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

【摘要】：目的:探討3周肌肉振動治療結(jié)合常規(guī)康復(fù)方案對腦卒中后肩-手綜合征(SHS)的臨床療效。方法:將60例患者隨機分為振動與常規(guī)康復(fù)結(jié)合組(試驗組,20例)、振動組(對照組A組,20例)、常規(guī)組(對照組B組,20例),肌肉振動治療由經(jīng)過專門培訓(xùn)的治療師進(jìn)行,每次用時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-手綜合征評分標(biāo)準(zhǔn)對患手及腕關(guān)節(jié)疼痛、腫脹及患側(cè)肱骨關(guān)節(jié)活動度進(jìn)行評定,同時采用手及腕部Fugl—Meyer評分法(0—24分)對患手及腕功能進(jìn)行評定。結(jié)果:干預(yù)前各組基線值無顯著意義差別(P0.05)。三組SHS疼痛、腫脹得分均有所降低(P0.05),Fugl-Meyer評分提高(P0.05)。組內(nèi)對比,干預(yù)后結(jié)合組及振動組肱骨外展及肱骨外旋得分有所降低(P0.05),常規(guī)組無明顯變化(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評分(FMA)較兩對照組高(P0.05);結(jié)合組疼痛、腫脹得分較振動組低(P0.05);結(jié)合組肱骨外旋及外展得分與振動組無明顯差異(P0.05)。干預(yù)后兩對照組SHS疼痛、腫脹、肱骨外展、肱骨外旋及Fugl-Meyer評分得分無明顯差異(P0.05)。試驗過程中不良反應(yīng)輕微而且短暫。結(jié)論:肌肉振動治療結(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);肌肉振動治療可以擴大肱骨外展及外旋活動度;肌肉振動治療的可接受性強,刺激過程中未見明顯不良反應(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;
【分類號】：R493;R743.3

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