徒手肌力评估联合三级平衡评定指导下的康复运动方案在心脏术后患者康复中的应用  

Application of the rehabilitation program guided by manual muscle testing combined with bobath level 3 balance rating in exercise rehabilitation for postoperative cardiac patients

作　　者：张英 彭芬芬[1] 郑翠玉 黄欢欢 宋瑜[1] 吴钟凯[1] 吕林华[1,2] Zhang Ying;Peng Fenfen;Zheng Cuiyu;Huang Huanhuan;Song Yu;Wu Zhongkai;Lv Linhua(Department of Cardiac Surgery,the First Affiliated Hospital,Sun Yat-senUniversity,Guangzhou,510080,China;Guangxi Hospital Division of The First Affiliated Hospital,Sun Yat-Sen University,Nanning,530000,China)

机构地区：[1]中山大学附属第一医院心脏外科,广东广州510080 [2]中山大学附属第一医院广西医院,广西壮族自治区南宁530000

出　　处：《现代临床护理》2023年第6期53-59,共7页Modern Clinical Nursing

摘　　要：目的评价基于徒手肌力评估(manual muscle testing,MMT)联合Bobath三级平衡评定康复运动方案对心脏术后患者运动时间和活动能力的影响。方法采用便利抽样方法,根据患者入院时间次序进行分组,将2021年5月至10月在本院心脏外科住院行瓣膜置换术或冠状动脉旁路移植术的42例患者设为对照组,术后实施常规康复运动;将2021年11月至2022年4月在本院心脏外科住院行瓣膜置换术或冠状动脉旁路移植术的42例患者设为干预组,应用徒手肌力评估联合Bobath三级平衡评定对患者进行评估,根据评估结果制定康复运动方案并实施。两组干预时间为术后10d。比较两组患者术后第1次下床活动时间、ICU转回3d内运动时间及出院前6min步行试验距离及运动过程中不良事件发生情况。结果干预组患者第1次下床活动的时间较对照组早[(1.4±0.4)d VS(2.6±0.6)d,P<0.05];干预组患者ICU转回3d内运动时间较对照组长[(35.5±12.9)min VS(25.8±8.3)min,P<0.05];干预组患者出院前6 min步行距离较对照组远[(364.5±87.1)m VS(333.0±80.0)m,P<0.05],两组患者康复运动过程中均未出现不良事件。结论徒手肌力评估联合Bobath三级平衡评定能对心脏术后患者的运动能力及平衡状态进行较好的评估,并且指导患者康复运动方案的制定,基于此的康复运动方案可延长患者康复运动的时间和提高活动能力,并且是安全的。Objective To evaluate the effect of rehabilitation program based on manual muscle testing(MMT)combined with the Bobath level 3 balance rating on the duration and mobility of postoperative cardiac patients.Method Using convenience sampling method,42 patients who underwent valve replacement surgery or coronary artery bypass grafting in the cardiac surgery department of our hospital from May to October 2021 were divided into the control group based on the chronological order of patient admission and were routinely evaluated postoperatively for routine exercise rehabilitation instruction.In addition,42 patients from November 2021 to April 2022 were assigned to the intervention group.A combination of manual muscle testing(MMT)and the Bobath Level 3 balance rating was used on the basis of routine evaluation,and tailored rehabilitation exercise instruction was given based on the assessment results.Furthermore,comparison was made between two groups of patients on their first postoperative ambulation time,the exercise time within 3 days of returning from ICU,6-minute walking test before discharge,and incidence of adverse events during exercise.Results The first time to get out of bed in the intervention group was earlier than that in the control group[(1.4±0.4)d vs(2.6±0.6)d,P<0.05];The exercise time(min)of patients in the intervention within 3 days of returning from ICU was longer than that of the control group(35.5±12.9)min vs(25.8±8.3)min,(P<0.05);The intervention group had a longer walking distance of 6 minutes before discharge compared to the control group[(364.5±87.1)min vs(333.0±80.0)min P<0.05],and neither both groups of patients had any adverse effects during rehabilitation exercise.Conclusion Combining manual muscle testing(MMT)and the Bobath level 3 balance rating can help assess patients’exercise capacity and balance following cardiac surgery and direct them during rehabilitation exercise,which can enhance the patient’s capacity for activity and exercise time.

关 键 词：心脏手术 运动康复 徒手肌力评估 Bobath三级平衡评定 活动能力 

分 类 号：R473.6[医药卫生—护理学]