太极云手对社区康复改善脑卒中后平衡功能障碍的疗效观察

发布时间：2018-06-27 10:45

本文选题：太极“云手” + 脑卒中　；参考：《河南中医药大学》2016年硕士论文

【摘要】：据统计,因医疗资源的限制、经济状况、功能恢复平台期等因素影响,75%~85%[1-2]的脑卒中患者最终出院回家。脑卒中平衡功能障碍患者因平衡功能差、行走能力弱、运动耐力不足等,日常生活中多数时间以坐、卧活动方式为主,从而导致社会活动参与水平低,生存质量不高,给患者自身及其家庭以至于社会都带来严重的精神压力及经济负担。因此,寻找一个简易、经济,又具有良好疗效的社区康复治疗技术对帮助患者恢复其良好的平衡功能,具有十分重大的意义。目的:本课题探讨太极“云手”训练在社区脑卒中患者平衡功能障碍康复中的疗效及评价,为社区平衡功能康复干预方法提供依据,以期为临床提供一疗效确切又简便、经济、易行的治疗方法。方法:将符合入选标准的脑卒中后平衡功能障碍患者54例,按随机数字表法分为试验组和对照组,两组均27例。对照组在基础治疗的同时进行常规康复训练,试验组在对照组的基础上同时接受太极“云手”训练。常规康复训练,5次/周,持续8周;太极“云手”训练每次30min,5次/周,持续8周。在治疗前、治疗4周后、治疗8周后、随访1个月后对两组患者用采用Berg平衡量表(BBS)、站起-走计时测试(TUGT)、改良Barthel指数(MBI)进行评估。数据分析采用SPSS22.0统计软件进行统计分析。结果:两组的处理方式、治疗周期均对BBS评分(P=0.022,P0.001)、TUGT评分(P=0.030,P0.001)、MBI评分(P=0.046,P0.001)的影响有统计学意义,治疗周期和处理之间存在交互作用(P0.001)。其中对照组和太极云手组的BBS、TUGT评分随着治疗时间的增加均不断升高,但太极云手组的BBS、TUGT评分随治疗时间的变化幅度较对照组的变化幅度大,说明两组均对脑卒中后平衡功能障碍有确切疗效,且疗效随着治疗时间的增加均不断升高,且太极云手组疗效更明显。MBI评分中,对照组治疗期间各个时间点评分随着治疗周期的增加均不断升高,但随访时间点评分升高不明显,太极云手组治疗期间各时间点及随访时间点的评分随着时间均不断升高。结论:1.太极“云手”训练作为一种社区康复干预手段,可改善社区康复脑卒中患者的平衡功能和步行能力,有利于日常生活活动能力的提高。2.太极“云手”训练其操作简便、廉验、安全有效,可为社区康复中脑卒中后平衡功能障碍脑卒中患者带来良好效益。
[Abstract]:According to statistics, 75% of stroke patients were discharged home due to medical resource limitation, economic status, functional recovery platform and other factors. Because of poor balance function, weak walking ability, insufficient exercise endurance and so on, stroke patients with balance dysfunction mainly take sitting and lying mode in daily life, which leads to low level of participation in social activities and low quality of life. It brings serious psychological pressure and economic burden to the patients and their families and even to the society. Therefore, it is of great significance to find a simple, economical and effective community rehabilitation therapy technology to help patients recover their good balance function. Objective: to explore the curative effect and evaluation of Taiji "cloud hand" training in the rehabilitation of balance dysfunction of stroke patients in community, and to provide the basis for the intervention method of community balanced functional rehabilitation, in order to provide a definite, simple and economical effect for clinical practice. An easy treatment. Methods: Fifty-four patients with poststroke balance dysfunction were randomly divided into two groups: the experimental group and the control group (n = 27). The control group received routine rehabilitation training while the control group received Taiji "cloud hand" training on the basis of the control group. Routine rehabilitation training lasted 8 weeks, and Taiji "cloud hand" training lasted 5 times a week for 30 mins per week for 8 weeks. The patients in both groups were evaluated with Berg balance scale (BBS), standing up and walking time test (TUGT) and modified Barthel index (MBI) before treatment, 4 weeks, 8 weeks and 1 month follow-up. SPSS 2. 0 statistical software was used to analyze the data. Results: the treatment style and treatment cycle had significant effects on the BBS score (P0.022 / P0.001) and TUGT score (P0. 030 / P0.001) and MBI score (P0. 046 / P0. 001). There was an interaction between the treatment cycle and the treatment (P0. 001). In the control group and Taiji cloud hand group, the BBSnTUGT score of the control group and Taiji cloud hand group increased with the increase of treatment time, but the change of BBStUGT score of Taiji cloud hand group with the treatment time was larger than that of the control group. The results showed that both groups had definite curative effect on balance dysfunction after stroke, and the curative effect increased with the increase of treatment time, and the curative effect of Taiji cloud hand group was more obvious in the score of .MBI. In the control group, the scores of each time point increased with the increase of the treatment cycle, but the score of the follow-up time point was not significantly increased. The scores of each time point and the follow-up time point of the Taiji cloud hand group were all increased with the time. Conclusion 1. As a kind of community rehabilitation intervention, Taiji "cloud hand" training can improve the balance function and walking ability of stroke patients in community rehabilitation. Taiji "cloud hand" training is simple, inexpensive, safe and effective, which can bring good benefit to stroke patients with balance dysfunction after stroke in community rehabilitation.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R743.33

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