体感互动康复训练在肩周炎患者社区康复中的应用研究

发布时间：2018-04-24 01:41

本文选题：体感互动技术 + 康复　；参考：《杭州师范大学》2017年硕士论文

【摘要】：【背景】体感互动康复训练是一种多媒体与运动康复相结合的新型的带有娱乐性和智能性的现代高科技的康复训练技术。国内外研究者发现它在运动障碍、认知障碍和平衡障碍的患者训练中具有很好的康复效果。肩周炎是中老年人的常见病,临床发病率高达20.6%。由于疾病带来的肩关节疼痛和功能障碍,以及病程较长,给患者的生活及工作带来极大的痛苦和不便,严重影响其生活质量。本研究结合目前体感互动技术的最新研究进展和信息技术在家庭、社区的普及,探索体感互动康复训练技术在肩周炎患者社区康复中的应用效果及其前景。围绕这一问题,本研究首先在社区开展肩周炎患者情况的现状调查,探索肩周炎患者在社区的分布情况,然后在社区医生和康复治疗师的配合下,应用体感互动康复训练设备对肩周炎患者实施康复训练,观察体感互动康复训练技术对肩周炎患者的运动功能及其他功能的康复效果。通过以上研究为此类技术在社区的广泛应用提供理论和现实依据。【目的】本研究在回顾国内外文献的基础上,从康复护理的专业视角,结合肩周炎患者的生理、心理特点,观察体感互动康复训练对肩周炎患者的康复效果,并对其在社区的应用前景进行研究,为改善肩周炎患者的肩关节功能,提高其生活质量、完善社区康复护理体系提供理论和实践指导。【方法】本研究由调查研究和类实验研究方法组成,以类实验研究方法为中心。在杭州市选取3个社区,以方便抽样方式调查了258例肩周炎患者。在调查研究的基础上招募愿意参加类实验研究的对象62例,随机分成实验组30例和对照组32例。对照组成员采用社区常规康复治疗方法,实验组成员实施体感互动康复训练,每次30分钟,每周3次,持续进行12周。分别在干预前、干预4周、干预8周和干预12周后使用肩关节功能评价量表和肩关节范围测量仪器进行疼痛、肩关节活动范围、肌力、日常生活活动能力和局部形态指标的评定,并使用握力器进行握力测定。【结果】1.调查结果:调查对象的年龄为28~79岁,平均(52.86±15.47)岁,患病率呈现年轻化的趋势;女性患者占54.3%,多于男性;调查对象的病程平均(3.93±2.91)年,病程5年以上居多,占24.8%;右肩患病者居多,达41.1%;采用最多的社区康复治疗方法是运动锻炼、推拿等中医疗法,分别占48.4%和43.4%。此外,16.7%的患者从未做过任何治疗。肩周炎康复知识和态度总均分为(27.92±6.40)分,高低分之间差值较大,且得分均处于较低水平。不同文化程度、婚姻状况、收入状况、认知状况的肩周炎患者康复知识态度得分不同,差异具有统计学意义(P0.05)。2.实验结果:(1)实验组成员的肩关节功能有所改善,尤其是疼痛、肩关节活动范围和日常生活活动能力方面。实验组成员的疼痛、肩关节活动范围和日常生活活动能力在干预8周时即有改善,与对照组相比差异有统计学意义(P0.01),且干预因素和时间因素存在交互作用。(2)实验组成员的肩关节功能总分干预前为(49.86±16.11)分,干预12周提高到(73.70±5.86)。其中疼痛得分由(12.50±5.68)分提高到(22.83±2.52)分,表明疼痛程度减轻;肩关节活动范围得分由(12.50±5.68)分提高到(22.83±2.52)分,活动范围扩大;日常生活活动能力得分由(19.96±6.73)分提高到(27.43±2.16)分,日常生活活动能力改善。(3)实验组和对照组成员的肩关节功能总分、疼痛、肩关节活动范围、肌力、日常生活活动能力和局部形态得分在四个时间点间差异有统计学意义(P0.05),随着时间的变化而变化。(4)干预12周后,实验组成员的肩关节功能总分、疼痛、肩关节活动范围和日常生活活动能力得分与对照组相比持续显著性提高(P0.01);其余各项得分均无统计学差异(P0.05)。(5)与基线相比,干预4周后实验组成员的肩关节功能总分、肩关节活动范围、日常生活活动能力显著提高(P0.01),肌力改善(P0.05),疼痛程度明显减轻(P0.01),且至干预12周后,效果得以保持(P0.01)。对照组成员的肩关节功能总分、肩关节活动范围和日常生活活动能力显著提高(P0.01),疼痛程度减轻(P0.05),且至干预12周后,效果得以保持(P0.01)。(6)实验组和对照组的治疗有效率经统计学检验Z=-2.380,P=0.017(P0.05),差异有统计学意义,说明两组不同的治疗干预措施在改善肩关节整体功能的治疗效应上存在差别,使用体感互动康复训练治疗肩周炎疗效更佳。3.握力方面,干预12周后,实验组和对照组成员的握力值差异无统计学意义(P0.05)。【结论】体感互动康复训练可以缓解肩周炎患者的疼痛程度,扩大肩关节活动的范围,减轻肩关节运动障碍的体征以及增强日常生活的能力,能有效应用于肩周炎患者的康复治疗。但是肩周炎患者在康复知识掌握方面欠缺,社区康复治疗服务体系并不完善。社区卫生服务机构应加强对肩周炎患者康复知识的指导和健康宣教,并提供可靠的康复治疗方法,以提高其生活质量。
[Abstract]:[background] somatosensory interactive rehabilitation training is a new kind of modern high-tech rehabilitation training with entertainment and intelligence combined with multimedia and exercise rehabilitation. Researchers at home and abroad have found that it has good rehabilitation effect in the training of patients with dyskinesia, cognitive impairment and balance disorder. The incidence of common diseases is up to 20.6%. due to the pain and dysfunction of the shoulder joint caused by the disease, as well as the long course of disease, which brings great pain and inconvenience to the life and work of the patients. This study combines the latest research progress of the current somatosensory interaction technology and the popularization of information technology in the family and the community. To explore the effect and Prospect of somatosensory rehabilitation training in community rehabilitation of patients with periarthritis of shoulder and its prospect. Around this problem, this study first investigates the situation of patients with periarthritis of shoulder in the community, explores the distribution of patients with periarthritis of shoulder in the community, and then applies the sense of body interaction under the cooperation of community medical students and rehabilitation therapists. The rehabilitation training equipment is applied to the patients with periarthritis of shoulder, and the effects of the physical activity rehabilitation training on the exercise function and other functions of the patients with periarthritis of shoulder are observed. From the professional perspective of rehabilitation nursing, combined with the physiological and psychological characteristics of the patients with periarthritis of shoulder, the effect of the rehabilitation training on the patients with periarthritis of shoulder is observed, and the prospect of its application in the community is studied. The theory and reality are provided to improve the shoulder function of the patients with periarthritis of shoulder, improve the quality of life and improve the community rehabilitation nursing system. [Methods] this study was made up of investigation and class experimental research methods, centered on the method of class experiment. In Hangzhou, 258 cases of scapulohumeral periarthritis were investigated by convenient sampling in 3 communities. On the basis of the investigation, 62 subjects were recruited to take part in the experimental research, and 30 cases were randomly divided into experimental groups and the two were randomly assigned to the experimental group. Group 32 cases. The members of the control group were treated with community routine rehabilitation therapy. The members of the experimental group implemented the physical interaction rehabilitation training, 30 minutes each time, 3 times a week for 12 weeks. Before intervention, intervention for 4 weeks, intervention for 8 weeks and intervention 12 weeks after 12 weeks of shoulder joint function assessment and shoulder joint range measurement instruments for pain and shoulder joint live. Dynamic range, muscle strength, daily living ability and local morphological indexes and grip strength measurement. [results] 1. survey results: the age of the survey was 28~79 years old, the average age was (52.86 + 15.47) years, the prevalence rate was younger, 54.3% of the female patients were more than men, and the average course of the survey was 3.93 + 2.91. In the year, the course of the disease was more than 5 years, accounting for 24.8%, the majority of the right shoulder patients were 41.1%, and the most common methods of community rehabilitation were exercise, massage, 48.4% and 43.4%., and 16.7% of the patients had never done any treatment. The total average score of the rehabilitation knowledge and attitude of scapulohumeral periarthritis was (27.92 + 6.40), and the difference between the high and low scores was compared. The scores of the patients with different cultural degree, marital status, income and cognition were different, the difference was statistically significant (P0.05).2. experimental results: (1) the shoulder joint function of the members of the experimental group was improved, especially the pain, the range of shoulder joint activity and daily life activities. The pain, range of shoulder joint activity and daily living ability of the members of the experimental group improved at 8 weeks. There was a significant difference between the control group and the control group (P0.01), and there was a interaction between the intervention and the time factors. (2) the members of the experimental group had a total score of (49.86 + 16.11) before the intervention of the shoulder joint function and the intervention for 12 weeks. The pain score increased from (12.50 + 5.68) to (22.83 + 2.52) score (22.83 + 2.52), indicating that the pain degree was reduced, the range of shoulder motion range was increased from (12.50 + 5.68) to (22.83 + 2.52), and the range of activity was enlarged. The scores of daily living ability were increased from 19.96 + 6.73 to 27.43 + 12.50, and daily life activity could be achieved. (3) the total score of shoulder joint function in the experimental group and the control group, the pain, the range of shoulder joint activity, the muscle strength, the ability of daily living activity and the local morphologic score were statistically significant between the four time points (P0.05), and changed with the time. (4) after 12 weeks of intervention, the total score of shoulder joint function, pain, and shoulder of the members of the experimental group were in the shoulder. The score of joint activity range and daily living activity increased significantly compared with the control group (P0.01), and the other scores were not statistically significant (P0.05). (5) compared with the baseline, the total score of shoulder joint function, shoulder joint activity, daily living ability increased significantly (P0.01) and muscle strength improvement (P0.). 05), the degree of pain was significantly reduced (P0.01), and the effect was maintained after 12 weeks. The total score of shoulder joint function, the range of shoulder joint activity and activity of daily living were significantly increased (P0.01), and the degree of pain was reduced (P0.05) in the control group, and the effect was maintained after 12 weeks (P0.01). (6) treatment and control group treatment. The effective rate was statistically tested Z=-2.380, P=0.017 (P0.05), the difference was statistically significant, indicating that there were differences in the treatment effect of two groups of different treatment interventions on improving the overall function of shoulder joints. The treatment of scapulohumeral periarthritis with somatosensory rehabilitation training was better in the treatment of.3. grip strength. After intervention, the control group and the control group were in the grip of the group. There was no statistical significance (P0.05). [Conclusion] somatosensory interactive rehabilitation training can relieve the pain degree of patients with periarthritis of shoulder, expand the range of shoulder joint activity, reduce the physical signs of shoulder joint movement and enhance the ability of daily life, and can be effectively applied to the rehabilitation treatment of patients with periarthritis of shoulder. The community rehabilitation treatment service system is not perfect. Community health service institutions should strengthen the guidance and health education for patients with periarthritis of shoulder, and provide reliable methods of rehabilitation in order to improve their quality of life.

【学位授予单位】：杭州师范大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.2

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