摘要
目的探讨基于表面肌电信号评价的蜡疗联合康复护理治疗脑卒中后肩手综合征的疗效。方法选取脑卒中后肩手综合征78例患者,分成2组,对照组采用常规康复护理和训练,试验组在对照组的基础上联合蜡疗。在干预前、干预第2周、干预第4周结束时分别采用视觉模拟评分法(VAS)测定患者手腕部及肩部疼痛强度;采用Fugl-Meyer(FMA)对患者患侧上肢及手功能进行评定;采用表面肌电(sEMG)对患侧旋前圆肌和三角肌肌力进行测定,客观评价肌力改善情况。结果干预的2周及干预后4周,试验组患者手腕部及肩部疼痛程度、上肢运动功能与干预前相比均有改善(P<0.05),且试验组的改善程度优于对照组(P<0.05);干预的2周及干预后4周,肩关节拮抗肌群中位频率(MF)、平均功率频率(MPF)协同收缩率明显增高,平均肌电值(AEMG)协同收缩率明显下降,且试验组协同收缩率改善优于对照组(P<0.05);试验组患者总有效率高于对照组(84.6%/64.1%),差异显著(P<0.05)。结论蜡疗联合康复护理能改善脑卒中后肩手综合征患者的上肢功能,提高肩关节拮抗肌群的协同收缩率,提高临床疗效。
Objective To explore the clinical study of wax therapy combined with rehabilitation care in rehabilitation of post-stroke shoulder hand syndrome patients by surface electromyography.Methods Seventy eight cases of post-stroke shoulder-hand syndrome patients were collected and divided into two groups.The control group was treated with routine rehabilitation nursing training.The treatment group was treated with Wax therapy on the basis of the control group.Visual acuity scale(VAS)was used to measure the wrist and shoulder pain intensity before intervention and at the end of 4 weeks.Fugl-Meyer(FMA)was used to assess the upper extremity and hand function.Electromyography(sEMG)on the affected side of the pronator and deltoid muscle strength were measured,the objective evaluation of muscle strength improvement. Results After intervention for 2 weeks and 4 weeks,in two groups patients with Wrist and shoulder pain degree,upper limb motor function life were improved(P<0.05),and the improvement of the study group was superior to that in the control group(P<0.05);After intervention for 2 weeks and 4 weeks,the MF,MPF signais in the co-contraction scores in both groups were increased significantly as compared with those before treatment(P<0.05);the sEMG signais in the co-contraction scores in both groups were decreased significantly as compared with those before treatment(P<0.05),which was more marked in study group(P<0.05);The rates of effective was significantly higher in the study group was than that in the control group(84.6%/64.1%)(P<0.05).Conclusion Wax therapy combined with rehabilitation nursing can improve the upper limb function of patients with post-stroke shoulder-hand syndrome,increase the synergistic contraction rate of shoulder joint antagonistic muscle group and improve the clinical curative effect.
作者
罗文群
林芝
Luo Wenqun;Lin Zhi(Rehabilitation Pepartment,Neijiang Second People′s Hospital,Neijiang 641000,China)
出处
《海军医学杂志》
2019年第5期468-470,共3页
Journal of Navy Medicine
关键词
肩手综合征
脑卒中
蜡疗
Shoulder hand syndrome
Stroke
Wax therapy
