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，但尚未建立治疗方法。分析脑卒中患者肩颈热疗及麻痹肢体被动运动5min后交感神经功能的变化。[方法]对38例患肩手综合征的脑卒中患者，在麻痹侧肩颈热疗前后连续监测皮肤温度及心率频率分析。以及麻痹的下肢或上肢被动运动前后。结果与结论热疗后麻痹手指体温和副交感神经功能成分明显升高，心率明显降低。认为热疗麻痹肩关节可减轻交感神经功能及星状神经节阻滞。在被动麻痹手臂运动后，麻痹手指的温度明显降低。认为麻痹臂被动运动可增加微损伤引起的交感神经功能和麻痹臂疼痛。自主神经系统与脑卒中康复治疗之间存在一定的关系。

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.