棍棒操预防脑卒中后肩—手综合征的临床疗效

目的探讨自编的棍棒操防治脑卒中后肩-手综合征的临床疗效。方法将100 例脑卒中早期上肢处于Brunnstrom Ⅰ～Ⅲ级，同时未出现肩痛、手肿患者，随机分为观察组(n=50)和对照组(n=50)，两组均进行常规康复治疗，观察组在此基础上结合棍棒操，30 d 为1 个疗程。比较两组治疗前、治疗2 个疗程后肩痛的发生率、肩关节主动活动范围、上肢运动功能以及日常生活活动能力(ADL)。结果治疗前两组各项指标均无显著性差异(P>0.05)，治疗2 个疗程后观察组肩关节的主动活动范围、上肢运动功能评分、ADL 均显著高于对照组(P<0.001)，肩痛的发生率明显低于对照组(P<0.01)。结论自编的棍棒操能降低脑卒中后患者肩痛的发生，改善肩关节活动度，提高上肢功能，最终提高患者ADL，有效地预防脑卒中后肩-手综合征的发生。

Effect of Club Exercise on Prevention of Shoulder-hand Syndrome after Stroke

Objective To observe the clinical effect of the club exercise designed ourselves on the prevention of should-hand syndrome after stroke.Methods 100 stroke patients in early stage,whose motor function of upper limb were lower than GradeⅢ evaluated by Brunnstrom assessment and without shoulder pain and swelling of hand,were randomly divided into control group(n=50) and observation group(n=50).All of them received routine rehabilitation therapy,and the observation group received club exercise in addition.The incidence of shoulder pain,the active range of motion of shoulder,the motor function of upper limb and activities of daily living(ADL) of 2 groups were evaluated before and 2 courses(60 d) after treatment.Results There was no statistical difference between 2 groups before the treatment(P>0.05).After 2-course treatment,the incidence of shoulder pain was significantly lower in the observation group than in the control group(P<0.001),the active range of motion of shoulder,motor function of upper limb and ADL were significantly better in the observation group than in the control group(P<0.001).Conclusion The club exercise can prevent the pain of shoulder joint,increase the active range of motion of shoulder joint and improve the motor function of upper limb and ADL in patients after stroke.