rC). Compared with different levels of the same factors, the extracorporeal shock wave therapy was better than infrared ray therapy (K2＞K1, k2＞k1), joint mobilization therapy was better than manipulation therapy (K1＞K2, k1＞k2), and warm needle penetration therapy was better than ordinary acupuncture therapy (K2＞K1, k2＞k1). Extracorporeal shock wave therapy combined with joint mobilization therapy and warm needle penetration joint mobilization therapy was the best treatment for patients with scapulohumeral periarthritis. Conclusion The combination of extracorporeal shock wave therapy, joint mobilization therapy and warm needle penetration therapy is the best optimized protocol for the treatment of pain and dysfunction in patients with scapulohumeral periarthritis, which is worthy being popularized.
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