文章摘要
朱保亮,王强,张洪蕊,周人龙,张强,巩小雪.体外冲击波联合不同牵伸训练对脑卒中后小腿三头肌痉挛的疗效观察[J].济宁医学院学报,2024,47(2):117-122
体外冲击波联合不同牵伸训练对脑卒中后小腿三头肌痉挛的疗效观察
Effect of extracorporeal shock wave therapy combined with different stretching training on spasticity of calf triceps after cerebral stroke
投稿时间:2022-08-05  
DOI:10.3969/j.issn.1000-9760.2024.02.008
中文关键词: 脑卒中;小腿三头肌;痉挛;体外冲击波;静态进展牵伸
英文关键词: Stroke;Triceps calf;Spasm;Extracorporeal shock wave;Static progressive drafting
基金项目:
作者单位E-mail
朱保亮 青岛大学附属医院康复医学科, 青岛, 266000
济宁医学院附属医院康复科, 济宁, 272029 
 
王强 青岛大学附属医院康复医学科, 青岛, 266000 Sakulawangqiang@hotmail.com 
张洪蕊 济宁医学院附属医院康复科, 济宁, 272029  
周人龙 济宁医学院附属医院康复科, 济宁, 272029  
张强 济宁医学院附属医院康复科, 济宁, 272029  
巩小雪 济宁医学院附属医院康复科, 济宁, 272029  
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中文摘要:
      目的 探讨体外冲击波(extracorporeal shock wave therapy,ESWT)联合不同牵伸训练治疗卒中后小腿三头肌痉挛的效果。方法 选取2020年3月到2021年8月符合标准的患者60例作为研究对象,采用随机数字表法分为ESWT治疗组(对照组)、ESWT联合斜板牵伸组(联合组A)及ESWT联合静态牵伸组(联合组B),每组各20例。所有患者均在治疗前、治疗2周后、治疗4周后分别采用改良Ashworth(MAS)、改良Tardieu(MTS)、简化Fugl-Meyer运动功能下肢部分(FMA-LE)、踝关节PROM评估患者肌张力和下肢运动功能改善情况。结果 训练前,3组患者MAS、MTS、FMA-LE和踝关节PROM比较无差异性(P>0.05)。给予2周训练后,3组患者以上4个指标和训练前相比均有一定的改善,联合组A、B MAS、MTS、PROM优于对照组(P<0.05);联合组A FMA-LE较对照组无明显差异性(P>0.05);联合组B踝关节PROM比联合组A效果明显,余3个指标无明显差异性(P>0.05)。给予4周训练后,3组患者MAS、MTS、FMA-LE和踝关节PROM改善程度明显,且联合组A较对照组显著(P<0.05),联合组B较其他两组改善显著(P<0.05)。结论 ESWT联合静态牵伸训练对降低脑卒中后小腿三头肌痉挛,改善患者下肢运动功能有积极治疗作用,且效果优于联合斜板牵伸或单纯冲击波治疗,可作为治疗脑卒中后小腿三头肌痉挛的有效手段在临床推广、应用。
英文摘要:
      Objective To investigate the effect of extracorporeal shock wave (ESWT) combined with different draft training in the treatment of calf triceps spasm after stroke.Methods A total of sixty patients with calf triceps spasm after stroke in the Rehabilitation Department of Affiliated Hospital of Jining Medical University from March 2020 to August 2021 were selected as the research subjects.The selected patients were be segmented into ESWT treatment group (control group),ESWT combined with oblique plate drafting group (combined group A) and ESWT combined with static drafting group (combined group B) by random number table method,with twenty patients in each group.All patients were evaluated for muscle tone and improvement of lower limb motor function by modified Ashworth (MAS),modified Tardieu (MTS),simplified FuGL-Meyer lower limb motor function (FMA-LE),and ankle PROM before treatment,2 weeks after treatment,and 4 weeks after treatment,respectively.Results Before training,there was no difference in MAS,MTS,FMA-LE and ankle PROM among the three groups(P>0.05).After 2 weeks of training,the above four indexes of the three groups were improved compared with those before training.MAS,MTS and PROM of the combined group were better than those of the control group (P<0.05),FMA-LE of the combined group A was not significantly different from that of the control group (P>0.05),ankle PROM of the combined group B was more effective than that of the combined group A.There was no significant difference in the other three indexes (P>0.05).After 4 weeks of training,MAS,MTS,FMA-LE and ankle PROM of the 3 groups were improved significantly (P<0.05),and the combination group A was significantly better than the control group (P<0.05),and the combination group B was significantly better than the other two groups (P<0.05).Conclusion sESWT combined with static drafting training has a positive therapeutic effect on reducing triceps spasm and improving lower limb motor function of patients after stroke,and the effect is better than oblique plate drafting or shock wave therapy alone,which can be used as an effective means of treating triceps spasm of the calf after stroke in clinical promotion and application.
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