| Objective: The study focused on the muscle reflex pattern and explored the clinical efficacy and mechanism of sling-massage exercise on upper limb spasticity for stroke patients.Based on the inheritance of Traditional Chinese Medicine and modern rehabilitation techniques,we were committed to promoting the integration of Traditional Chinese Medicine and Western Medicine to provide a new idea for standardized and precise formulation of rehabilitation programs for post-stroke upper limb spasticity.Methods: Following the study criteria,60 patients with post-stroke upper limb spasticity originating from a rehabilitation hospital were collected.Patients were randomly divided into a control group and an observation group using a computerized random grouping method and allocation concealment,with 30 cases in each group.According to the stroke rehabilitation prescription,patients in both groups were given essential medication,conventional rehabilitation,and nursing care.No medication or treatment was used that might affect the degree of spasticity or the evaluation of the efficacy index.On this basis,the control group received stretching training based on the principle of “active and passive combination”,while the observation group received sling-massage exercise based on the principle of “sinew management,rectification and movement”.Both groups were given the same duration,once a day,5 times as a course of treatment,with each course interval of 2 days,for a total of 4 courses of treatment.They were assessed with the Modified Ashworth Scale(MAS),Fugl-Meyer Assessment Upper Extremity(FMA-UE),and Modified Barthel Index(MBI)before and after treatment.Surface electromyography was used to extract the Root Mean Square(RMS)of the affected biceps brachii during passive elbow extension and the RMS of the triceps brachii during maximal isometric contraction with active elbow extension to quantitatively assess the muscle characteristics of the affected upper limb.The differences in the efficacy of the two groups in improving the abnormal muscle tension were compared,and the correlation between the difference in RMS of the affected biceps brachii and MAS,FMA-UE and MBI score differences were analyzed separately before and after treatment.Results: Clinical case reports showed no patients with poor compliance,incomplete clinical observation data,or shedding cases in either group.1.Inter-group comparison: The comparison of baseline data,pre-treatment MAS,FMA-UE,MBI scores,and RMS of the biceps brachii and triceps brachii between the two groups was not statistically significant(P>0.05).After treatment,the difference in MAS,FMA-UE scores,and the RMS difference of the affected side of the biceps brachii and triceps brachii were better in the observation group than in the control group,and the difference was statistically significant(|t|>2.020,|Z|>1.996,P<0.05);The difference in MBI scores between the two groups was not statistically significant(P>0.05).2.Intra-group comparison: After treatment,MAS scores and the RMS of the affected side of the biceps brachii decreased significantly in both groups compared to the before treatment,and the difference was statistically significant(|t|>9.168,|Z|>4.315,P<0.05);MBI,FMA-UE scores and the RMS of triceps brachii were significantly higher than before treatment,and the difference was statistically significant(|t|>9.269,P<0.05).3.Efficacy Analysis: The total clinical efficiency of the observation group in reducing upper limb spasticity symptoms after stroke was 86.7%,including 6 cases of cure,12 cases of markedly effective,8cases of effective,and 4 cases of ineffective.The total clinical efficiency of the control group in reducing upper limb spasticity symptoms after stroke was 73.3%,including 3 cases of cure,5 cases of markedly effective,14 cases of effective,and 8 cases of ineffective.Therefore,the efficacy of the observation group was slightly better than that of the control group in improving upper limb spasticity,and the difference was statistically significant(P<0.05).4.Correlation analysis: A positive linear correlation existed between the changes in the RMS value of biceps brachii and MAS scores(|r|>0.684,P<0.05),and a negative linear correlation with changes in FMA-UE and MBI scores(|r|>0.631,P<0.05).Conclusions: 1.Sling-massage exercise can effectively reduce the symptoms of upper limb spasticity in stroke survivors.In addition,sling-massage exercise is superior to stretching training in optimizing upper limb motor function,reconstructing muscle balance,and improving activities of daily living ability with significant efficacy.2.Sling-massage exercise reversibly regulates the muscle reflex pattern of active muscle and antagonistic muscle by inducing reciprocal inhibitory effects,which may be the mechanism of alleviating upper limb spasticity after stroke.3.Sling-massage exercise correlates the sinew-meridian system of Traditional Chinese Medicine with the myofascial meridian described in biomechanics,which confirms the potential correlation between the rehabilitation concept of Traditional Chinese Medicine and the modern rehabilitation concept.It provides the basis for the scientific and precise application of slingmassage exercise. |
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