整体控制疗法对脑卒中患者早期康复运动功能训练效果的影响
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摘要
目的:探讨整体控制疗法(GCT)对脑卒中患者早期康复运动功能训练的效果。方法:选取2018年1～5月本院收治的脑卒中患者40例,随机分为观察组和对照组各20例。对照组采用常规的偏瘫肢体综合训练,观察组在对照组基础上采用GCT。比较两组治疗前后上肢运动、下肢运动与平衡功能(Fugl-Meyer量表)改善情况,比较两组患者日常生活活动能力(Barthel指数)改善情况。结果:治疗后6周,两组UE-FM、LE-FM、FM-B评分及MBI评分均较治疗前显著提高(P<0.05),且观察组显著高于对照组(P<0.05)。结论:脑卒中早期康复锻炼中应用GCT能改善运动功能,增强日常生活活动能力,值得推广应用。
Objective: To explore effect of global control therapy(GCT) on early rehabilitation exercise training in stroke patients. Methods: From January to May 2018, 40 stroke patients were randomly divided into two groups: the observation group(n=20) and the control group(n=20).The control group was given comprehensive training for hemiplegia limbs, while the observation group was given GCT based on the control group. The improvements of upper limb movement, lower limb movement and balance function(evaluated by Fugl-Meyer scale) and activities of daily living(evaluated by modified Barthel index) were compared before and after treatment between two groups. Results: After 6 weeks of treatment, The UE-FM,LE-FM,FM-B score and MBI score in both groups were significantly higher than those before treatment(P<0.05).and these indexes in the observation group were significantly higher than the control group(P<0.05). Conclusion: Application of GCT in early rehabilitation in stroke patients can improve motor function and enhance activities of daily living, so it is worthy of popularization and application.
Objective: To explore effect of global control therapy(GCT) on early rehabilitation exercise training in stroke patients. Methods: From January to May 2018, 40 stroke patients were randomly divided into two groups: the observation group(n=20) and the control group(n=20).The control group was given comprehensive training for hemiplegia limbs, while the observation group was given GCT based on the control group. The improvements of upper limb movement, lower limb movement and balance function(evaluated by Fugl-Meyer scale) and activities of daily living(evaluated by modified Barthel index) were compared before and after treatment between two groups. Results: After 6 weeks of treatment, The UE-FM,LE-FM,FM-B score and MBI score in both groups were significantly higher than those before treatment(P<0.05).and these indexes in the observation group were significantly higher than the control group(P<0.05). Conclusion: Application of GCT in early rehabilitation in stroke patients can improve motor function and enhance activities of daily living, so it is worthy of popularization and application.
引文
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[17]王艳,唐强,陈国平.神经松动术结合头穴丛刺与康复训练对臂丛神经损伤后上肢功能的影响[J].中国康复医学杂志,2011,26(6):575-576.
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[2]Fisher M.Stroke and TIA:epidemiology,risk factors,and the need for early intervention[J].Am J Manag Care,2008,14(6 Suppl2):204-211.
[3]宇传华,罗丽莎,李梅,等.从全球视角看中国脑卒中疾病负担的严峻性[J].公共卫生与预防医学,2016,27(1):1-5.
[4]杨阳,胡利杰,蔡西国,等.重复经颅磁刺激对脑卒中下肢痉挛患者肢体功能恢复的影响[J].中华物理医学与康复杂志,2015,37(8):602-603.
[5]张备,何嫱,李莹莹,等.规范的三级康复治疗对脑出血后患者上肢痉挛程度及运动功能的影响[J].中华物理医学与康复杂志,2014,36(11):828-831.
[6]超早期康复训练对急性脑卒中偏瘫患者运动功能及日常生活能力的影响[J].内蒙古医学杂志,2015,47(3):281-283.
[7]Lo AC,Guarino PD,Richards LG,et al.Robot-assisted therapy for long-term upper-limb impairment after stroke[J].New England Journal of Medicine,2010,362(19):1772-1783.
[8]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[9]王玉龙.康复评定技术[M].北京:人民卫生出版社,2010:331-334.
[10]励建安,王彤.康复医学[M].北京:科技出版社,2002:187-217.
[11]Good DC,Bettermann K,Reichwein R K.Stroke Rehabilitation[J].Continuum Life long Learning Neurol,2011,17(3):545-567.
[12]席建明,冯晓东.核心力量训练对脑卒中患者步行及平衡能力的影响[J].中国康复医学杂志,2011,26(8):777-778.
[13]Bobath B.Adult hemiplegia:evaluation and treatment[M].3rd ed.Oxford:Heinemann Medical Books,1990:20-69.
[14]Kollen BJ,Lennon S,Lyons B,et al.The effectiveness of the Bobath concept in stroke rehabilitation:what is the evidence[J].Stroke,2009,40(4):e89-97.
[15](挪威)bente E.Bass?e Gjelsvik,Line Syre著,刘钦刚译.The Bobayh Concept in Adult Neurology[M].2nd edition.西安:世界图书出版西安有限公司,2017:147-148.
[16]苏久龙,潘翠环,叶正茂,等.神经松动术对早期脑卒中偏瘫患者上肢功能的影响[J].国际医药卫生导报,2010,16(13):1571-1573.
[17]王艳,唐强,陈国平.神经松动术结合头穴丛刺与康复训练对臂丛神经损伤后上肢功能的影响[J].中国康复医学杂志,2011,26(6):575-576.
[18]古泽正道,李建军.康复治疗-新Bobath治疗[M].北京:人民军医出版社,2015:201-202.
[19]Nudo RJ,McNeal D.Plasticity of cerebral funcions[J].Handb ClinNeurol,2013,28(1):13-21.