蜡疗结合康复训练干预对脑梗死后上肢痉挛患者肢体运动功能的影响OA
Effects of Wax Therapy Combined with Rehabilitation Training on Limb Motor Function in Patients with Upper Limb Spasticity After Cerebral Infarction
目的:探讨蜡疗联合康复训练对脑梗死后上肢痉挛的疗效.方法:采用随机对照试验设计,将150例脑梗死后上肢痉挛患者分为干预组和对照组各75例.对照组接受常规康复训练,干预组则在常规康复训练基础上增加上肢蜡疗干预.于干预前、干预4周后,采用改良Ashworth量表(Modified Ashworth Scale,MAS)评估上肢屈肘、屈腕肌群痉挛等级;采用Fugl-Meyer上肢运动功能评定量表(Fugl-Meyer Assessment-Upper Extremity,FMA-UE)、上肢动作研究量表(Action Research Arm Test,ARAT)评估上肢运动功能;采用改良Barthel指数(Modified Barthel Index,MBI)评估日常生活活动能力;采用表面肌电图(Surface Electromyog-raphy,sEMG)采集患侧上肢肱二头肌、肱桡肌在最大等长收缩时的积分肌电值和协同收缩率.结果:干预4周后,两组患者各项指标均较干预前显著改善(P<0.05).干预组在屈肘、屈腕肌群MAS等级降低程度、FMA-UE评分、ARAT评分、MBI评分方面的改善幅度均显著优于对照组(P<0.05).sEMG结果显示,干预组肱二头肌积分肌电值显著增加,而肱二头肌与肱桡肌的协同收缩率显著降低(P<0.01),且优于对照组.结论:在常规康复训练基础上结合蜡疗,能更有效地缓解脑梗死后患者上肢痉挛,改善上肢运动功能和日常生活活动能力,其机制可能与优化主动肌与拮抗肌的协调性有关.蜡疗是一种安全、有效的辅助康复手段.
Objective:To investigate the efficacy of wax therapy combined with rehabilitation training on upper limb spasticity after cerebral infarction.Methods:A randomized controlled trial design was adopted.A total of 150 patients with upper limb spasticity after cerebral infarction were divided into an intervention group and a control group,with 75 cases in each.The control group received conventional rehabilitation training,while the intervention group received upper limb wax therapy in addition to conventional rehabilitation training.Before the intervention and after 4 weeks of intervention,the Modified Ashworth Scale(MAS)was used to assess the spasticity grade of elbow flexor and wrist flexor muscle groups.The Fugl-Meyer Assessment-Upper Extremity(FMA-UE)and the Action Research Arm Test(ARAT)were used to evaluate upper limb motor function.The Modified Barthel Index(MBI)was used to assess activities of daily living.Surface electromyography(sEMG)was used to collect the integrated electromyographic values and co-contraction ratios of the biceps brachii and brachioradialis muscles on the affected side during maximum isometric contraction.Results:After 4 weeks of intervention,all outcome measures in both groups were significantly improved compared with pre-intervention values(P<0.05).The intervention group demonstrated significantly greater improvements in the reduction of MAS grades for elbow flexor and wrist flexor muscle groups,FMA-UE scores,ARAT scores,and MBI scores compared with the control group(P<0.05).The sEMG results showed that the integrated electromyographic values of the biceps brachii were significantly increased in the intervention group,while the co-contraction ratios of the biceps brachii and brachioradialis were significantly decreased(P<0.01),both values being superior to those of the control group.Conclusion:Combining wax therapy with conventional rehabilitation training can more effectively alleviate upper limb spasticity,improve upper limb motor function,and enhance activities of daily living in patients after cerebral infarction.The underlying mechanism may be related to the optimization of coordination between agonist and antagonist muscles.Wax therapy is a safe and effective adjunctive rehabilitation modality.
秦欢欢;魏珺颖;毕守红
山西中医药大学附属医院,山西 太原 030000山西中医药大学附属医院,山西 太原 030000山西中医药大学附属医院,山西 太原 030000
医药卫生
脑梗死上肢痉挛蜡疗康复训练运动功能表面肌电图
cerebral infarctionupper limb spasticitywax therapyrehabilitation trainingmotor functionsurface electromyography
《中医康复》 2026 (9)
52-57,6
山西中医药大学附属医院青年基金培育项目(QN202214)
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