不同运动贴扎治疗偏瘫痉挛期肩痛对比研究

目的:对比分析不同运动贴扎法治疗偏瘫痉挛期肩痛的临床效果。方法:收集康复医学科120例脑卒中后偏瘫痉挛期肩痛住院患者,按照随机数字表法分为治疗组、对照组和空白组各40例。所有患者均接受常规康复干预,对照组采用三角肌与前锯肌运动贴扎措施(常规方法),治疗组采用冈上肌、菱形肌与上斜方肌运动贴扎方法(新型方法),疗程均为1个月。空白组不予运动贴扎干预。结果:治疗1个月后,在VAS评分方面,对照组改善(3.4±0.2)分,治疗组改善(4.9±0.3)分,2组比较差异有统计学意义(P<0.01);在无痛PROM方面,对照组改善幅度(23±0.8)°,治疗组改善幅度(42±1.4)°,2组比较差异有统计学意义(P<0.01);治疗组的疼痛与活动度改善均优于对照组(P<0.01);治疗组和对照组的VAS评分、无痛PROM改善幅度均显著高于空白组(P<0.01),而上肢FMA评分、改良Ashworth评分与空白组比较差异无统计学意义(P>0.05)。结论:新型贴扎方法能够显著改善脑卒中后偏瘫痉挛期疼痛、无痛被动关节活动度范围,该方法对偏瘫痉挛期肩痛的功能改善具有更好的辅助作用。但是贴扎治疗对单纯软组织支持短暂不持久,稳定性欠缺,可能远期效果不佳;痉挛期肢体肌张力持续增高,肌力增长缓慢,短时间内采用贴扎与训练对上肢运动功能和肌张力改善较少。

Clinical Effects of Kinesio-taping on Shoulder Pain in Patients with Spastic Hemiplegia after Stroke

Objective:The aim of this study is to analysialysis clinical effects of different kinesio-taping on shoulder pain in patients with spastic hemiplegia after stroke.Methods:One hundred twenty patients from Rehabilitation Department with shoulder pain in spastic hemiplegia after stroke were randomly divided into observation group,control group and blank group,with 40 cases in each group.All patients received routine rehabilitation intevation.The control group was treated with the deltoid muscle and serratus anterior muscle(routine kinesio-taping),while the observation group was treated with the supraspinatus muscle,rhomboid muscle and superior trapezius muscle(new kinesio-taping).The curative effects were observed after 1 month.Patients in the blank group were not affected by kinesio-taping.Results:After one month of treatment,VAS scores were improved by(3.4±0.2)in the control group and(4.9±0.3)in the treatment group(P<0.01).The improvement amplitude of painless PROM was(23±0.8)°in the control group and(42±1.4)°in the treatment group.The comparison was statistically significant(P<0.01).The pain and activities of patients in the treatment group were better than those in the control group.VAS scores and painless PROM both in the treatment group and the control group were significantly better than those in the blank group(P<0.01).There were no significant differences of FMA scores and modified Ashworth scores in the treatment group and the control group compared with those in the blank group(P>0.05).Conclusion:The new method of kinesio-taping on shoulder pain has a significant effect on improving the function of patients with stroke during spasticity.But kinesio-taping therapy is short and unstable,and the long-term effect may be poor.During the spasticity period,the muscle tension of limbs keeps increasing,and the muscle strength grows slowly.In a short time,kinesio-taping and training have little effect on the motor function and muscle tension of the upper limbs.