| 摘要: |
| 目的：观察推拿联合电子生物反馈对脑卒中后肩关节半脱位患者的上肢功能及脱位程度、肩周肌肉功能的影响。方法：将66 例脑卒中后肩关节半脱位患者随机分为治疗组和对照组，每组各33 例。对照组行电子生物反馈治疗，治疗组在此基础上行推拿治疗。分别于治疗前、治疗4周、治疗8周后采用Fugl-Meyer评定量表（Fugl-Meyer assessment scale，FMA）和肩关节功能评价量表（Constant-Murley score，CMS）评价2组患者肩关节功能，采用视觉模拟评分法（visual analogue scale，VAS）评估肩部疼痛程度，表面肌电图检测三角肌后束和冈上肌收缩时的积分肌电值，通过肩峰与肱骨头间距（acromion-greater tuberosity，AGT）评估疗效。结果：治疗过程中，对照组脱落1例。2组治疗4、8周后的FMA评分、CMS评分和积分肌电值均高于治疗前，VAS评分、AGT均低于治疗前，差异均有统计学意义（P＜0.01），且治疗组治疗4、8周后的FMA评分、CMS评分和积分肌电值均高于对照组，AGT均低于对照组，治疗8周时的VAS评分低于对照组，差异均有统计学意义（P＜0.01或P＜0.05）。结论：推拿联合电子生物反馈治疗能显著改善脑卒中后肩关节半脱位患者的肩部肌肉状态，减轻疼痛，同时改善患者肩关节半脱位状态，有助于上肢和肩关节功能的恢复，促进患者病情好转。 |
| 关键词: 脑卒中 肩关节半脱位 推拿 电子生物反馈 上肢功能 脱位程度 肩周肌肉功能 |
| DOI： |
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| Clinical effect of massage combined with electronic biofeedback in treatment of post-stroke shoulder subluxation：An analysis of 33 cases |
| ZHANG Yuntao,ZHAO Yong,YANG Lanlan |
| (Qianjiang Hospital of Traditional Chinese Medicine，Qianjiang 433100，Hubei，China) |
| Abstract: |
| Objective：To investigate the effect of massage combined with electronic biofeedback on upper limb function，degree of dislocation，and shoulder muscle function in patients with post-stroke shoulder subluxation.Methods：A total of 66 patients with post-stroke shoulder subluxation were randomly divided into treatment group and control group，with 33 patients in each group.The patients in the control group received electronic biofeedback therapy，and those in the treatment group received massage in addition to the treatment in the control group.Before treatment and after 4 and 8 weeks of treatment，Fugl-Meyer Assessment （FMA）and Constant-Murley Score （CMS）were used to assess shoulder function；Visual Analogue Scale （VAS）was used to evaluate the degree of shoulder pain；surface electromyography was used to measure the integrated electromyography value of posterior deltoid and supraspinatus during contraction；acromion-greater tuberosity （AGT）was used to assess treatment outcome.Results：One patient in the control group was lost to follow-up during treatment.Both groups had significant increases in FMA score，CMS score，and integrated electromyography value and significant reductions in VAS score and AGT after 4 and 8 weeks of treatment （P＜0.01），and compared with the control group，the treatment group had significantly higher FMA score，CMS score，and integrated electromyography value and a significant lower AGT after 4 and 8 weeks of treatment，as well as a significantly lower VAS score after 8 weeks of treatment （P＜0.01 or P＜0.05）.Conclusion：In patients with post-stroke shoulder subluxation，massage combined with electronic biofeedback therapy can significantly improve the state of shoulder muscle，alleviate pain，improve shoulder subluxation，facilitate the recovery of upper limb and shoulder function，and promote the improvement in disease conditions. |
| Key words: stroke shoulder subluxation massage electronic biofeedback upper limb function degree of dislocation shoulder muscle function |
