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超声评估神经肌肉电刺激对偏瘫患者肩肱关节半脱位的疗效:一项随机对照研究。

Ultrasonographic assessment of neuromuscular electrical stimulation efficacy on glenohumeral subluxation in patients with hemiplegia: a randomized-controlled study.

作者信息

Türkkan Canan, Öztürk Gökhan Tuna, Uğurlu Fatma Gülçin, Ersöz Murat

机构信息

Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey.

Department of Physical Medicine and Rehabilitation, Medical Faculty of Yıldırım Beyazıt University, Ankara, Turkey.

出版信息

Turk J Phys Med Rehabil. 2017 May 17;63(4):287-292. doi: 10.5606/tftrd.2017.953. eCollection 2017 Dec.

Abstract

OBJECTIVES

This study aims to investigate the short-term effects of neuromuscular electrical stimulation (NMES) on glenohumeral subluxation (GHS) in stroke patients.

PATIENTS AND METHODS

This prospective, randomized-controlled study included 24 unilateral hemiplegic patients (10 males, 14 females; mean age 64.1±14.8 years; range 22 to 84 years) with GHS as assessed by ultrasonography between December 2013 and September 2014. The patients were randomly divided into two groups as those in the NMES group (n=12) who were treated with NMES to supraspinatus, upper trapezius, and posterior deltoid muscles combined with conventional physiotherapy and as those in the control group (n=12) who were received conventional physiotherapy alone. Clinical (the Brunnstrom Motor Recovery Stage, Visual Analog Scale [VAS] for Pain and Shoulder Disability Questionnaire [SDQ]) and ultrasonographic (acromion-greater tuberosity distance, thicknesses of supraspinatus, upper trapezius, and posterior deltoid muscles) variables were evaluated before and after treatment in both groups.

RESULTS

The SDQ index, acromion-greater tuberosity distance, and supraspinatus muscle thickness were improved in the NMES group, compared to the control group (for all p<0.05). The VAS-pain scores decreased in both groups. There was no statistically significant alterations in the other measurements in both groups (for all p>0.05). The percentage change (%) of the VAS-pain scores was not significantly different between two groups (p=0.03).

CONCLUSION

Our study results showed that GHS decreased after 20 sessions of NMES treatment. Based on these findings, ultrasonography appears to be a proper imaging tool for the evaluation of GHS in stroke patients.

摘要

目的

本研究旨在调查神经肌肉电刺激(NMES)对中风患者肩肱关节半脱位(GHS)的短期影响。

患者与方法

本前瞻性随机对照研究纳入了24例单侧偏瘫患者(10例男性,14例女性;平均年龄64.1±14.8岁;年龄范围22至84岁),这些患者在2013年12月至2014年9月期间经超声检查确诊为GHS。患者被随机分为两组,NMES组(n = 12)采用NMES刺激冈上肌、斜方肌上部和三角肌后部肌肉并结合传统物理治疗,对照组(n = 12)仅接受传统物理治疗。在两组治疗前后评估临床指标(Brunnstrom运动恢复阶段、疼痛视觉模拟量表[VAS]和肩部残疾问卷[SDQ])以及超声指标(肩峰 - 大结节距离、冈上肌、斜方肌上部和三角肌后部肌肉厚度)。

结果

与对照组相比,NMES组的SDQ指数、肩峰 - 大结节距离和冈上肌厚度有所改善(所有p < 0.05)。两组的VAS疼痛评分均下降。两组的其他测量指标均无统计学显著变化(所有p > 0.05)。两组之间VAS疼痛评分的百分比变化(%)无显著差异(p = 0.03)。

结论

我们的研究结果表明,20次NMES治疗后GHS有所减轻。基于这些发现,超声检查似乎是评估中风患者GHS的合适影像学工具。

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