肌内效贴联合运动想象疗法治疗脑卒中后肩手综合征的疗效分析

Effects of Kinesio taping combined with motor imaginary therapy on shoulder-hand syndrome after stroke

目的探索肌内效贴联合运动想象疗法对脑卒中合并肩手综合征患者的疗效。方法采用析因设计将满足纳入排除标准的164例患者分为对照组、运动想象疗法组、肌内效贴组及联合治疗组。对照组给予常规康复治疗;在常规康复治疗基础上,运动想象疗法组给予运动想象治疗,肌内效贴组给予贴布痛点贴扎治疗,联合治疗组同时给予3种方式综合治疗。治疗前后评估患者疼痛程度[视觉模拟评分法(VAS)]、肿胀程度、上肢运动功能[Fugl-Meyer运动功能评分法(FAM)]、日常生活活动能力(Barthel评分),并于治疗后评价疗效。结果与治疗前比较,各组患者治疗后VAS评分、肿胀程度明显下降,FMA评分及Barthel评分明显升高(P<0.001)。治疗前后4组患者VAS评分、肿胀程度、FMA评分及Barthel评分比较,差异均有统计学意义(F=23.030、177.648、135.571、114.092,P<0.001);联合治疗组VAS评分下降幅度最高,对照组下降幅度最低;肿胀缩减程度、FMA及Barthel评分增加幅度:联合治疗组>肌内效贴组>运动想象疗法组>对照组。对照组、运动想象疗法组、肌内效贴组、联合治疗组治疗有效率分别为60.98%、78.05%、85.36%、92.68%,差异有统计学意义(χ^2=13.803,P=0.003)。结论联合应用肌内效贴及运动想象疗法可提高脑卒中后肩手综合征的疗效。

Objective To explore the effect of Kinesio taping combined with motor imaginary therapy on stroke patients with shoulder-hand syndrome.Methods A total of 164 patients that met the exclusion criteria were randomly assigned to the control group,the Kinesio taping group,the motor imaginary therapy group and the combined treatment group using factorial design.The control group was given routine rehabilitation treatment.The motor imaginary therapy group was given motor imaginary therapy on the basis of conventional rehabilitation treatment,while the Kinesio taping group was given patch pain point sticking treatment,and the combined treatment group was given three kinds of comprehensive treatment simultaneously.Before and after treatment,the patients′pain degree[visual analogue scale(VAS)],swelling degree,upper limb motor function[Fugl-Meyer motor function scale(FAM)],and activity of daily living(Barthel score)and the efficacy were evaluated after treatment.Results Compared with before treatment,VAS score and swelling degree significantly decreased after treatment,while FMA score and Barthel score significantly increased(P<0.001).After treatment,there were statistically significant differences in VAS score,swelling degree,FMA score and Barthel score in the 4 groups compared with before treatment(F=23.030,177.648,135.571,114.092,P<0.001).The decrease of VAS score in the combined treatment group was the highest,which in the control group was the lowest.Reduction of swelling,increase of FMA and Barthel score was the combined treatment group>the Kinesio taping group>the motor imaginary therapy group>the control group.The effective rate was 60.98%,78.05%,85.36%,92.68%in the control group,the Kinesio taping group,the motor imaginary therapy group and the combined treatment group,respectively,with statistically significant differences(χ^2=13.803,P=0.003).Conclusion Kinesio taping therapy combined with motor imaginary therapy can significantly enhance the curative effect of stroke patients with shoulder-hand syndrome.