| Research BackgroundThe subluxation of shoulder joint,also known as glenohumeral subluxation(GHS),is one of the most important early complications of hemiplegic patients after stroke.If improper treatment is easy to cause rotator cuff injury and shoulder hand syndrome,it seriously affects the recovery of upper limb function.At present,the study of the mechanism of shoulder subluxation is not very clear.The main research is the decrease of the muscle strength of the shoulder muscles,the relaxation of the shoulder joint and the imbalance of the stable structure around the shoulder of the scapula.The conventional training methods for the subluxation of shoulder joint after hemiplegia mainly include the placement of the good limb position,the exercise training of the scapula,the passive movement of the shoulder joint,the extrusion of the shoulder joint,the shoulder support,the functional electrical stimulation(FES)and so on.However,they often have long course of treatment,poor results,or even improper protection,leading to serious complications.Glen Gillen and Ann Burkhardty research suggest that the loss of control ability of trunk,thorax and scapula will affect the stability of the glenohumeral joint [1].In this study,the patients with GHS were given routine rehabilitation therapy with trunk control training to correct the abnormal lines of trunk,chest and scapula,and to restore the stability of the glenohumeral joint.ObjectiveObjective To observe the effect of routine rehabilitation therapy combined with trunk control training on improving GHS position.MethodsMethods 62 patients with stroke and hemiplegia accompanied by GHS were collected from rehabilitation department of the Fifth Affiliated Hospital of Zhengzhou University from May 2015 to December 20176.Stroke patients were divided into observation group(n=31)and control group(n=31)by random number table.The control group received routine rehabilitation treatment,while the observation group received trunk control training on this basis.AHI,FMA,TCT and TIS were examined before treatment,at the end of treatment and 3 months after treatment.The clinical efficacy of each group was statistically analyzed.Result(1)There was no significant difference in the general data between the two groups(P>0.05),and they were comparable.(2)Before treatment,there was no significant difference in TIS scores between the two groups(P>0.05).At the end of treatment and at 3 months after treatment,the TIS scores of both groups were significantly higher than before treatment(P<0.05).TIS scores in the observation group were significantly higher than those in the control group at the same time point(P<0.05).(3)Before treatment,there was no significant difference in FMA scores between the two groups(P>0.05).At the end of treatment and at 3 months after treatment,the FMA scores of the two groups were significantly higher than before treatment(P<0.05).The FMA score in the observation group was significantly higher than that in the control group at the same time point(P<0.05).(4)Before treatment,there was no significant difference in AHI between the two groups(P>0.05).At the end of treatment and at 3 months after treatment,the AHI in both groups was significantly lower than before treatment(P<0.05),and at the same time The AHI in the observation group was significantly lower than that in the control group(P<0.05).(5)Before treatment,there was no significant difference in TCT scores between the two groups(P>0.05).At the end of treatment and at 3 months after treatment,the TCT scores of the two groups were significantly higher than before treatment(P<0.05).The TCT scores in the observation group were significantly higher than those in the control group at the same time point(P<0.05).(6)The total effective rates of observation group and control group were 97.83% and 84.78% respectively,there was a significant difference between the two groups(P<0.05).Conclusion(1)conventional rehabilitation therapy combined with trunk control training and simple rehabilitation treatment can improve the symptoms of shoulder joint subluxation after stroke,but conventional rehabilitation therapy combined with trunk control training is better than that of simple routine rehabilitation therapy.(2)restoring the correct alignment of the trunk may be a biomechanical mechanism for correcting the subluxation of shoulder,and also a prerequisite for the recovery of upper limb motor function after stroke. |
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