肩部控制训练联合神经松动术对脑卒中偏瘫患者肩痛及上肢功能的效果

doi:10.3969/j.issn.1006-9771.2024.01.011

《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (1): 81-86.doi: 10.3969/j.issn.1006-9771.2024.01.011

肩部控制训练联合神经松动术对脑卒中偏瘫患者肩痛及上肢功能的效果

胡永林, 马颖, 窦超, 陆安民, 江小鸽, 宋新建, 肖玉华()

南通市第二人民医院/南通大学附属南通康复医院康复医学科，江苏南通市 226002

收稿日期:2023-07-13 修回日期:2023-12-20 出版日期:2024-01-25 发布日期:2024-02-04
通讯作者: 肖玉华(1965-)，女，汉族，江苏南通市人，主任护师，主要研究方向：中枢瘫后功能重建、康复评定、治疗及康复管理。E-mail：770030340@qq.com
作者简介:胡永林(1986-)，男，汉族，江苏淮安市人，硕士研究生，副主任技师，主要研究方向：脑血管病的康复治疗及管理。
基金资助:
南通市卫生健康委员会科技计划项目(QA2021034)

Effect of neural mobilization based on shoulder control training on shoulder pain and upper limb function in stroke patients with hemiplegia

HU Yonglin, MA Ying, DOU Chao, LU Anmin, JIANG Xiaoge, SONG Xinjian, XIAO Yuhua()

Rehabilitation Medicine Department, the Second People's Hospital of Nantong/Affiliated Nantong Rehabilitation Hospital of Nantong University, Nantong, Jiangsu 226002, China

Received:2023-07-13 Revised:2023-12-20 Published:2024-01-25 Online:2024-02-04
Contact: XIAO Yuhua, E-mail: 770030340@qq.com
Supported by:
Nantong Health Commission Science and Technology Plan(QA2021034)

摘要/Abstract

摘要：

目的观察肩部控制训练基础上联合神经松动术治疗脑卒中偏瘫患者肩痛的效果。

方法 2020年1月至2021年11月，南通市第二人民医院脑卒中偏瘫患者43例，随机分为对照组(n = 21)和治疗组(n = 22)。对照组采用肩部控制训练，治疗组加用神经松动术。治疗前、治疗4周后，采用疼痛数字表法(NRS)和Fugl-Meyer评定量表上肢部分(FMA-UE)进行评定。

结果对照组脱落1例，治疗组脱落2例。两组治疗后NRS和FMA-UE评分显著改善(|t| > 7.898, P < 0.001)，且治疗组优于对照组(|t| > 2.337, P < 0.05)。

结论肩部控制训练联合神经松动术能显著缓解脑卒中偏瘫患者的肩痛，改善其上肢运动功能。

关键词: 脑卒中, 偏瘫, 肩痛, 神经松动术, 肩部控制训练

Abstract:

Objective To observe the effect of neural mobilization based on shoulder control training on shoulder pain and upper limb function in stroke patients with hemiplegia.

Methods From January, 2020 to November, 2021, 43 patients with hemiplegia after stroke in the Second People's Hospital of Nantong were randomly divided into control group (n = 21) and treatment group (n = 22). The control group received shoulder control training, while the treatment group received neural mobilization in addition. Before and after four weeks of treatment, they were evaluated with the Numeric Rating Scale (NRS) of pain and Fugl-Meyer Assessment-Upper Extremities (FMA-UE).

Results One case dropped off in the control group and two cases dropped off in the treatment group. After treatment, the NRS score and FMA-UE score improved in both groups (|t| >7.898, P< 0.001), and they were better in the treatment group than in the control group (|t| >2.337, P< 0.05).

Conclusion Neural mobilization based on shoulder control training can significantly alleviate shoulder pain and improve upper limb motor function in stroke patients with hemiplegia.

Key words: stroke, hemiplegia, shoulder pain, neural mobilization, shoulder control training

中图分类号:

R743.3

胡永林, 马颖, 窦超, 陆安民, 江小鸽, 宋新建, 肖玉华. 肩部控制训练联合神经松动术对脑卒中偏瘫患者肩痛及上肢功能的效果[J]. 《中国康复理论与实践》, 2024, 30(1): 81-86.

HU Yonglin, MA Ying, DOU Chao, LU Anmin, JIANG Xiaoge, SONG Xinjian, XIAO Yuhua. Effect of neural mobilization based on shoulder control training on shoulder pain and upper limb function in stroke patients with hemiplegia[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 81-86.

图/表 3

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组别	n	性别(男/女)/n	年龄/岁	病程/d	脑卒中类型(梗死/出血)/n	偏瘫侧别(左/右)/n
对照组	21	12/9	56.67±9.72	55.62±22.75	12/9	10/11
治疗组	22	15/7	57.64±9.43	52.82±21.44	12/10	13/9
t/χ²值		0.560	-0.332	0.416	0.029	0.568
P值		0.454	0.742	0.680	0.864	0.451

组别	n	治疗前	治疗后	t值	P值
对照组	20	5.75±1.33	4.10±1.12	9.903	< 0.001
治疗组	20	5.90±1.48	3.10±1.55	11.854	< 0.001
t值		-0.336	2.337
P值		0.738	0.025

组别	n	治疗前	治疗后	t值	P值
对照组	20	25.90±8.27	31.35±6.23	-7.898	< 0.001
治疗组	20	24.75±7.48	40.75±7.21	-35.315	< 0.001
t值		0.461	-4.413
P值		0.647	< 0.001

肩部控制训练联合神经松动术对脑卒中偏瘫患者肩痛及上肢功能的效果

Effect of neural mobilization based on shoulder control training on shoulder pain and upper limb function in stroke patients with hemiplegia

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