摘要
目的观察放散式体外冲击波对脑梗死患者下肢痉挛状态和步行能力的影响。方法将20例伴有下肢痉挛状态的初发脑梗死患者,采用随机数字表法分为治疗组和对照组,每组各10例,所有患者均接受常规康复治疗,包括关节松动、牵伸技术、神经肌肉促进技术等。治疗组脑梗死患者患侧胫后肌和小腿三头肌给予放散式体外冲击波治疗,对照组给予安慰剂刺激。治疗前、治疗3周后,对患者进行综合痉挛评分(CSS)、积分肌电值(IEMG)、站立行走测试(TUGT)三项评定。结果治疗前,治疗组和对照组CSS、IEMG、TUGT评分分别为(13.50±1.51)分和(14.00±1.83)分、(246.78±281.23)μV·s和(168.55±194.06)μV·s、(41.29±24.80)和(51.45±17.83)s,组间比较差异无统计学意义(P>0.05)。治疗3周结束后,治疗组和对照组患者上述指标分别为(11.10±1.66)和(14.90±1.20)分、(336.45±299.61)和(269.55±259.21)μV·s、(31.00±17.73)和(44.11±17.69)s,除CSS评分外,均较治疗前显著改善(P<0.05),且治疗组CSS评分与治疗前及对照组相比明显降低(P<0.05),IEMG和TUGT评分组间比较差异无统计学意义(P>0.05)。结论放散式体外冲击波疗法可以降低脑梗死患者下肢痉挛程度,但3周时间并未观测到步行功能改善。
Objective To assess whether mobility and the extend of spasticity could be improved in poststroke subjects by treating tibialis posterior and spastic calf muscles with radial extracorporeal shock wave therapy.Methods 20 first-ever stroke patients were randomly divided into a treatment group and a control group.Each group contained 10 subjects and all patients received the same conventional therapy such as joint mobilization,neuromuscular facilitation technique et al.In addition,the treatment group and the control group were also given radial extracorporeal shock wave therapy and placebo stimulation on the spastic calf muscles and tibialis posterior,respectively.All the conventional therapies were set once a day for 120 minutes,5 days a week,3 weeks totally.However,the shock wave therapy and placebo stimulation were once a week,3 times.Composite spasticity scale(CSS),timed"up&go"test(TUGT)and integrated electromyography(IEMG)of tibialis anterior were evaluated for each patients before and after the treatment.ResultsThe baseline CSS scores in treatment group and control group were 13.50±1.51 and 14.00±1.83 points,the corresponding IEMG and TUGT were 246.78±281.23 and 168.55±194.06μV·s,41.29±24.80 and 51.45±17.83 s,respectively.There was no significant difference between the two groups in terms of all the assessments before treatment(P>0.05).At the end of the treatment,the average CSS,IEMG and TUGT were 11.10±1.66 and 14.90±1.20 points,336.45±299.61 and 269.55±259.21μV·s,31.00±17.73 and 44.11±17.69 s,respectively.All the assessments were significantly improved before treatment except CSS in control group(P<0.05).CSS score in the treatment group was lower than that in the control group(P<0.05).There was no significant difference in IEMG and TUGT between groups(P>0.05).Conclusion Radial extracorporeal shock wave therapy can effectively relieve the spasticity of hemiplegic lower extremity in stroke subjects,but have no effect on active function.
作者
宋小慧
纵亚
崔立军
谢青
SONG Xiao⁃hui;ZONG Ya;CUI Li⁃jun;Xie Qing(Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)
出处
《解剖学研究》
CAS
2020年第3期253-257,共5页
Anatomy Research
基金
上海市临床重点专科项目(shslczdzk02701)
关键词
冲击波
痉挛
步态
脑卒中
Shock wave
Spasticity
Mobility
Stroke
