作业疗法配合有氧运动治疗急性出血性脑卒中偏瘫的疗效及对肢体神经运动功能的影响
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摘要
目的研究作业疗法配合有氧运动治疗急性出血性脑卒中偏瘫的疗效及对肢体、神经运动功能的影响。方法选择2017年1月至2018年6月在我院接诊急性出血性脑卒中致偏瘫患者128例纳入研究,依据随机数字表法方式分对照组、研究组,各64例。对照组患者采用作业疗法治疗,研究组患者采用作业疗法配合有氧运动治疗。对比2组患者治疗效果及治疗前后的肢体运动功能、神经运动功能变化。结果研究组患者的治疗总有效率95%(61/64)高于对照组的81%(52/64),差异有统计学意义(P<0.05);治疗后2组肢体运动功能Fugl-Meyer评测法(FMA)评分升高,研究组更高,差异有统计学意义(P<0.05);治疗后2组神经运动功能美国国立卫生研究院卒中量表(NIHSS)评分降低,研究组更低,差异有统计学意义(P<0.05)。结论作业疗法配合有氧运动治疗急性出血性脑卒中偏瘫疗效显著,能有效改善患者肢体运动功能及神经运动功能,促进患者康复,值得临床推广。
Objective To investigate the therapeutic efficacy of occupational therapy combined with aerobic exercise on acute hemorrhagic stroke-induced hemiplegia and its impacts on limb movements and neuromotor functions. Methods A total of 128 patients with hemiplegia caused by acute hemorrhagic stroke in our hospital between January 2017 and June 2018 were enrolled in the study, and according to the random number table, divided into the control group and the study group(n=64 each). Patients in the control group were treated with occupational therapy,and those in the study group were treated with occupational therapy plus aerobic exercise. The therapeutic efficacy and changes in limb movements and neuromotor functions before and after treatment were compared between the two groups. Results The overall rate of effectiveness in the study group was 95%(61/64), which was higher than that in the control group [81%(52/64)], with statistically significant difference(P<0.05). After treatment, the FMA scores of limb movements were increased in the two groups, but the increase was greater in study group compared with the con-trol group, with statistically significant difference(P<0.05). After treatment, the NIHSS scores of limb neuromotor function were lowered in the two groups, but the reduction was greater in the study group compared with the control group, with statistically significant difference(P<0.05). Conclusion Occupational therapy combined with aerobic exercise for treatment of hemiplegia caused by acute hemorrhagic stroke is effective in improving limb movements and neuromotor functions. It promotes rehabilitation of patients, and therefore is worthwhile for widespread use in clinical setting.
Objective To investigate the therapeutic efficacy of occupational therapy combined with aerobic exercise on acute hemorrhagic stroke-induced hemiplegia and its impacts on limb movements and neuromotor functions. Methods A total of 128 patients with hemiplegia caused by acute hemorrhagic stroke in our hospital between January 2017 and June 2018 were enrolled in the study, and according to the random number table, divided into the control group and the study group(n=64 each). Patients in the control group were treated with occupational therapy,and those in the study group were treated with occupational therapy plus aerobic exercise. The therapeutic efficacy and changes in limb movements and neuromotor functions before and after treatment were compared between the two groups. Results The overall rate of effectiveness in the study group was 95%(61/64), which was higher than that in the control group [81%(52/64)], with statistically significant difference(P<0.05). After treatment, the FMA scores of limb movements were increased in the two groups, but the increase was greater in study group compared with the con-trol group, with statistically significant difference(P<0.05). After treatment, the NIHSS scores of limb neuromotor function were lowered in the two groups, but the reduction was greater in the study group compared with the control group, with statistically significant difference(P<0.05). Conclusion Occupational therapy combined with aerobic exercise for treatment of hemiplegia caused by acute hemorrhagic stroke is effective in improving limb movements and neuromotor functions. It promotes rehabilitation of patients, and therefore is worthwhile for widespread use in clinical setting.
引文
[1]缪欢欢,谢瑞满.洛文斯顿作业疗法认知评定量表在腔隙性脑梗死患者中的应用价值[J].老年医学与保健,2018,24(2):133-135,153.
[2]张君,刘红.火针配合康复作业疗法治疗中风后肩手综合征80例疗效观察[J].新疆中医药,2015,33(4):40-41.
[3]邢晓东,薛宏伟,范志华.红外多峰宽带技术配合作业疗法治疗中风后手指拘挛的临床观察[J].中医临床研究,2017,9(30):34-35.
[4] De Lorenzo RJ,Sun DA,Blair RE,et al. An in vitro model of stroke-induced epilepsy:elucidation of the roles of glutamate and calcium in the induction and maintenance of stroke-induced epileptogenesis[J].Int Rev Neurobiol,2014,81(26):59-84.
[5]杨栋,廖麟荣,贺青涛,等.振动刺激与浮针疗法对早期中风偏瘫患者运动功能的协同康复作用[J].云南中医中药杂志,2018,39(2):63-65.
[6]曹渺,刘晓瑞,黄彬洋,等.ICF模式下的作业疗法配合电针平衡区改善脑卒中患者平衡功能临证心得[J].中医外治杂志,2017,26(2):57-58.
[7]胡跃强,兰鹏,梁妮,等.清热化瘀方治疗急性缺血性中风的临床疗效观察及其作用机制研究[J].辽宁中医杂志,2017,44(10):2105-2107.
[8]方芳,蔡玲.自拟清热凉血通瘀方加减在缺血性脑中风急性期的临床应用及效果评价[J].中华中医药学刊,2014,32(6):1296-1299.
[9]刘颖,姜丹丹,何春凤.系统中医康复护理对早期中风偏瘫患者65例肢体功能恢复的影响[J].辽宁中医杂志,2015,42(7):1342-1344.
[10]刘军兵.董氏奇穴疗法配合本体感觉神经肌肉促进技术治疗急性中风肢体偏瘫80例临床观察[J].实用中医药杂志,2016,32(5):478-479.
[11]郝建波,王云翠.拮抗肌推拿结合Bobath疗法治疗中风痉挛性偏瘫的临床观察[J].湖北中医药大学学报,2016,18(3):98-100.
[12]汤凯,刘莉.益气活血化瘀汤联合康复运动治疗急性出血性脑卒中偏瘫的临床观察[J].中西医结合心脑血管病杂志,2017,15(24):3183-3186.
[13]高丽君,王海涛,刘木朋,等.中医针灸结合穴位敷贴治疗急性缺血性脑中风的随机、对照研究[J].辽宁中医杂志,2018,45(3):614-617.
[14] Stearns SC,Bemard SL,Fasiek SB,et al.The economic implications of self-care:the effect of lifestyle,functional adaptations,and medical self-care among a national sample of medicare beneficiaries[J].Am J Publie Health,2014,90(10):1608-1612.
[15]黎文杰.阴-阳对刺呼吸补泻法对缺血性脑中风偏瘫患者下肢功能的影响[J].牡丹江医学院学报,2016,37(1):48-49,54.
[16]聂勇.补阳还五汤加减合巨刺法辅助肢体功能锻炼治疗缺血性中风偏瘫临床研究[J].现代中西医结合杂志,2018,27(16):1775-1778.
[17] Kuncewitch M, Yang WL, Jacob A, et al. Stimulation of Wnt/beta carenin signaling pathway with Wnt agonist reduces organ injury after hemorrhagic shock[J]. J Trauma Acute Care Surg,2015,78(4):793-900.
[18]苏美莲,邓永福,张飞,等.阴阳调衡针法治疗缺血性中风偏瘫痉挛状态临床观察[J].中国保健营养,2018,28(14):86-87.
[19]韩明姬.针灸与康复医学结合治疗中风偏瘫的临床效果观察[J/CD].世界最新医学信息文摘(连续型电子期刊),2015,15(22):162-163.
[20]李玉红.针药结合康复训练对中风偏瘫痉挛状态的康复疗效及安全性评价[J].按摩与康复医学,2018,9(5):30-31.
[21] Tanaka Y, Nariai T, Nagaoka T, et al.Quantitative evaluation of cerebral hemodynamics in patients with moyamoya disease bydynamic suseeptibility contrast magnetic resonance imaging comparison with positron emission tomography[J].J Cereb Blood Flow Metab, 2016,26(2):291-300.
[22]韩薇.中药熏洗配合康复护理治疗改善中风后偏瘫肢体功能的护理探析[J/CD].实用临床护理学电子杂志,2017,2(35):126-127.
[23]阮贵基,张亚云.推拿结合康复训练治疗中风后偏瘫的临床研究概况[J/CD].世界最新医学信息文摘(连续型电子期刊),2016,16(65):48-49.
[24]农李宁.中医特色护理和常规护理在中风后偏瘫患者中的护理效果对比观察[J].大家健康(中旬版),2016,10(6):27-28.
[2]张君,刘红.火针配合康复作业疗法治疗中风后肩手综合征80例疗效观察[J].新疆中医药,2015,33(4):40-41.
[3]邢晓东,薛宏伟,范志华.红外多峰宽带技术配合作业疗法治疗中风后手指拘挛的临床观察[J].中医临床研究,2017,9(30):34-35.
[4] De Lorenzo RJ,Sun DA,Blair RE,et al. An in vitro model of stroke-induced epilepsy:elucidation of the roles of glutamate and calcium in the induction and maintenance of stroke-induced epileptogenesis[J].Int Rev Neurobiol,2014,81(26):59-84.
[5]杨栋,廖麟荣,贺青涛,等.振动刺激与浮针疗法对早期中风偏瘫患者运动功能的协同康复作用[J].云南中医中药杂志,2018,39(2):63-65.
[6]曹渺,刘晓瑞,黄彬洋,等.ICF模式下的作业疗法配合电针平衡区改善脑卒中患者平衡功能临证心得[J].中医外治杂志,2017,26(2):57-58.
[7]胡跃强,兰鹏,梁妮,等.清热化瘀方治疗急性缺血性中风的临床疗效观察及其作用机制研究[J].辽宁中医杂志,2017,44(10):2105-2107.
[8]方芳,蔡玲.自拟清热凉血通瘀方加减在缺血性脑中风急性期的临床应用及效果评价[J].中华中医药学刊,2014,32(6):1296-1299.
[9]刘颖,姜丹丹,何春凤.系统中医康复护理对早期中风偏瘫患者65例肢体功能恢复的影响[J].辽宁中医杂志,2015,42(7):1342-1344.
[10]刘军兵.董氏奇穴疗法配合本体感觉神经肌肉促进技术治疗急性中风肢体偏瘫80例临床观察[J].实用中医药杂志,2016,32(5):478-479.
[11]郝建波,王云翠.拮抗肌推拿结合Bobath疗法治疗中风痉挛性偏瘫的临床观察[J].湖北中医药大学学报,2016,18(3):98-100.
[12]汤凯,刘莉.益气活血化瘀汤联合康复运动治疗急性出血性脑卒中偏瘫的临床观察[J].中西医结合心脑血管病杂志,2017,15(24):3183-3186.
[13]高丽君,王海涛,刘木朋,等.中医针灸结合穴位敷贴治疗急性缺血性脑中风的随机、对照研究[J].辽宁中医杂志,2018,45(3):614-617.
[14] Stearns SC,Bemard SL,Fasiek SB,et al.The economic implications of self-care:the effect of lifestyle,functional adaptations,and medical self-care among a national sample of medicare beneficiaries[J].Am J Publie Health,2014,90(10):1608-1612.
[15]黎文杰.阴-阳对刺呼吸补泻法对缺血性脑中风偏瘫患者下肢功能的影响[J].牡丹江医学院学报,2016,37(1):48-49,54.
[16]聂勇.补阳还五汤加减合巨刺法辅助肢体功能锻炼治疗缺血性中风偏瘫临床研究[J].现代中西医结合杂志,2018,27(16):1775-1778.
[17] Kuncewitch M, Yang WL, Jacob A, et al. Stimulation of Wnt/beta carenin signaling pathway with Wnt agonist reduces organ injury after hemorrhagic shock[J]. J Trauma Acute Care Surg,2015,78(4):793-900.
[18]苏美莲,邓永福,张飞,等.阴阳调衡针法治疗缺血性中风偏瘫痉挛状态临床观察[J].中国保健营养,2018,28(14):86-87.
[19]韩明姬.针灸与康复医学结合治疗中风偏瘫的临床效果观察[J/CD].世界最新医学信息文摘(连续型电子期刊),2015,15(22):162-163.
[20]李玉红.针药结合康复训练对中风偏瘫痉挛状态的康复疗效及安全性评价[J].按摩与康复医学,2018,9(5):30-31.
[21] Tanaka Y, Nariai T, Nagaoka T, et al.Quantitative evaluation of cerebral hemodynamics in patients with moyamoya disease bydynamic suseeptibility contrast magnetic resonance imaging comparison with positron emission tomography[J].J Cereb Blood Flow Metab, 2016,26(2):291-300.
[22]韩薇.中药熏洗配合康复护理治疗改善中风后偏瘫肢体功能的护理探析[J/CD].实用临床护理学电子杂志,2017,2(35):126-127.
[23]阮贵基,张亚云.推拿结合康复训练治疗中风后偏瘫的临床研究概况[J/CD].世界最新医学信息文摘(连续型电子期刊),2016,16(65):48-49.
[24]农李宁.中医特色护理和常规护理在中风后偏瘫患者中的护理效果对比观察[J].大家健康(中旬版),2016,10(6):27-28.
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