基于Brunnstrom分期的ADL任务导向训练在脑卒中偏瘫患者中的应用  

Application of ADL task-oriented training based on Brunnstrom staging in hemiplegic patients with stroke

作　　者：朱磊 桂小彤 张会慧[1] 蒋庆新 杨婷[1] 林强[1] 谢增艳 Zhu Lei;Gui Xiaotong;Zhang Huihui;Jiang Qingxin;Yang Ting;Lin Qiang;Xie Zengyan(Department of Rehabilitation Medicine,Nanjing Hospital,Nanjing Medical University/Nanjing First Hospital,Nanjing 210000,China)

机构地区：[1]南京医科大学附属南京医院/南京市第一医院康复医学科,南京210000

出　　处：《保健医学研究与实践》2024年第9期88-94,共7页Health Medicine Research and Practice

基　　金：江苏省卫生健康委员会科研项目(S2020071);南京市卫生科技发展专项资金项目(YKK20106)。

摘　　要：目的探讨基于Brunnstrom分期的日常生活活动能力(ADL)任务导向训练在脑卒中偏瘫患者中的应用效果,以期为制定脑卒中偏瘫患者的康复训练方案提供参考。方法选取南京市第一医院2021年1月—2023年10月收治的130例脑卒中偏瘫患者为研究对象,以基于Brunnstrom分期的ADL任务导向训练实施时间(2022年6月)为分界线,将2021年1月—2022年5月收治的65例进行常规康复训练的患者纳入对照组,将2022年6月—2023年10月收治的65例进行基于Brunnstrom分期的ADL任务导向训练的患者纳入观察组。比较2组患者治疗前后的神经功能、肢体肌力、运动功能、步行能力、日常生活能力及生活质量等指标。结果干预前,2组患者的美国国立卫生研究院卒中量表(NIHSS)评分比较,差异无统计学意义(P>0.05);干预后,2组患者的NIHSS评分均低于干预前,且观察组低于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者的上肢和下肢Lovett肌力评分比较,差异均无统计学意义(P>0.05);干预后,2组患者的上肢和下肢Lovett肌力评分均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者的上肢和下肢Fugl-Meyer量表(FMA)评分比较,差异均无统计学意义(P>0.05);干预后,2组患者的上肢和下肢FMA评分均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者的10 m步行时间和步行功能量表(FAC)评分比较,差异均无统计学意义(P>0.05);干预后,2组患者的10 m步行时间均短于干预前且观察组短于对照组,FAC评分均高于干预前且观察组高于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者的Barthel指数(MBI)评分比较,差异无统计学意义(P>0.05);干预后,2组患者的MBI评分均高于干预前,且观察组高于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者的生活质量综合评定问卷-74(GQOL-74)的躯体功能Objective To explore the application effect of activities of daily living(ADL)task-oriented training based on Brunnstrom staging in hemiplegic patients with stroke,aiming to provide a reference for formulating rehabilitation training programs for these patients.Methods A total of 130 hemiplegic patients with stroke admitted to Nanjing First Hospital from January 2021 to October 2023 were selected as the study participants.The implementation time of ADL task-oriented training based on Brunnstrom staging(June 2022)was used as the dividing line.Overall,65 patients admitted from January 2021 to May 2022 who underwent conventional rehabilitation training were included in the control group,and 65 patients admitted from June 2022 to October 2023 who underwent ADL task-oriented training based on Brunnstrom staging in the observation group.The neurological function,limb muscle strength,motor function,walking ability,ADL,and quality of life indicators of the two groups of patients before and after treatment were compared.Results Before intervention,no significant difference was noted in the National Institutes of Health Stroke Scale(NIHSS)scores between the two groups(P>0.05);after intervention,the NIHSS scores of both groups were significantly lower than before intervention,and the observation group was significantly lower than the control group(P<0.05).Before intervention,no significant difference was found in the upper and lower limb Lovett muscle strength scores between the two groups(P>0.05);the upper and lower limb Lovett muscle strength scores of both groups were significantly increased after intervention,and the observation group was significantly higher than the control group(P<0.05).Before intervention,no significant difference was observed in the upper and lower limb Fugl-Meyer Assessment(FMA)scores between the two groups(P>0.05);the upper and lower limb FMA scores of both groups showed an increase after intervention,and the observation group was significantly higher than the control group(P<0.05).Before interve

关 键 词：脑卒中偏瘫患者 ADL任务导向训练 Brunnstrom分期 运动功能 日常生活能力 神经功能 生活质量 

分 类 号：R743.3[医药卫生—神经病学与精神病学]