Effect of closed-chain exercise training on hemiplegic shoulder pain and shoulder joint stability in stroke patients:a study with ultrasound
摘要
Objective To investigate the effect of closed-chain exercise training on hemiplegic shoulder pain and shoulder joint stability in stroke patients, and to explore the relationship between hemiplegic shoulder pain and shoulder joint stability. Methods A total of 52 stroke patients with hemiplegic shoulder pain in Jiangsu Province Hospital from October, 2020 to January, 2023 were selected, and were randomly divided into control group (n = 26) and experimental group (n =26). Both groups received conventional rehabilitation therapy, while the experimental group additionally underwent closed-chain exercise training for shoulder joint. Pain severity and motor function were assessed using Visual Analog Scale (VAS) and Fugl-Meyer Assessment-Upper Extremities (FMA-UE) before and after intervention. Musculoskeletal ultrasound was used to measure acromion-greater tuberosity distance (AGT), acromion-lesser tuberosity distance (ALT), acromiohumeral distance (AHD) and supraspinatus thickness (SST) to evaluate shoulder joint stability. Correlation analysis was conducted on the improvements in shoulder pain and shoulder joint stability in the experimental group. Results Two cases in the control group and two in the experimental group dropped down. Both groups showed significant improvements in VAS and FMA-UE scores after intervention (|t| ＞ 5.214, P ＜ 0.001), and the scores improved more in the experimental group than in the control group (|t| ＞ 2.087, P ＜ 0.05). The experimental group also showed significant improvements in AGT, ALT, AHD and SST (|t| ＞ 4.187, P ＜ 0.001), with AGT, ALT and AHD being superior to those in the control group (|t| ＞ 2.155, P ＜ 0.05). The difference of VAS score in the experimental group was correlated with the difference of FMA-UE, AGT and ALT after intervention (r ＞ 0.434, P＜0.05). Conclusion Closed-chain shoulder exercise training can significantly improve shoulder joint stability while alleviating shoulder pain, and effectively enhancing upper limb fu