| Aims: To investigate the effects of radial extracorporeal shock wave on lower limb muscle spasm and motor function in patients with hemiplegia after ischemic stroke.Methods: Sixty ischemic stroke patients with hemiplegia who met the inclusion criteria were randomly divided into rehabilitation treatment group and conventional rehabilitation control group.Patients in both groups received standardized medical treatment and routine rehabilitation treatment after stroke,with routine rehabilitation treatment lasting 60 minutes each time,twice a day,for 4 weeks.Experimental group given routine rehabilitation therapy and radial extracorporeal shock wave treatment,using the model for the Swiss Dolor Clast radiation type for stocks inside muscle in patients with extracorporeal shock wave treatment,select 20 mm shock wave probe and adduction muscle group and the treatment of the gastrocnemius muscle 2000 pulse,a total of 4000 pulse,is 8 Hz frequency,intensity is 2.0 bar,1 week,4 weeks in a row.The modified Ashworth scale(MAS)was used to evaluate the lower extremity muscle spasm before and 4 weeks after treatment.The lower extremity of Fugl-Meyer motor function evaluation scale(FMA-LE)was used to carry out special rehabilitation assessment of patients’ lower extremity motor function.The walking ability of the patients was evaluated by using the parameters of the Walker View digital gait analysis system produced in Italy,such as stride frequency,step length,pace,and the maximum motion Angle of hip and knee,etc.,and the blinding was performed after all the evaluations were completed.Results :(1)General data comparison: a total of 30 cases in the experimental group,including 17 males and 13 females,age of(53.73±5.69)years old,course of disease of(5.29±1.13)months,cerebral hemorrhage in 9 cases,cerebral infarction in 21 cases.In the control group,there were 30 patients,including 18 males and 12 females,the age was(52.87±6.32)years old,the course of disease was(4.91±1.30)months,13 cases of cerebral hemorrhage and 17 cases of cerebral infarction.There was no statistical significance in the general information of age,gender,type of stroke and course of disease between the two groups,but the comparison was comparable(P > 0.05).There were no significant differences in MAS,FMA,stride frequency,step length,pace speed and the maximum motion Angle of hip and knee between 2 groups(P > 0.05).(2)Comparison of MAS scores: After 4 weeks of systematic treatment,MAS in both groups improved,Z=-2.137,P < 0.05,the difference was statistically significant,the treatment effect of the experimental group was significantly better than the control group.The MAS of the experimental group was evaluated before and after 4 weeks of treatment,and compared with that before treatment,Z=-2.055,P < 0.05,the difference was statistically significant.The MAS of the control group was evaluated before and after 4 weeks of treatment,and compared with that before treatment,Z=-1.734,P < 0.05,the difference was statistically significant.(3)Comparison of FMA-LE scores: After 4 weeks of systematic treatment,the FMA-LE scores of the experimental group increased from(11.26±0.45)to(23.37±1.33),and that of the control group increased from(11.31±0.46)to(16.07±0.50),with statistical significance for intra-group comparison.The difference between the groups was also statistically significant after 4 weeks of treatment.(4)Comparison of walking ability: After 4 weeks of systematic treatment,the pace of patients in the experimental group increased from(34.92±2.39)cm/s to(52.58±6.41)cm/s,the step length of the affected side increased from(24.62±2.81)cm to(41.93±5.34)cm,the step frequency increased from(44.77±2.70)steps /min to(77.87±9.88)steps /min,and the maximum Angle of hip flexion increased from(5.44±0.19)° to(14.60±0.24)°.The maximum knee flexion Angle increased from(14.50±0.77)° to(45.22±3.07)°.In the control group,the pace increased from(35.03±2.50)cm/s to(40.42±4.28)cm/s,the step length on the affected side increased from(25.17±2.29)cm to(33.31±2.41)cm,the step frequency increased from(44.20±2.34)steps /min to(61.43±8.72)steps /min,and the maximum Angle of hip flexion increased from(5.34±0.21)° to(11.60±1.60)°.The maximum knee flexion Angle increased from(14.46±0.63)° to(35.29±3.17)°.Comparison between groups P < 0.05,the differences between the two groups were statistically significant,intra-group comparison P < 0.05,the treatment effect of the experimental group was better than the control group.Conclusion : Compared with conventional rehabilitation therapy,the radial extracorporeal shock wave therapy can improve the limb spasm and motor function of stroke patients with hemiplegia to a certain extent. |
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