理筋手法联合常规康复治疗脑卒中后肩痛25例临床观察

Clinical observation on 25 cases of shoulder pain after cerebral apoplexy treated by tendon-smoothing manipulation combined with routine rehabilitation

目的观察理筋手法联合常规康复治疗脑卒中后肩痛的临床疗效。方法将50例脑卒中后肩痛患者采用随机数字表法分为对照组和治疗组,各25例。对照组予常规康复治疗,治疗组在对照组治疗方法的基础上联合理筋手法治疗。2组均每日治疗1次,每周6次,1个月后比较2组的临床疗效以及治疗前后的视觉模拟评分法(VAS)、Fugl-Meyer运动功能评定量表(FMAS)、改良Barthel指数(BI)评分。结果对照组总有效率为76%(19/25),治疗组为100%(25/25),2组比较差异有统计学意义(P<0.05);治疗后2组VAS评分均明显降低,FMAS、BI评分均明显升高,与同组治疗前比较差异均有统计学意义(P<0.05),且治疗组降低VAS评分,升高FMAS、BI评分的作用明显优于对照组,与对照组治疗后比较差异均有统计学意义(P<0.05)。结论在常规康复治疗的基础上运用理筋手法可明显减轻脑卒中后肩痛患者的疼痛症状,改善其上肢运动功能,提高生活质量,疗效确切。

Objective To observe the clinical efficacy of tendon-smoothing manipulation combined with routine rehabilitation in the treatment of shoulder pain after cerebral apoplexy. Methods Fifty cases of shoulder pain after cerebral apoplexy were divided into treatment group and control group according to random number table method,with 25 cases in each group. The control group was given routine rehabilitation treatment,on this basis,the treatment group was combined with tendon-smoothing manipulation. Both groups were treated once a day,6 times a week. One month later,the clinical efficacy,scores of visual analogue scale( VAS),Fugl-Meyer assessment scale( FMAS) and modified Barthel Index( BI) scores before and after treatment between the 2 groups were compared.Results The total effective rate of the control group was 76%( 19/25),and that of the treatment group was 100%( 25/25),and the difference was statistically significant between the 2 groups( P<0.05). After treatment,the VAS scores of the 2 groups were significantly decreased,and the FMAS and BI scores were significantly increased,and the difference was statistically significant compared with the same group before treatment( P <0.05),moreover,the effect of reducing the VAS score and increasing the FMAS and BI scores of the treatment group was significantly better than that of the control group,and the difference was statistically significant compared with the control group after treatment( P<0.05). Conclusion On the basis of routine rehabilitation,tendon-smoothing manipulation can markedly reduce the pain symptoms of the patients with shoulder pain after cerebral apoplexy,improve the upper limb motor function,enhance the quality of life with definite efficacy.