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目的探讨规范三级康复治疗对卒中后遗症期偏瘫患者关节活动度和下肢运动功能的影响。方法将2011年11月至2013年11月聊城市东昌府人民医院收治的60例脑卒中偏瘫患者按照随机数字表法分为观察组和对照组,各30例。对照组给予常规康复训练,观察组实施规范三级康复治疗。6个月后评价两组患者关节活动度、肢体运动功能和生活质量。结果 6个月后两组患者髋关节、膝关节活动度均显著提高,其中观察组髋关节、膝关节活动度显著高于对照组[(15.4±3.6)°比(12.3±2.4)°、(26.6±3.5)°比(22.0±3.5)°,P<0.01];观察组上肢简式运动功能评分量表(FAM)评分、下肢FAM评分及独立性检测量表(FIM)评分亦显著高于对照组[(26±8)比(22±7)、(27±7)比(22±8)、(58±10)比(44±12),P<0.05或P<0.01]。6个月后观察组患者角色功能、社会功能、身体功能、情绪功能以及总生活质量评分均显著高于对照组[(1.6±0.4)比(0.9±0.4)、(1.07±0.41)比(0.79±0.27)、(1.87±0.21)比(1.55±0.18)、(1.8±0.5)比(1.0±0.3)、(5.0±1.2)比(4.0±1.1),P<0.01]。结论规范三级康复能改善脑卒中偏瘫患者髋关节、膝关节活动度,促进患侧肢体运动功能恢复,提高患者生活质量。
Objective To investigate the effect of standard three-level rehabilitation on joint mobility and lower extremity motor function in hemiplegia patients with stroke sequelae. Methods From November 2011 to November 2013, 60 patients with stroke hemiplegia who were treated in Dongchangfu People’s Hospital of Liaocheng were divided into observation group and control group according to random number table method, with 30 cases in each group. The control group was given routine rehabilitation training, and the observation group was given standard three-level rehabilitation treatment. After 6 months, the patients in both groups were evaluated for joint mobility, motor function and quality of life. Results After 6 months, the activities of hip joint and knee joint in both groups were significantly increased. The activities of hip joint and knee joint in the observation group were significantly higher than those in the control group [(15.4 ± 3.6) ° vs (12.3 ± 2.4) ° 26.6 ± 3.5) ° (22.0 ± 3.5) °, P <0.01]. The FAM score, FAM score and FIM score of the upper extremity in the observation group were also significantly higher than those of the FIM score (26 ± 8), (22 ± 7), (27 ± 7), (22 ± 8), (58 ± 10), (44 ± 12), P <0.05 or P <0.01, respectively. After 6 months, the role, social function, physical function, emotional function and total quality of life in the observation group were significantly higher than those in the control group [(1.6 ± 0.4) vs (0.9 ± 0.4), (1.07 ± 0.41) vs (1.87 ± 0.21) vs (1.55 ± 0.18), (1.8 ± 0.5) vs (1.0 ± 0.3), (5.0 ± 1.2) vs (4.0 ± 1.1), P <0.01. Conclusion Standard three-level rehabilitation can improve the hip joint and knee joint activity in stroke patients with hemiplegia, and promote the recovery of motor function of affected limbs and improve the quality of life of patients.