Clinical Observation On The Treatment Of Hemiplegic Shoulder Pain After Stroke By Proximal Needing And Proprioceptive Neuromuscular Facilitation

Objective:To observe the clinical effect of proximal needing combined with proprioceptive neuromuscular facilitation on hemiplegic shoulder pain after stroke,and provide a basis for further optimizing the treatment of hemiplegic shoulder pain after stroke.Methods:In this study,60 patients with hemiplegic shoulder pain after stroke were randomly divided into treatment group(treated by proximal needing and proprioceptive neuromuscular facilitation)and control group(treated by proprioceptive neuromuscular facilitation),30 cases in each group.Among them,One case in the treatment group dropped out,two cases in the control group dropped out,so there are twenty nine cases in the treatment group and twenty eight cases in the control group.On the basis of routine treatment for three courses in two groups,the control group was treated with proprioceptive neuromuscular facilitation alone,the treatment group was treated with the same proprioceptive neuromuscular facilitation,and acupuncture the four points of shoulder(JianYu?JianQian?JianZhen?JianLiao)by proximal needing,acupuncture of three points at elbow and wrist(QuChi?WaiGuan?HeGu)by conventional acupuncture.The treatment group which was treated by proximal needing and proprioceptive neuromuscular facilitation and the control group which was treated proprioceptive neuromuscular facilitation alone were treated for 3 courses(three weeks).Visual analogue score?simplified Fugl-Meyer upper limb motor function score and modified Barthel index score was given to the two groups before and after each course of treatment.Results:1.The VAS scores of the treatment group which was treated by proximal needing and proprioceptive neuromuscular facilitation and the control group which was treated proprioceptive neuromuscular facilitation alone after three courses of treatment were significantly different from those before treatment(P<0.05),pain was improved in both groups after treatment,the course of the VAS scores of the treatment group which was treated by proximal needing and proprioceptive neuromuscular facilitation and the control group which was treated proprioceptive neuromuscular facilitation alone were statistically significant(P<0.05),pain improvement in the treatment group was better than that in the control group,and VAS score of the treatment group changed greatly after the first course of treatment,pain improved significantly.2.The FMA scores of the treatment group which was treated by proximal needing and proprioceptive neuromuscular facilitation and the control group which was treated proprioceptive neuromuscular facilitation alone after three courses of treatment were statistically significant compared with those before treatment(P<0.05),upper limb motor function was improved in both groups after treatment,the treatment of the treatment group which was treated by proximal needing and proprioceptive neuromuscular facilitation and the control group which was treated proprioceptive neuromuscular facilitation alone of FMA score was statistically significant(P<0.05),the improvement of upper limb motor function in the treatment group was better than that in the control group.3.The MBI scores of the treatment group which was treated by proximal needing and proprioceptive neuromuscular facilitation and the control group which was treated proprioceptive neuromuscular facilitation alone after three courses of treatment were significantly dif'ferent from those before treatment(P<0.05),After treatment,the self-care ability of daily life was improved in both groups,there was no significant difference in MBI scores between the treatment group which was treated by proximal needing and proprioceptive neuromuscular facilitation and the control group which was treated proprioceptive neuromuscular facilitation alone after the first course and the second course,(P>0.05),there was no significant difference in self-care ability in daily life between the two groups,however,after the third course of treatment,there was significant differences in MBI scores between the two groups(P<0.05),the daily life self-care ability of the treatment group was better than that of the control group.Conclusion:1.The treatment group which was treated by proximal needing and proprioceptive neuromuscular facilitation and the control group which was treated proprioceptive neuromuscular facilitation can effectively improve the degree of pain of the shoulder,but the treatment group which use the combining therapy is better than the control group which use the restorative therapy alone in the therapeutic effect.In the early stage of treatment,the treatment of proximal needing and proprioceptive neuromuscular facilitation can obviously improve the symptoms of pain.2.The treatment plan which was treated by proximal needing and proprioceptive neuromuscular facilitation and another plan which was treated by proprioceptive neuromuscular facilitation alone both have good curative effect,and the treatment of proximal needing and proprioceptive neuromuscular facilitation is more effective to improve the motor function of upper limb ability and the self-care ability in life.