CAJ | 학술논문

目的：探讨冷热交替漩涡浴治疗脑卒中后肩手综合征Ⅰ期的疗效。方法选取60例脑卒中后肩手综合征Ⅰ期患者随机分为对照组(n=30)和观察组(n=30)。对照组进行综合康复训练，包括运动疗法、向心性缠绕、关节松动术和意念性训练，30 min/次；观察组在此基础上给予温度分别为12~15℃和37~43℃的冷热交替漩涡浴治疗，20 min/次。两组均2次/d，5 d/周，共4周。治疗前及治疗4周后分别采用视觉模拟评分(VAS)、手排水体积差、改良Ashworth量表(MAS)、Fugl-Meyer量表(FMA)和Barthel指数(BI)评定上肢疼痛、水肿、肌张力、运动功能和日常生活活动能力。结果治疗前，两组上肢疼痛、水肿、肌张力、运动功能、日常生活活动能力均无显著性差异(P>0.05)。治疗4周后，两组以上指标均较治疗前改善(P<0.05)，且观察组明显均优于对照组(P<0.01)。结论冷热交替漩涡浴能进一步提高康复训练治疗脑卒中后肩手综合征Ⅰ期的治疗效果。
목적：탐토랭열교체선와욕치료뇌졸중후견수종합정Ⅰ기적료효。방법선취60례뇌졸중후견수종합정Ⅰ기환자수궤분위대조조(n=30)화관찰조(n=30)。대조조진행종합강복훈련，포괄운동요법、향심성전요、관절송동술화의념성훈련，30 min/차；관찰조재차기출상급여온도분별위12~15℃화37~43℃적랭열교체선와욕치료，20 min/차。량조균2차/d，5 d/주，공4주。치료전급치료4주후분별채용시각모의평분(VAS)、수배수체적차、개량Ashworth량표(MAS)、Fugl-Meyer량표(FMA)화Barthel지수(BI)평정상지동통、수종、기장력、운동공능화일상생활활동능력。결과치료전，량조상지동통、수종、기장력、운동공능、일상생활활동능력균무현저성차이(P>0.05)。치료4주후，량조이상지표균교치료전개선(P<0.05)，차관찰조명현균우우대조조(P<0.01)。결론랭열교체선와욕능진일보제고강복훈련치료뇌졸중후견수종합정Ⅰ기적치료효과。
Objective To investigate the effect of alternating cooling and heating whirlpool bath on patients with shoulder-hand syn-drome in stage I after stroke. Methods 60 patients with shoulder-hand syndrome in stage I after stroke were randomly divided into control group (n=30) and observation group (n=30). The control group received comprehensive rehabilitation training including exercise therapy, concentric winding, joint mobilization and ideation training, 30 minutes every time, twice a day, 5 days a week for 4 weeks. The observation group received alternating cooling (12~15℃) and heating (37~43℃) whirlpool bath treatment 20 minutes every time in addition, twice a day, 5 days a week for 4 weeks. Visual Analogue Scale (VAS), hand drainage volume, modified Ashworth Scale (MAS), Fugl-Meyer Assess-ment (FMA) and Barthel Index (BI) were used to assess the upper limb pain, the degree of edema, muscle tension, motor function and activi-ties of daily living. Results Before treatment, there was no significant difference in the scores of VAS, MAS, FMA and BI, and the hand drainage volume between 2 groups (P>0.05). 4 weeks after treatment, all the indexes improved in both groups (P<0.05), and were better in the observation group than in the control group (P<0.01). Conclusion The effect of alternating cooling and heating whirlpool bath may fur-ther improve the symptoms of shoulder-hand syndrome in stage I after stroke.