物理疗法为主的综合康复治疗对脑卒中后肌张力增高患者的疗效

Therapeutic effect of physiotherapy-based comprehensive rehabilitation therapy on patients with hypermyotonia after stroke

目的:探讨物理疗法为主的综合康复治疗对脑卒中后肌张力增高患者的疗效。方法:我院收治的98例脑卒中后肌张力增高患者被随机均分为药物治疗组和联合治疗组(在药物治疗组基础上接受物理疗法),两组均治疗4周。比较两组治疗前后改良Ashworth量表(MAS)分级、Fugl-Meyer运动功能评定量表(FMA)评分及日常生活活动能力量表(ADLS)评分。结果:与治疗前比较,两组治疗后上下肢FMA评分、ADLS评分均显著升高(P均<0.01);联合治疗组治疗后MAS I级(16.33%比34.69%)、I^+级(26.53%比48.98%)比例显著升高,MAS II级比例(42.86%比14.29%)显著降低(P<0.05或<0.01);药物治疗组治疗后MAS分级情况无显著改变(P均>0.05)。与药物治疗组比较,联合治疗组治疗后上肢FMA评分[(16.79±4.52)分比(20.58±4.44)分]、下肢FMA评分[(19.77±5.06)分比(24.62±6.47)分]、ADLS评分[(49.16±11.20)分比(58.82±11.48)分]均显著升高(P均=0.001)。结论:以物理疗法为主的综合康复治疗能显著改善脑卒中后肌张力增高患者的临床症状,促进运动功能和日常生活活动能力的恢复。

Objective:To explore therapeutic effect of physiotherapy-based comprehensive rehabilitation therapy on patients with hypermyotonia after stroke.Methods:A total of 98 patients with hypermyotonia after stroke treated in our hospital were randomly and equally divided into medication group and combined treatment group(received physiotherapy based on medication group).Both groups were treated for four weeks.Grade of modified Ashworth scale(MAS),scores of Fugl-Meyer motor assessment scale(FMA)and activity of daily living scale(ADLS)were compared between two groups before and after treatment.Results:Compared with before treatment,there were significant rise in scores of upper and lower limbs FMA and ADLS in two groups after treatment(P<0.01 all);there were significant rise in percentages of MAS grade I(16.33%vs.34.69%)and grade I^+(26.53 vs.48.98%),and significant reduction in percentage of MAS grade II(42.86%vs.14.29%)in combined treatment group after treatment(P<0.05 or<0.01);there were no significant changes in MAS grades in medication group after treatment(P>0.05 all).Compared with medication group,after treatment,there were significant rise in scores of upper limb FMA[(16.79±4.52)scores vs.(20.58±4.44)scores],lower limb FMA[(19.77±5.06)scores vs.(24.62±6.47)scores]and ADLS[(49.16±11.20)scores vs.(58.82±11.48)scores]in combined treatment group(P=0.001 all).Conclusion:Physiotherapy-based comprehensive rehabilitation therapy can significantly improve clinical symptoms,and promote recovery of motor function and activity of daily living in patients with hypermyotonia after stroke.