发散式体外冲击波联合PNF治疗脑卒中患者踝关节功能障碍  

Radial Extracorporeal Shock Wave Therapy Combined with PNF in the Treatment of Ankle Dysfunction in Stroke Patients

作　　者：蒋灼 储晓红 黄明勇[2] 张宇虹[2] 杜书兰 于毅 JIANG Zhuo;CHU Xiao-hong;HUANG Ming-Yong;ZHANG Yu-hong;DU Shu-lan;YU Yi(School of Biomedical Engineering,Xinxiang Medical College,Xinxiang,Henan 453000;Department of Rehabilitation,Fifth Clinical College,Suizhou Central Hospital,Hubei Medical College,Suizhou,Hubei 441300,China)

机构地区：[1]新乡医学院生物医学工程学院,河南新乡453000 [2]湖北医药学院附属随州市中心医院第五临床学院康复教研室,湖北随州441300

出　　处：《湖北医药学院学报》2023年第6期632-636,641,共6页Journal of Hubei University of Medicine

基　　金：湖北省随州市卫生健康委科研项目(SZ2023013,2021SZ32039)。

摘　　要：目的:观察发散式体外冲击波(radial extracorporeal shock wave therapy,rESWT)联合本体感觉神经肌肉促进疗法(proprioceptive neuromuscular facilitation,PNF)治疗脑卒中患者的踝关节功能障碍的效果。方法:将符合条件的54名脑卒中后伴有踝关节功能障碍的患者分为3组,常规组每日接受抗痉挛药物治疗,rESWT组在常规组的基础上增加rESWT,每周接受1次治疗,联合组在rESWT组的基础上增加每周5次的PNF治疗,整个治疗过程为4周,在治疗前和治疗后第1、4、7周给予评估,评估方法采用可视化数字疼痛图表(visual analogue scale,VAS),关节活动度(range of motion,ROM),改良阿什沃斯肌张力评定量表(modified ashworth scale,MAS)。结果:联合组患者的VAS、MAS、ROM评分和常规组对比显著改善,和单纯rESWT组对比,远期效果更好,功能改善持续时间更长。结论:rESWT联合PNF治疗效果显著优于常规治疗,明显改善了患者踝关节的疼痛、肌张力、关节活动度和运动功能,可用于改善脑卒中后踝关节功能障碍。Objective To observe the effect of Radial Extracorporeal Shock Wave Therapy(rESWT)combined with proprio⁃ceptive neuromuscular facilitation(PNF)in the treatment of ankle joint dysfunction in stroke patients.Methods Fifty-four eligible post-stroke patients with ankle dysfunction were studied and divided into three groups.The conventional treatment group received antispasmodic medication every day,the rESWT treatment group added rESWT on the basis of the conven⁃tional group and received treatment once a week,and the combined treatment group added PNF treatment five times a week on the basis of the rESWT treatment group.The entire treatment process lasted for 4 weeks.Before and after the first week of treatment,evaluation was conducted using visual analogue scale(VAS),range of motion(ROM),and modified Ash⁃worth scale(MAS)on the 1st,4th and 7th week.Results The VAS,MAS,and ROM scores of patients in the rESWT combined with PNF treatment group were significantly improved compared with the conventional group.Compared with the rESWT group alone,the long-term effect was better and the functional improvement lasted longer.Conclusion The combi⁃nation of rESWT and PNF has a significantly better therapeutic effect than conventional treatment,significantly improving ankle pain,muscle tone,joint range of motion,and motor function in patients.It can be used to improve ankle dysfunction after stroke.

关 键 词：发散式体外冲击波 神经肌肉促进疗法 脑卒中 踝关节 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R687.4[医药卫生—临床医学]