神经松动术对脑卒中后肩手综合征患者的疗效观察

目的:观察神经松动术对脑卒中后肩手综合征(SHS)的疗效,为临床上脑卒中后SHS的康复治疗提供一种更为优化的治疗方案。方法:将36例SHS患者随机分为观察组和对照组各18例。对照组进行常规康复训练,观察组在常规康复训练的基础上增加神经松动术。分别于治疗前及治疗4周后采用上肢简化Fugl-Meyer量表(FMA-UE)、视觉模拟评分法(VAS)、健患手8字缠绕法以及改良Barthel指数(MBI)评估患者上肢运动功能、疼痛情况、水肿以及日常生活活动能力(ADL)。结果:治疗4周后,2组患者FMA-UE、MBI评分较治疗前均明显提高(均P<0.01),且观察组均更高于对照组(均P<0.05);2组VAS评分较治疗前均明显降低(P<0.01,0.05),且观察组更低于对照组(P<0.05);2组健患手围度差值较治疗前均明显减小(均P<0.01),且观察组差值更小于对照组(P<0.01)。结论:神经松动术可明显改善脑卒中后SHS患者的上肢运动功能、疼痛情况、水肿以及ADL,是一种有效的训练措施。

Efficacy of neurodynamic technique in patients with shoulder-hand syndrome after stroke

Objective: To observe the efficacy of neurodynamic technique for shoulder-hand syndrome (SHS) after stroke, so as to provide a more optimized treatment plan for the rehabilitation of SHS after stroke. Methods: A total of 36 cases of SHS were randomly divided into the treatment group and the control group with 18 patients in each group. The control group and treatment group received routine rehabilitation training, and the treatment group was given additional neurodynamic technique. The Fugl-Meyer Assessment of upper extremity (FMA-UE), visual analogue scale (VAS), 8-word twist circumference and the Modified Barthel Index (MBI) were used to evaluate the upper extremity motor function, pain, edema and activities of daily living (ADL) of the patients respectively before and after 4 weeks of treatment.Results: After 4 weeks of treatment, the scores of FMA-UE and MBI in the two groups were significantly higher than those before treatment (all P<0.01), and those in the treatment group were significantly higher than those in the control group (all P<0.05). The VAS scores in the two groups after treatment were significantly lower than those before treatment (P<0.01, 0.05), and those in the treatment group were significantly lower than those in the control group (P<0.05). The difference of hand circumference after treatment in the two groups was significantly less than that before treatment (all P<0.01), and that in the treatment group was significantly less than that in the control group (P<0.01).Conclusion: Neurodynamic technique can significantly improve the upper limb motor function, pain, edema and ADL of SHS patients after stroke, and it is an effective training measure.