规范化轮椅技能训练在康复治疗专业临床实习中的应用
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摘要
目的探讨在康复治疗专业临床教学中增加规范化轮椅技能训练的意义。方法 2017年5月至2018年4月,48例康复治疗专业本科实习学生随机分为对照组和实验组各24例。在常规实习安排的基础上,实验组增加规范化轮椅技能训练5 h。分别于训练前、训练后和训练后4周,采用轮椅技能测试(WST) 4.3进行测试,实验组进行轮椅技能训练问卷调查。结果实验组训练后及4周后随访WST评分显著优于对照组(|t|> 9.330, P <0.001),实验组WST评分提升率优于对照组(|t|=11.214, P <0.001)。实验组认为,系统规范化轮椅技能训练非常必要,建议作为作业治疗学的必修科目。结论规范化轮椅技能训练能提高康复治疗专业学生轮椅使用熟练程度和对轮椅使用者需求的理解,可以适当补充进临床教学计划中。
Objective To introduce the standardized wheelchair skills training program into clinical teaching for the rehabilitation therapeutics students.Methods From May, 2017 to April, 2018, 48 undergraduate interns of rehabilitation therapeutics were randomly divided into control group(n = 24) and experimental group(n = 24). Both groups accepted the regular practice, and the experimental group accepted standardized wheelchair skills training for five hours. They were tested with Wheel‐chair Skills Test(WST) 4.3 before, post training and four-week follow-up. The experimental group completed a questionnaire related to the wheelchair skills training.Results The score of WST was more in the experimental group than in the control group both post training and fourweek follow-up(|t| > 9.330, P < 0.001). The rate of improvement of WST scores was also more in the experimen‐tal group than in the control group(|t| = 11.214, P < 0.001). The experimental group suggested that the standard‐ized wheelchair skills training was necessary, and should be a compulsory subject of the occupational therapy.Conclusion The standardized wheelchair skills training is effective to improve the students' wheelchair-skills perfor‐mance and understand the needs of the wheelchair users, which may be included in the curriculum program.
Objective To introduce the standardized wheelchair skills training program into clinical teaching for the rehabilitation therapeutics students.Methods From May, 2017 to April, 2018, 48 undergraduate interns of rehabilitation therapeutics were randomly divided into control group(n = 24) and experimental group(n = 24). Both groups accepted the regular practice, and the experimental group accepted standardized wheelchair skills training for five hours. They were tested with Wheel‐chair Skills Test(WST) 4.3 before, post training and four-week follow-up. The experimental group completed a questionnaire related to the wheelchair skills training.Results The score of WST was more in the experimental group than in the control group both post training and fourweek follow-up(|t| > 9.330, P < 0.001). The rate of improvement of WST scores was also more in the experimen‐tal group than in the control group(|t| = 11.214, P < 0.001). The experimental group suggested that the standard‐ized wheelchair skills training was necessary, and should be a compulsory subject of the occupational therapy.Conclusion The standardized wheelchair skills training is effective to improve the students' wheelchair-skills perfor‐mance and understand the needs of the wheelchair users, which may be included in the curriculum program.
引文
[1]陈艳,潘翠环,罗爱华.康复治疗专业实验教学与学生操作能力的培养[J].中国康复理论与实践, 2008, 14(1):99-100.
[2] World Health Organization. Guidelines on the provision of wheelchairs in less resourced settings[DB/OL].[2018-06-01]. http://www.who.int/disabilities/publications/technology/wheelchairguidelines/en/.
[3]李高峰,魏晨婧,赖卿,等.我国轮椅服务存在的问题及对策[J].中国康复理论与实践, 2014, 20(2):188-191.
[4]钟磊,朱图陵.世界卫生组织轮椅中级服务及其对我国辅具服务的启示[J].中国康复理论与实践, 2016, 22(7):860-862.
[5]薛晶晶,肖玲君,燕铁斌,等.康复治疗专业本科生教学满意度调查及教学设置研究[J].中国康复医学杂志, 2014, 29(8):754-756.
[6] Giesbrecht E M, Wilson N, Schneider A, et al. Preliminary evidence to support a"boot camp"approach to wheelchair skills training for clinicians[J]. Arch Phys Med Rehabil, 2015, 96(6):1158-1161.
[7]王杨,李奎成,邓小倩.规范化轮椅技能训练对截瘫患者的康复疗效[J].中国康复, 2013, 28(5):351-353.
[8] Keeler L, Kirby R L, Parker K, et al. Effectiveness of the Wheelchair Skills Training Program:a systematic review and meta-analysis[J].Disabil Rehabil Assist Technol, 2018, 4(1):1-19.
[9] Tu C J, Liu L, Wang W, et al. Effectiveness and safety of wheelchair skills training program in improving the wheelchair skillscapacity:a systematic review[J]. Clin Rehabil, 2017, 31(12):1573-1582.
[10] Worobey L A, Kirby R L, Heinemann A W, et al. Effectiveness of group wheelchair skills training for people with spinal cord injury:a randomized controlled trial[J]. Arch Phys Med Rehabil, 2016, 97(10):1777-1784.
[11] Best K L, Routhier F, Miller W C. A description of manual wheelchair skills training:current practices in Canadian rehabilitation centers[J]. Disabil Rehabil Assist Technol, 2015, 10(5):393-400.
[12] Rispin K L, Huff K, Wee J. Test-retest reliability and construct validity of the Aspects of Wheelchair Mobility Test as a measure of the mobility of wheelchair users[J]. Afr J Disabil, 2017, 6(1):a331.
[13] Kirby R L, Smith C, Parker K, et al. The Wheelchair Skills Program Manual[M]. Halifax, Canada:Dalhousie University[2018-06-01]. http://www.wheelchairskillsprogram.ca/eng/manual.php.
[14] Coolen A L, Kirby R L, Landry J, et al. Wheelchair Skills Training Program for clinicians:a randomized controlled trial with occupational therapy students[J]. Arch Phys Med Rehabil, 2004, 85(1):1160-1167.
[15] Rushton P W, Daoust G. Wheelchair skills training for occupational therapy students:comparison of university-course versus"boot-camp"approaches[J]. Disabil Rehabil Assist Technol, 2018, 11(7):1-7.
[16]薛晶晶,王清,燕铁斌,等.国内康复治疗学专业教育现状的调查与思考[J].中国康复医学杂志, 2011, 26(12):1149-1151.
[17]敖丽娟,李咏梅,王文丽,等.昆明医学院康复治疗学专业教学计划及课程设置探讨[J].中国康复医学杂志, 2008, 23(4):363-365.
[18] Kentar Y, Zastrow R, Bradley H, et al. Prevalence of upper extremity pain in a population of people with paraplegia[J]. Spinal Cord, 2018,56(7):695-703.
[19] Thais P, Betania G, Laura N R, et al. Determining the burden of the family caregivers of people with neuromuscular diseases who use a wheelchair[J]. Medicine, 2018, 97(24):e11039.
[20] Dyson-Hudson T A, Kirshblum S C. Shoulder pain in chronic spinal cord injury, part I:epidemiology, etiology, and pathomechanics[J]. J Spinal Cord Med, 2004, 27(1):4-17.
[21] van Drongelen S, de Groot S, Veeger H E, et al. Upper extremity musculoskeletal pain during and after rehabilitation in wheelchair using persons with a spinal cord injury[J]. Spinal Cord, 2006, 44(1):152-159.
[22] Yasser K, Manuela B, Thomas B, et al. Impact of spine alignment on the rotator cuff in long-term wheelchair users[J]. J Shoulder Elbow Surg, 2017, 27(6):1004-1011.
[23]陈艳,潘翠环,龙大宏.康复治疗学专业作业治疗方向师资培养与实践教学初探[J].中国康复理论与实践, 2013, 19(8):791-793.
[24] Krista B, William M, Fran?ois R. A description of manual wheelchair skills training curriculum in entry-to-practice occupational and physical therapy programs in Canada[J]. Disabil Rehabil Assist Tech,2015, 10(5):401-406.
[25] Kirby R L, Crawford K A, Smith C, et al. A wheelchair workshop for medical students improves knowledge and skills:a randomized controlled trial[J]. Am J Phys Med Rehabil, 2011, 90(1):197-206.
[2] World Health Organization. Guidelines on the provision of wheelchairs in less resourced settings[DB/OL].[2018-06-01]. http://www.who.int/disabilities/publications/technology/wheelchairguidelines/en/.
[3]李高峰,魏晨婧,赖卿,等.我国轮椅服务存在的问题及对策[J].中国康复理论与实践, 2014, 20(2):188-191.
[4]钟磊,朱图陵.世界卫生组织轮椅中级服务及其对我国辅具服务的启示[J].中国康复理论与实践, 2016, 22(7):860-862.
[5]薛晶晶,肖玲君,燕铁斌,等.康复治疗专业本科生教学满意度调查及教学设置研究[J].中国康复医学杂志, 2014, 29(8):754-756.
[6] Giesbrecht E M, Wilson N, Schneider A, et al. Preliminary evidence to support a"boot camp"approach to wheelchair skills training for clinicians[J]. Arch Phys Med Rehabil, 2015, 96(6):1158-1161.
[7]王杨,李奎成,邓小倩.规范化轮椅技能训练对截瘫患者的康复疗效[J].中国康复, 2013, 28(5):351-353.
[8] Keeler L, Kirby R L, Parker K, et al. Effectiveness of the Wheelchair Skills Training Program:a systematic review and meta-analysis[J].Disabil Rehabil Assist Technol, 2018, 4(1):1-19.
[9] Tu C J, Liu L, Wang W, et al. Effectiveness and safety of wheelchair skills training program in improving the wheelchair skillscapacity:a systematic review[J]. Clin Rehabil, 2017, 31(12):1573-1582.
[10] Worobey L A, Kirby R L, Heinemann A W, et al. Effectiveness of group wheelchair skills training for people with spinal cord injury:a randomized controlled trial[J]. Arch Phys Med Rehabil, 2016, 97(10):1777-1784.
[11] Best K L, Routhier F, Miller W C. A description of manual wheelchair skills training:current practices in Canadian rehabilitation centers[J]. Disabil Rehabil Assist Technol, 2015, 10(5):393-400.
[12] Rispin K L, Huff K, Wee J. Test-retest reliability and construct validity of the Aspects of Wheelchair Mobility Test as a measure of the mobility of wheelchair users[J]. Afr J Disabil, 2017, 6(1):a331.
[13] Kirby R L, Smith C, Parker K, et al. The Wheelchair Skills Program Manual[M]. Halifax, Canada:Dalhousie University[2018-06-01]. http://www.wheelchairskillsprogram.ca/eng/manual.php.
[14] Coolen A L, Kirby R L, Landry J, et al. Wheelchair Skills Training Program for clinicians:a randomized controlled trial with occupational therapy students[J]. Arch Phys Med Rehabil, 2004, 85(1):1160-1167.
[15] Rushton P W, Daoust G. Wheelchair skills training for occupational therapy students:comparison of university-course versus"boot-camp"approaches[J]. Disabil Rehabil Assist Technol, 2018, 11(7):1-7.
[16]薛晶晶,王清,燕铁斌,等.国内康复治疗学专业教育现状的调查与思考[J].中国康复医学杂志, 2011, 26(12):1149-1151.
[17]敖丽娟,李咏梅,王文丽,等.昆明医学院康复治疗学专业教学计划及课程设置探讨[J].中国康复医学杂志, 2008, 23(4):363-365.
[18] Kentar Y, Zastrow R, Bradley H, et al. Prevalence of upper extremity pain in a population of people with paraplegia[J]. Spinal Cord, 2018,56(7):695-703.
[19] Thais P, Betania G, Laura N R, et al. Determining the burden of the family caregivers of people with neuromuscular diseases who use a wheelchair[J]. Medicine, 2018, 97(24):e11039.
[20] Dyson-Hudson T A, Kirshblum S C. Shoulder pain in chronic spinal cord injury, part I:epidemiology, etiology, and pathomechanics[J]. J Spinal Cord Med, 2004, 27(1):4-17.
[21] van Drongelen S, de Groot S, Veeger H E, et al. Upper extremity musculoskeletal pain during and after rehabilitation in wheelchair using persons with a spinal cord injury[J]. Spinal Cord, 2006, 44(1):152-159.
[22] Yasser K, Manuela B, Thomas B, et al. Impact of spine alignment on the rotator cuff in long-term wheelchair users[J]. J Shoulder Elbow Surg, 2017, 27(6):1004-1011.
[23]陈艳,潘翠环,龙大宏.康复治疗学专业作业治疗方向师资培养与实践教学初探[J].中国康复理论与实践, 2013, 19(8):791-793.
[24] Krista B, William M, Fran?ois R. A description of manual wheelchair skills training curriculum in entry-to-practice occupational and physical therapy programs in Canada[J]. Disabil Rehabil Assist Tech,2015, 10(5):401-406.
[25] Kirby R L, Crawford K A, Smith C, et al. A wheelchair workshop for medical students improves knowledge and skills:a randomized controlled trial[J]. Am J Phys Med Rehabil, 2011, 90(1):197-206.
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