| Objective:To study the changes of the scapular rhythm(SHR)in the upper limbs of stroke patients based on x-ray fluoroscopy,and to provide strategies for the rehabilitation of hemiplegic shoulder joints in stroke patients.Methods:According to the inclusion criteria and exclusion criteria,38 patients with stroke were selected,including 6 cases of Brunnstrom stage I(group A),8 cases of stage II(group B),8 cases of stage III(group C),and 8 cases of stage IV.(Group D)and V period 8 cases(Group E).Each patient underwent X-ray fluoroscopy.Check position: With the external fixation bracket,the upper limbs of the affected side are passively abducted by 0°,30°,60°,90° and 120° respectively.The shoulder X-ray images of different angles were taken,and the angle between the longitudinal axis of the tibia(A1)and the upper and lower points of the scapula(A2)and the spine was measured by the computer's own software.The ratio between the two was calculated(A2/A1),ie SHR.Results:(1)There was no statistically significant difference in the healthy side of the a~e group at 0°~120° angles.There was no significant difference between the two groups(P>0.06)..(2)The difference of SHR at different angles of the healthy side of group a was statistically significant(F=16.670,P<0.001).The comparison between the two groups showed that there was significant difference between 0° and 30°SHR and each angle(P<0.001).The difference of SHR at different angles of the healthy side of group b was statistically significant(F=15.213,P<0.001);the comparison between the two groups showed that the difference between 30°SHR and each angle was significant(P<0.001).The difference of SHR at different angles of the healthy side of group c was statistically significant(F=33.434,P<0.001).The comparison between the two groups showed that the difference between 0°SHR and each angle was significant(P<0.01).The difference of SHR at different angles of the healthy side of group d was statistically significant(F=20.629,P<0.001).The comparison between the two groups showed that the difference between 0° and 30°SHR was significant(P<0.03).The difference of SHR at different angles of the healthy side of group e was statistically significant(F=11.307,P<0.001);the comparison between the two groups showed that the difference between 30°SHR and each angle was significant(P<0.02).(3)At 0°,60°,90° and 120°,there was no significant difference between the ahr and the affected group(P>0.3).At 30°,the difference in SHR between the a~e groups was statistically significant(F=4.626,P=0.004).The comparison between the two groups showed that the difference in SHR between group c and each group was statistically significant(P < 0.02).In the comparison of the two points under various angles,the SHR variability is larger.(4)The difference of SHR at different angles of the affected group was statistically significant(F=20.954,P<0.001);the comparison between the two groups showed that the difference between 0° and 30°SHR was significant(P<0.01).There was a statistically significant difference in the SHR at different angles of the b group(F=16.648,P<0.001).The comparison between the two groups showed that the difference between 0° and 30°SHR was significant(P<0.02).There was a statistically significant difference in the SHR at different angles in the c group(F=20.988,P<0.001).The comparison between the two groups showed that the difference between 0°SHR and each angle was significant(P<0.001),30° and 90°.Compared with 120°,the difference in SHR was significant(P<0.03).There was a statistically significant difference in the SHR at different angles in the d group(F=153.337,P<0.001).The comparison between the two groups showed that there was a significant difference between the 0° and 30°SHR angles(P<0.001).There was a statistically significant difference in the SHR between the different angles of the e-group(F=10.483,P<0.001).The difference between 0° and 30°SHR and the mid-outer range(60°-120°)was found between the two groups.Obvious(P ? 0.02).(5)The comparison of the overall healthy side of the SHR at different angles,except for 90°,the difference between the remaining angles was statistically significant(P<0.01).There was a statistically significant difference in the overall healthy side of the SHR between the c-group and the e-group(P<0.02).There was a statistically significant difference between the 0° and 30° points in the a group at different angles(P<0.03).There was a statistically significant difference between the 0 and 30° angles in the b group at different angles(P<0.02).There was a statistically significant difference between the 0 and 30° angles of the c group at different angles in the c group(P<0.03).There was a statistically significant difference between the 0° and 30° points in the d group at different angles(P<0.01).The difference of the healthy side of the e group at different angles was statistically significant at 30° and 60°(P?0.03).Conclusions:(1)The variability of the healthy side SHR in stroke patients occurs mainly in the early stage of abduction;(2)The SHR of the stroke patients also has variability,which also occurs mainly in the early stage of abduction,but the dependence of the angle of the outreach and the function of the affected limb is more obvious;(3)Under the same conditions,the SHR of the affected side of the stroke patient is smaller than the healthy side,suggesting that the lateral scapula is insufficient;(4)Insufficient scapula external rotation in the early stage of shoulder abduction requires compensation by rotation of the scapula in the mid-outer abduction?... |
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