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目的:探讨上肢功能康复对早期脑卒中偏瘫患者日常生活活动(ADL)能力和生活质量(QOL)的影响。方法:252位脑卒中偏瘫患者(1个月内),随机分为康复组(T1组,n=84)、康复+针刺组(T2组,n=83)和对照组(C组,n=85)。治疗前(V0)及治疗1个月后(V1)采用Fugl-Meyer上肢运动功能评定、综合功能评定量表及生活质量指数分别评估上肢运动能力、认知和ADL能力、QOL。结果:(1)V0期,3组的各项指标间无显著性差异(P>0.05);(2)3组的各项功能指标在V1均较V0提高,有显著性差异(P<0.01);(3)V1期,T1组及T2组除认知功能外,其它各项指标与对照组间有显著性差异(P<0.01),但在T1组与T2组之间这些指标均无显著性差异(P>0.05);(4)上肢的运动功能与患者的ADL及QOL有显著正相关性(P<0.01)。结论:早期规范化康复治疗可以改善脑卒中患者的上肢运动功能和ADL能力,提高患者的QOL;上肢功能的恢复对改善患者的ADL能力及QOL有积极作用。
Objective: To investigate the effect of upper limb functional rehabilitation on ADL and quality of life (QOL) in patients with hemiplegia of early stroke. Methods: 252 stroke patients with hemiplegia (within 1 month) were randomly divided into rehabilitation group (T1 group, n = 84), rehabilitation + acupuncture group (T2 group, n = 83) and control group = 85). Before treatment (V0) and after 1 month of treatment (V1), upper limb motor function, cognition and ADL ability and QOL were assessed by Fugl-Meyer upper limb motor function assessment, comprehensive functional assessment scale and quality of life index respectively. Results: (1) There was no significant difference between V0 and the three groups (P> 0.05). (2) The functional indexes of all three groups were significantly higher than V0 in V0 (P <0.01) ); (3) In V1, T1 and T2 groups, except for cognitive function, there were significant differences between the other indexes and the control group (P <0.01), but there was no significant difference between the T1 group and the T2 group (P> 0.05). (4) The motor function of upper limbs was positively correlated with ADL and QOL of patients (P <0.01). CONCLUSION: Early standardized rehabilitation can improve the motor function and ADL ability of stroke patients and improve their QOL. Recovery of upper limb function has a positive effect on improving ADL ability and QOL of patients.