脑梗死急性期康复训练流程对患者运动功能和日常生活活动能力改善程度的影响

发布时间：2018-03-17 04:18

本文选题：康复训练流程　切入点：脑梗死　出处：《中国康复医学杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的:初步探究脑梗死急性期标准化康复训练流程对患者运动功能及ADL能力改善程度的影响。方法:选取2014年6月—2014年12月在江苏省人民医院进行住院康复治疗的中重度运动功能损伤脑梗死急性期患者32例,随机分入实验组与对照组,各16例。对照组患者接受常规的神经内科药物治疗和3周常规康复训练;实验组患者接受常规神经内科药物治疗和3周的标准化运动训练流程干预,该流程从患者生命体征稳定无进行性加重时开始执行,持续3周,要求总训练强度至少达到每天1.5h,且其中治疗师的一对一训练与手法训练应≥60min,且从第一周就开始进行既定的5个主要方面,16到22项具体的训练介入。具体内容包括:肢体主被动活动、神经肌肉电刺激、床上运动、站立训练和日常生活活动(ADL)能力训练等。使用Fugl-Meyer运动功能评估量表(FMA)和改良Barthel指数(MBI)分别于康复介入前后对患者的肢体运动功能和日常活动能力进行评估。结果:试验组患者MBI差值(MBI_1-MBI_0)与MBI改善程度([MBI_1-MBI_0]/[100-MBI_0]×100%)均显著高于常规治疗组(P0.05);两组患者的FMA相关指标评分及其差值无显著性差异(P0.05)。结论:脑梗死急性期标准化康复训练流程能够在一定程度上改善脑梗死急性期患者的ADL能力恢复速度和恢复程度;虽然与常规治疗相比未能获得运动功能的显著差异,但该运动训练方案有助于脑梗死急性期患者的标准化康复干预。
[Abstract]:Objective: to explore the effect of standardized rehabilitation training procedure on motor function and ADL ability in patients with acute cerebral infarction. Methods: from June 2014 to December 2014, we conducted rehabilitation treatment in Jiangsu Provincial people's Hospital. A total of 32 patients with moderate and severe motor function injury in acute stage of cerebral infarction were studied. The patients in the control group received routine neuromedical therapy and routine rehabilitation training for 3 weeks, and the patients in the experimental group received routine neuromedical therapy and 3 weeks standardized exercise training process intervention, the patients in the experimental group were randomly divided into the experimental group and the control group, 16 cases in each group received routine neuromedical therapy and 3 weeks of routine rehabilitation training. The procedure was performed for 3 weeks when the patient's vital signs were stable without progressive exacerbation. The total training intensity is required to be at least 1.5 hours per day, in which the therapist's one-to-one training and manipulation training should be more than 60 mins, and from the first week, 16 to 22 specific training interventions will be carried out in 5 major areas. Including: active and passive physical activity, Neuromuscular electrical stimulation, exercise in bed, Standing training and activities of daily living (ADL) ability training were used to evaluate the motor function and daily activity of patients before and after rehabilitation intervention using Fugl-Meyer motor function evaluation scale (Fugl-Meyer) and modified Barthel index (MBI). The difference of MBI and MBI ([MBI_1-MBI_0] / [100-MBI 0] 脳 100) in the trial group was significantly higher than that in the routine treatment group (P 0.05), and there was no significant difference between the two groups in FMA related index score and difference (P 0.05). Conclusion: the standardized rehabilitation training procedure can be used in the acute phase of cerebral infarction. Enough to improve the recovery speed and degree of ADL ability in patients with acute cerebral infarction to a certain extent; Although there was no significant difference in motor function as compared with conventional treatment, the exercise training program was helpful to standardized rehabilitation intervention in patients with acute cerebral infarction.
【作者单位】：华中科技大学同济医学院附属同济医院;南京医科大学第一附属医院康复医学科;无锡同仁(国际)康复医院;
【基金】：江苏省临床医学科技专项项目(BL2012029)
【分类号】：R493;R743.3

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