assessing the post-intervention outcome of small needle knife therapy on frozen shoulder

오십견 치료에서 작은 바늘 칼 요법의 치료 효능

Frozen shoulder is a disease characterized by pain and limitation of active and passive shoulder movement, which causes great inconvenience to the work and life of patients1. The global incidence of frozen shoulder is 2%-5%2,3 and higher in females than in males, showing a certain genetic tendency4. The majority of frozen shoulder patients are 40-60 years old5. Moreover, the frozen shoulder brings about a heavy social burden due to the longer recovery cycle and the absence of established treatment consensus in the clinic practice.
The main treatment methods for frozen shoulders include oral or external use of herbal medicine, acupuncture, massage, functional exercise, and so on6; however, the compliance of the patients is poor due to the multiple treatment frequency and longer time-consuming, and cannot meet the urgent necessities of patients to improve pain and functional limitations. Therefore, it is urgently needed to identify more effective therapeutics in the clinical management of frozen shoulder patients.
Small needle knife therapy is a special and effective external treatment of traditional Chinese medicine, which has arisen rapidly in the field of traditional Chinese medicine in recent decades7. It has the advantages of quick effect, definite curative effect, and high repeatability. Moreover, the operation instrument is cheap and easy to obtain, the operation process is simple, and the method is not limited by the environment and condition. The normal work and life of patients are not affected after the small needle knife therapy since the micro-incision will be recovered quickly without damage to the body, causing infection, or other side effects8,9,10,11. Systematic reviews showed that the efficacy of small needle knife on frozen shoulder was significantly superior to acupuncture, massage, and oral Chinese medicine12,13. Modern studies show that the mechanism of small needle knife treatment of frozen shoulder is to dredge the meridians and collaterals, promote the circulation of qi and blood, cut and strip the lesion tissue, remove adhesion, promote tissue repair, and restore the dynamic balance of the human body14,15.
The protocol presented here demonstrates the operation of small needle knife in treating frozen shoulders including patient management, material preparation, positioning, operation, and postoperative care. The purpose of this protocol is to relieve the pain and functional limitations and improve the living ability of patients with frozen shoulders.
With the development of small needle knife therapy, its application has been extended from the treatment of neck, shoulder, waist, leg pain, and other muscle and bone diseases to internal medicine, surgery, gynecology, pediatrics, and other diseases, playing an increasingly important role in the field of rehabilitation medicine16. In recent years, the small needle knife shows a more accurate, scientific, and safe therapeutic efficacy due to the application of ultrasound-guided small needle knife visualization therapy, whose development has entered a new stage17,18.

저자 스포트라이트: 작은 바늘 칼 요법으로 오십견 치료 

I-II 오십견에 대한 작은 바늘 칼 요법의 임상적 효능

Our study investigated the therapeutic efficacy of small needle knife in patients with frozen shoulders, and evidence that the improvement of pain function and the life ability. Our protocol addresses the detailed operation process of small needle knife in frozen shoulder patients. Our protocol has the advantages of quicker and definite therapeutic effects, high repeatability, broader availability, also there are less physical injury in patients.

Watch this Scientific Journal Video about Assessing the Post-Intervention Outcome of Small Needle Knife Therapy on Frozen Shoulder at JoVE.com

Assessing the Post-Intervention Outcome of Small Needle Knife Therapy on Frozen Shoulder  

오십견에 대한 작은 바늘 칼 요법의 개입 후 결과 평가

작은 바늘 요법 중재를 받은 환자의 어깨 운동 범위를 평가하려면 먼저 환자에게 어깨를 가능한 최대 각도로 들어 올리도록 요청합니다. 그런 다음 켜기 버튼을 눌러 평가 도구를 켭니다. 측정 눈금자를 돌려 측정값을 얻습니다.측정을 두 번 반복하기 전에 측정기 눈금을 다시 0으로 설정하십시오. Off를 길게 눌러 전원을 끕니다. 상완골 인대의 두께를 측정하려면 먼저 전원 버튼을 눌러 초음파 기계를 켭니다.그런 다음 초음파 소프트웨어를 엽니다. 환자 버튼을 누르고 피험자의 이름을 입력합니다. 환자에게 앉은 자세에서 영향을 받은 어깨를 완전히 노출하도록 요청합니다.환자의 어깨 관절을 수동적으로 움직여 상완골 인대를 찾습니다. 프로브에 적절한 양의 의료용 커플러를 도포한 후 초음파 프로브를 상완골 인대에 맞춥니다. Freeze 버튼을 눌러 화면을 고정한 후 Store 버튼을 눌러 초음파 영상을 저장합니다.시연된 대로 두 개의 다른 이미지를 계속 기록합니다. 환자 버튼을 누른 후 연구 목록에서 녹화된 이미지를 찾습니다. 캘리퍼스 버튼을 눌러 측정 모드로 들어가 코상완골 인대 두께를 평가합니다.마지막으로 측정값을 기록한 후 기계를 끕니다. 치료 후 대조군에 비해 치료군에서 상완골 인대 두께가 유의하게 감소했다.

assessing-post-intervention-outcome-small-needle-knife-therapy-on

Research

JoVE Journal

Medicine

Assessing the Post-Intervention Outcome of Small Needle Knife Therapy on Frozen Shoulder

49 조회수.  Shanghai University of Traditional Chinese Medicine. 작은 바늘 요법 중재를 받은 환자의 어깨 운동 범위를 평가하려면 먼저 환자에게 어깨를 가능한 최대 각도로 들어 올리도록 요청합니다. 그런 다음 켜기 버튼을 눌러 평가 도구를 켭니다. 측정 눈금자를 돌려 측정값을 얻습니다.측정을 두 번 반복하기 전에 측정기 눈금을 다시 0으로 설정하십시오. Off를 길게 눌러 전원을 끕니다. 상완골 인대의 두께를 측정하려면 먼저 ?...

비디오: Assessing the Post-Intervention Outcome of Small Needle Knife Therapy on Frozen Shoulder  

Clinical Efficacy of Small Needle Knife Therapy on Stage I-II Frozen Shoulder

Frozen shoulder is a kind of aseptic inflammatory disease of the shoulder caused by strain, trauma, and other reasons, resulting in shoulder joint pain and limited function. The protocol presented here demonstrates the operation of a small needle knife in treating frozen shoulders, including patient management, material preparation, positioning, operation, and postoperative care. The purpose of this protocol is to relieve the pain and functional limitations and improve the living ability of patients with frozen shoulders. In our study, 76 stage I-II frozen shoulder patients who met the inclusion criteria were randomly divided into a control group and a treatment group (n=38). Patients in the control group received functional exercise, while the treatment group received small needle knife therapy with functional exercise. The visual analogue scores (VAS), the Constant and Murley scores (CMS), and the thickness of the coracohumeral ligament (CHL) under ultrasound were evaluated. After small needle knife therapy, the VAS score was significantly lower in the treatment group (5.11 &plusmn; 0.89) than in the control group (5.49 &plusmn; 0.65; t=-2.065, p&lt;0.05); the CMS score was significantly higher in the treatment group (64.72 &plusmn; 4.78) than in the control group (60.97 &plusmn; 6.00; t=2.947, p&lt;0.05); the CHL thickness was significantly decreased in the treatment group (2.38 &plusmn; 0.36) than in the control group (2.57 &plusmn; 0.42; t=-2.117, p&lt;0.05). These results indicate that the small needle knife significantly relieved the pain symptoms, improved the shoulder function, reduced the CHL thickness, and improved the quality of life and, therefore, had significant therapeutic efficacy in stage I-II frozen shoulder patients.

The protocol presented here describes the detailed operation method and proves the effectiveness of a small needle knife in the treatment of frozen shoulders.

Frozen shoulder is a kind of aseptic inflammatory disease of the shoulder caused by strain, trauma, and other reasons, resulting in shoulder joint pain ...

연구

의학

Performing the Small Needle Knife Therapy on Patients with Frozen Shoulder

Begin the preoperative preparations by gathering all the necessary materials. Then proceed to check the basic information of each patient, including name, age, and the affected shoulder. Once the patient assumes a sitting position, fully expose the affected shoulder and mark the obvious tenderness points on the shoulder.Then, pour type two skin disinfectant on cotton balls, and with those, disinfect the affected area in circular motions, starting from about 15 centimeters around each marked point, and gradually reducing the diameter. Next, load five milliliters of 2%lidocaine into a 10 milliliter syringe with a 22 gauge needle. Then, load five milliliters of sterile water into the same syringe to prepare 10 milliliters of 1%lidocaine working solution.Replace the 22 gauge needle with a 25 gauge needle. While wearing sterile gloves on the left hand, hold the syringe in the right hand, insert the needle into a marked point, and ensure no blood enters the syringe after suction. Perpendicularly, inject one to two milliliters of 1%lidocaine working solution at the marked point.To perform the small needle knife insertion, hold the small needle in the right hand while wearing sterile gloves. Rapidly insert the small needle knife into the lidocaine injection site perpendicularly, maintaining a depth of about one to three centimeters. Then, perform the three step manipulation, beginning with the longitudinal incision, followed by stripping, and finally releasing the adhesion.Withdraw the needle when there is a feeling of looseness under the knife. Using a dry, sterile dressing block, press the injection site for one minute. Then cover the operating area with a sterile self-adhesive dressing.After assisting the patient in dressing properly, ask the patient to sit still for about 15 minutes before leaving the operating room to avoid postoperative discomfort. After the small needle knife therapy, the visual analog score was significantly lower in the treatment group than in the control group. The Constant and Murley score was significantly higher in the treatment group than in the control group.

오십견 환자에 대한 작은 바늘 칼 요법 수행

To begin assessing the range of motion of the shoulder of the patients who received the small needle therapy intervention, first, ask the patient to lift the shoulder to the maximum angle possible. Then press the On button to switch on the assessment instrument. Rotate the measuring ruler and obtain the measured value.Set the measuring instrument scale back to zero before repeating the measurement two times. Press and hold Off, to turn the power off. To measure the thickness of the coracohumeral ligament, first turn on the ultrasound machine by pressing the power button.Then open the ultrasound software. Press the patient button and enter the name of the subject. Ask the patient to fully expose the affected shoulder in a seated position.Move the patient's shoulder joint passively, to locate the coracohumeral ligament. After applying an appropriate amount of medical coupler to the probe, align the ultrasound probe with the coracohumeral ligament. Press the Freeze button to freeze the screen, and then press the Store button to save the ultrasound image.Continue to record two different images as demonstrated. After pressing the patient button, look for the recorded images in the study list. Press the Caliper button to enter the measurement mode and assess the coracohumeral ligament thickness.Finally, after recording the measurements, turn off the machine. After the treatment, the coracohumeral ligament thickness was significantly decreased in the treatment group, compared to the control group.