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肌肉骨骼超声检查在脑卒中后偏瘫肩康复中的临床应用价值

The clinical utility of musculoskeletal ultrasonography in hemiplegic shoulder rehabilitation poststroke.

作者信息

Liu Jun, Pan Huijuan, Bao Yong, Huang Li, Hu Yunyun

机构信息

Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of Rehabilitation Medicine, Shanghai Ruijin Rehabilitation Hospital, Shanghai, China.

出版信息

Front Rehabil Sci. 2025 May 15;6:1576890. doi: 10.3389/fresc.2025.1576890. eCollection 2025.

Abstract

OBJECTIVE

This study aimed to assess the utility of musculoskeletal ultrasound (MSUS) in the rehabilitation of stroke patients with hemiplegic shoulder pain.

METHODS

We conducted a study involving 80 stroke patients with hemiplegia and concomitant shoulder pain on the affected side, admitted to our hospital between April 2020 and March 2021. MSUS was used to evaluate shoulder structures, including the long head of the biceps brachii tendon (BICT) and its sheath, rotator cuff, subacromial-subdeltoid (SA-SD) bursa, labrum, acromioclavicular ligament, acromiocoracoid ligament, and acromion-greater tuberosity (AGT) distance. We compared pre- and post-rehabilitation measurements of supraspinatus tendon (SST) thickness, BICT sheath effusion thickness, SA-SD bursa effusion thickness, AGT distance, and visual analog scale (VAS) scores. Statistical significance was set at  < 0.05.

RESULTS

Post-rehabilitation, the SST thickness on the hemiplegic side showed a statistically significant reduction ( = 0.023). No significant difference was observed in the mean maximum rupture diameter ( = 0.796). Both BICT sheath effusion ( < 0.001) and SA-SD bursa effusion ( < 0.001) exhibited significant decreases. The AGT distance on the hemiplegic side also demonstrated a statistically significant change ( < 0.001). Additionally, the VAS score significantly improved post-rehabilitation ( < 0.001).

CONCLUSION

MSUS is a feasible and reproducible tool for monitoring rehabilitation progress in stroke patients with hemiplegic shoulder pain.

摘要

目的

本研究旨在评估肌肉骨骼超声(MSUS)在偏瘫性肩痛中风患者康复中的应用价值。

方法

我们进行了一项研究,纳入了2020年4月至2021年3月期间我院收治的80例偏瘫且患侧伴有肩痛的中风患者。使用MSUS评估肩部结构,包括肱二头肌长头肌腱(BICT)及其腱鞘、肩袖、肩峰下-三角肌下滑囊(SA-SD)、盂唇、肩锁韧带、喙肩韧带以及肩峰-大结节(AGT)距离。我们比较了康复前后的冈上肌腱(SST)厚度、BICT腱鞘积液厚度、SA-SD滑囊积液厚度、AGT距离以及视觉模拟评分(VAS)。统计学显著性设定为<0.05。

结果

康复后,偏瘫侧的SST厚度显示出统计学显著降低(=0.023)。平均最大破裂直径未观察到显著差异(=0.796)。BICT腱鞘积液(<0.001)和SA-SD滑囊积液(<0.001)均显著减少。偏瘫侧的AGT距离也显示出统计学显著变化(<0.001)。此外,康复后VAS评分显著改善(<0.001)。

结论

MSUS是监测偏瘫性肩痛中风患者康复进展的一种可行且可重复的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b2f/12119546/e2b229f604ec/fresc-06-1576890-g001.jpg

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