肌内效贴对脑卒中患者肩关节半脱位后肩痛的疗效观察

目的:观察肌内效贴对脑卒中患者偏瘫侧肩关节半脱位后肩痛的疗效。方法:56例脑卒中肩关节半脱位后肩痛患者,按照随机数字表法分为治疗组与对照组(各28例),两组患者均实施常规康复治疗及宣教,治疗组在此基础上结合肌内效贴干预。分别于治疗前和治疗6周后通过X线测量法测量肩峰与肱骨头间距(AHI)、肩关节视觉模拟评分(VAS)疼痛、Fugl-Meyer上肢功能评分、肩痛侧腋神经及肌皮神经的运动神经传导测定,对两组治疗结果进行疗效评价。结果:治疗前,两组患者AHI值、VAS评分、Fugl-Meyer上肢功能评分无明显差异(P0.05),且检测所有患者肩痛侧腋神经(刺激部位:Erb点;记录部位:三角肌)及肌皮神经(刺激部位:Erb点;记录部位:肱二头肌)后发现两组中某些患者肌皮神经(30例,53.57%)、腋神经(31例,55.36%)波幅明显低于正常值,而潜伏期轻度延长或正常(提示轴索损伤)。两组治疗6周后,治疗组各项评分改善优于对照组(P0.05)且无不良事件发生。结论:在常规康复治疗的基础上,肌内效贴在脑卒中患者偏瘫侧肩关节半脱位后肩痛早期防治中,具有良好的疗效,其相应机制有待进一步研究。

Therapeutic effectiveness of Kinesio taping for relieving shoulder pain in stroke patients with shoulder subluxation

Abstract Objective: To study the effect of Kinesio taping for relieving shoulder pain in stroke patients with shoulder subluxation. Method: Fifth-six stroke patients with shoulder pain and shoulder subluxation were randomly and equally divided into treatment group and control group. All patients received conventional rehabilitation therapy and propaganda, education. In addition, treatment group received Kinesio taping therapy. Before and six weeks after treatment, we evaluated and analyzed the degree of shoulder subluxation pain, upper limb function and nervous function by the acromio-humeral interval (AHI) measured by X-rays, visual analogue scale (VAS), Fugl-Meyer test with upper limb (FMA) and the motor nerve conduction velocity of axillaris nerve and musculocutaneous nerve at shoulder-pain side. Result: After treatment, there were obvious improvement in the AHI, VAS score, FMA score, motor nerve amplitudes, and recovery rate of nerve injuries for the treatment group when compared the control group(P<0.05). Conclusion: Due to its therapeutic effectiveness, in clinical practice, the conventional rehabilitation therapy combined with Kinesio taping could be recommended for relieving shoulder pain in stroke patients with shoulder subluxation. However, the underlying mechanism remains unclear and needs to be further investigated.