冲击波联合下肢负重振动训练治疗脑卒中后下肢肌痉挛的疗效观察

doi:10.3969/j.issn.1006-6233.2022.12.026

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Abstract Objective: To study the effect and function of extracorporeal shock wave combined with lower limb weight-bearing vibration training in the treatment of lower limb muscle spasm after stroke. Methods: 120 patients with lower limb spasm after stroke treated in our hospital from January 2019 to January 2020 were selected as the research subjects. They were randomly divided into observation group and control group, with 60 cases in each group. All patients were treated with routine antispasmodic rehabilitation therapy. On this basis, the patients in the observation group were given extracorporeal shock wave combined with lower limb weight-bearing vibration training. The patients in both groups were treated for 4 weeks. Before and at the end of treatment, the patients in the two groups were examined with modified Ashworth Scale (MAS), activities of daily living (ADL), Fugl Meyer assessment (FMA), modified Barthel index, functional ambulation category scale (FAC) Joint mobility (ROM), and ultrasonic muscle structural parameters such as pinnate angle of muscle (PA), muscle fiber length (FL) and muscle fiber thickness (MT) were measured. Results: After treatment, the MAS grade of the two groups was significantly improved (P<0. 05). After treatment, the proportion of MAS grade I in the observation group was significantly higher than that in the control group (70. 00% vs 50. 00%), and the proportion of grade Ⅲ in the observation group was significantly lower than that in the control group (0. 00% vs 15. 00%) (P<0. 05). After treatment, the MAS score of the two groups was significantly lower than that before treatment, and the FMA score, FAC score and modified Barthel index were significantly higher than those before treatment (P<0. 05). The a-rom score and p-rom score of the observation group after treatment were significantly lower than those before treatment (P<0. 05). After treatment, the MAS score of the observation group was significantly lower than that of the control group, and the FMA score, FAC score, modified Barthel index, a-rom score and p-rom score of the observation group were significantly higher than those of the control group (P<0. 05). After treatment, PA and MT decreased significantly and FL increased significantly in the two groups (P<0. 05). After treatment, PA and MT of the affected limbs in the observation group were significantly lower than those in the control group, and FL was significantly higher than that in the control group (P<0. 05). Conclusion: On the basis of routine antispasmodic rehabilitation, the combined application of extracorporeal shock wave and lower limb weight-bearing wave vibration therapy can significantly alleviate the spasticity of lower limbs, improve the muscle strength of lower limbs, and improve the trunk stability, posture control ability and muscle structure parameters of patients. The clinical effect is accurate and worthy of popularization.

Key words： Vibration training Extracorporeal shock wave Stroke Muscle spasm Lower limb function Muscle structure

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2022.12.026 OR http://www.hbyxzzs.cn/EN/Y2022/V28/I12/2072