本文選題：肌肉振動(dòng)治療 + 腦卒中��； 參考：《中國(guó)康復(fù)醫(yī)學(xué)雜志》2017年08期

【摘要】：目的:探討3周肌肉振動(dòng)治療結(jié)合常規(guī)康復(fù)方案對(duì)腦卒中后肩-手綜合征(SHS)的臨床療效。方法:將60例患者隨機(jī)分為振動(dòng)與常規(guī)康復(fù)結(jié)合組(試驗(yàn)組,20例)、振動(dòng)組(對(duì)照組A組,20例)、常規(guī)組(對(duì)照組B組,20例),肌肉振動(dòng)治療由經(jīng)過(guò)專(zhuān)門(mén)培訓(xùn)的治療師進(jìn)行,每次用時(shí)20 min,每日治療1次,每周治療5天,持續(xù)治療3周。干預(yù)前后采用肩-手綜合征評(píng)分標(biāo)準(zhǔn)對(duì)患手及腕關(guān)節(jié)疼痛、腫脹及患側(cè)肱骨關(guān)節(jié)活動(dòng)度進(jìn)行評(píng)定,同時(shí)采用手及腕部Fugl—Meyer評(píng)分法(0—24分)對(duì)患手及腕功能進(jìn)行評(píng)定。結(jié)果:干預(yù)前各組基線(xiàn)值無(wú)顯著意義差別(P0.05)。三組SHS疼痛、腫脹得分均有所降低(P0.05),Fugl-Meyer評(píng)分提高(P0.05)。組內(nèi)對(duì)比,干預(yù)后結(jié)合組及振動(dòng)組肱骨外展及肱骨外旋得分有所降低(P0.05),常規(guī)組無(wú)明顯變化(P0.05)。三組組間比較,干預(yù)后結(jié)合組SHS疼痛、腫脹,肱骨外展及肱骨外旋得分較常規(guī)組低(P0.05);FuglMeyer評(píng)分(FMA)較兩對(duì)照組高(P0.05);結(jié)合組疼痛、腫脹得分較振動(dòng)組低(P0.05);結(jié)合組肱骨外旋及外展得分與振動(dòng)組無(wú)明顯差異(P0.05)。干預(yù)后兩對(duì)照組SHS疼痛、腫脹、肱骨外展、肱骨外旋及Fugl-Meyer評(píng)分得分無(wú)明顯差異(P0.05)。試驗(yàn)過(guò)程中不良反應(yīng)輕微而且短暫。結(jié)論:肌肉振動(dòng)治療結(jié)合常規(guī)康復(fù)可以更加有效地減輕腦卒中后肩-手綜合征的腫脹、疼痛癥狀,促進(jìn)手及腕部功能恢復(fù);肌肉振動(dòng)治療可以擴(kuò)大肱骨外展及外旋活動(dòng)度;肌肉振動(dòng)治療的可接受性強(qiáng),刺激過(guò)程中未見(jiàn)明顯不良反應(yīng)。
[Abstract]:Objective: to investigate the clinical effect of 3 weeks muscle vibration therapy combined with routine rehabilitation in the treatment of shoulder-hand syndrome (SHS) after stroke. Methods: sixty patients were randomly divided into two groups: vibration group (n = 20), control group (n = 20), group B (n = 20). Each time 20 minutes, daily treatment, 5 days a week, continuous treatment for 3 weeks. Before and after intervention, the pain, swelling and range of motion of humerus joint of affected hand and wrist were evaluated by the standard of shoulder-hand syndrome, and the function of the affected hand and wrist was evaluated by Fugl-Meyer score of hand and wrist (0-24 points). Results: there was no significant difference in baseline value of each group before intervention (P 0.05). The scores of SHS pain and swelling were decreased in all three groups (P 0.05) and Fugl-Meyer score was increased (P 0.05). Compared with the control group, the scores of humeral abduction and humeral rotation in the combination group and vibration group were decreased (P 0.05), but there was no significant change in the routine group (P 0.05). Compared with the control group, the SHS pain, swelling, humeral abduction and humeral outerrotation score in the combined group were lower than those in the control group (P 0.05), and the pain in the combined group was significantly higher than that in the control group. The score of swelling was lower than that of vibration group (P 0.05), and the score of humerus rotation and abduction in combination group was not significantly different from that of vibration group (P 0.05). After intervention, there was no significant difference in SHS pain, swelling, humeral abduction, humeral rotation and Fugl-Meyer score between the two control groups (P 0.05). Adverse reactions during the trial were mild and transient. Conclusion: muscle vibration therapy combined with routine rehabilitation can more effectively alleviate the swelling and pain symptoms of shoulder-hand syndrome after stroke and promote the recovery of hand and wrist function. The treatment of muscle vibration is more acceptable and there is no obvious adverse reaction during stimulation.
【作者單位】： 上海交通大學(xué)上海市第一人民醫(yī)院;
【分類(lèi)號(hào)】：R493;R743.3

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