Research On The Effect Of Radial Extracorporeal Shock Wave Treatment On Upper Extremity Motor Function Disorder Caused By Stroke

Objective : This study explored the therapeutic effects of Radial Extracorporeal Shock Wave Treatment(r ESWT)on upper limb dyskinesia caused by stroke,and proposed a new safe,convenient and non-invasive clinical treatment.Methodas:60 stroke patients who were admitted into the Department of Neurology and Rehabilitation of our hospital from December 2019 to December 2020 were randomly divided into control group and r ESWT group,with 30 patients in each group.Both groups were given conventional treatment.On the basis of conventional treatment,the r ESWT group was given r ESWT with effective stimulation for 4 times,namely once every 5 days,4 consecutive times.Shock wave pressure intensity was70 m J,shock frequency was 10 Hz,and shock times was 6000 times.Among them,there were 5000 times for upper extremity flexor muscles,and 1000 times for upper extremity extensor muscles.The control group only were given conventional treatment.The changes in passive range of motion(PROM),modified Ashworth scale(MAS)and Fugl-Meyer Assessment Upper Extremity Scale(FMA-UE)of upper extremity joints in the two groups were compared before treatment(T1),immediately after the first treatment(T2)and after treatment for 4 times(T3).Results :(1)Changes in FMA-UE score: There was no significant change in the r ESWT group and the control group immediately after the first treatment(T2)and compared with before treatment(T1),and the difference was not statistically significant(P > 0.05).After treatment for 4 times(T3),the FMA-UE scores in r ESWT group and control group increased significantly(P < 0.05),and the effect in r ESWT group was better than that in control group(P < 0.05).(2)Changes in MAS scores of musculus biceps brachii and wrist flexor muscle: the MAS scores of musculus biceps brachii and wrist flexor muscle in the r ESWT group were decreased immediately after the first treatment(T2)compared with those before treatment(T1)(P < 0.05),and there was no change in the control group(P > 0.05).After treatment for 4 times(T3),the MAS scores in r ESWT group and control group decreased significantly(P < 0.05),and the effect in r ESWT group was better than that in control group(P < 0.05).(3)Changes in PROM of upper extremity joints:(1)Changes in PROM of shoulder joints: After treatment,there were significant differences in the range of motion of shoulder abduction,adduction,internal rotation and external rotation between the two groups(P < 0.05).The r ESWT group was better than the control group;after treatment,there was no significant difference in anteflexion and rear protraction(P > 0.05).Compared with those before and after treatment,the range of motion in the two groups improved significantly(P < 0.05).(2)Changes in range of motion of elbow joints: there were significant differences in the range of motion of elbow anteflexion and rear protraction between the two groups immediately after the first treatment(T1)and after treatment for 4 times(T3)(P <0.05),and the r ESWT group was superior to the control group;compared with those before and after treatment,the range of motion in the two groups improved significantly(P < 0.05).(3)Changes of range of motion wrist joints: After treatment,there were significant differences in range of motion of palmar flexion,dorsiflexion and ulnar deviation between the two groups(P < 0.05),and the r ESWT group was better than the control group;there was no significant difference in radial deviation after treatment(P > 0.05).Compared with those before and after treatment,the range of motion in the two groups improved significantly(P < 0.05).Conclusion:1.r ESWT can obviously reduce the degree of upper extremity spasm in stroke patients.2.Single r ESWT can reduce upper extremity spasm in stroke patients.3.r ESWT can effectively improve the range of motion of upper extremity joints in stroke patients.4.r ESWT can improve the motor function of the affected upper extremity of stroke patients.