文章摘要
宋振华,随燕芳,林夏妃,王良,汪良,甘春苗,张黎,张婷.不同体位上肢作业治疗对脑梗死偏瘫患者功能活动的影响[J].中国康复,2018,33(3):191-194
不同体位上肢作业治疗对脑梗死偏瘫患者功能活动的影响
Effect of occupational therapy in different postures on functional activities in patients with cerebral infarction
  
DOI:
中文关键词: 脑梗死  作业治疗  功能活动  ADL
英文关键词: Cerebral infarction  Occupational therapy  functional activities  ADL
基金项目:海南省卫生厅医学科研课题(琼卫2012PT-63);海口市科信局基金(2013-SHG-04-021)
作者单位
宋振华 海口市人民医院康复医学科海口 570208 
随燕芳 海口市人民医院康复医学科海口 570208 
林夏妃 海口市人民医院康复医学科海口 570208 
王良 海口市人民医院神经内科,海口 570208 
汪良 海口市人民医院医学工程科海口 570208 
甘春苗 海口市人民医院康复医学科海口 570208 
张黎 海口市人民医院康复医学科海口 570208 
张婷 海口市人民医院康复医学科海口 570208 
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中文摘要:
  目的:观察2种不同体位下的上肢作业治疗对脑梗死偏瘫患者运动功能的影响。方法:选择60例脑梗死后伴有上肢功能障碍的患者,随机分为坐位训练组和站位训练组,每组30例。2组患者在常规康复治疗的基础下,分别给予坐位和站位下的上肢作业治疗。在治疗前、治疗2周、4周后,采用简式Fugl-Myer评分(FMA)、BBS评分及改良Barthel指数(MBI)分别对患者的上肢功能、平衡功能、ADL能力作出评价。结果:治疗2周、4周后,坐位训练组FMA评分与治疗前比较差异无统计学意义(均P>0.05),站位训练组FMA评分较治疗前明显增加(P<0.05);2个时间点站位训练组评分均高于坐位训练组(均P<0.05)。治疗2周、4周后,2组患者BBS评分均较治疗前明显提高(均P<0.05),2个时间点站位训练组BBS评分均高于坐位训练组(均P<0.05)。治疗2周后坐位治疗组MBI评分与治疗前比较差异无统计学意义(均P>0.05),治疗4周后,坐位治疗组MBI较治疗前明显提高(均P<0.05);治疗2周、4周后,站位治疗组患者MBI均较治疗前明显提高(均P<0.05);治疗2周、4周后,站位训练组MBI评分均明显高于坐位训练组(均P<0.05)。结论:站位下的上下肢一体化的作业治疗,加强了全身其他肌肉配合作业活动所必须的稳定和平衡的能力,强化了上肢活动,更容易促进脑梗死偏瘫患者运动功能恢复和生活质量改善。
英文摘要:
  Objective: To observe the effect of upper limb occupational therapy in two different postures on functional activities in patients with cerebral infarction. Methods: Sixty patients with upper limb dysfunction after cerebral infarction were randomly divided into sitting group and standing group. Two group were given routine rehabilitation therapy in the sitting position and standing position, respectively. The Fugl-Meyer assessment (FMA), and the modified Barthel index (MBI) were performed before, and 2 weeks and 4 weeks after the treatment. Results: There were no significant differences between the two groups at baseline. In sitting group, the scores of BBS and MBI increased after 4 weeks, but FMA had no obvious improvement. In the standing group, the scores of BBS, MBI and FMA all increased and were higher than those in the sitting group at 2nd and 4th week after treatment (P<0.05). Conclusion: Occupational therapy in standing position can strengthen the general muscle, promote the balance and stability in patient with hemiplegia, then improve the motor function and quality of life.
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