本文選題：康復(fù)訓(xùn)練流程　切入點(diǎn)：腦梗死　出處：《中國康復(fù)醫(yī)學(xué)雜志》2017年04期 　論文類型：期刊論文

【摘要】：目的:初步探究腦梗死急性期標(biāo)準(zhǔn)化康復(fù)訓(xùn)練流程對(duì)患者運(yùn)動(dòng)功能及ADL能力改善程度的影響。方法:選取2014年6月—2014年12月在江蘇省人民醫(yī)院進(jìn)行住院康復(fù)治療的中重度運(yùn)動(dòng)功能損傷腦梗死急性期患者32例,隨機(jī)分入實(shí)驗(yàn)組與對(duì)照組,各16例。對(duì)照組患者接受常規(guī)的神經(jīng)內(nèi)科藥物治療和3周常規(guī)康復(fù)訓(xùn)練;實(shí)驗(yàn)組患者接受常規(guī)神經(jīng)內(nèi)科藥物治療和3周的標(biāo)準(zhǔn)化運(yùn)動(dòng)訓(xùn)練流程干預(yù),該流程從患者生命體征穩(wěn)定無進(jìn)行性加重時(shí)開始執(zhí)行,持續(xù)3周,要求總訓(xùn)練強(qiáng)度至少達(dá)到每天1.5h,且其中治療師的一對(duì)一訓(xùn)練與手法訓(xùn)練應(yīng)≥60min,且從第一周就開始進(jìn)行既定的5個(gè)主要方面,16到22項(xiàng)具體的訓(xùn)練介入。具體內(nèi)容包括:肢體主被動(dòng)活動(dòng)、神經(jīng)肌肉電刺激、床上運(yùn)動(dòng)、站立訓(xùn)練和日常生活活動(dòng)(ADL)能力訓(xùn)練等。使用Fugl-Meyer運(yùn)動(dòng)功能評(píng)估量表(FMA)和改良Barthel指數(shù)(MBI)分別于康復(fù)介入前后對(duì)患者的肢體運(yùn)動(dòng)功能和日常活動(dòng)能力進(jìn)行評(píng)估。結(jié)果:試驗(yàn)組患者M(jìn)BI差值(MBI_1-MBI_0)與MBI改善程度([MBI_1-MBI_0]/[100-MBI_0]×100%)均顯著高于常規(guī)治療組(P0.05);兩組患者的FMA相關(guān)指標(biāo)評(píng)分及其差值無顯著性差異(P0.05)。結(jié)論:腦梗死急性期標(biāo)準(zhǔn)化康復(fù)訓(xùn)練流程能夠在一定程度上改善腦梗死急性期患者的ADL能力恢復(fù)速度和恢復(fù)程度;雖然與常規(guī)治療相比未能獲得運(yùn)動(dòng)功能的顯著差異,但該運(yùn)動(dòng)訓(xùn)練方案有助于腦梗死急性期患者的標(biāo)準(zhǔn)化康復(fù)干預(yù)。
[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.
【作者單位】： 華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬同濟(jì)醫(yī)院;南京醫(yī)科大學(xué)第一附屬醫(yī)院康復(fù)醫(yī)學(xué)科;無錫同仁(國際)康復(fù)醫(yī)院;
【基金】：江蘇省臨床醫(yī)學(xué)科技專項(xiàng)項(xiàng)目(BL2012029)
【分類號(hào)】：R493;R743.3

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