阶段性抗阻训练对脑卒中肩手综合征康复效果的影响

Impact of periodical resistance exercise on shoulder-hand syndrome after stroke rehabilitation

目的探讨阶段性抗阻训练对脑卒中肩手综合征康复效果的影响。方法将79例脑卒中肩手综合征患者按照随机数字表法分为两组。对照组(33例)给予常规康复锻炼护理模式,观察组(46例)在对照组基础上给予阶段性抗阻训练模式。治疗3个月后,比较两组治疗前后痉挛程度及关节功能变化、康复效果及生活质量。结果治疗后,观察组MAS评分低于对照组,差异有统计学意义(P<0.05),FMA评分、改良Barthel指数及ROM高于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率为82.6%(38/46),对照组为63.6%(21/33),两组比较,差异有统计学意义(P<0.05);治疗1个月后,两组患者SF-36量表各项评分均有改善,观察组改善程度优于对照组,差异有统计学意义(P<0.05)。结论阶段性抗阻训练应用于脑卒中肩手综合征有助于缓解痉挛状态、改善患者关节功能,提高其生存质量,值得在临床上推广应用。

Objective To explore the effect of periodical resistance exercise on shoulder-hand syndrome after stroke rehabilitation. Methods 79 cases of patients with shoulder-hand syndrome after stroke were selected and randomly divided into 2 groups.33 patients in the control were given routine rehabilitation nursing mode while 46 patients in the observation group were given periodical resistance exercise mode based on the nursing mode in the control group.After three months treatment,the degrees of convulsions,changes of joint function,rehabilitation effect and quality of life of two groups were compared before and after treatment. Results After treatment,MAS scores of observation group were lower than those of control group and the difference was statistically significant（P0.05）.FMA score,modified Barthel indexes and ROM were higher than those of control group and the difference was statistically significant（P0.05）.The total efficiency of the observation group was 82.6%（38/46） while that in the control group was 63.6%（21/33）.The differences of comparison of the total efficiency of treatment in two groups had statistical significance（P0.05）.After one month treatment,all scores of SF-36 of two groups were improved.The degree of improvement in the observation group was better than that of control group and the difference was statistically significant（P0.05）. Conclusion Periodical resistance exercise on shoulder-hand syndrome after stroke can help relieve convulsion,improve joint function of patients and improve the quality of life,which is worthy of clinical application.