体外冲击波联合肩肱节律训练对卒中后肩痛的疗效观察

Effects of extracorporeal shockwave therapy combined with scapulohumeral rhythm trainingon post-stroke shoulder pain

目的探讨体外冲击波联合肩肱节律训练对卒中后肩痛的治疗效果。方法将40例患者随机分为研究组和对照组,对照组给予常规康复治疗,研究组在此基础上辅以体外冲击波联合肩肱节律训练,研究组4例中途退出,最终16例患者入研究组,20例患者入对照组。治疗前和治疗2周后,使用VAS评分评估肩痛、被动肩关节活动度(passive shoulder range of motion,PROM)评估肩关节运动情况、上肢Fugl-Meyer评分(Fugl-Meyer motor function assessment,FMA)评估上肢运动功能。结果治疗2周后,两组患者的VAS评分均较前下降,PROM、FMA均较前增加,两组治疗后有显著差异(P<0.05),差异多数达到中等效应。结论冲击波联合肩肱节律训练能够缓解患者的卒中后肩痛,改善肩关节被动活动度和上肢运动功能。

Objective To examine the clinical effect of extracorporeal shockwave therapy combined with scapulohumeral rhythm training on post-stroke shoulder pain.Methods Forty patients were randomly assigned into study group and control group.The control group was given routine rehabilitation treatment.On this basis,the study group was supplemented with extracorporeal shockwave therapy combined with scapulohumeral rhythm training.Four patients in the study group quitted from the study,finally,16 patients were enrolled in the study group,while 20 patients in the control group.The VAS scale was used to evaluate the intensity of shoulder pain before and after treatment.Changes in upper limb motor function were evaluated by the Fugl-Meyer motor function assessment scale(FMA).Results Compared with pretreatment,the VAS scores of the two groups decreased after treatment for 2 weeks,while PROM and FMA increased,and there were significant differences between the two groups after treatment(P<0.05).Most of the differences reached medium effect.Conclusion Extracorporeal shockwave therapy combined with scapulohumeral rhythm training can alleviate the post-stroke shoulder pain and improve the passive range of motion of shoulder and upper limb motor function.