目的：观察强化肩胛胸壁关节运动训练对治疗卒中后偏瘫患者肩痛及肩关节功能障碍的疗效。方法：选取60例脑卒中后偏瘫伴有肩痛及肩关节功能障碍的患者，应用随机数字表法分为治疗组和对照组，每组各30例。2组均予以脑卒中后偏瘫肩痛及肩关节功能障碍的常规康复方法治疗，治疗组在常规治疗的同时再予以8周的强化肩胛胸壁关节运动训练。运用Constant-Murley肩关节功能评分量表(Constant-Murley Shoulder Function Score Scale，CMS)、基本概念视觉模拟疼痛评分法(Visual Analogue Scale，VAS)、Fugl-Meyer Motor Assessment简式Fugl-meyer上肢运动功能评分量表(Fugl-Meyer Motor Assessment Fugl-meyer Simple Upper Limb Motor Function Score，FMA-UE)对患者情况进行评估。评估时间分别是治疗前、治疗4周后、治疗8周后。结果：治疗4周后与治疗前相比，两组在CMS评定量表中5个方面都有好转(P<0.05)，VAS疼痛得分明显降低(P<0.05)，FMA-UE上肢功能评定也有显著好转(P<0.05)；治疗8周后，治疗组和对照组CMS 5个方面，VAS，FMA-UE都有显著好转，且与治疗4周后相比，两组各方面也都有明显好转(P<0.05)。治疗4周后，只有VAS疼痛得分治疗组明显低于对照组(P<0.05)；治疗8周后，两组CMS评分除却力量测试上无明显区别(P>0.05)外，其他4个方面以及FMA-UE上肢功能评定、VAS疼痛得分上都存在明显区别(P<0.05)，并且治疗组优于对照组。结论：对于卒中后偏瘫患者的肩痛及肩关节功能障碍，常规综合康复治疗方法以及强化肩胛胸壁关节运动训练都有着不错的治疗效果，然而强化肩胛胸壁关节运动训练对缓解肩痛及改善肩关节功能障碍的疗效更为显著。
Effect of shoulder joint exercise training on shoulder pain and shoulder joint dysfunction after stroke
Objective: To observe the effect of strengthening the shoulder joint movement training on the shoulder pain and shoulder joint dysfunction in patients with hemiplegia after cerebra stroke. Methods: We selected 60 patients who have shoulder pain and shoulder joint dysfunction with hemiplegia after cerebra stroke, and with the application of random number table method, 60 patients were divided into a treatment group and a control group, 30 cases in each group. Two groups were treated with conventional rehabilitation therapy for shoulder pain and shoulder joint dysfunction after stroke, while the treatment group was treated with routine treatment for 8 weeks. Using Constant-Murley shoulder function score scale (CMS), the basic concept of visual analogue scale (VAS), the Fugl-Meyer Motor Assessment Fugl-meyer simple upper limb motor function score (FMA-UE) were used to evaluate the clinical situation. Evaluation time is respectively before the treatment, after 4 weeks treatment, and 8 weeks after treatment. Results: Compared with before treatment, all aspects of the CMS of the two groups were significantly improved at 4 weeks after treatment (P<0.05) and significantly reduced in VAS pain score (P<0.05), upper limb function assessment of FMA-UE also improved significantly (P<0.05); 8 weeks after treatment when compared with before, each evaluation of every aspect in CMS, VAS and FMA-UE were improved significantly in the two groups (P<0.05), and compared with 4 weeks after treatment, all aspects in the two groups were also improved significantly (P< 0.05). Three or 4 weeks after treatment, only VAS pain score in the treatment group was significantly lower than that in the control group (P<0.05), 8 weeks after treatment, CMS scores had no significant difference except the strength test (P>0.05), the other four aspects and FMA-UE upper limb function the assessment, VAS pain score had obvious difference (P<0.05), and the treatment group was better than the control group. Conclusion: For the shoulder pain and shoulder joint dysfunction in patients with hemiplegia after cerebra stroke, the routine comprehensive rehabilitation treatment methods and strengthen the scapulothoracic sports training were all have good therapeutic effect, however, strengthen the scapulothoracic effects of exercise training on alleviating shoulder pain and improving shoulder joint dysfunction is more significant.