病房日常生活活动训练对脑卒中患者上肢运动功能的影响  

The influence of ADL training mode on upper limb motor function and daily life activities of the patients with stroke in the ward

作　　者：顾华丽 戈含笑 贾子善[1] 高谦[1] 肖红雨[1] 于增志[1] Gu Huali;Ge Hanxiao;Jia Zishan(Department of Rehabilitation Medicine,First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心康复医学科

出　　处：《中华保健医学杂志》2019年第6期518-520,共3页Chinese Journal of Health Care and Medicine

基　　金：解放军总医院科技创新苗圃（17KMM38）

摘　　要：目的 探讨病房日常生活活动(ADL)训练模式的作业疗法对脑卒中后偏瘫患者上肢运动功能和ADL能力的影响,为脑卒中患者提供经济而有效的家庭康复训练方法。方法 选取2016年7月~2018年5月解放军总医院第一医学中心康复医学科住院的脑卒中后上肢运动功能障碍的患者40例,随机数表法分为对照组(20例)和治疗组(20例)。对照组进行常规作业治疗,治疗组进行常规作业治疗和以ADL训练为主的病房作业,并对两组患者治疗前与治疗4周后进行上肢Fugl-Meyer评价(FMA-UE)、香港版偏瘫上肢功能测试(FTHUE-HK)和Barthel指数评价,观察两组脑卒中后偏瘫患者的上肢运动功能和ADL能力的变化情况。结果 治疗后,两组脑卒中患者偏瘫侧上肢的运动功能和ADL能力均有改善,治疗组和对照组患者的上肢Fugl-Meyer评价(FMA-UE)、香港版偏瘫上肢功能测试(FTHUE-HK)、Barthel指数评价均得到提高,与治疗前比较,差异有统计学意义(P<0.05);且治疗组患者的运动功能和日常生活活动能力的提高明显高于对照组,FMA-UE和FTHUE-HK以及Barthel指数评分差异有统计学意义(P<0.05)。结论 病房ADL训练模式的作业疗法有助于改善脑卒中患者的运动功能和ADL能力,是一项经济而有效的康复训练方法,值得临床推广应用。Objective To explore the influence of the occupational therapy which includes the activities of daily living(ADL)training mode on upper limb motor function and activities of daily living of patients with hemiplegia after stroke,and provide an economical and effective family rehabilitation training method for stroke patients.Methods 40 patients with hemiplegia after stroke were randomly divided into control group(20 cases)and treatment group(20 cases).The control group were given routine occupational therapy,the treatment group accept routine occupational therapy and ward operation with ADL training as the main task.The upper limbs Fugl-Meyer assessment(FMA-UE),the Hong Kong version of the hemiplegic upper limb function test(FTHUE-HK)and the Barthel index evaluation were performed on both two groups before and after 4 weeks of treatment,the statistical processing software SPSS20.0 was used to do the statistical analysis of data,the motor function and the ability of daily life of hands and upper limbs of two groups of hemiplegic patients after stroke were observed.Results After the treatment,the motor function and the abilities of daily living of two groups were improved,the patients in treatment group and control group got a higher score in upper limb Fugl-Meyer assessment(FMA-UE),the Hong Kong version of the hemiplegic upper limb function test(FTHUE-HK),the Barthel index,there was a significant difference before and after getting the treatment(P<0.05).The improvement of motor function and activities of daily life in the treatment group is significantly higher than that in the control group.Made the comparison between the control group and the treatment group,there was a significantly difference in FMA-UE,FTHUE-HK and Barthel index scores(P<0.05).Conclusion Ward ADL training mode of occupational therapy is helpful to improve stroke patients'motor function and abilities of daily living.It is an economic and effective rehabilitation training method,and is worthy of clinical application.

关 键 词：作业治疗 日常生活活动 训练模式 脑卒中 上肢运动功能 

分 类 号：R493[医药卫生—康复医学]