综合康复疗法干预偏瘫肌痉挛

Comprehensive rehabilitation therapy for hemiplegic muscular spasm

目的:探讨综合康复疗法干预脑损伤及脑卒中后偏瘫肌痉挛的效果,及其对患者生活自理能力的影响。方法:选择2002-01/2004-08解放军第三军医大学西南医院康复科收治住院的偏瘫患者17例为研究对象。所有研究对象瘫痪侧上肢肌张力平均中等度到重度增高。采用综合康复疗法对患者进行干预。具体干预措施包括:巴氯芬口服、正确肢位摆放、被动运动、持续的牵张运动、手法按摩、石蜡疗法、肢体空气压力治疗、站立训练、康复教育等。采用修订的Ashworth分级法和改良的巴氏指数评定法对患者治疗前后肌张力及生活自理能力进行评定。结果:干预后患者患侧肢体肌张力显著低于治疗前,差异有非常显著性意义(P<0.01);干预后患者生活自理能力改良的巴氏指数评定法评分为60.37±9.19,较治疗前(30.81±6.34)明显提高,差异有非常显著性意义(P<0.01)。结论:综合康复疗法对脑损伤及脑卒中所致偏瘫肌痉挛有显著改善作用,可提高患者生活自理能力。

AIM: To study the effects of the comprehensive rehabilitation therapy on hemiplegic muscle spasm after brain injury and stroke. METHODS: Totally 17 patients were selected from Southwest Hospital of Third Military Medical University of Chinese PLA from January 2002 to August 2004. The muscular tension of upper and lower limbs in paralytic side of patients was strengthened averagely from severe to moderate.Comprehensive rehabilitation therapy administrated included Baclofen,precision position of limb,passive exercise, durative stretching exercise, massage, paraffin therapy, air pressure therapy, standing exercise and rehabilitative education, etc.The muscular tension and self care ability in patients before and after treatment were assessed with modified Ashworth scale and modified Barthel index. RESULTS:The muscular tension was significantly decreased in patients after treatment than before treatment, and there was significant difference(P< 0.01). The scores on modified Barthel index was significant increased from 30.81±6.34 to 60.31±9.19 after treatment, and there was significant difference(P< 0.01). CONCLUSION: Comprehensive rehabilitation therapy is effective for improving hemiplegic muscle spasm and self care ability of patients after brain injury and stroke.