佩戴腕托对脑卒中后偏瘫手功能康复的影响

doi:10.3969/j.issn.1006-9771.2020.03.008

《中国康复理论与实践》 ›› 2020, Vol. 26 ›› Issue (3): 306-309.doi: 10.3969/j.issn.1006-9771.2020.03.008

佩戴腕托对脑卒中后偏瘫手功能康复的影响

马善新¹(),许建文¹,马楠²,苏义¹,林伟山¹,陶广林¹

1.广西医科大学第一附属医院康复医学科,广西南宁市 530021
2.山东省东营市东营区人民医院,山东东营市 257000

收稿日期:2019-08-02 修回日期:2019-09-02 出版日期:2020-03-25 发布日期:2020-04-01
通讯作者: 马善新 E-mail:583948337@qq.com
作者简介:马善新(1986-),男,壮族,广西南宁市人,硕士,主治医师,主要研究方向：肌骨超声与痛症。
基金资助:
1.广西康复临床重点专科建设项目经费资助项目(桂卫医发)([2018]6);2.广西医药卫生基金(Z20190845)

Effects of Wrist Brace on Activities of Hemiplegic Hand after Stroke

MA Shan-xin¹(),XU Jian-wen¹,MA Nan²,SU Yi¹,LIN Wei-shan¹,TAO Guang-lin¹

1. Department of Rehabilitation, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China
2. Dongying District People's Hospital, Dongying, Shandong 257000, China

Received:2019-08-02 Revised:2019-09-02 Published:2020-03-25 Online:2020-04-01
Contact: MA Shan-xin E-mail:583948337@qq.com
Supported by:
Guangxi Clinical Rehabilitation Construction([2018]6);Guangxi Medical and Health Foundation(Z20190845)

摘要/Abstract

摘要：

目的观察在注射A型肉毒毒素(BTX-A)和电刺激的基础上,佩戴腕托对脑卒中患者偏瘫上肢活动的效果。方法 2016年1月至2018年12月,脑卒中上肢痉挛性偏瘫患者52例,均接受BTX-A注射治疗,注射2 d后行伸指肌群电刺激。A组(n = 26)在刺激时佩戴腕托,B组(n = 26)不佩戴。于治疗前(T0)、治疗2周后(T1)、治疗4周后(T2)、治疗12周后(T3)采用改良Ashworth量表(MAS)、积木盒障碍测试(BBt)、上肢动作研究量表(ARAT)进行评定。结果治疗后,两组MAS、BBt、ARAT评分均提高(F_时间 > 118.32, P < 0.001),A组BBt、ARAT各时间点评分均优于B组( F_组别 > 31.26, P < 0.001; F_交互 = 10.65,P < 0.001)。结论佩戴腕托能进一步提高BTX-A注射后电刺激对脑卒中患者偏瘫手的疗效。

关键词: 脑卒中, 偏瘫, A型肉毒毒素, 电刺激, 腕托, 手

Abstract:

Objective To observe the effect of a wrist brace on activities of spastic hemiplegic hand after stroke, based on Botulinum toxin type A (BTX-A) injection and electrical stimulation. Methods From January, 2016 to December, 2018, 52 stroke patients with spastic hemiplegia on upper extremities accepted BTX-A injection, and electrical stimulation two days later, while group A (n = 26) wore a wrist brace during stimulation and group B (n = 26) did not. They were assessed with modified Ashworth Scale (MAS), Box and Block test (BBt) and Action Research Arm Test (ARAT) before treatment (T0), and two (T1), four (T2) and twelve 12 (T3) weeks after treatment. Results The scores of MAS, BBt and ARAT improved after treatment in both groups (F_time > 118.32, P < 0.001), and improved more in group A than in group B in the scores of BBt and ARAT at each time point ( F_group > 31.26, P < 0.001; F_interact = 10.65,P < 0.001). Conclusion Based on the BTX-A injection and electrical stimulation, wearing a wrist brace would further improve the activities of hand for stroke patients.

Key words: stroke, hemiplegia, Botulinum toxin type A, electric stimulation, wrist brace, hand

中图分类号:

R743.3

马善新,许建文,马楠,苏义,林伟山,陶广林. 佩戴腕托对脑卒中后偏瘫手功能康复的影响[J]. 《中国康复理论与实践》, 2020, 26(3): 306-309.

MA Shan-xin,XU Jian-wen,MA Nan,SU Yi,LIN Wei-shan,TAO Guang-lin. Effects of Wrist Brace on Activities of Hemiplegic Hand after Stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(3): 306-309.

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参考文献 27

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组别	n	性别(n)		年龄(岁)	卒中类型(n)		病程(d)	偏瘫侧(n)
组别	n	男	女	年龄(岁)	脑梗死	脑出血	病程(d)	左侧	右侧
A组	26	17	9	53.2±6.52	15	11	91.2±26.81	16	10
B组	26	14	12	54.7±7.45	18	8	98.2±24.19	13	13
χ²/t值		0.719		1.796	0.746		2.364	0.746
P值		0.397		0.471	0.388		0.142	0.388

组别	指浅屈肌	指深屈肌	拇长屈肌
A组	28.42±15.0	35.71±18.7	22.5±20.5
B组	30.12±14.5	36.52±20.2	21.4±25.2

佩戴腕托对脑卒中后偏瘫手功能康复的影响

Effects of Wrist Brace on Activities of Hemiplegic Hand after Stroke

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组别	n	T0	T1	T2	T3
A组	26	3.31±0.48	2.96±0.43	2.56±0.51	2.21±0.41
B组	26	3.17±0.52	2.91±0.46	2.52±0.53	2.18±0.45

组别	n	T0	T1	T2	T3
A组	26	3.06±3.32	4.01±4.82	4.98±5.12	5.72±6.46
B组	26	3.02±3.47	3.76±3.99	4.32±4.51	5.08±5.63

组别	n	T0	T1	T2	T3
A组	26	11.16±8.52	13.39±8.38	15.19±9.43	18.72±9.47
B组	26	11.23±8.51	12.24±8.16	14.32±8.54	16.65±9.38

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