开链和闭链训练治疗脑卒中肩关节半脱位患者的临床疗效观察  

Clinical observation of open chain and closed chain training in treatment of shoulder subluxation after stroke

作　　者：黄超 HUANG Chao(Department of Neurology,Second Affiliated Hospital of Nanchang University,Nanchang City,Jiangxi Province,330001,China)

机构地区：[1]南昌大学第二附属医院神经内科,江西南昌330001

出　　处：《蛇志》2023年第3期360-363,398,共5页Journal of Snake

摘　　要：目的探讨开链与闭链联合训练治疗脑卒中肩关节半脱位的临床疗效。方法选择我院2022年1月至2023年1月收治的脑卒中肩关节半脱位患者60例,采用随机数字表法分为对照组和观察组,每组30例。对照组采用常规开链训练,观察组采取开链与闭链联合训练,比较两组患者训练前及训练第4、8周时的肩部疼痛程度、上体运动功能、日常生活能力改善情况及临床疗效。结果训练前,两组患者视觉模拟评分法(VAS)、简化Fugl-Meyer运动功能量表(FMA)、改良Barthel指数评分法(MBI)评分比较,差异均无统计学意义(均P>0.05);训练第4、8周时,两组患者的VAS评分均逐渐降低,FMA、MBI评分均逐渐升高,差异均具有统计学意义(均P<0.001);且观察组训练第4、8周时的VAS评分均低于对照组,FMA、MBI评分均高于对照组,差异均有统计学意义(均P<0.05)。两组患者的临床效果比较,观察组的总有效率为93.33%高于对照组的73.33%,差异有统计学意义(P<0.05)。结论开链与闭链联合训练治疗脑卒中肩关节半脱位的临床效果显著,可有效改善脑卒中肩关节半脱位患者的上肢运动功能,缓解肩部疼痛程度,提高日常生活活动能力。Objective To explore the clinical effect of combined open-chain and closed-chain training on the treatment of shoulder subluxation after stroke and its influence on the degree of shoulder pain,upper body motor function and daily living ability of patients.Methods 60 patients with shoulder subluxation after stroke admitted to our hospital from January 2022 to January 2023 were selected.They were divided into control group and observation group by random number method,with 30 cases in each group.The control group received routine open-chain training,while the observation group received open-chain and closed-chain training.The improvement of shoulder pain,upper body motor function,daily living ability and clinical efficacy were compared between the two groups before training,4 weeks and 8 weeks after training.Results Before training,there was no significant difference in VAS,FMA and MBI scores between the two groups(all P>0.05);After 4 and 8 weeks of training,the VAS scores of both groups decreased gradually,while the FMA and MBI scores increased gradually(all P<0.001);The VAS score of the observation group was lower than that of the control group after 4 and 8 weeks of training,and the FMA and MBI scores were higher than those of the control group(all P<0.05);The total effective rate of the observation group was 93.33%higher than that of the control group(73.33%,P<0.05).Conclusion The combined open-chain and closed-chain training can significantly improve the upper limb motor function of patients with shoulder subluxation after stroke,relieve the degree of shoulder pain,and improve the ability of daily living.The clinical effect is satisfactory.

关 键 词：开链训练 闭链训练 脑卒中 肩关节半脱位 康复效果 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]