本文選題：太極“云手” + 腦卒中　； 參考：《河南中醫(yī)藥大學》2016年碩士論文

【摘要】：據(jù)統(tǒng)計,因醫(yī)療資源的限制、經(jīng)濟狀況、功能恢復(fù)平臺期等因素影響,75%~85%[1-2]的腦卒中患者最終出院回家。腦卒中平衡功能障礙患者因平衡功能差、行走能力弱、運動耐力不足等,日常生活中多數(shù)時間以坐、臥活動方式為主,從而導(dǎo)致社會活動參與水平低,生存質(zhì)量不高,給患者自身及其家庭以至于社會都帶來嚴重的精神壓力及經(jīng)濟負擔。因此,尋找一個簡易、經(jīng)濟,又具有良好療效的社區(qū)康復(fù)治療技術(shù)對幫助患者恢復(fù)其良好的平衡功能,具有十分重大的意義。目的:本課題探討太極“云手”訓練在社區(qū)腦卒中患者平衡功能障礙康復(fù)中的療效及評價,為社區(qū)平衡功能康復(fù)干預(yù)方法提供依據(jù),以期為臨床提供一療效確切又簡便、經(jīng)濟、易行的治療方法。方法:將符合入選標準的腦卒中后平衡功能障礙患者54例,按隨機數(shù)字表法分為試驗組和對照組,兩組均27例。對照組在基礎(chǔ)治療的同時進行常規(guī)康復(fù)訓練,試驗組在對照組的基礎(chǔ)上同時接受太極“云手”訓練。常規(guī)康復(fù)訓練,5次/周,持續(xù)8周;太極“云手”訓練每次30min,5次/周,持續(xù)8周。在治療前、治療4周后、治療8周后、隨訪1個月后對兩組患者用采用Berg平衡量表(BBS)、站起-走計時測試(TUGT)、改良Barthel指數(shù)(MBI)進行評估。數(shù)據(jù)分析采用SPSS22.0統(tǒng)計軟件進行統(tǒng)計分析。結(jié)果:兩組的處理方式、治療周期均對BBS評分(P=0.022,P0.001)、TUGT評分(P=0.030,P0.001)、MBI評分(P=0.046,P0.001)的影響有統(tǒng)計學意義,治療周期和處理之間存在交互作用(P0.001)。其中對照組和太極云手組的BBS、TUGT評分隨著治療時間的增加均不斷升高,但太極云手組的BBS、TUGT評分隨治療時間的變化幅度較對照組的變化幅度大,說明兩組均對腦卒中后平衡功能障礙有確切療效,且療效隨著治療時間的增加均不斷升高,且太極云手組療效更明顯。MBI評分中,對照組治療期間各個時間點評分隨著治療周期的增加均不斷升高,但隨訪時間點評分升高不明顯,太極云手組治療期間各時間點及隨訪時間點的評分隨著時間均不斷升高。結(jié)論:1.太極“云手”訓練作為一種社區(qū)康復(fù)干預(yù)手段,可改善社區(qū)康復(fù)腦卒中患者的平衡功能和步行能力,有利于日常生活活動能力的提高。2.太極“云手”訓練其操作簡便、廉驗、安全有效,可為社區(qū)康復(fù)中腦卒中后平衡功能障礙腦卒中患者帶來良好效益。
[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.
【學位授予單位】：河南中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R743.33

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