上肢加压振动联合悬吊治疗对脑卒中后肩关节半脱位及功能的疗效观察  

Effects of upper extremity compression vibration combined with sling exercise therapy on glenohumeral subluxation and function in stroke patients

作　　者：刘宝祥 胡川 王欣 Liu Baoxiang;Hu Chuan;Wang Xin(Department of Rehabilitation Medicine, Shandong Provincial Third Hospital, Jinan 250031, China)

机构地区：[1]山东省立第三医院康复医学中心,济南250031

出　　处：《中国康复》2022年第4期200-203,共4页Chinese Journal of Rehabilitation

基　　金：山东省基层卫生协会2020年度基层卫生科技创新计划立项课题(JCK20004)。

摘　　要：目的:观察上肢加压振动联合悬吊治疗对脑卒中后肩关节半脱位及功能的治疗效果。方法:将60例脑卒中后肩关节半脱位的患者随机分为观察组和对照组,各30例。对照组采用悬吊治疗系统进行患侧上肢的闭链运动训练,观察组采用上肢加压振动与悬吊训练相结合的训练方案。治疗前后分别进行患侧肩关节影像学肩峰到肱骨头的间距(AHI)、肩部疼痛视觉模拟量表(VAS)、被动关节活动范围(PROM)(前屈、水平外展、内收三个方向)、Fugl-Meyer运动功能量表上肢部分(FMA-UE)、改良Barthel指数(MBI)及改良诺丁汉感觉评估(rNSA)的评估。结果:治疗4周后,2组的AHI值及VAS评分均较治疗前明显下降(P<0.05),且观察组明显低于对照组(P<0.05);2组的PROM、FMA-UE、MBI和rNSA评分治疗4周后较治疗前均明显提高(P<0.05),且观察组明显高于对照组(P<0.05)。结论:上肢加压振动联合悬吊治疗能改善脑卒中后肩关节半脱位的程度、缓解疼痛,提高关节活动度及上肢功能。Objective:To observe the effects of upper extremity compression vibration combined with sling exercise therapy(SET)on glenohumeral subluxation and function in stroke patients.Methods:A total of 60 stroke patients with glenohumeral subluxation were randomly divided into treatment group and control group,30 cases in each group.The control group used SET system for closed kinetic chain exercise on the affected upper extremity,and the treatment group was given the affected upper extremity compression vibration combined with SET.The acromion humeral interval(AHI),the degree of shoulder pain by visual analogue scale(VAS),the passive range of motion of the shoulder(three directions of glenohumeral joint flexion,horizontal abduction,and adduction),the upper extremity portion of the Fugl-Meyer motor assessment(FMA-UE),Modified Barthel Index(MBI)and revised Nottingham Sensory Assessment(rNSA)were evaluated before and after treatment.Results:Before the treatment,there was no significant difference in AHI,VAS,PROM,FMA-UE,MBI and rNSA(P>0.05).After 4 weeks of treatment,there was significant improvement in the scores of AHI,VAS,PROM,FMA-UE,MBI and rNSA in both groups as compared with those before treatment(P<0.05),and the scores in the treatment group were higher than those in the control group(P<0.05).Conclusion:Upper extremity compression vibration combined with SET can improve the degree of glenohumeral subluxation and the passive range of motion and function,and relieve pain in post-stroke patients.

关 键 词：脑卒中 振动治疗 悬吊治疗 肩关节半脱位 功能 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]