【摘要】 目的急性脑血管病和脑外伤的偏瘫患者,常在3个月内发生上肢痉挛。本研究研发上肢肌张力定量评估技术,旨在准确评估上肢痉挛的程度,以有效地进行干预和治疗。方法 73例脑血管病和脑外伤患者分为实验组(38例)和对照组(35例)。肌张力评定采用改良Ashworth痉挛评定分级,实验组同时还用我们研发的上肢肌张力测量装置进行评定。上肢运动功能评分采用Brunnstrom六级评定法。日常生活活动能力的评定采用Barthel Index指数法。分别在入组时(M0)、治疗1个月(M1)、2个月(M2)及3个月(M3)进行评定。结果 M0时上述3项评分组间比较差异无统计学意义(P>0.05);M1、M2时上述3项评分虽然有变化,但无论是组内比较还是组间比较差异均无统计学意义(P>0.05);M3时上述3项评分组间比较实验组均优于对照组,差异具有统计学意义(P<0.005)。特别是实验组采用上肢肌张力测量装置进行肌张力的评估,在M1与M0时比较差异均有高度统计学意义(P<0.01),而M2与M1、M3与M2时比较差异具有高度统计学意义(P<0.001)。结论上肢肌张力定量评估装置通过检测肘关节被动伸展的阻抗力,可客观、直观及精确地评估肘关节屈肌群痉挛的程度,不仅有助于判断疗效,及时调整康复训练方案,还有助于提高患者的依从性,增加了康复治疗的效果,改善了患侧上肢运动功能,提高了生活质量。更多还原

【Abstract】 Objective The incidence of spasticity in upper limbs is generally 3 months after acute cerebrovascular disease and traumatic brain injury.This study developed a quantitative assessment technique for spasticity in upper limbs,designed to accurately assess the extent of upper limb spasm to effectively intervene and treat it.Me thods 73 patients with acute cerebrovascular disease and traumatic brain injury were divided into experimental group(38 cases)and control group(35 cases).Improved Ashworth Spasm Assessment Classification was adopted to assess muscle tension.The spasm level of the exp erimental group was also assessed by the muscle tension measurement device designed by us.Brunnstrom six-level rating method was adopted to assess the motor fucntion of upper limbs while Barthel Index was used to assess activities of daily living of upper limbs.The assessments were carried out when the patients were admitted into groups(M0),1 month(M1),2 months(M2) and 3 months(M3) after treatment.Re s ults The comparison of the assessment of muscle tension,motor function and ctivities of daily living was conducted at M0,M1,M2 and M3.The two groups showed no significant difference between the three scores(P >0.05) at M0.At M1 and M2,the scores of two grouos changed but showed no statistical significance when compared within group and betweeen groups(P <0.05).At M3,scores of muscle tension,motor function and activities of daily living of the experiment group were significantly better than that ofthe control group( P<0.005).The assessment of mucle tension by measurement device between M0 and M1was statistically significant( P<0.01) while the significance was greater between M2 and M1and M3 and M2(P <0.001).Conclus ion The quantitative assessment device of muscle tension in upper limbs can test the resistance of passive stretching of elbow flexion,evaluate the spasm level of flexor digitorum of elbow joint objectively,intuitively and accurately passive resistance of the. It not only helps to judge curative effect,adjust rehabilitation training program but also improves compliance of patients,the motor function of ipsilateral upper limbs,and the quality of life.更多还原