日常生活活动自我管理方案对脑卒中偏瘫上肢功能的疗效研究  

Effects of ADL based self-management program on hemiplegic upper limb functions after stroke

作　　者：何爱群 黎景波 叶思媚 应其兴 宋秋爽 刘海鸥 何茂莉 He Aiqun;Li Jingbo;Ye Simei(Guangdong Work Injury Rehabilitation Hospital,Guangzhou 510440,China)

机构地区：[1]广东省工伤康复医院作业治疗科,广州510440

出　　处：《中国康复》2024年第12期714-718,共5页Chinese Journal of Rehabilitation

基　　金：广东省医学科学技术研究基金项目(B2021192)。

摘　　要：目的:观察日常生活活动(ADL)自我管理方案对脑卒中偏瘫上肢功能的疗效。方法:将符合条件的93例脑卒中偏瘫患者随机分为观察组47例,对照组46例。2组患者均接受常规康复治疗,除此之外,2组另接受作业治疗师制定的延伸训练方案,对照组接受常规延伸训练方案,观察组接受ADL自我管理方案,连续治疗3周。分别于治疗前和治疗3周后,采用Fugl-Meyer评定量表上肢部分(FMA-UE)评估患侧上肢运动功能,偏瘫上肢功能测试香港地区版(FTHUE-HK)评估患侧上肢的活动功能,运动活动日记(MAL)评估患侧上肢的使用数量(MAL-AOU)和使用质量(MAL-QOM),改良巴氏指数(MBI)评估患者的生活自理能力。结果:治疗3周后2组FMA-UE评分、FTHUE-HK分级、MAL-AOU、MAL-QOM及MBI评分均较治疗前显著提高(P<0.05),且观察组FMA-UE评分、FTHUE-HK分级、MAL-AOU、MAL-QOM及MBI评分均高于对照组(P<0.05)。结论:ADL自我管理方案可有效增加治疗外偏瘫上肢的日常使用并促进功能。Objective:To investigate the effects of a 3-week ADL based self-management program on hemiplegic upper limb functions after stroke.Methods:A total of 93 eligible inpatients with stroke were divided into observation group(n=47)and control group(n=46)according to the random number table method.Both groups received routine rehabilitation training.The observation group was given ADL based self-management program for 1 h every day,7 days a week,for 3 weeks,while the control group was given routine hemiplegic upper limb supplementary program.Assessments were administered at baseline and immediately after all the intervention.The Fugl-Meyer assessment-upper extremity(FMA-UE)was used to assess the upper limb motor functions,the functional test of hemiplegic upper extremity-Hong Kong(FTHUE-HK)was used to assess occupational performance,and the MAL was used to assess amount of use(AOU)and quality of use(QOM)of the hemiplegic upper limb.The modified Bathel index(MBI)was used to assess the independence of daily living.Results:After 3 weeks,the scores in all scales were improved significantly in both groups(P<0.05),more significantly in the observation group than in the control group(P<0.05).Conclusion:ADL based self-management program can increase effectively the daily use of the hemiplegic upper limb outside the treatment and improve the upper limb functions.

关 键 词：脑卒中 偏瘫 上肢功能 ADL 自我管理 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]