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基于吊带悬吊的主动肩关节运动对亚急性脑卒中患者肩关节半脱位、疼痛、肌肉力量和上肢功能的影响。

Effects of Sling-Suspension-Based Active Shoulder Joint Exercise on Shoulder Joint Subluxation, Pain, Muscle Strength, and Upper Limb Function in Patients with Subacute Stroke.

机构信息

Graduate School of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea.

Department of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea.

出版信息

Medicina (Kaunas). 2024 Aug 20;60(8):1350. doi: 10.3390/medicina60081350.

Abstract

: We investigated the effects of sling-suspension-based active shoulder joint exercise training on shoulder joint subluxation, pain, muscle strength, and upper extremity function in patients with subacute stroke. : Twenty-eight patients with subacute stroke were randomly assigned to either the sling-suspension-based active shoulder joint exercise (SASE) group ( = 14) or the motorized upper extremity exercise (MUEE) group ( = 14). The SASE group actively performed shoulder joint flexion, extension, abduction, adduction, external and internal rotation, and horizontal abduction and adduction using a sling suspension system, whereas the MUEE group underwent an exercise program using a motorized upper extremity exercise machine. All participants underwent a 4-week intervention with 30 min of exercise once a day for 5 days a week. Additionally, both groups received general physical therapy and functional electrical stimulation for 30 min twice a day for 5 days a week. Shoulder joint subluxation was measured by radiographic examination before and after training, and pain was evaluated in the splenius, upper trapezius, and infraspinatus muscles using pressure parameters. In addition, a manual muscle tester was used to assess the muscle strength of the shoulder joint flexors, extensors, abductors, adductors, and external and internal rotators, and the Fugl-Mayer Assessment (FMA) and Manual Functional Test (MFT) were used to evaluate upper extremity function. : A significant group-time interaction was observed for pain, with F-values of (1, 26) = 7.470, < 0.011 for the splenius and (1, 26) = 9.623, < 0.005 for the upper trapezius. A significant time-group interaction was observed for the muscle strength of the shoulder, with F-values of (1, 26) = 13.211, < 0.001; (1, 26) = 4.974, = 0.035 and (1, 26) = 9.674, = 0.004 for flexors, abductors, and external rotators, respectively. A significant time-group interaction was observed in the FMA, with F-values of (1, 26) = 13.243, < 0.001. When comparing the interaction effects between time and group for MFT scores, a significant difference was observed, with F-values of (1, 26) = 32.386, < 0.001. : This study confirmed that sling-suspension-based active shoulder joint exercises are effective in improving shoulder joint subluxation, pain, muscle strength, and upper extremity function in patients with subacute stroke.

摘要

我们研究了吊带悬吊带式主动肩关节运动训练对亚急性脑卒中患者肩关节半脱位、疼痛、肌肉力量和上肢功能的影响。

将 28 例亚急性脑卒中患者随机分为吊带悬吊带式主动肩关节运动(SASE)组(n=14)和电动上肢运动(MUEE)组(n=14)。SASE 组通过吊带悬吊带系统主动进行肩关节前屈、伸展、外展、内收、外旋和内旋、水平外展和内收,而 MUEE 组则使用电动上肢运动机器进行运动计划。所有参与者接受为期 4 周的干预,每天 30 分钟,每周 5 天。此外,两组均接受每天两次、每次 30 分钟的常规物理治疗和功能性电刺激。在训练前后通过放射检查测量肩关节半脱位,使用压力参数评估斜方肌、上斜方肌和肩胛下肌的疼痛。此外,使用手动肌肉测试仪评估肩关节屈肌、伸肌、外展肌、内收肌、外旋肌和内旋肌的肌肉力量,使用 Fugl-Meyer 评估(FMA)和手动功能测试(MFT)评估上肢功能。

疼痛的组间时间交互作用有统计学意义,F 值为(1,26)=7.470, <0.011 (斜方肌)和(1,26)=9.623, <0.005(上斜方肌)。肩关节肌肉力量的组间时间交互作用有统计学意义,F 值为(1,26)=13.211, <0.001;(1,26)=4.974, =0.035 和(1,26)=9.674, <0.004(屈肌、外展肌和外旋肌)。FMA 的组间时间交互作用有统计学意义,F 值为(1,26)=13.243, <0.001。当比较 MFT 评分的时间和组间交互效应时,发现差异有统计学意义,F 值为(1,26)=32.386, <0.001。

这项研究证实,吊带悬吊带式主动肩关节运动对亚急性脑卒中患者肩关节半脱位、疼痛、肌肉力量和上肢功能的改善是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a04/11356110/4dedf48a2565/medicina-60-01350-g001.jpg

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