作业疗法结合经皮神经电刺激对脑卒中后肩痛的疗效观察

doi:10.3969/j.issn.1000-8535.2024.05.011

摘要/Abstract

摘要： 目的探讨作业疗法结合经皮神经电刺激对脑卒中后肩痛的疗效。方法选取2020年6月—2023年6月在肇庆市第一人民医院治疗的60例脑卒中后肩痛患者为研究对象,随机分为观察组和对照组各30例。其中,观察组进行作业疗法结合经皮神经电刺激;对照组单纯进行作业疗法。记录患者治疗前及治疗4周后的视觉模拟疼痛评分（VAS）,改良Barthel指数（MBI）和汉密顿抑郁量表评分（HAMD）,并对记录进行检验和t检验。结果观察组和对照组的治疗效果比较差异有统计学意义（P=0.019）,观察组治疗有效率（93.33%）高于对照组（63.33%）;治疗前两组患者的VAS（P=0.536）和HAMD（P=0.558）分值比较差异无统计学意义,治疗后其VAS（P=0.049）及HAMD（P=0.023）分值均较治疗前下降,且观察组下降幅度分别为（2.23±1.14）分和（4.47±3.06）分,均高于对照组的（1.27±0.98）和（1.33±1.35）,组间比较差异有统计学意义;治疗前两组患者的MBI分值比较差异无统计学意义（P=0.216）,治疗后其MBI分值均较治疗前提高,且观察组提高幅度（21.87±10.25）较对照组（12.00±13.58）更显著,组间比较差异有统计学意义（P=0.003）。结论作业疗法结合经皮神经电刺激可缓解脑卒中肩痛,改善患者日常生活能力和心理精神状态,减少抑郁的发生。

关键词: 脑卒中, 作业疗法, 经皮神经电刺激, 肩痛

Abstract: Objective To explore the therapeutic effect of occupational therapy combined with transcutaneous electrical nerve stimulation（TENS） on shoulder pain after stroke．Methods Sixty patients with post-stroke shoulder pain who were treated in the First People’s Hospital of Zhaoqing from June 2020 to June 2023 were selected as the study subjects and randomly divided into an observation group and a control group,with 30 cases in each group．Among them,the observation group received occupational therapy combined with TENS,while the control group received occupational therapy alone．This study recorded the Visual Analogue Scale（VAS）,modified Barthel Index（MBI）,and Hamilton Depression Rating Scale（HAMD）of patients before and after 4 weeks of treatment,and conducted the and t-test analysis．Results The test analysis showed a significant difference in treatment effectiveness between the observation group and the control group（P=0.019）,with the observation group having a significantly higher treatment effectiveness rate（93.33%）than the control group（63.33%）;t-test analysis showed that there was no statistically significant difference in VAS（P=0.536）and HAMD（P=0.558）indicators between the two groups of patients before treatment．However,after treatment,the VAS（P=0.049）and HAMD（P=0.023）indicators decreased compared to before treatment．The observation group had decreased（2.23±1.14）and（4.47±3.06）,respectively,which were significantly higher than the control group’s（1.27±0.98）and（1.33±1.35）,and the inter group differences were statistically significant;before treatment,there was no statistically significant difference in MBI indicators between the two groups of patients（P=0.216）．After treatment,their MBI indicators increased compared to before treatment,and the observation group（21.87±10.25）showed a more significant improvement compared to the control group（12.00±13.58）．The difference between the groups was statistically significant（P=0.003）．Conclusions Occupational therapy combined with TENS can significantly alleviate shoulder pain after stroke,improve daily living ability and psychological state of patients,and reduce the occurrence of depression．

Key words: stroke, occupational therapy, transcutaneous electrical nerve stimulation, shoulder pain

苏海婷, 李天裕, 安建军, 余惠仪, 陈瑞旦. 作业疗法结合经皮神经电刺激对脑卒中后肩痛的疗效观察[J]. 广州医药, 2024, 55(5): 524-529.

SU Haiting, LI Tianyu, AN Jianjun, YU Huiyi, CHEN Ruidan. Observation on the therapeutic effect of occupational therapy combined with transcutaneous electrical nerve stimulation on shoulder pain after stroke[J]. Guangzhou Medical Journal, 2024, 55(5): 524-529.

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