Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu, Republic of Korea.
NeuroRehabilitation. 2013;32(2):369-75. doi: 10.3233/NRE-130857.
We investigated the effect of a static stretching device on spasticity and motor function for people with chronic hemiparesis following stroke. Ten participants with chronic hemiparesis following stroke who had severe spasticity and incomplete weakness of the affected wrist and hand were recruited. The stretching device consisted of a resting hand splint, a finger and thumb stretching system, and a frame. The stretched state was maintained for 10 minutes/session, and the static stretching program was performed for 2 sessions/day and 7 days/week for 4 weeks. Spasticity and motor function of the affected wrist and hand were assessed three times with intervals of 4 weeks (twice [Pre-1, Pre-2] before and once [Post-1] after starting the static stretching program). The effect of the static stretching device was assessed using modified Ashworth scale (MAS) scores, by measuring active range of motion (AROM), and using the wrist and hand subsection of the Fugl-Meyer motor assessment (FMA). The main effects of the static stretching program on MAS scores for wrist and metacarpophalangeal (MCP) joints and FMA scores were significant. AROMs of MCPs and wrist showed an increase, however, no significant main effects of the static stretching program were observed. MAS in flexor muscles of MCP joints showed a significant decreased from Pre-2 (mean ± standard deviation (SD): 2.56 ± 0.55; median and interquartile range (IQR): 2.42, 2.12-3.08) to Post-1 (mean ± SD: 1.05 ± 0.49; median and IQR: 1.08, 0.87-1.50) (P < 0.001), and MAS in wrist flexor muscles also showed a significant decrease from Pre-2 (mean ± SD: 3.20 ± 0.78; median and IQR: 3.0, 2.75-4.0) to Post-1 (mean ± SD: 1.90 ± 0.73; median and IQR: 2.0, 1.0-2.5) (P < 0.001). FMA score also showed a significant increase from Pre-2 (11.3 ± 6.09) to Post-1 (14.5 ± 6.20) (P < 0.001). It was found that the static stretching device effectively relieved spasticity and improved motor function in subjects with severe spasticity and incomplete weakness following stroke.
我们研究了一种静态拉伸装置对脑卒中后慢性偏瘫患者的痉挛和运动功能的影响。招募了 10 名患有慢性偏瘫且手腕和手部严重痉挛、且存在不完全无力的脑卒中患者。拉伸装置由一个休息手夹板、一个手指和拇指拉伸系统和一个框架组成。每次拉伸 10 分钟/节,每天进行 2 节/次,每周进行 7 天/次,共进行 4 周。在开始静态拉伸方案前(Pre-1 和 Pre-2)和开始后(Post-1)分别进行 3 次评估,评估的内容为患侧手腕和手部的痉挛和运动功能。采用改良 Ashworth 量表(MAS)评分、主动活动范围(AROM)和 Fugl-Meyer 运动评估(FMA)的腕和手部子项评估静态拉伸装置的效果。静态拉伸方案对腕关节和掌指关节(MCP)MAS 评分和 FMA 评分的主要影响具有统计学意义。MCP 和腕关节的 AROM 增加,但静态拉伸方案的主要影响无统计学意义。MCP 屈肌 MAS 评分从 Pre-2(均值±标准差(SD):2.56±0.55;中位数和四分位数范围(IQR):2.42,2.12-3.08)到 Post-1(均值±SD:1.05±0.49;中位数和 IQR:1.08,0.87-1.50)显著降低(P<0.001),腕关节屈肌 MAS 评分从 Pre-2(均值±SD:3.20±0.78;中位数和 IQR:3.0,2.75-4.0)到 Post-1(均值±SD:1.90±0.73;中位数和 IQR:2.0,1.0-2.5)也显著降低(P<0.001)。FMA 评分从 Pre-2(11.3±6.09)到 Post-1(14.5±6.20)也显著增加(P<0.001)。结果表明,该静态拉伸装置可有效缓解脑卒中后严重痉挛和不完全无力患者的痉挛,改善运动功能。