Effects of thermal therapy and the exercise of limbs on the sympathetic nervous function

肩手综合征是脑卒中患者的严重并发症之一。反射性交感神经营养不良(RSD)被认为是肩手综合征的发病机制，但目前尚无治疗方法。分析了脑卒中患者肩颈热疗及瘫痪肢体被动运动5min后交感神经功能的变化。方法对38例中风后肩手综合征患者在瘫痪侧肩、颈部施药前后，以及瘫痪肢体或上肢被动运动前后，连续监测皮温及心率频谱分析。结果与结论热疗后瘫痪手指温度及副交感神经功能成分明显升高，心率明显降低。认为热疗可降低麻木肩的交感神经功能和星状神经节阻滞。瘫痪手指的温度在被动瘫痪手臂运动后立即显著降低。认为瘫痪手臂的被动运动可增加微创引起的交感神经功能，增加瘫痪手臂的疼痛。自主神经系统与卒中康复治疗有一定关系。

Shoulder hand syndrome was one of the severe complications in stroke patients. The reflex sympathetic dystrophy (RSD) was considered as the pathogenesis of shoulder hand syndrome, but a method of therapy has not been established. We analyzed the changes of sympathetic nervous function induced by thermotherapy of the shoulder and neck, and passive exercise of the paralytic limbs in stroke patients for 5min. <Methods> In 38 stoke patients suffering from shoulder hand syndrome, we monitored continuously the skin temperatures and frequency analysis of heart rates before and after the therapy was applied to shoulder/neck of the paralytic sides, and before and after the passive exercise of the paralytic lower limbs or upper limbs. <Results&Conclusion> The temperature of the paralytic fingers and HF (parasympathetic nervous function) components became significantly higher and heart rate became significantly lower after the thermal therapy. It was thought that the thermal therapy for the paralytic shoulder might reduce the sympathetic nervous function as well as the stellate ganglion block. The temperature of the paralytic fingers was significantly lower just after the passive paralytic arm exercise. It was thought the passive exercise of the paralytic arms might increase the sympathetic nervous function induced by micro injury and the pain of paralytic arms. There was a relationship between the autonomic nervous system and rehabilitation therapy of stroke.