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拉伸运动在痉挛管理中的应用:有效性、风险及辅助治疗

Stretching exercises in managing spasticity: effectiveness, risks, and adjunct therapies.

作者信息

Mehraban Jahromi Mostafa, Vlček Přemysl, Grünerová Lippertová Marcela

机构信息

Third Faculty of Medicine, Charles University, Prague.

Third Faculty of Medicine, Charles University, Prague; National Institute of Mental Health, Klecany.

出版信息

Eur J Transl Myol. 2024 Jun 13;34(2):12455. doi: 10.4081/ejtm.2024.12455.

Abstract

Spasticity is a component of upper motor neuron disorders and can be seen in neurological conditions like stroke and multiple sclerosis. Although the incidence rate of spasticity is unknown, it can put pressure on the health condition of those with spasticity, and there is no absolute effective way to control it. In the past, stretching exercises were an accessible tool for physical therapists to manage and control spasticity, but opinions on the optimal dose, aftereffects, and mechanism of effects were controversial. Therefore, this article tries to provide an overview of the effectiveness and risks of stretching exercises. Furthermore, there are several adjunct therapies, such as brain stimulation and botulinum injection, that can increase the effectiveness of a simple stretch by increasing cortical excitability and reducing muscle tone and their role is evaluated in this regard. The results of this study propose that several prospective and case studies have demonstrated the benefits of stretching to control spasticity, but it seems that other methods such as casting can be more effective than a simple stretch. Therefore, it is better to use stretching in combination with other therapeutic regimes to increase its effectivity of it.

摘要

痉挛是上运动神经元疾病的一个组成部分,在中风和多发性硬化症等神经系统疾病中可见。尽管痉挛的发病率尚不清楚,但它会给痉挛患者的健康状况带来压力,而且目前尚无绝对有效的控制方法。过去,伸展运动是物理治疗师管理和控制痉挛的一种常用手段,但对于最佳剂量、后效应和作用机制,各方观点存在争议。因此,本文试图概述伸展运动的有效性和风险。此外,还有几种辅助疗法,如脑刺激和肉毒杆菌注射,它们可以通过增加皮层兴奋性和降低肌张力来提高单纯伸展运动的效果,本文将对它们在这方面的作用进行评估。这项研究的结果表明,一些前瞻性研究和案例研究已经证明了伸展运动对控制痉挛的益处,但似乎其他方法,如石膏固定,可能比单纯的伸展运动更有效。因此,最好将伸展运动与其他治疗方案结合使用,以提高其有效性。

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