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中国初级卫生保健:2023,37(9):89-99
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基于KTH整合模式的早期康复锻炼对脑卒中偏瘫患者 功能改善的效果*
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中文摘要: 摘 要:目的:了解脑卒中偏瘫患者通过 KTH整合模式的早期康复锻炼,其肌力、运动功能、日常生活活动能力改善 情况。方法:选取2019年12月—2021年11月上海市浦东新区老年医院收治的114例脑卒中偏瘫患者,将其随机分为对照组 (n=58) 和研究组 (n=56)。对照组:对患者实施常规早期康复锻炼,研究组:对患者实施基于 KTH整合模式的早期康复 锻炼。采用徒手肌力量表 (MMT)、运动功能评定量表 (Fugl-Meyer)、Barthel指数评定表、美国国立卫生研究院卒中量表 (NIHSS) 等分别于康复治疗前、康复治疗 2 w、4 w后对患者进行评估,比较两组患者肌力、运动、日常生活活动、神经等 功能差异。结果:康复治疗2 w、4 w后,研究组患者MMT肌力分级大于对照组,差异均有统计学意义 (Z值分别为10.201、 6.885,P值均<0.05);Fugl-Meyer评分均高于对照组,差异均有统计学意义 (t值分别为3.245、3.272,P值均<0.05);Bar⁃ thel指数均高于对照组,差异均有统计学意义 (t值分别为3.005、3.282, P值均<0.05);NIHSS评分均低于对照组 (t值分别 为3.159、7.027,P值均<0.05)。康复治疗4 w后,研究组患者10 m最大步行速度大于对照组,“起立—行走”时间小于对照 组,差异均有统计学意义 (t值分别为 4.019、2.955,P值均<0.05)。结论:对脑卒中偏瘫患者实施基于 KTH整合模式的早 期康复锻炼,能够显著提高其肌力,改善运动功能和日常生活活动能力,减轻患者肢体残疾,有助于患者早日回归社会。
Abstract:Abstract: OBJECTIVE To explore the effect of integrated mode (KTH) combined with early rehabilitation exercise on muscle strength, motor function and activities of daily living of stroke patients with hemiplegia. METHODS A total of 114 patients with stroke hemiplegia were enrolled between December 2019 and November 2021, with 58 patients selected as the control group given early rehabilitation exercise, and 56 patients as the study group given early rehabilitation exercise under the guidance of KTH inte⁃ grated mode. Manual muscle strength test (MMT), Fugl-Meyer scale, Barthel index, NIHSS and other scales were used to evaluate the two groups before rehabilitation treatment, 2 and 4 weeks after rehabilitation treatment, to compare the differences in muscle strength, movement, activities of daily living, nerve and other functions between the two groups. RESULTS After the rehabilitation treatment of 2 weeks, 4 weeks, the MMT muscle strength grade of the patients in the study group was greater than that in the control group, the differences were statistically significant (Z=10.201, 6.885, P<0.05); Fugl-Meyer scores were all higher than the control group, the differences were statistically significant (t= 3.245, 3.272, P<0.05); the Barthel index was all higher than that of the con⁃ trol group, the differences were statistically significant (t=3.005, 3.282, P<0.05); all the NIHSS scores were lower than the control group (t=3.159, 7.027, P<0.05). after 4 weeks of rehabilitation treatment, the maximum walking speed of 10 m was greater than that of the control group, and the “rise-walk” time was less than that of the control group, the differences were statistically signifi⁃ cant (t=4.019, 2.955, P<0.05). CONCLUSION The implementation of KTH integrated mode combined with early rehabilitation in patients with stroke hemiplegia can significantly enhance muscle strength, improve motor function and activities of daily living, and reduce physical disabilities, which is beneficial to return to society as soon as possible.
文章编号:3202110027     中图分类号:R743.33;R493    文献标志码:
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王晓丹,陈燕红  
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