神经肌肉本体易化技术联合神经肌肉电刺激治疗脑卒中患者肩关节半脱位疗效观察

Effectiveness of PNF combined with neuromuscular electrical stimulation in treatment of shoulder subluxation in stroke patients

目的观察神经肌肉本体易化技术(proprioceptive neuromuscular facilitation,PNF)技术联合神经肌肉电刺激对脑卒中后肩关节半脱位的治疗效果。方法将90例脑卒中后肩关节半脱位患者按随机数字表示分为治疗组和对照组各45例。2组患者均接受早期药物治疗、良肢位摆放及常规康复治疗,治疗组加用PNF技术联合神经肌肉电刺激。2组患者治疗前及治疗后均拍摄双肩关节X射线片并进行指诊,测定两侧肩峰至肱骨头的间距(AHI)评价肩关节脱位恢复情况,采用FuglMeyer评定量表(FMA)评价患者患侧上肢运动功能。结果 2组患者在治疗1月后AHI评分及FMA评分均较治疗前改善,且治疗组较对照组改善更显著(P<0.05)。结论 PNF技术联合神经肌肉电刺激对脑卒中后肩关节半脱位及上肢运动功能改善效果显著,其疗效优于常规康复治疗。

Objectvi e To evaluate the therapeutic effectiveness of proprioceptive neuromuscular facilitation （ PNF） combined with neuromuscular electrical stimulation in treatment of shoulder subluxation after stroke .Methods Ninety stroke patients with shoul-der subluxation were randomly divided into control （n =45） and treatment （n =45） groups.Patients in the two groups were given treatments of early medicine ,limbs in good position and regular rehabilitation .The PNF combined with neuromuscular electrical stimula-tion was added to the treatment group .Before and after the therapy ,the both groups received X-ray examination and palpation on bilater-al shoulder .Acromio humeral interval （ AHI） was measured to assess the recovery of shoulder luxation .Fugl-Meyer score was used to evaluate the motor function of upper limbs .Results After 6 weeks of the treatment,scores of AHI and FMA were improved in all the pa-tients when compare to treatment before ,and the improvements in the treatment group were better than that in the control group （ P〈0.05 ） .Conclusion The therapy of PNF combined with neuromuscular electrical stimulation has obvious therapeutic effect on upper limb motor function in the patients with shoulder subluxation after stroke . It is also more effective than regular rehabilitation treatment .