Government Physiotherapy College, Government Spine Institute, Civil Hospital, Ahmedabad, Gujrat, India.
Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Medicine (Baltimore). 2022 Aug 5;101(31):e29926. doi: 10.1097/MD.0000000000029926.
Impaired motor function and upper extremity spasticity are common concerns in patients after stroke. It is essential to plan therapeutic techniques to recover from the stroke. The objective of this study was to investigate the effects of myofascial release with the tennis ball on spasticity and motor functions of the upper extremity in patients with chronic stroke.
Twenty-two chronic stroke patients (male-16, female-6) were selected to conduct this study. Two groups were formed: the control group (n=11) which included conventional physiotherapy only and the experimental group (n=11) which included conventional physiotherapy along with tennis ball myofascial release - in both groups interventions were performed for 6 sessions (35 minutes/session) per week for a total of 4 weeks. The conventional physiotherapy program consisted of active and passive ROM exercises, positional stretch exercises, resistance strength training, postural control exercises, and exercises to improve lower limb functions. All patients were evaluated with a modified Ashworth scale for spasticity of upper limb muscles (biceps brachii, pronator teres, and the long finger flexors) and a Fugl-Meyer assessment scale for upper limb motor functions before and after 4 weeks. Nonparametric (Mann-Whitney U test and Wilcoxon signed-rank test) tests were used to analyze data statistically. This study has been registered on clinicaltrial.gov (ID: NCT05242679).
A significant improvement (P < .05) was observed in the spasticity of all 3 muscles in both groups. For upper limb motor functions, significant improvement (P < .05) was observed in the experimental group only. When both groups were compared, greater improvement (P < .05) was observed in the experimental group in comparison to the control group for both spasticity of muscles and upper limb motor functions.
Myofascial release performed with a tennis ball in conjunction with conventional physiotherapy has more beneficial effects on spasticity and motor functions of the upper extremity in patients with chronic stroke compared to conventional therapy alone.
运动功能障碍和上肢痉挛是脑卒中后患者常见的问题。制定治疗技术以从脑卒中恢复非常重要。本研究的目的是探讨网球肌筋膜松解对慢性脑卒中患者上肢痉挛和运动功能的影响。
选择 22 例慢性脑卒中患者(男 16 例,女 6 例)进行本研究。将患者分为两组:对照组(n=11)仅接受常规物理治疗,实验组(n=11)在常规物理治疗的基础上增加网球肌筋膜松解治疗-两组每周各进行 6 次治疗(每次 35 分钟),共 4 周。常规物理治疗方案包括主动和被动关节活动度练习、位置伸展练习、阻力力量训练、姿势控制练习和改善下肢功能的练习。所有患者在治疗前后均采用改良 Ashworth 量表评估上肢肌肉(肱二头肌、旋前圆肌和长指屈肌)痉挛程度和 Fugl-Meyer 上肢运动功能评估量表评估上肢运动功能。采用非参数(Mann-Whitney U 检验和 Wilcoxon 符号秩检验)对数据进行统计学分析。本研究已在 clinicaltrial.gov 注册(ID:NCT05242679)。
两组患者 3 块肌肉的痉挛均有显著改善(P <.05)。在实验组中,上肢运动功能也有显著改善(P <.05)。与对照组相比,实验组在肌肉痉挛和上肢运动功能方面均有更大的改善(P <.05)。
与单独常规治疗相比,网球肌筋膜松解联合常规物理治疗对慢性脑卒中患者上肢痉挛和运动功能的改善效果更好。