引导式教育在成人偏瘫功能训练中的应用  

Conductive Education Approach for the Retraining of Functional Performance in Adult Hemiplegic Patients

作　　者：郭铁成[1] 岳翔[1] 夏燕萍[1] 孟玲[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院康复医学科,武汉430030

出　　处：《中国康复》2007年第6期400-402,共3页Chinese Journal of Rehabilitation

摘　　要：目的:探讨偏瘫成人应用引导式教育(CE)训练的疗效。方法:脑损伤致偏瘫患者12例,均接受CE治疗。每日的功能活动训练与程序按CE的原理设计和实施。每天1次,共4周。治疗前后对患者的肌张力、运动功能及ADL分别按Ashworth评分法、运动评定量表(MAS)及Barther(BI)指数进行评分。结果:与治疗前比较,Ashworth、MAS及BI评分,12例患者均明显提高(P<0.05,0.01)。此外患者的独立运动及躯体、姿势控制意识和与人交流意识亦有所增强。结论:CE对于成人偏瘫具有明显疗效,值得在临床上推广应用。Objective： To describe a pilot conductive education （CE） principles-based rehabilitation program set up by the authors for adult hemiplegic patients and to report its effectiveness. Methods： Twelve hemiplegic patients caused by traumatic brain injury or stroke participated in this study, All the patients followed a highly structured daily session which included task series such as hand task series and sit-to-stand series. All involved a functional task such as practicing eating, drinking and putting on socks. The muscle tone of the upper and lower limbs, the motor functions and dependence were evaluated with Ashworth Scale, Motor Assessment Scale and Barthel index, respectively at admission and one month after entry to the program. Results： As indicated by the standardized evaluation, significant improvement was achieved in muscle tone （decreased from 2.75±1.14 to 1.83±0.72 in biceps, P〈0.05, and from 3. 17±0.83 to 1.67±0. 65 in quadriceps, P〈0.01） , performance of motor skills （increased from 30.4±9.2 to 38.3±9.8, P〈0.05） and functional activities （increased from 30.9±4.9 to 52.3±16.3, P〈0.01） was found. It was also found that all patients developed greater awareness of quality of movement as well as posture control. Conclusion： The CE approach is a feasible strategy for the retraining of functional performance of hemiplegic patients and should be incorporated into the existing approaches.

关 键 词：引导式教育 偏瘫 功能活动 

分 类 号：R49[医药卫生—康复医学] R651.15[医药卫生—临床医学]