低频脉冲电刺激结合上肢运动训练对脑卒中后肩手综合征患者上肢功能的影响  

Effect of low frequency pulsed electrical stimulation combined with upper limb motor training on upper limb function in patients with post-stroke shoulder hand syndrome

作　　者：孙玲 张青[1] 郭艮春 张文慧 SUN Ling;ZHANG Qing;GUO Genchun;ZHANG Wenhui(Yancheng Clinical College of Nanjing Medical University/Yancheng Third People’s Hospital/The Sixth Affiliated Hospital of Nantong University,Yancheng 224000,China)

机构地区：[1]南京医科大学盐城临床医学院、盐城市第三人民医院、南通大学第六附属医院,江苏盐城224000

出　　处：《中国实用神经疾病杂志》2025年第1期58-62,共5页Chinese Journal of Practical Nervous Diseases

基　　金：盐城市重点研发计划(社会发展)指导性项目(编号:YCBE202221)。

摘　　要：目的分析低频脉冲电刺激结合上肢运动训练对脑卒中后肩手综合征患者上肢功能的影响。方法选取2021-01—2023-01南通大学第六附属医院收治的100例脑卒中肩手综合征患者,按随机数字表分为观察组50例与对照组50例。对照组患者予以常规康复治疗,观察组患者在对照组基础上采取低频脉冲电刺激结合上肢运动训练,2组患者康复治疗均为8周,比较2组患者的临床疗效、上肢肌肉的表面肌电信号(s EMG)、肩手功能与关节活动度状况及并发症发生情况。结果观察组患者的总有效率94.00%,高于对照组患者的80.00%(P<0.05)。观察组患者治疗后肱二头肌、肱三头肌、腕伸肌、三角肌等上肢肌肉s EMG的RMS、MF水平均高于对照组(P<0.05),SHSS评分[(3.87±0.95)分]低于对照组[(5.32±1.04)分](P<0.05),肩、腕ROM评分[分别为(2.21±0.47)分、(2.26±0.49)分]均高于对照组[分别为(1.78±0.55)分、(1.82±0.50)分](P<0.05)。观察组患者并发症发生率8.00%,低于对照组患者的24.00%,差异有统计学意义(P<0.05)。结论低频脉冲电刺激结合上肢运动训练能够显著改善脑卒中肩手综合征患者的上肢功能和肩腕活动度,促进上肢肌肉sEMG指标恢复,临床疗效显著,并发症发生率低。Objective To investigate the effect of low frequency pulsed electrical stimulation combined with upper limb motor training on upper limb function in patients with shoulder hand syndrome after stroke.Methods From January 2021 to January 2023,100 patients with post-stroke shoulder hand syndrome admitted to the Sixth Affiliated Hospital of Nantong University were selected,who were divided into observation group(50 cases)and control group(50 cases)according to the random number table.Patients in the control group were treated by conventional rehabilitation treatment,and patients in the observation group were intervened by low-frequency pulsed electrical stimulation combined with upper limb exercise training on the basis of the control group.Rehabilitation treatment in both groups was 8 weeks.The clinical efficacy,surface myoelectric signal(sEMG)of the upper limb muscles,shoulder hand function and joint mobility status,and complications were compared between the two groups.Results The total response rate of patients in the observation group was 94.00%,which was higher than 80.00%in the control group.In the observation group,the RMS and MF levels of sEMG of upper limb muscles,such as biceps,triceps,wrist extensor,and deltoid,were higher than those in the control group.The SHSS score((3.87±0.95)points)in the observation group was lower than the control score((5.32±1.04)points)(P<0.05),shoulder and wrist ROM scores((2.21±0.47)points and(2.26±0.49)points,respectively)in the observation group were higher than the control group((1.78±0.55)points and(1.82±0.50)points,respectively)(P<0.05).The complication rate of 8.00%in the observation group was lower than 24.00%of the control group,the difference was statistically significant(P<0.05).Conclusion Low-frequency pulsed electrical stimulation combined with upper limb exercise training can significantly improve the upper limb function,and shoulder and wrist motion of stroke patients,and promote the recovery of sEMG index of upper limb muscles.The clinical efficacy is signi

关 键 词：脑卒中 肩手综合征 低频脉冲电刺激 上肢运动训练 上肢功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]