悬吊推拿运动对脑卒中恢复期上肢痉挛的效果

doi:10.3969/j.issn.1006-9771.2022.11.003

Abstract

Abstract:

Objective To explore the clinical efficacy of sling-massage exercise on upper limb spasticity for stroke patients.

Methods From March, 2021 to January, 2022, 60 patients with hemiplegia and spasticity from the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine were randomly divided into control group (n= 30) and experimental group (n= 30). Both groups accepted conventional therapy; additionally, the control group accepted stretching training, while the experimental group accepted sling-massage exercise, for four weeks. They were assessed with modified Ashworth Scale (MAS), Fugl-Meyer Assessment-Upper Extremities (FMA-UE), modified Barthel Index (MBI), H-reflex latency and the Hmax/Mmax ratio before and after treatment; while the root mean square (RMS) and integrated electromyography (iEMG) of the affected biceps brachii, triceps brachii, wrist flexor and wrist extensor were measured with surface electromyography.

Results All the indexes improved after treatment in both groups (|t| > 2.411, |Z| > 4.441, P< 0.05), and the MAS scores of some muscles, FMA-UE score, MBI score, H-reflex latency, RMS and the iEMG of some muscles improved more in the experimental group than in the control group (|t| > 2.149, |Z| > 2.037, P< 0.05).

Conclusion Sling-massage exercise could improve upper limb spasticity, upper limb motor function and activities of daily living for stroke patients.

Key words: stroke, hemiplegia, spasm, sling exercise, massage, reciprocal inhibition

CLC Number:

R743.3

LI Zewen,ZHANG Peixiao,LI Li. Effect of sling-massage exercise on upper limb spasticity for stroke patients at recovery stage[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(11): 1252-1258.

Figures/Tables 16

References 35

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组别	n	性别(男/女)/n	年龄/岁	病程/周	卒中类型(缺血/出血)/n	偏瘫侧(左/右)/n
对照组	30	16/14	59.93±7.15	9.30±4.55	19/11	12/18
试验组	30	18/12	60.27±6.14	8.97±4.14	16/14	13/17
χ²/t值		0.271	-0.194	0.297	0.617	0.069
P值		0.602	0.847	0.768	0.432	0.793

组别	n	治疗前	治疗后	Z值	P值
对照组	30	3(3, 4)	1(1, 2)	-4.615	< 0.001
试验组	30	3(3, 4)	1(0, 1)	-4.672	< 0.001
Z值		-0.645	-2.145
P值		0.519	0.032

组别	n	治疗前	治疗后	Z值	P值
对照组	30	3(3, 4)	2(1, 2)	-4.815	< 0.001
试验组	30	3(3, 4)	1(1, 2)	-4.617	< 0.001
Z值		-0.761	-2.037
P值		0.446	0.042

组别	n	治疗前	治疗后	Z值	P值
对照组	30	3(3, 4)	2(1, 2)	-4.441	< 0.001
试验组	30	3(3, 4)	1(1, 2)	-4.765	< 0.001
Z值		-0.564	-1.746
P值		0.573	0.081

组别	n	治疗前	治疗后	t值	P值
对照组	30	28.67±8.05	41.83±7.15	-8.283	< 0.001
试验组	30	27.80±7.46	47.20±6.24	-11.677	< 0.001
t值		0.432	-3.096
P值		0.667	0.003

Effect of sling-massage exercise on upper limb spasticity for stroke patients at recovery stage

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组别	n	治疗前	治疗后	t值	P值
对照组	30	39.50±11.19	63.73±11.12	-9.121	< 0.001
试验组	30	40.63±11.42	72.07±10.87	-11.913	< 0.001
t值		-0.388	-2.936
P值		0.699	0.005

组别	n	治疗前	治疗后	t值	P值
对照组	30	26.97±12.03	12.94±7.15	9.956	< 0.001
试验组	30	27.65±11.27	8.75±4.81	11.964	< 0.001
t值		-0.226	2.660
P值		0.822	0.010

组别	n	治疗前	治疗后	t值	P值
对照组	30	13.25±5.30	7.35±3.96	7.894	< 0.001
试验组	30	12.82±5.61	5.36±2.11	7.452	< 0.001
t值		0.305	2.431
P值		0.761	0.018

组别	n	治疗前	治疗后	t值	P值
对照组	30	23.27±11.12	10.36±4.22	7.833	< 0.001
试验组	30	23.57±11.64	7.22±2.78	8.399	< 0.001
t值		-0.099	3.404
P值		0.922	0.001

组别	n	治疗前	治疗后	t值	P值
对照组	30	10.25±3.64	6.54±2.72	5.288	< 0.001
试验组	30	9.98±3.26	4.82±2.16	7.920	< 0.001
t值		0.313	2.698
P值		0.755	0.009

组别	n	治疗前	治疗后	t值	P值
对照组	30	30.94±9.19	40.08±10.46	-18.317	< 0.001
试验组	30	29.88±8.42	45.29±10.37	-30.568	< 0.001
t值		0.466	-1.933
P值		0.643	0.058

组别	n	治疗前	治疗后	t值	P值
对照组	30	35.32±9.77	40.13±8.43	-8.400	< 0.001
试验组	30	34.92±10.04	45.25±9.73	-23.276	< 0.001
t值		0.159	-2.179
P值		0.874	0.033

组别	n	治疗前	治疗后	t值	P值
对照组	30	47.35±10.47	61.13±8.48	-21.928	< 0.001
试验组	30	51.07±11.59	68.28±11.44	-23.994	< 0.001
t值		-1.305	-2.750
P值		0.197	0.008

组别	n	治疗前	治疗后	t值	P值
对照组	30	65.75±11.92	84.89±13.05	-36.647	< 0.001
试验组	30	69.47±11.84	92.35±13.85	-25.952	< 0.001
t值		-1.212	-2.149
P值		0.230	0.036

组别	n	治疗前	治疗后	t值	P值
对照组	30	25.21±1.72	26.20±0.58	-3.130	0.004
试验组	30	24.87±1.51	26.87±0.62	-7.566	< 0.001
t值		0.799	-4.360
P值		0.427	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	30	0.195±0.047	0.168±0.061	2.411	0.022
试验组	30	0.216±0.065	0.146±0.057	6.635	< 0.001
t值		-1.422	1.390
P值		0.160	0.170

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