深层肌肉刺激联合肌内效贴对脑卒中后肩手综合征Ⅰ期患者的疗效研究

Efficacy of deep muscle stimulation combined with kinesio taping on stage I patients with shoulder-hand syndrome after stroke

目的 观察深层肌肉刺激(DMS)联合肌内效贴(KT)对脑卒中后肩手综合征(SHS)Ⅰ期患者上肢局部肿胀、疼痛及运动功能的影响。方法 收集SHS患者40例,分为对照组20例和试验组20例。对照组采用常规康复治疗,试验组在常规康复治疗基础上采用DMS联合KT治疗4周。治疗前后采用肩手综合征评估量表(SHSS)对患侧上肢进行综合评估,视觉模拟评分(VAS)评定患者上肢疼痛,Fug1-Meyer量表上肢部分(FMAUE)评定患者上肢的运动功能,改良Barthel指数评定量表(MBI)评定患者日常生活活动能力。结果 2组患者治疗后SHSS中的水肿评分及VAS评分均较治疗前降低(P <0. 05),FMA-UE及MBI评分均较治疗前升高(P <0. 05);试验组感觉及肩部外展评分均较治疗前降低(P <0. 05);试验组水肿评分及VAS评分较对照组明显降低(P <0. 05)。结论 DMS联合KT对于SHS患者上肢水肿、疼痛改善获益更佳,但对于患者感觉、关节活动度、上肢运动功能及日常生活活动能力与常规康复治疗效果相当。

Objective To observe the effect of deep muscle stimulation(DMS)combined with kinesio taping(KT)on local swelling,pain and motor function of upper limbs in patients with stage I shoulder-hand syndrome(SHS)after stroke.Methods 40 SHS patients were collected and randomly divided into the control group(20 cases)and the experimental group(20 cases).The control group was treated with the conventional rehabilitation treatment,and the experimental group was treated with DMS combined with KT for 4 weeks.Before and after treatment,the shoulder-hand syndrome assessment scale(SHSS)was used to comprehensively evaluate the upper limbs,the visual analogue scale(VAS)was used to evaluate the pain,the Fug1-Meyer scale(FMA-UE)was used to evaluate the upper limb motor function,and the Modified Barthel Index Rating Scale(MBI)was used to evaluate the activities of daily living.Results After treatment,the score of edema and VAS in the two groups were lower than those before treatment(P<0.05),and the scores of FMA-UE and MBI were higher than those before treatment(P<0.05).The scores of sensation and shoulder abduction in the experimental group were both lower than those before treatment(P<0.05).The edema score and VAS score of the experimental group were significantly lower than those of the control group(P<0.05).Conclusion DMS combined with KT is better for the improvement of upper limb edema and pain in SHS patients,but the effect of DMS combined with KT is equivalent to conventional rehabilitation in terms of sensation,joint range of motion,upper limb motor function and activities of daily living.