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目的观察医院-家庭康复模式对脑卒中偏瘫患者运动功能及日常生活活动能力的影响。方法观察入选的100例首次发病的脑卒中偏瘫患者,随机分为治疗组和对照组,其中治疗组53例,对照组47例。两组均在医院进行早期康复治疗。治疗组出院时由康复团队针对患者病情制定详细、个体化的家庭康复治疗方案,并对其家属进行康复技能指导培训,确保出院后患者在家中严格按照方案进行康复训练,并定期到医院复诊、评估及调整方案;对照组出院后常规按医嘱进行家庭自我康复,并规定门诊随访时限。两组于出院时、出院后6个月、12个月分别对患者的运动功能(Fugl-Meyer运动功能评分)及日常生活活动能力(改良Barthel指数评分)进行评定。结果出院时两组患者的Fugl-Meyer运动功能评分、改良Barthel指数评分基线水平对比无明显差异(P>0.05)。出院后6个月治疗组上肢、手、下肢Fugl-Meyer运动功能评分、改良Barthel指数评分改善均优于对照组,差异有统计学意义(P<0.05);出院后12个月治疗组上肢、下肢Fugl-Meyer运动功能评分、改良Barthel指数评分改善均优于对照组,差异有统计学意义(P<0.05)。结论医院-家庭康复模式可显著改善脑卒中偏瘫患者的运动功能及日常生活活动能力,不失为一种行之有效的康复治疗延续模式,值得研究探索。
Objective To observe the effects of hospital-family rehabilitation on motor function and activities of daily living in patients with hemiplegia after stroke. Methods 100 cases of first-time stroke patients with hemiplegia were randomly divided into treatment group and control group, including 53 cases in treatment group and 47 cases in control group. Both groups were in the hospital for early rehabilitation. At the time of discharge from the treatment group, the rehabilitation team developed a detailed and individualized family rehabilitation program for the patient’s condition and conducted rehabilitation training for their relatives to ensure that patients discharged from the hospital were trained in rehabilitation programs at home in strict accordance with the program and returned to the hospital on a regular basis. Evaluation and adjustment programs; control group after discharge from the hospital according to doctor’s order for self-healing, and set the out-patient follow-up time. The patients were assessed for motor function (Fugl-Meyer motor function score) and activities of daily living (modified Barthel index score) at discharge and at 6 and 12 months after discharge. Results There was no significant difference in baseline level of Fugl-Meyer motor function score and modified Barthel index between the two groups at discharge (P> 0.05). At 6 months after discharge, the scores of Fugl-Meyer motor function and modified Barthel index of upper limbs, hands and lower limbs in treatment group were better than those in control group (P <0.05) Lower limb Fugl-Meyer motor function score, improved Barthel index score improved better than the control group, the difference was statistically significant (P <0.05). Conclusion The hospital-family rehabilitation model can significantly improve the motor function and activities of daily living in patients with hemiplegia after stroke, which is an effective mode of continuation of rehabilitation and is worth exploring.