电脑中频治疗仪联合康复训练对脑卒中伴上肢痉挛患者腕手功能障碍的影响

Influence of computerized intermediate frequency therapy apparatus combined with rehabilitation training on wrist-hand dysfunction in patients with post-stroke upper limb spasm

目的 探讨电脑中频治疗仪联合康复训练对脑卒中伴上肢痉挛患者腕手功能障碍的影响。方法 60例脑卒中伴上肢痉挛患者作为研究对象,按收治顺序分为对照组和观察组,每组30例。对照组患者单纯进行常规康复训练,观察组患者给予电脑中频治疗仪联合康复训练治疗。比较两组患者干预前后的各量表[Fugl-Meyer运动功能评分量表(FMA)、改良Ashworth量表(MAS)、日常生活能力量表(ADL)、视觉模拟评分法(VAS)]评分、10 s抓握测试(HGRT)、患侧腕关节活动度,临床疗效,不良反应发生情况。结果 干预8周结束时,两组患者的FMA、ADL评分高于本组干预前, MAS、VAS评分低于本组干预前, HGRT多于本组干预前,且观察组患者的FMA评分(30.08±4.13)分、ADL评分(72.35±12.35)分高于对照组的(22.85±4.39)、(54.45±12.66)分, MAS评分(1.35±0.20)分、VAS评分(1.05±0.95)分低于对照组的(2.20±0.10)、(3.10±1.50)分, HGRT(13.35±3.28)次多于对照组的(9.35±3.03)次,差异具有统计学意义(P<0.05)。干预8周结束时,两组患者患侧腕关节掌屈、背伸、桡偏、尺偏活动度均大于本组干预前,且观察组患者患侧腕关节掌屈、背伸、桡偏、尺偏活动度分别为(58.21±11.20)、(21.76±6.63)、(11.24±2.88)、(25.09±6.01)°,均大于对照组的(51.56±10.10)、(13.83±5.74)、(7.65±3.22)、(18.20±5.08)°,差异具有统计学意义(P<0.05)。观察组的临床总有效率为86.67%,高于对照组的63.33%,差异具有统计学意义(P<0.05)。两组患者治疗过程中均未见明显不良反应。结论 电脑中频治疗仪联合康复训练能有效降低脑卒中伴上肢痉挛患者的肌张力,减轻疼痛症状,促进上肢运动功能恢复,提高腕关节活动度及抓握功能,提高日常生活能力。

Objective To discuss the influence of computerized intermediate frequency therapy apparatus combined with rehabilitation training on wrist-hand dysfunction in patients with post-stroke upper limb spasm.Methods A total of 60 patients with post-stroke upper limb spasm were studied and divided into the control group and the observation group according to the order of admission,with 30 cases in each group.The control group simply received routine rehabilitation training,and the observation group received computerized intermediate frequency therapy apparatus combined with rehabilitation training.Both groups were compared in terms of scales[Fugl-Meyer Assessment Scale(FMA),Modified Ashworth Scale(MAS),Activities of Daily Living Scale(ADL),Visual Analogue Scale(VAS)]before and after intervention,hand grab and relax test in 10 s(HGRT),wrist range of motion on the affected side,clinical efficacy,and occurrence of adverse reactions.Results At the end of 8 weeks of intervention,FMA and ADL scores in both groups were higher than those before intervention in this group,MAS and VAS scores were lower than those before intervention in this group,and HGRT was higher than that before intervention in this group;FMA score of(30.08±4.13)points and ADL score of(72.35±12.35)points in the observation group were higher than those of(22.85±4.39)and(54.45±12.66)points in the control group;MAS score of(1.35±0.20)points and VAS score of(1.05±0.95)points in the observation group were lower than those of(2.20±0.10)and(3.10±1.50)points in the control group;HGRT of(13.35±3.28)times in the observation group was higher than that of(9.35±3.03)times in the control group;the differences were statistically significant(P<0.05).At the end of 8 weeks of intervention,the range of motion of palmar flexion,dorsiflexion,radial deviation and ulnar deviation in both groups was greater than before intervention in this group;the range of motion of palmar flexion,dorsiflexion,radial deviation and ulnar deviation in the observation group were(58.21±11.20),(21.76±6.63),(11.24±2.88)and(25.09±6.01)°,which were higher than those of(51.56±10.10),(13.83±5.74),(7.65±3.22)and(18.20±5.08)°in the control group;the differences were statistically significant(P<0.05).The total clinical effective rate of the observation group was 86.67%,which was higher than that of 63.33%of the control group,and the difference was statistically significant(P<0.05).There were no obvious adverse reactions during treatment in both groups.Conclusion Computerized intermediate frequency therapy combined with rehabilitation training can effectively reduce the muscle tension of patients with post-stroke upper limb spasm,reduce pain symptoms,promote the recovery of upper limb motor function,improve wrist range of motion and grasping function,and improve the activities of daily living.