体外冲击波缓解脑卒中后肱二头肌痉挛的效果

目的观察体外冲击波对脑卒中后肱二头肌痉挛的治疗效果。方法12 例脑卒中后肱二头肌痉挛患者分成对照组(n=6)和治疗组(n=6)。治疗组予单次体外冲击波治疗，对照组予安慰性治疗。两组患者在治疗前、治疗后即刻采用改良Ashworth 量表(MAS)、上肢肩肘部分Fugl-Meyer 评分(FMA)进行评定，表面肌电图测定肘伸展最大等长收缩时肱二头肌、肱三头肌的积分肌电值及协同收缩率。结果治疗组治疗后MAS、FMA评分，肱二头肌积分肌电值及协同收缩率均较治疗前改善(P<0.05)，并优于对照组(P<0.05)。结论体外冲击波可以即刻缓解脑卒中后肱二头肌痉挛，降低肘伸展时肱二头肌的协同激活水平及协同收缩率，改善上肢运动功能。

Effects of Extracorporeal Shock Wave on Spasticity of Biceps Brachii after Stroke

Objective To observe the effects of extracorporeal shock wave therapy (ESWT) on spasticity of biceps brachii after stroke. Methods 12 patients with spasticity of biceps brachii after stroke were divided into control group (n=6) and ESWT group (n=6). The ESWT group received a session of ESWT and the control group received placebo treatment. All patients were assessed before and immediately after treatment, including integrated electromyogram (iEMG) and co-contraction ratio during maximum isometric voluntary contraction (MIVC) of elbow extension with surface electromyography, the modified Ashworth Scale (MAS) and content of shoulder and elbow of Fugl-Meyer Assessment (FMA). Results The scores of MAS and FMA, the iEMG and the cocontraction ratio of biceps brachii improved in the ESWT group after the treatment (P<0.05), and improved more than those in the control group (P<0.05). Conclusion ESWT can immediately relieve the spasticity of biceps brachii, inhibit the cocontraction of biceps brachii during elbow extension and improve the motor function of upper limb in patients post stroke.