Kumar R, Metter E J, Mehta A J, Chew T
Department of Rehabilitation Medicine Service, Veterans Administration Medical Center, Sepulveda, California 91343.
Am J Phys Med Rehabil. 1990 Aug;69(4):205-8. doi: 10.1097/00002060-199008000-00007.
One of the causes for shoulder pain associated with hemiplegia is thought to be vigorous range of motion to the involved upper extremity. The objective of this study was to analyze the occurrence of pain in patients treated with one of the three exercise programs commonly used in the rehabilitation of hemiplegia: 1) range of motion by the therapist, 2) skate board and 3) overhead pulley. Of the 48 hemiplegic patients evaluated, 28 were assigned to one of the three exercise groups. Comparing the number of patients who developed pain in each group, there was a significant difference, with 8% of the patients in the range of motion by the therapist group, 12% of the patients in the skate board group and 62% of the patients in the overhead pulley group developing pain (chi 2 = 8.44) (P = 0.014). The three groups did not differ in the side of involvement (P = 0.57), extent of hemiplegia (P = 0.25) or presence of subluxation (P = 0.84). Use of overhead pulley has the highest risk of developing shoulder pain and should be avoided during rehabilitation of stroke patients.
偏瘫相关性肩痛的原因之一被认为是受累上肢的剧烈活动范围。本研究的目的是分析采用偏瘫康复中常用的三种锻炼方案之一进行治疗的患者疼痛的发生情况：1）治疗师辅助活动范围训练、2）滑板训练和3）头顶滑轮训练。在评估的48例偏瘫患者中，28例被分配到三个锻炼组之一。比较每组出现疼痛的患者数量，存在显著差异，治疗师辅助活动范围训练组有8%的患者、滑板训练组有12%的患者、头顶滑轮训练组有62%的患者出现疼痛（卡方 = 8.44）（P = 0.014）。三组在受累侧（P = 0.57）、偏瘫程度（P = 0.25）或半脱位情况（P = 0.84）方面无差异。使用头顶滑轮训练出现肩痛的风险最高，在中风患者康复期间应避免使用。
