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肩半脱位对脑卒中患者偏瘫上肢周围神经传导和功能的影响:一项回顾性、配对研究。

Impact of shoulder subluxation on peripheral nerve conduction and function of hemiplegic upper extremity in stroke patients: A retrospective, matched-pair study.

机构信息

Rehabilitation Medical Center, The Affiliated Suzhou Science & Technology Town Hospital of Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China.

出版信息

Neurol Res. 2021 Jun;43(6):511-519. doi: 10.1080/01616412.2020.1870360. Epub 2021 Jan 5.

Abstract

: To investigate the impact of shoulder subluxation (SS) on peripheral nerve conduction and function of the hemiplegic upper extremity (HUE) in poststroke patients.: Thirty post-stroke patients were selected (SS group: 15 patients, non-SS group: 15 patients, respectively). Evaluation of nerve conduction in upper limbs: the compound muscle action potential (CMAP) amplitude and latency of suprascapular, axillary, musculocutaneous, radial, median, and ulnar nerves; the motor and sensory conduction velocity and the sensory nerve action potential (SNAP) amplitude of median, ulnar, and radial nerves. The Brunnstrom stage scale was used to evaluate the HUE motor function.: Compared with the healthy side, the CMAP and SNAP amplitudes of tested nerves on the HUE in both groups were lower, and the CMAP latency of the suprascapular, axillary and musculocutaneous nerves on the HUE in the SS group was longer (P < 0.05). Compared with the HUE in non-SS group, the CMAP amplitude of tested nerves (except ulnar) was decreased more (P < 0.05), the motor conduction velocity of the median nerve was lower (P < 0.05), and the Brunnstrom stage of the HUE was lower in SS group (P < 0.05).: Stroke may lead to extensive abnormal nerve conduction on the HUE, and SS may aggravate the abnormality, which may disturb the recovery of upper limb function.

摘要

: 探讨脑卒中后患者肩关节半脱位(SS)对偏瘫上肢(HUE)周围神经传导和功能的影响。

: 共选择 30 例脑卒中患者(SS 组 15 例,非 SS 组 15 例)。上肢神经传导评估:检测冈上肌、腋神经、肌皮神经、桡神经、正中神经和尺神经的复合肌肉动作电位(CMAP)幅度和潜伏期;正中神经、尺神经和桡神经的运动和感觉传导速度以及感觉神经动作电位(SNAP)幅度。采用 Brunnstrom 分期量表评估 HUE 运动功能。

: 与健侧相比,两组 HUE 测试神经的 CMAP 和 SNAP 幅度均降低,SS 组 HUE 的冈上肌、腋神经和肌皮神经的 CMAP 潜伏期延长(P < 0.05)。与非 SS 组相比,SS 组 HUE 测试神经(尺神经除外)的 CMAP 幅度下降更明显(P < 0.05),正中神经的运动传导速度较低(P < 0.05),且 HUE 的 Brunnstrom 分期较低(P < 0.05)。

: 脑卒中可导致 HUE 广泛的异常神经传导,SS 可加重异常,可能干扰上肢功能的恢复。

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