肌肉振动治疗配合常规康复对脑卒中后肩-手综合征的临床效果观察

发布时间：2018-05-06 08:47

本文选题：肌肉振动治疗 + 脑卒中　；参考：《中国康复医学杂志》2017年08期

【摘要】：目的:探讨3周肌肉振动治疗结合常规康复方案对脑卒中后肩-手综合征(SHS)的临床疗效。方法:将60例患者随机分为振动与常规康复结合组(试验组,20例)、振动组(对照组A组,20例)、常规组(对照组B组,20例),肌肉振动治疗由经过专门培训的治疗师进行,每次用时20 min,每日治疗1次,每周治疗5天,持续治疗3周。干预前后采用肩-手综合征评分标准对患手及腕关节疼痛、肿胀及患侧肱骨关节活动度进行评定,同时采用手及腕部Fugl—Meyer评分法(0—24分)对患手及腕功能进行评定。结果:干预前各组基线值无显著意义差别(P0.05)。三组SHS疼痛、肿胀得分均有所降低(P0.05),Fugl-Meyer评分提高(P0.05)。组内对比,干预后结合组及振动组肱骨外展及肱骨外旋得分有所降低(P0.05),常规组无明显变化(P0.05)。三组组间比较,干预后结合组SHS疼痛、肿胀,肱骨外展及肱骨外旋得分较常规组低(P0.05);FuglMeyer评分(FMA)较两对照组高(P0.05);结合组疼痛、肿胀得分较振动组低(P0.05);结合组肱骨外旋及外展得分与振动组无明显差异(P0.05)。干预后两对照组SHS疼痛、肿胀、肱骨外展、肱骨外旋及Fugl-Meyer评分得分无明显差异(P0.05)。试验过程中不良反应轻微而且短暂。结论:肌肉振动治疗结合常规康复可以更加有效地减轻脑卒中后肩-手综合征的肿胀、疼痛症状,促进手及腕部功能恢复;肌肉振动治疗可以扩大肱骨外展及外旋活动度;肌肉振动治疗的可接受性强,刺激过程中未见明显不良反应。
[Abstract]:Objective: to investigate the clinical effect of 3 weeks muscle vibration therapy combined with routine rehabilitation in the treatment of shoulder-hand syndrome (SHS) after stroke. Methods: sixty patients were randomly divided into two groups: vibration group (n = 20), control group (n = 20), group B (n = 20). Each time 20 minutes, daily treatment, 5 days a week, continuous treatment for 3 weeks. Before and after intervention, the pain, swelling and range of motion of humerus joint of affected hand and wrist were evaluated by the standard of shoulder-hand syndrome, and the function of the affected hand and wrist was evaluated by Fugl-Meyer score of hand and wrist (0-24 points). Results: there was no significant difference in baseline value of each group before intervention (P 0.05). The scores of SHS pain and swelling were decreased in all three groups (P 0.05) and Fugl-Meyer score was increased (P 0.05). Compared with the control group, the scores of humeral abduction and humeral rotation in the combination group and vibration group were decreased (P 0.05), but there was no significant change in the routine group (P 0.05). Compared with the control group, the SHS pain, swelling, humeral abduction and humeral outerrotation score in the combined group were lower than those in the control group (P 0.05), and the pain in the combined group was significantly higher than that in the control group. The score of swelling was lower than that of vibration group (P 0.05), and the score of humerus rotation and abduction in combination group was not significantly different from that of vibration group (P 0.05). After intervention, there was no significant difference in SHS pain, swelling, humeral abduction, humeral rotation and Fugl-Meyer score between the two control groups (P 0.05). Adverse reactions during the trial were mild and transient. Conclusion: muscle vibration therapy combined with routine rehabilitation can more effectively alleviate the swelling and pain symptoms of shoulder-hand syndrome after stroke and promote the recovery of hand and wrist function. The treatment of muscle vibration is more acceptable and there is no obvious adverse reaction during stimulation.
【作者单位】：上海交通大学上海市第一人民医院;
【分类号】：R493;R743.3

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