在对侧控制功能电刺激指导下的双侧训练治疗亚急性卒中肩关节疼痛和半脱位:一项随机对照试验。

IF 1.4 4区 医学 Q3 ORTHOPEDICS
Yafei Zhou, Yaolong Tu, Qingzhen Chen, Yingying Li, Qingqing Sun, Fenglan Zhan, Shihong Hu
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Current rehabilitation interventions alone can not purposefully address the aforementioned problems, while bilateral training (BT) and contralaterally controlled functional electrical stimulation (CCFES) can be synergistically coordinated to provide a simultaneous treatment for hemiplegic shoulders.ObjectiveThis study attempted to treat hemiplegic patients using bilateral training with contralaterally controlled functional electrical stimulation (BT-CCFES), aiming to observe the changes of shoulder pain, subluxation, and motor function.MethodsThirty-eight individuals who had experienced hemiplegia with shoulder pain and subluxation due to stroke were randomly divided into two groups: a control group and an experimental group consisting of nineteen cases both. Patients in the control group underwent neuromuscular electrical stimulation (NMES) therapy, while those in the experimental group received BT-CCFES. Before and after a four-week treatment period, shoulder subluxation distance (SSD) was measured using a flexible ruler, and the pain level was assessed using the visual analogue scale (VAS). Additionally, shoulder joint active range of motion (AROM) and the upper extremity Fugl-Meyer assessment (UE-FMA) were used to evaluate shoulder motor function.ResultsAfter four weeks of treatment, there were significant improvements in SSD, VAS, UE-FMA, and AROM in the experimental group (<i>p </i>< 0.001), as well as in the control group (<i>p </i>< 0.05). 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Before and after a four-week treatment period, shoulder subluxation distance (SSD) was measured using a flexible ruler, and the pain level was assessed using the visual analogue scale (VAS). Additionally, shoulder joint active range of motion (AROM) and the upper extremity Fugl-Meyer assessment (UE-FMA) were used to evaluate shoulder motor function.ResultsAfter four weeks of treatment, there were significant improvements in SSD, VAS, UE-FMA, and AROM in the experimental group (<i>p </i>< 0.001), as well as in the control group (<i>p </i>< 0.05). 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引用次数: 0

摘要

背景肩痛、半脱位和运动功能障碍是偏瘫患者常见的问题,这些问题阻碍了上肢功能的恢复,并对患者的日常生活能力和生活质量产生了负面影响。目前的康复干预措施本身并不能有针对性地解决上述问题,而双侧训练(BT)和对侧控制功能电刺激(CCFES)可以协同协调,为偏瘫肩部提供同时治疗。目的采用双侧控制功能电刺激(BT-CCFES)训练治疗偏瘫患者,观察其肩关节疼痛、半脱位及运动功能的变化。方法38例中风所致偏瘫伴肩痛半脱位患者随机分为对照组和实验组各19例。对照组采用神经肌肉电刺激(NMES)治疗,实验组采用BT-CCFES治疗。治疗前后用柔性尺测量肩关节半脱位距离(SSD),用视觉模拟评分(VAS)评估疼痛程度。此外,肩关节活动范围(AROM)和上肢Fugl-Meyer评估(UE-FMA)用于评估肩关节运动功能。结果治疗4周后,实验组患者的SSD、VAS、UE-FMA、AROM均有显著改善(p p p = 0.016),屈曲(37.37±14.08 vs 21.05±12.65,p = 0.001)、UE-FMA(15.21±4.30 vs 8.84±4.26,p p = 0.619)、外展(15.00±8.82 vs 10.79±7.86,p = 0.111)无显著改善(p p = 0.111)。结论bt - ccfes可预防和治疗脑卒中后偏瘫性肩关节半脱位,改善肩肢及上肢功能,除疼痛缓解外优于NMES。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bilateral training guided by contralaterally controlled functional electrical stimulation for shoulder pain and subluxation in subacute stroke: A randomized controlled trial.

BackgroundShoulder pain, subluxation, and motor dysfunction are common issues in hemiplegic patients, which hinder the recovery of upper limb function and have a negative impact on patients' daily life abilities and quality of life. Current rehabilitation interventions alone can not purposefully address the aforementioned problems, while bilateral training (BT) and contralaterally controlled functional electrical stimulation (CCFES) can be synergistically coordinated to provide a simultaneous treatment for hemiplegic shoulders.ObjectiveThis study attempted to treat hemiplegic patients using bilateral training with contralaterally controlled functional electrical stimulation (BT-CCFES), aiming to observe the changes of shoulder pain, subluxation, and motor function.MethodsThirty-eight individuals who had experienced hemiplegia with shoulder pain and subluxation due to stroke were randomly divided into two groups: a control group and an experimental group consisting of nineteen cases both. Patients in the control group underwent neuromuscular electrical stimulation (NMES) therapy, while those in the experimental group received BT-CCFES. Before and after a four-week treatment period, shoulder subluxation distance (SSD) was measured using a flexible ruler, and the pain level was assessed using the visual analogue scale (VAS). Additionally, shoulder joint active range of motion (AROM) and the upper extremity Fugl-Meyer assessment (UE-FMA) were used to evaluate shoulder motor function.ResultsAfter four weeks of treatment, there were significant improvements in SSD, VAS, UE-FMA, and AROM in the experimental group (p < 0.001), as well as in the control group (p < 0.05). The changes between the experimental group and control group showed significant differences in SSD (-9.74 ± 6.63 vs -3.58 ± 5.51, p = 0.016), flexion (37.37 ± 14.08 vs 21.05 ± 12.65, p = 0.001), and UE-FMA (15.21 ± 4.30 vs 8.84 ± 4.26, p < 0.001), while the difference in VAS (-1.31 ± 1.34 vs -1.10 ± 1.24, p = 0.619) and abduction (15.00 ± 8.82 vs 10.79 ± 7.86, p = 0.111) was not significant.ConclusionBT-CCFES can be used to prevent and treat hemiplegic shoulder subluxation after stroke, improve shoulder and upper limb function, and is superior to NMES except in pain relief.

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来源期刊
CiteScore
2.70
自引率
0.00%
发文量
194
审稿时长
6 months
期刊介绍: The Journal of Back and Musculoskeletal Rehabilitation is a journal whose main focus is to present relevant information about the interdisciplinary approach to musculoskeletal rehabilitation for clinicians who treat patients with back and musculoskeletal pain complaints. It will provide readers with both 1) a general fund of knowledge on the assessment and management of specific problems and 2) new information considered to be state-of-the-art in the field. The intended audience is multidisciplinary as well as multi-specialty. In each issue clinicians can find information which they can use in their patient setting the very next day.
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