量化评估指标评价等速被动牵伸训练的疗效研究  

Study curative effect of quantitative evaluation index in evaluating isokinetic passive stretch training

作　　者：雷斌[1,2] 陆云 冉军[2] 贾瑶琪 靳仲夏 LEI Bin;LU Yun;RAN Jun;JIA Yaoqi;JIN Zhongxia(Affiliated Yangzhi Rehabilitation Hopsital,Tongji University/Shanhai Municipal Sunshine Rehabilitation Center,Shanghai 201619,China;Wuxi Guoji Rehabilitation Hospital,Wuxi,Jiangsu 214000,China)

机构地区：[1]同济大学附属养志康复医院/上海市阳光康复中心,上海201619 [2]无锡国济康复医院,江苏无锡214000

出　　处：《现代医药卫生》2021年第1期22-25,29,共5页Journal of Modern Medicine & Health

基　　金：上海市残疾人联合会科研入围项目(K2014029)。

摘　　要：目的应用肢体痉挛量化评估指标评估等速被动牵伸训练对痉挛的治疗作用。方法选取2017年6月至2019年6月同济大学附属养志康复医院/上海市阳光康复中心收治的脑卒中伴痉挛患者40例,其中改良Ashworth量表(MAS)1级、1+级、2级、3级患者各10例。采用等速测试系统以5°/s角速度被动牵伸训练20 min,分别于治疗前(T 0)、治疗后即刻(T 1)、治疗后20 min(T 2)测试5°/s及180°/s角速度的峰力矩(PT)、被动伸肘所做的功(Work)、Work差值及MAS。结果与T 0时比较,40例患者T 1时180°/s角速度的PT及Work,T 2时180°/s角速度的Work,以及T 1时5°/s角速度的Work、Work差值均明显改善,差异均有统计学意义(P<0.05);MAS 2级患者T 1时180°/s角速度的PT、Work、Work差值,以及T 2时180°/s角速度的PT均较T 0时明显改善,差异均有统计学意义(P<0.05);1、3级患者T 1、T 2时MAS较T 0时无明显变化,1+、2级患者改善较好。结论5°/s角速度进行等速被动牵伸训练20 min可有效改善痉挛,但对非神经因素的疗效并不理想,疗效可维持20 min左右,其中MAS 2级患者对治疗最敏感。Objective To evaluate the therapeutic effect of isokinetic passive stretch training on spasm by applying the quantitative evaluation index of limb spasm.Methods A total of 40 patients with stroke complicating spasm treated in these two hospitals from June 2017 to June 2019 were selected,including each 10 cases of modified Ashworth scale(MAS)grade 1,grade 1+,grade 2 and grade 3.The isokinetic test system was adopted to conduct the 20 min passive stretch training with 5°/s angle velocity.PT,Work,Work difference value and MAS were measured before treatment(T 0)and immediately after treatment(T 1)and at 20 min after treatment(T 2)respectively.Results Compared with at T 0,PT and Work with 180°/s angular velocity at T 1,Work 180°/s angular velocity at T 2,Work with 5°/s angular velocity at T 1 and Work difference value in 40 cases were significantly improved after treatment(T 1),and the difference were statistically significant(P<0.05).PT,Work and Work difference value with 180°/s angular velocity at T 1 in the patients with MAS grade 2 and PT with 180°/s angular velocity at T 2 were significantly improved compared with those at T 0,and the differences were statistically significant(P<0.05);MAS at T 1,T 2 in the patients with grade 1,3 had no obvious change compared with that at T 0,and the patients with grade 1+,2 were better improved.Conclusion The isokinetic passive stretch training with 5°/s angular velocity for 20 min can effectively improve the spasm.But the therapeutic effect on non-neurological factors is not satisfactory,and the therapeutic effect can be maintained for about 20 min.The patients with MAS grade 2 are the most sensitive to the treatment.

关 键 词：卒中 痉挛 治疗结果 牵伸训练 等速测试指标 

分 类 号：R493[医药卫生—康复医学] R743.3[医药卫生—临床医学]