功能性电刺激联合PNF治疗脑卒中后偏瘫肩痛的临床效果

Clinical Effect of Functional Electrical Stimulation Combined with PNF in the Treatment of Hemiplegic Shoulder Pain after Stroke

目的:探究功能性电刺激(FES)联合本体感觉神经肌肉促进疗法(PNF)治疗脑卒中后偏瘫肩痛的临床效果。方法:选取2020年2月—2023年3月江阴南闸医院收治的118例脑卒中后偏瘫肩痛患者。根据随机数表法将其分为观察组(59例)和对照组(59例)。对照组给予常规治疗,观察组在对照组基础上给予FES联合PNF。比较两组干预前及干预2个月后肩痛程度及肩关节情况、上肢运动功能及肌张力、日常生活能力。结果:干预2个月后,两组视觉模拟评分法(VAS)评分、肩痛和残疾指数(SPADI)评分均下降,且观察组VAS评分、SPADI评分均低于对照组,差异有统计学意义(P<0.05)。干预2个月后,两组Fugl-Meyer运动功能评估量表上肢部分(FMA-UE)评分升高,改良Ashworth量表(MAS)评分降低,观察组FMA-UE评分高于对照组,MAS评分低于对照组,差异有统计学意义(P<0.05)。干预2个月后,两组Barthel指数量表(BI)评分均升高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:FES联合PNF治疗可有效缓解脑卒中后偏瘫肩痛,有利于改善患者上肢运动功能,提升日常生活能力。

Objective:To explore the clinical effect of functional electrical stimulation(FES)combined with proprioceptive neuromuscular facilitation(PNF)in the treatment of hemiplegic shoulder pain after stroke.Method:A total of 118 patients with hemiplegia shoulder pain after stroke who treated in Jiangyin Nanzha Hospital from February 2020 to March 2023 were selected.They were divided into the observation group(59 cases)and the control group(59 cases)according to random number table method.The control group was given conventional treatment,and the observation group was given FES combined with PNF on the basis of the control group.The degree of shoulder pain,shoulder joint condition,upper limb motor function,muscle tension and daily living ability were compared between two groups before intervention and after 2 months of intervention.Result:After 2 months of intervention,the visual analogue scale(VAS)scores,shoulder pain and disability index(SPADI)scores of two groups were decreased,and the VAS score and SPADI score of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).After 2 months of intervention,the upper limb of Fugl-Meyer motor function assessment scale(FMA-UE)scores in two groups were increased,and the modified Ashworth scale(MAS)scores were decreased,the FMA-UE score of the observation group was higher than that of the control group,and the MAS score was lower than that of the control group,the differences were statistically significant(P<0.05).After 2 months of intervention,the Barthel index scale(BI)scores of two groups were increased,and the BI score of the observation group was higher than that of the control group,the differences were statistically significant(P<0.05).Conclusion:FES combined with PNF treatment can effectively relieve hemiplegic shoulder pain after stroke,improve the upper limb motor function of patients and enhance daily living ability.