摘要
目的探讨神经肌肉电刺激(NMES)联合肩胸关节训练对卒中后偏瘫肩痛(HSP)患者疼痛及上肢功能的影响,以期为卒中后HSP患者康复策略的制定提供参考。方法采用随机数字表法将2021年2月—2024年2月江油市九〇三医院收治的152例卒中后HSP患者分为对照组(n=76)和联合组(n=76)。对照组患者接受肩胸关节训练,联合组患者接受NMES联合肩胸关节训练。比较2组患者治疗前后的疼痛程度、上肢功能、肩关节功能及日常生活能力等指标。结果治疗前,2组患者视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05);治疗后,2组患者VAS评分均低于治疗前,且联合组低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者上肢运动功能评定量表(FMA-UE)评分和上肢功能独立性评定量表(FIM)评分比较,差异均无统计学意义(P>0.05);治疗后,2组患者FMA-UE评分和FIM评分均高于治疗前,且联合组均高于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者Constant-Murley肩关节功能评分量表(CMS)的肩关节活动度、力量测试、疼痛、日常活动4个维度评分比较,差异均无统计学意义(P>0.05);治疗后,2组患者CMS的4个维度评分均高于治疗前,且联合组均高于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者改良Barthel指数评定量表(MBI)评分比较,差异无统计学意义(P>0.05);治疗后,2组患者MBI评分均高于治疗前,且联合组高于对照组,差异均有统计学意义(P<0.05)。结论NMES联合肩胸关节训练可以显著减轻卒中后HSP患者的疼痛程度,改善患者上肢功能及肩关节功能,并提高患者的日常生活能力。
Objective To investigate the effects of neuromuscular electrical stimulation(NMES)combined with scapulothoracic joint training on pain and upper limb function in post-stroke patients with hemiplegic shoulder pain(HSP),aiming to provide references for developing rehabilitation strategies.Methods Using a random number table,152 post-stroke HSP patients admitted to Jiangyou 903 Hospital from February 2021 to February 2024 were assigned to a control group(n=76)and a combined group(n=76).The control group received scapulothoracic joint training alone,while the combined group received NMES combined with scapulothoracic joint training.Pain levels,upper limb function,shoulder joint function,and activities of daily living were compared between the two groups before and after treatment.Results Before treatment,no significant difference was observed in Visual Analogue Scale(VAS)scores between groups(P>0.05);after treatment,VAS scores decreased in both groups compared to pre-treatment levels,with the combined group showing lower scores than the control group,with statistically significant differences(P<0.05).Before treatment,Fugl-Meyer Assessment for Upper Extremity(FMA-UE)scores and Functional Independence Measure(FIM)scores showed no significant intergroup differences(P>0.05);after treatment,both FMA-UE and FIM scores increased in both groups compared to pre-treatment levels,with the combined group demonstrating higher scores than the control group,with statistically significant differences(P<0.05).Before treatment,no significant differences were observed in the four dimensions of the Constant-Murley Shoulder Score(CMS)-range of motion,strength testing,pain,and activities of daily living-between groups(P>0.05);after treatment,all CMS dimension scores increased in both groups compared to pre-treatment levels,with the combined group showing higher scores than the control group,with statistically significant differences(P<0.05).Before treatment,Modified Barthel Index(MBI)scores showed no significant intergroup difference(P>0.05);after treatment,MBI scores increased in both groups compared to pre-treatment levels,with the combined group scoring higher than the control group,with statistically significant differences(P<0.05).Conclusion NMES combined with scapulothoracic joint training markedly reduces pain,improves upper limb and shoulder function,and raises activities of daily living in post-stroke HSP patients.
作者
文皓
徐涛
高政
阚烨
陈瑜川
郭纯良
李刚
Wen Hao;Xu Tao;Gao Zheng;Kan Ye;Chen Yuchuan;Guo Chunliang;Li Gang(Department of Rehabilitation Medicine,Jiangyou 903 Hospital,Jiangyou Sichuan 621700,China;Department of Rehabilitation Medicine,Jiangyou People's Hospital,Jiangyou Sichuan 621700,China;Department of Orthopedics,West China Hospital,Sichuan University,Chengdu 610000,China)
出处
《保健医学研究与实践》
2025年第3期100-105,124,共7页
Health Medicine Research and Practice
基金
四川省自然科学基金项目(22NSFSC1296)。
关键词
神经肌肉电刺激
肩胸关节训练
脑卒中
偏瘫肩痛
疼痛
上肢功能
生活质量
Neuromuscular electrical stimulation
Scapulothoracic joint training
Stroke
Hemiplegic shoulder pain
Pain
Upper limb function
Quality of life
