Deep transverse friction massage for treating tendinitis

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Abstract
Deep transverse friction massage (DTFM) is one of several physiotherapy interventions suggested for the management of tendinitis pain. To assess the efficacy of DTFM for treating tendinitis. We searched the MEDLINE, EMBASE, HealthSTAR, Sports Discus, CINAHL, the Cochrane Controlled Trials Register, PEDro, the specialized registry of the Cochrane musculoskeletal group and the Cochrane field of Physical and Related Therapies up to the end of June 2002. The reference list of the trials and key experts in the area were also consulted for additional studies. All randomized controlled trials (RCTs) and controlled clinical trials (CCTs) comparing therapeutic ultrasound with control or another active intervention in patients with all types of tendinitis, such as iliotibial band friction syndrome and extensor carpi radialis tendinitis (i.e. tennis elbow or lateral epicondylitis or lateralis epicondylitis humeri), were selected. Two reviewers determined the studies to be included based upon the inclusion and exclusion criteria (LB, VR). Data were independently abstracted by two reviewers (VR, LB), and checked by a third reviewer (BS) using a pre-developed form of the Cochrane Musculoskeletal Group. The two reviewers, using a validated checklist, assessed the methodological quality of the RCTs and CCTs independently. The pooled analysis was performed using weighted mean differences (WMDs) for continuous outcomes. One RCT included patients with ITBFS. DTFM combined with rest, stretching exercises, cryotherapy and therapeutic ultrasound was compared to the control group (rest, stretching exercises, cryotherapy and therapeutic ultrasound only). This trial showed no statistical difference in the three types of pain relief measured after four consecutive sessions of DTFM combined with other physiotherapy modalities for runners. There was a clinically important relative percentage difference in pain while running of 22%. A RCT on ECRT showed no statistical difference in pain relief, grip strength and the three types of functional status measured after 9 consecutive sessions within 5 weeks of DTFM compared with other physiotherapy modalities. DTFM combined with other physiotherapy modalities did not show consistent benefit over the control of pain, or improvement of grip strength and functional status for patients with ITBFS or for patients with ECRT. These conclusions are limited by the small sample size of the included RCTs. No conclusions can be drawn concerning the use or non use of DTFM for the treatment of ITBFS. Future trials, utilizing specific ITBFS methods and adequate sample sizes are needed, before conclusions can be drawn regarding the specific effect of DTFM on tendinitis. 深部橫向摩擦按摩用於治療肘部側面疼痛﹝網球肘﹞ 深部橫向摩擦按摩用於治療肘部側面疼痛﹝網球肘﹞是許多治療方法之一。 研究深部橫向摩擦按摩治療肌腱炎的效果。 搜尋包括MEDLINE, EMBASE, HealthSTAR, Sports Discus, CINAHL, the Cochrane Controlled Trials Register, PEDro, the specialized registry of the Cochrane musculoskeletal group and the Cochrane field of Physical and Related Therapies到2002年6月，並搜尋所選文章之參考文獻及諮詢專家以搜尋其它文獻。 所有隨機對照試驗及控制對照研究，比較治療性超音波與對照組或另一種治療對所有型態肌腱炎的效果。 2個評論者分別擷取數據跟評估試驗品質，並由第3位評論者檢查。連續性資料使用加權平均差異(weighted mean difference, WMD)來分析。 1個隨機對照試驗納入ITBFS (iliotibial band friction syndrome)病患，深部橫向摩擦按摩(DTFM)結合休息、伸展運動、低溫療法及治療性超音波。研究顯示DTFM結合其它物理治療四輪次相對於僅作物理治療，對跑者疼痛並無顯著改善。1篇隨機對照試驗發現ECRT (extensor carpi radialis tendonitis) 五週內施行九輪次DTFM與其他物理治療比較，對疼痛、握力及功能並無顯著改善。 深部橫向摩擦按摩(DTFM)與其他物理治療比較，對疼痛、握力及功能並無顯著改善。但結論受限於小樣本，因而無法確認。未來需進一步採用良好設計及適當病人樣本數的研究。 本摘要由林口長庚醫院余光輝翻譯。 此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。 這是一個系統性回顧2個檢視深部橫向摩擦按摩用於治療肘部側面疼痛的隨機臨床試驗(RCT)。隨機對照試驗表明，無論是相比於對照組相同的物理治療方式(但不包括深部橫向摩擦按摩)，或其他積極療法如超音波導入法或治療性超音波結合安慰劑軟膏等，深部橫向摩擦按摩結合現有的物理治療方式對肘部側面疼痛並沒下列好處：緩解賽跑者髂脛帶摩擦症候群疼痛，緩解疼痛，改善功能狀態，提高橈側腕伸肌腱炎者握力。缺乏可用之研究，使用主觀且非驗證的量表來衡量疼痛，合併幾個物理治療模式和低樣本大小的隨機對照試驗在本系統性回顧，因此本研究結論是侷限的。