首页|基于肌肉激活的斜方肌平衡训练对偏瘫肩痛患者上肢运功功能及神经电生理的影响

基于肌肉激活的斜方肌平衡训练对偏瘫肩痛患者上肢运功功能及神经电生理的影响

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目的:本研究探讨斜方肌平衡训练对卒中偏瘫后肩痛患者上肢运动功能及神经电生理的影响.方法:选取2021年10月~2023年11月在广东省第二中医院康复科住院且符合纳入标准的卒中偏瘫后肩痛患者144例,随机分为对照组和观察组各72例.两组患者均采用常规用药及神经发育学治疗,对照组在此基础上采用肩胛带的稳定性训练,观察组在对照组的基础上采用斜方肌平衡训练(侧卧位肩外旋、侧卧位外旋、俯卧位水平外展、俯卧位水平后伸),两组患者训练均30min/次,1次/d,5次/周,连续训练6周;分别在治疗前和治疗6周后,对两组患者分别进行Fugl-Meyer上肢运动功能评分和VAS视觉模拟评分,以及上肢静息运动阈值(rMT)、中枢运动传导时间(CMCT)检测.结果:观察组9例及对照组7例患者因提前出院中途退出被剔除,最终观察组63例,对照组65例.治疗后,两组患者的VAS评分均较治疗前降低(P<0.05),FMA-UE评分均较治疗前升高(P<0.05),且观察组治疗后的VAS评分低于对照组(P<0.05),FMA-UE评分高于对照组(P<0.05).治疗后,两组患者的rMT和CMCT均较治疗前降低(P<0.05),且观察组治疗后的rMT和CMCT均低于对照组(P<0.05).结论:在肩胛带的稳定性训练基础上,斜方肌平衡训练能更好的改善偏瘫后肩痛患者的疼痛、运动功能及神经电生理.
The Effects of Trapezius Balance Training Based on Muscle Activation Onupper Extremity Motor Function and Neuroelectrophysiology in Patients with Hemiplegic Shoulder Pain
Objective:This study investigated the effects of trapezius balance training on upper extremity motor function and neuro-physiology in patients with shoulder pain after stroke hemiplegia.Method:One hundred and forty-four patients with post-stroke hemiplegic shoulder pain who were hospitalized in the Department of Rehabilitation of Guangdong Second Traditional Chinese Medi-cine Hospital from October 2021 to November 2023 and who met the inclusion criteria were selected and randomly divided into 72 cases in the control group and 72 cases in the observation group.Both groups were treated with conventional medication and neurode-velopmental therapy,on the basis of which scapular girdle stability training was used in the control group,and trapezius muscle balance training(shoulder external rotation in lateral position,external rotation in lateral position,horizontal abduction in prone position,and horizontal posterior extension in prone position)was used in the observation group,and the training of patients in both groups was con-ducted for 30 min/times,once/d,5 times/week for 6 weeks;before and after 6 weeks of therapy,the patients'shoulder pains were evalu-ated and assessed,respectively,in the control and observation groups.Fugl-Meyer upper extremity motor function score and VAS vi-sual analog score,as well as upper extremity resting Motor Threshold(rMT)and central motor conduction time(CMCT)testing were performed in the two groups before and after 6 weeks of treatment,respectively.Results:9 patients in the observation group and 7 pa-tients in the control group were excluded midway due to early discharge,resulting in a total of 63 patients in the observation group and 65 patients in the control group.After treatment,the VAS scores of patients in both groups were lower than before treatment(P<0.05),and the FMA-UE scores were higher than before treatment(P<0.05),and the VAS scores of the observation group group were lower than that of the control group after treatment(P<0.05),and the FMA-UE scores were higher than that of the control group(P<0.05).Af-ter treatment,the rMT and CMCT of both groups were lower than before treatment(P<0.05),and the rMT and CMCT of the observa-tion group were lower than that of the control group after treatment(P<0.05).Conclusion:Based on the stability training of the scapu-lar girdle,trapezius balance training can better improve the pain,motor function and neurophysiology of patients with hemiplegic posterior shoulder pain.

Posthemiplegic shoulder painTrapezius balance trainingPainOperator functionresting Motor ThresholdCentral motor conduction time

董明、余静、陆彦青、李琎、林立军

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广东省第二中医院,广东 广州 510095

偏瘫后肩痛 斜方肌平衡训练 疼痛 运功功能 静息运动阈值 中枢运动传导时间

2025

按摩与康复医学
广东省第二中医院(广东省中医药工程技术研究院)

按摩与康复医学

影响因子:0.227
ISSN:1008-1879
年,卷(期):2025.2(1)