目的 观察对脑卒中后下肢痉挛的患者进行发散式体外冲击波治疗后对改善平衡及姿势控制能力的疗效。方法 选取2022-04至2022-12在北京同仁医院康复医学科住院的脑卒中后偏瘫侧下肢痉挛患者30例,采用随机数字表法分为试验组和对照组,各15例。对照组行常规康复治疗,试验组在常规康复治疗的基础上给予冲击波治疗,3次/周,共治疗3周。治疗前后分别测量两组患者踝关节主、被动关节活动度,以及下肢Fugl-meyer功能评分、Berg平衡功能评定、10 m步行能力、计时起立行走测试及改良Ashworth 量表评分。结果 治疗后,试验组踝关节被动关节活动度(12.00°±5.75°),高于对照组的(7.27°±3.90°);试验组踝关节主动关节活动度(4.47°±4.98°),高于对照组的(0.53°±4.73°);试验组下肢Fugl-meyer功能评分(27.86±5.31),高于对照组的(25.33±6.55);试验组Berg平衡功能评定分数(44.27±5.31),高于对照组的(40.07±6.51);试验组的10 m步行能力所用时间(23.13±5.47)s少于对照组(25.93±7.35)s;试验组计时-起立步行测试所用时间[(20.13±7.69)s]少于对照组的[(23.66±7.22)s];试验组的改良Ashworth 量表肌张力分级(1.10±0.48),少于对照组(1.34±0.41),差异均有统计学意义(P<0.05)。治疗3周后试验组和对照组的各项评价指标均有改善,但对照组治疗前后踝关节主动活动度差异无统计学意义。结论 冲击波治疗可以改善脑卒中后下肢的功能,提高步行能力及平衡和姿势控制能力。
Abstract
Objective To observe the effect of extracorporeal shock wave therapy on improving balance and postural control in patients with lower limb spasm after stroke. Methods Thirty patients with hemiplegic lower limb spasm after stroke from April 2022 to December 2022 were selected from the Department of Rehabilitation of Beijing Tongren Hospital, and randomly divided into experimental group and control group with 15 cases each group by random number method, The control group received routine rehabilitation treatment, while on the basis of routine rehabilitation treatment, the experimental group received shock wave treatment of three times a week and a total of three weeks of treatment. The active and passive ankle joint motion, lower limb Fugl-meyer function score, Berg balance function assessment, 10-meter walking ability,timing standing and walking test and modified Ashworth scale were measured before and after treatment. Results After therapy, the passive ankle joint motion (12.00±5.75), the active ankle joint motion (4.47±4.98), the lower limb Fugl-meyer function score (27.86±5.31) and the Berg balance function assessment (44.27±5.31) in the experimental group were higher than those (7.27±3.90, 0.53±4.73, 25.33±6.55 and 40.07±6.51) in the control group respectively, while the time of 10-meter walking test (23.13±5.47), the timing “Stand-Up” and “Go” test ( 20.13±7.69) and the modified Ashworth scale (1.10±0.48) were less than those (25.93±7.35, 23.66±7.22 and 1.34±0.41)in the control group. After treatment, the above indexes in the experimental group were significantly improved compared with the control group (P<0.05).After 3 weeks of treatment, all the indexes of the experimental group and the control group were improved, but there was no significant difference in the active range of ankle joint in the control group before and after treatment. Conclusions Shock wave therapy can improve lower limb function, walking ability, balance and postural control after stroke.
关键词
脑卒中 /
体外冲击波治疗 /
痉挛 /
平衡功能 /
姿势控制
Key words
stroke /
extracorporeal shock wave therapy /
spasm /
balance function /
postural control
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