[PD-1-4] ポスター：運動器疾患 1Effect of the therapeutic use of ultrasound on shoulder range of motion was examined by Tau-U analysis ～ a case study ～
Introduction: Ultrasound (US) has been used to improve the range of motion; however, there is noconsensus on its therapeutic effects. Some rehabilitation studies used Tau-U analysis to examine whetherthe improvement in outcome after intervention can be interpreted as the improvement by the interventionin single-case design. This study aimed to explore the therapeutic effects of the US in combination withexercise and mobilization on the range of motion based on a single case design.
Case: The patient was a 40-year-old man presented with a fracture of the greater tuberosity of the righthumerus and had limited ROM in shoulder flexion after surgery. He had worked in the constructionindustry prior to his injury. To return to work, he needs to use electric tools with his affected armapproximately 150°elevated. However, he elevated his arm up to 90°and experienced pain, although hehad received standard interventions comprised of stretching and the ROM exercises approximately 1month postoperatively.
Methods: The standard intervention, namely stretching and ROM exercises of the glenohumeral joint,was administered in 5 sessions (twice a week for 4 weeks), and the US was performed in 10 sessions(twice a week for 8 weeks). The US was applied to the anterior-posterior aspects of the affectedglenohumeral joint at a dose of 1.5 W/cm2
with a frequency of 1 MHz for 5 min continuously. Aftercoating the skin with an aquasonic gel, the US was delivered by moving the probe over the anterior andposterior regions of the glenohumeral joint in slow, overlapping strokes. We defined the last five sessionsin which the patient received the standard treatment, as the baseline phase (Phase A), and the periodfrom the start of the combination of standard treatment and the US to the time when the patient returnedto work was defined as Phase B. The primary outcome was ROM in flexion, which is required forreturning work. The Tau-U, which allowed us to identify the effect of the intervention on the outcomesbased on a comparison between the baseline and intervention phase, was used to compare the Phases Aand B. Statistical significance was set at 0.05.
Results: The ROM outcomes in flexion were ranged from 90°to 100°during Phase A. However, thoseduring Phase B increased from 100°to maximally 135°. Tau-U analysis indicated that there was nosignificant trend during Phase A (Tau-U = 0.100, p >>0.999), whereas the Phase B showed a significanttrend with a mild effect size (Tau-U = 0.556, p = 0.025). There was a significant difference in the primaryoutcome of shoulder joint flexion between Phases A and B (p<0.001). The effect size was also high(Tau-U = 0.758).
Conclusion: The use of US improved shoulder range of motion during flexion. The Tau-U analysis canbe useful analysis to indicate the effect of intervention in single-case design.
Case: The patient was a 40-year-old man presented with a fracture of the greater tuberosity of the righthumerus and had limited ROM in shoulder flexion after surgery. He had worked in the constructionindustry prior to his injury. To return to work, he needs to use electric tools with his affected armapproximately 150°elevated. However, he elevated his arm up to 90°and experienced pain, although hehad received standard interventions comprised of stretching and the ROM exercises approximately 1month postoperatively.
Methods: The standard intervention, namely stretching and ROM exercises of the glenohumeral joint,was administered in 5 sessions (twice a week for 4 weeks), and the US was performed in 10 sessions(twice a week for 8 weeks). The US was applied to the anterior-posterior aspects of the affectedglenohumeral joint at a dose of 1.5 W/cm2
with a frequency of 1 MHz for 5 min continuously. Aftercoating the skin with an aquasonic gel, the US was delivered by moving the probe over the anterior andposterior regions of the glenohumeral joint in slow, overlapping strokes. We defined the last five sessionsin which the patient received the standard treatment, as the baseline phase (Phase A), and the periodfrom the start of the combination of standard treatment and the US to the time when the patient returnedto work was defined as Phase B. The primary outcome was ROM in flexion, which is required forreturning work. The Tau-U, which allowed us to identify the effect of the intervention on the outcomesbased on a comparison between the baseline and intervention phase, was used to compare the Phases Aand B. Statistical significance was set at 0.05.
Results: The ROM outcomes in flexion were ranged from 90°to 100°during Phase A. However, thoseduring Phase B increased from 100°to maximally 135°. Tau-U analysis indicated that there was nosignificant trend during Phase A (Tau-U = 0.100, p >>0.999), whereas the Phase B showed a significanttrend with a mild effect size (Tau-U = 0.556, p = 0.025). There was a significant difference in the primaryoutcome of shoulder joint flexion between Phases A and B (p<0.001). The effect size was also high(Tau-U = 0.758).
Conclusion: The use of US improved shoulder range of motion during flexion. The Tau-U analysis canbe useful analysis to indicate the effect of intervention in single-case design.