发散式冲击波联合痉挛肌电刺激治疗脑卒中偏瘫患者肱二头肌痉挛的效果  

Clinical study on the treatment of biceps brachii spasticity in hemiplegic patients with stroke by radial extracorporeal shock wave therapy combined with spastic muscle electrical stimulation

作　　者：江剑华 沈仁泽 邱斐 何剑全[1] JIANG Jianhua;SHEN Renze;QIU Fei;HE Jianquan(Department of Rehabilitation Medicine,Zhongshan Hospital Xiamen University,Xiamen 361004,Fujian,China;不详)

机构地区：[1]厦门大学附属中山医院康复医学科,福建厦门361004 [2]厦门大学附属中山医院口腔科,福建厦门361004

出　　处：《实用医学杂志》2025年第4期529-535,共7页The Journal of Practical Medicine

基　　金：国家自然科学基金项目(编号:82004433)。

摘　　要：目的研究发散式冲击波联合痉挛肌电刺激治疗脑卒中偏瘫患者肱二头肌痉挛的疗效。方法选择2022年6月至2024年6月由医院收治并介入康复的98例肱二头肌痉挛的偏瘫患者,使用随机法将患者随机分配到两个不同的组别,各49例。对照组采用痉挛肌电刺激治疗患侧上肢肱二头肌,而观察组采用发散式冲击波联合痉挛肌电刺激治疗。干预2个月后,比较两组肌张力变化,日常生活能力,生活质量,运动功能表现的改善情况以及康复满意度和依从性。结果干预后,对照组改良Barthel指数和上肢FMA的评分,均低于观察组(P<0.05);对照组肌张力评定MAS量表的评分高于观察组(P<0.05);对照组的康复满意度和依从性均低于观察组(P<0.05);对照组各方面生活质量评分均低于观察组(P<0.05)。结论脑卒中偏瘫患者肱二头肌痉挛应用发散式冲击波联合痉挛肌电刺激治疗能降低患者肱二头肌的肌张力,缓解痉挛,增强患者的运动表现和自理能力,有助于提升整体生活质量,且无伴随药物治疗,安全性高,值得推广。Objective A study of the therapeutic effect of the treatment of biceps brachii spasticity in hemiplegic patients with stroke by radial extracorporeal shock wave therapy combined with spastic muscle electrical stimulation.Methods Select 98 cases of biceps spasticity hemiplegic patients admitted and intervened in rehabilitation in the Zhongshan Hospital Xiamen University from June 2022 to June 2024,and randomly assign the patients to two different groups,each with 49 cases,using a random method.The controlled group received spastic muscle electrical stimulation treatment for the affected upper limb biceps(the“Controlled Group”),while the observation group received radial extracorporeal shock wave therapy combined with spastic muscle electrical stimulation treatment(the“Observation Group”).After two months of intervention,the changes in muscle tone,activities of daily living,quality of life,improvement in motor function performance,as well as rehabilitation satisfaction and compliance were compared between the two groups.Results After the intervention,the modified Barthel index and the upper limb FMA scores of the Controlled Group were lower than those of the Observation Group(P<0.05);the muscle tone assessment MAS scale score of the Controlled Group was higher than that of the Observation Group(P<0.05);the rehabilitation satisfaction and compliance of the Controlled Group were lower than those of the Observation Group(P<0.05);the quality of life scores in all aspects of the Controlled Group were lower than those of the Observation Group(P<0.05).Conclusion The application of radial extracorporeal shock wave therapy combined with spastic muscle electrical stimulation treatment in treating biceps spasticity in hemiplegic patients with stroke can reduce the muscle tone of the patient′s biceps,alleviate spasticity,enhance the patient′s motor performance and self-care ability,as well as improve their overall quality of life,and there is no concomitant medication,which is highly safe and worth promoting.

关 键 词：脑卒中 偏瘫 肱二头肌痉挛 发散式冲击波 痉挛肌电刺激 运动功能 日常生活能力 生活质量 

分 类 号：R493[医药卫生—康复医学]