目的 探讨全身振动训练联合超声注射治疗脑卒中后肩痛患者的疗效。 方法 选取2023年3月-2024年4月广州医科大学附属第四医院康复医学科收治的脑卒中后肩痛患者60例，随机分为对照组和观察组各30例；对照组采用常规康复训练和超声引导下复方倍他米松注射治疗，观察组在对照组基础上采用全身振动训练。对比2组治疗前(t0)、治疗后7 d（t1）和治疗后30 d(t2)，采用疼痛视觉模拟量表评分（VAS）、Fugy-Meyer评定量表上肢部分评分（FMA-UE）、无痛被动肩外展+外旋总评分（PROM）及改良Barthel指数量表（MBI）进行评价。 结果 治疗前两组患者的性别、年龄、病程、卒中类型差异均无统计学意义(P>0.05)；与t0相比较，两组患者治疗后各时间点的VAS评分、FMA-UE评分、PROM总评分、MBI评分均有改善（P<0.01）；观察组在t1的FMA-UE评分、MBI评分显著高于对照组（P<0.01）；观察组在t2的FMA-UE评分、MBI评分显著高于对照组（P<0.01），而VAS评分、PROM总评分显著低于对照组（P<0.01）。 结论 全身振动训练联合超声注射治疗脑卒中后肩痛可缓解患肩疼痛和改善肩关节活动范围，提高肩关节活动功能。
Abstract
Objective To investigate the therapeutic effect of whole body vibration training combined with ultrasound injection in the treatment of shoulder pain after stroke. Methods A total of 60 patients with post-stroke shoulder pain admitted to the department of Rehabilitation Medicine, the Fourth Affiliated Hospital of Guangzhou Medical University from January 2022 to December 2023 were randomly divided into control group and observation group, with 30 patients in each group. The control group received routine rehabilitation training and ultrasound-guided injection of compound betamethasone, and the observation group received whole body vibration training on the basis of the control group. The two groups were compared before treatment (t0) and 7 days after treatment (t1). At 30 days after treatment (t2), pain Visual Analogue Scale (VAS) score, Fugy-Meyer Rating Scale Upper limb partial score (FMA-UE), painless passive shoulder abduction + external rotation total score (PROM) and modified Barthel Index scale (MBI) were used to evaluate the situation. Results There were no significant differences in gender, age, course of disease and type of stroke between the two groups before treatment (P>0.05). Compared with t0, VAS score, FMA-UE score, PROM total score and MBI score of the two groups were improved at each time point after treatment (P<0.01). The FMA-UE score and MBI score of observation group at t1 were significantly higher than those of control group (P<0.01). The FMA-UE score and MBI score at t2 in the observation group were significantly higher than those in the control group (P<0.01), while the VAS score and PROM score in the observation group were significantly lower than those in the control group (P<0.01). Conclusions Whole body vibration training combined with ultrasound injection in the treatment of post-stroke shoulder pain can relieve the pain of the affected shoulder, improve the range of motion of the shoulder joint, and improve the mobility of the shoulder joint.
关键词
全身振动训练； /
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超声注射； /
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脑卒中后肩痛
Key words
Whole body vibration training; /
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Ultrasonic injection; /
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Shoulder pain after stroke
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