Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Dose-related Effect of Extracorporeal Shock Wave Therapy for Lateral Epicondylitis - Prospective Randomized Double Blind Comparative Study -

주관절 외상과염의 체외 충격파 시술에서 에너지량에 따른 치료 효과 - 전향적 무작위적 이중 맹검 대조군 연구 -

  • Oh, Joo-Han (Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Yoon, Jong-Pil (Department of Orthopedic Surgery, Seoul Medical Center) ;
  • Oh, Chung-Hee (Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Jo, Ki-Hyun (Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Gong, Hyun-Sik (Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital)
  • 오주한 (서울대학교 의과대학 정형외과학교실, 분당서울대학교병원 관절센터) ;
  • 윤종필 (서울의료원 정형외과) ;
  • 오정희 (서울대학교 의과대학 정형외과학교실, 분당서울대학교병원 관절센터) ;
  • 조기현 (서울대학교 의과대학 정형외과학교실, 분당서울대학교병원 관절센터) ;
  • 공현식 (서울대학교 의과대학 정형외과학교실, 분당서울대학교병원 관절센터)
  • Published : 2009.06.15
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Abstract

Purpose: The aim of this study was to examine the dose-related effect of extracorporeal shock wave therapy (ESWT) for lateral epicondylitis. Materials and methods: Thirty patients with refractory lateral epicondylitis despite conservative treatment for 6 months were enrolled in this study. The patients were divided randomly into a low- and high-energy group. All patients were treated 3 times with ESWT with an interval of 1 week in a double blinded manner. The mean energy level in the low- and high-energy group was $0.12 mJ/mm^2$ and $0.24 mJ/mm^2$, respectively. The upper extremity functional scales and Mayo elbow scores were measured prospectively at the baseline, 1, 3 and 6 months after ESWT. Results: Significant clinical improvement was observed in both groups after ESWT. The high-energy group showed better pain improvement at 6 months after ESWT (p=0.019). The effect of ESWT was dominant between 1 and 6 months after ESWT than within 1 month. Conclusion: ESWT for lateral epicondylitis demonstrated showed good results regardless of the energy dose. However, a high-energy level was more effective in pain improvement after 6 months of treatment.

목적: 주관절 외상과염 환자에서 체외 충격파 시술의 에너지량에 따른 치료 효과를 전향적 무작위적 이중 맹검 비교 방법으로 분석해 보고자 하였다. 대상 및 방법: 6개월 이상의 비수술적 치료로 호전이 없어, 체외 충격파 시술을 시행한 주관절 외상과염 환자들을 무작위적으로 각각 15명씩 저에너지군과 고에너지군으로 나누어 전향적 이중 맹검법으로 분석하였다. 모든 환자들은 1주 간격으로 총 3회 동안 체외 충격파 시술을 시행받았고, 평균 에너지량은 저에너지군이 $0.12 mJ/mm^2$, 고에너지군이 $0.24 mJ/mm^2$ 이었다. 시술 전과 시술 1개월, 3개월, 6개월에 각각 Upper extremity function score, Mayo elbow score를 측정하여 임상적 결과를 비교하였다. 결과: 체외 충격파 시술 후 저에너지군과 고에너지군 모두에서 유의한 임상적 호전을 보였으며, 특히 시술 후 6개월에서 고에너지군이 통증의 호전이 유의하게 높았다(p=0.019). 체외 충격파 치료에 의한 치료 효과는 1개월 내의 단기 효과보다는 시술 후 1개월에서 6개월 사이에 주로 나타났다. 결론: 주관절 외상과염에서 체외충격파 치료는 에너지량에 상관없이 모두 유의한 치료 효과를 보였고, 특히 고에너지의 사용이 통증 조절에 보다 효과적이었다.

Keywords

References

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