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1.
目的探讨运动保持困难(MI)对左侧偏瘫患者康复疗效的影响,为预测左侧偏瘫患者的康复预后提供理论依据。方法将64例脑卒中左侧偏瘫患者,通过Joyn等编制的MI评定量表,分为MI组31例,对照组33例。2组除有、无运动保持困难外,其余一般资料差异无统计学意义。2组均给予传统康复训练。用Brunnstrom运动功能分期、上田敏偏瘫手指功能评定表、偏瘫上肢能力评定表、Berg平衡量表、Holden步行功能量表、改良的Barthel指数等量表,分别于治疗前、治疗1个月后、治疗2个月后对2组的肢体运动功能、平衡能力、步行能力、日常生活活动能力等进行统计学分析。结果经常规康复训练1个月后,MI组患者与治疗前比较,除上肢运动功能、手功能、立位平衡、步行能力、日常生活活动能力(ADL)评分差异有统计学意义外(P〈0.05),其余各项差异均无统计学意义(P〉0.05);而对照组治疗1个月后与治疗前比较,上述各项指标除下肢运动功能外(P〉0.05),其余各项功能评分差异均有统计学意义(P〈0.05)。常规康复训练2个月后,2组与本组治疗前比较,各项评分差异均有统计学意义(P〈0.01):同期MI组患者除上、下肢运动功能外,其余各项功能评分均显著低于对照组(P〈0.01)。结论运动保持困难对脑卒中左侧偏瘫患者的功能恢复有显著负性影响。但传统康复训练对具有运动保持困难的左侧偏瘫患者的各项功能提高具有一定促进作用,只是提高程度明显受到影响。说明运动保持困难可以作为左侧偏瘫患者康复预后较差的重要指标之一,临床上在对这类患者制订康复治疗方案时应该充分考虑到运动保持困难对康复疗效的影响。  相似文献   

2.
专业系统性康复训练改善脑卒中偏瘫患者的运动功能   总被引:6,自引:3,他引:3  
为观察偏瘫康复治疗对脑卒中偏瘫患者运动功能的影响,将50例脑卒中偏瘫患者单纯随机分为康复治疗组和对照组,两组神经内科治疗相同,康复治疗组由经过专业训练的康复师进行系统的物理疗法、作业疗法及结合电子偏瘫治疗仪等治疗。由同一康复医师对患者进行入院时及3个月后进行简式Fugl-Meyer运动功能评分。两组比较,康复治疗组治疗后评分明显高于对照组,两组比较有显著性差异(P&;lt;0.05)。偏瘫康复治疗对脑卒中偏瘫患者的运动功能有明显的促进作用。  相似文献   

3.
目的探讨运动再学习方案(MRP)对脑卒中偏瘫患者运动功能的影响。方法用MRP在康复门诊对所有偏瘫患者进行12周规律的康复训练,用运动功能评估量表(MAS)评估29例偏瘫患者训练前和训练后从仰卧到健侧卧、从仰卧到床边、坐位平衡、从坐到站、步行、上肢功能、手部运动、手的精细功能共8个方面的功能状况。结果29例患者训练前、后MAS各项得分和总分经t检验,差异都有统计学意义(P〈0.05),其中7例发病在6个月以内的患者比22例病程超过6个月的患者疗效更好(P〈0,05);在22例病程超过6个月的患者中,10例积极主动参与的患者比其他12例疗效更好(P〈0.05)。结论MRP是一种将患者从被动接受治疗转变为主动参与学习的运动疗法,对提高脑卒中偏瘫患者的运动功能有满意的疗效。  相似文献   

4.
目的:探讨强制性使用运动疗法配合针灸对脑卒中偏瘫患者上肢运动功能障碍的治疗效果。方法:将60例脑卒中偏瘫患者随机分成2组各30例,对照组采用传统康复功能训练,疗程共2周,而治疗组要求受试者连续2周每天除去睡眠时间,其余90%的时间健肢带上手套限制使用,用患肢进行功能训练和日常生活活动,功能训练方案与对照组相同,并给予针灸治疗,共2周。采用Wolf运动功能评定方法对人组患者在入组前、治疗后2周、治疗后3个月进行评定。结果:治疗后2周及3个月,2组WMFT功能评分与治疗前比较均有显著性差异(P〈0.05),2组之间相比有显著性差异(P〈0.05),治疗组优于对照组。结论:强制性使用运动疗法联合针灸治疗是一种有效的康复治疗方法,可用于改善脑卒中偏瘫患者上肢运动功能,与传统康复功能训练同时应用,可促进偏瘫侧上肢运动功能的恢复,疗效优于传统康复治疗。  相似文献   

5.
综合康复治疗对脑卒中患者运动功能的影响   总被引:6,自引:3,他引:3  
目的:探讨综合复康治疗对脑卒中患者运动功能的影响。方法:采用运动疗法、ADL训练及皮肤刺激对94例脑卒中偏瘫患者进行6-12个月治疗,结果:治疗后94例患者运动能力,日常生活活动能力,步行能力均有显著提高(P<0.001)。结论综合康复治疗能促进脑卒中患者偏瘫肢体能力的恢复。  相似文献   

6.
强化运动治疗在脑卒中偏瘫患者中的运用与临床研究   总被引:5,自引:3,他引:2  
目的:观察强化运动治疗对脑卒中偏瘫患者运动功能障碍的临床疗效,并与常规运动治疗作对比分析。方法:42例病程6个月内无合并严重认知功能障碍的脑卒中偏瘫患者随机分成强化运动治疗组(21例)和常规运动治疗组(21例)。强化运动治疗组为每天3h,每周5天,常规运动治疗组为每天1h,每周5天。结果:两组患者康复治疗1个月后运动功能均有明显改善.且强化运动治疗组明显优于常规运动治疗组。结论:常规运动与强化运动康复治疗均可明显改善脑卒中偏瘫患者的运动障碍,但强化运动康复治疗的疗效更好。  相似文献   

7.
朱红 《中国临床康复》2004,8(22):4589-4589
目的探讨脑卒中患者功能恢复的最佳治疗方法。方法应用理疗、针灸、运动治疗等综合治疗方法对40例脑血管意外所致偏瘫患者进行综合治疗,同时对40例脑血管意外所致偏瘫患者进行单纯运动治疗,应用fugl-meyer上下肢运动功能评定表及日常生活活动能力barthel指数分级法比较疗效。结果综合疗法的疗效明显优于单纯运动疗法(t=7.6043,7.8409,P&;lt;0.01)。结论综合疗法为脑卒中患者功能恢复的最佳治疗方法。  相似文献   

8.
脑卒中康复运动功能评定量表的临床应用分析   总被引:2,自引:1,他引:1  
目的:运动脑卒中康复运动功能评定量表(stroke rehabilitation assessment of movement,STREAM)比较脑卒中偏瘫患者患侧上、下肢运动功能损害程度、恢复结果以及不同临床特征偏瘫患者运动功能恢复的差异。方法:用STREAM方法对114例脑卒中偏瘫患者治疗前、后进行评定并进行统计分析。结果:康复治疗前、后STREAM平均上、下肢运动分无明显差异(P>0.05),平均下肢改变值和恢复效率高于上肢(P<0.05)。病程≤1个月的脑卒中患者其治疗后的平均STREAM总分、改变值和效率均高于病程>1个月的患者(P<0.05)。年轻患者(<65岁)的平均STREAM改变值和恢复效率均高于年老组(≥65岁)。脑出血患者平均STREAM改变值高于脑梗死患者(P<0.05)。男、女患者间以及不同偏瘫侧患者间的运动功能恢复结果无明显差异(P>0.05)。结论:脑卒中偏瘫患者偏瘫侧下肢运动功能恢复的幅度和速度都高于上肢。早期康复的结果和治疗效率要好于延迟康复的患者。年轻患者运动功能恢复的幅度和速度要优于年老患者。故在康复治疗初期,制定训练计划和进行训练时应考虑脑卒中患者偏瘫侧上、下肢恢复的差异以及患者病程、年龄等因素的差异。  相似文献   

9.
背景:研制自动化运动治疗设备是肢体功能障碍患者和家属的迫切要求,而国外同类产品价格相对昂贵.目前国内外尚无主动运动和被动运动结构合成一体,体现出两者作用相辅的运动治疗仪.目的:应用自行研制的电脑多功能运动治疗仪对脑卒中肢体偏瘫患者进行主动运动和被动运动训练,观察其训练效果.方法:将60例脑卒中肢体偏瘫患者按随机数字表法分为试验组和对照组,每组30例.两组患者均采用偏瘫肢体综合训练手法,如Bobath握手、桥式运动、翻身、PNF技术训练、坐位平衡和站立平衡功能训练等.试验组在偏瘫肢体综合训练基础上,采用自行研制的电脑多功能运动治疗仪训练偏瘫侧上下肢体.治疗30 d后采用Brufinsfrom方法评定2组患者运动功能的改善情况,以BartheI指数评定日常生活活动能力的改善情况.结果与结论:与治疗前相比,治疗30 d后2组患者肢体运动功能和日常生活活动能力均有较明显改善,试验组总有效率明显高于对照组(P<0.05).提示采用自行研制的电脑多功能运动治疗仪对脑卒中后偏瘫患者进行运动训练有利于其偏瘫肢体运动功能的恢复,从而提高其生活质量;应根据患者具体病情制定个体化康复治疗方案,尽早应用于脑卒中偏瘫患者的康复治疗中.  相似文献   

10.
目的:观察强化骨盆运动训练对脑出血偏瘫患者平衡功能、下肢运动功能的影响。方法:脑出血偏瘫恢复期患者72例,随机分成观察组和对照组各36例。2组均进行常规康复训练,观察组增加骨盆运动训练。结果:治疗2周后,2组平衡功能评分均较治疗前明显提高(P〈0.01),2组间比较差异无统计学意义;治疗4周后观察组平衡功能评分显著高于对照组(P〈0.01),2组下肢运动功能评分均明显高于治疗前(P〈0.01),且观察组高于对照组(P〈0.05);治疗8周后,观察组下肢运动功能评分显著高于对照组(P〈0.01),2组功能性步行分级均较治疗前明显提高(P〈0.01),且观察组功能性步行分级≥3级的患者较对照组明显增加(P〈0.05)。结论:强化骨盆运动训练在改善脑出血偏瘫患者平衡功能和下肢运动功能方面具有较好的疗效。  相似文献   

11.
The short- and long-term outcome of exercise reconditioning on exercise tolerance and breathlessness scores were evaluated in a group of patients with severe chronic obstructive pulmonary disease (COPD). After a combined initial program of eight weeks, the patients were randomized into two groups: group A followed a supervised training program for another 12 weeks; group B was discharged after this initial program and received written instructions to continue exercise training at home. The patients were evaluated at the start, after the initial eight weeks' training, after six months, and after one year. For the total group, exercise tolerance, assessed by 12-minute walking distance, increased significantly from 784m to 848m (p less than .05) after the initial program. Neither breathlessness scores nor spirometric data changed significantly. In group A, the increase in exercise tolerance persisted not only at the end of the continued training program but even at the end of the one-year follow-up. In group B, there was a progressive and significant decline of exercise tolerance during the one-year follow-up. Our data confirm that even in severe COPD patients, exercise tolerance can increase significantly without any change in spirometric data and without an increased tolerance for the sensation of dyspnea. A supervised training program must be continued to stabilize the obtained effects because even when an initial improvement is experienced, patients may lack motivation to continue an unsupervised training program.  相似文献   

12.
Several authors have reported on post-polio syndrome, indicating a decline in muscle strength in individuals years after the onset of poliomyelitis. These reports include suggestions that strenuous exercise programs are contraindicated and may have deleterious effects for patients with post-polio syndrome. The purpose of this case study was to examine the effects of an aggressive, six-week isokinetic exercise program on a 59-year-old patient with post-polio syndrome. Peak torque values were assessed before and during the exercise program, and 6 and 22 weeks following cessation of the exercise program. The results indicate no deleterious effects secondary to the exercise program. The authors suggest future research strategies to investigate the efficacy of exercise programs for patients with post-polio syndrome.  相似文献   

13.
OBJECTIVE: To evaluate muscle histopathological outcomes, adaptation in muscle fiber area, and fiber type proportion after a resistance training program for patients with chronic kidney disease. DESIGN: Vastus lateralis muscle biopsies before and after the study period in seven patients and six healthy subjects performing the exercise program and in five patients in a nonexercising comparison group. RESULTS: The change in degree of histopathological abnormality did not differ between the groups after the exercise program. Muscle fiber type proportion and muscle fiber area was also the same after the observation period. CONCLUSIONS: Patients with chronic kidney disease have muscle histopathological abnormalities already in the predialysis phase. There was no indication that the exercise program had disadvantageous effects on muscle histopathology in these patients. There were no differences in muscle fiber area or in fiber type proportion after the exercise program within or between the groups. Thus, a workload of 60% of one repetition maximum was sufficient to increase muscular strength and endurance in patients with chronic kidney disease but not to increase muscle fiber area or to change muscle fiber type proportion.  相似文献   

14.
Two treatment approaches used by two hand clinics were compared for patients who had undergone carpal tunnel release surgery. One of the clinics used an exercise program consisting of progressive resistive exercise; the other clinic used limited activity and no specific exercise program. Measurements of grip strength and active and passive wrist flexion and extension were taken 3 weeks and 6 weeks after surgery and then analyzed to determine if significant differences existed between the two treatment approaches. A significant difference was found only in active wrist extension, which increased after 3 weeks of a progressive resistive exercise program. Grip strength was also greater after 3 weeks of exercise; however, the increase was not statistically significant. The study raises a question about the efficacy of postoperative treatment for patients who have had carpal tunnel release surgery.  相似文献   

15.
Pulmonary rehabilitation can be a beneficial and cost-effective mode of therapy for patients with chronic obstructive pulmonary disease (COPD). At St Joseph's Hospital in Stockton, California, we established a multi-disciplinary, 10-week program combining outpatient education with aerobic exercise to promote both improved subjective well-being and increased exercise tolerance in patients with COPD. We studied 74 patients who had completed the program at least 1 year before the study began. Subjective data about the program were collected by use of a questionnaire. Changes in physical work capacity were measured by use of stress tests performed before and after the program was completed. Of the 57 patients responding to the questionnaire, most felt that the program had improved the quality of their lives. After the program was completed, significant decreases were seen in oxygen consumption, minute ventilation, and heart rate during treadmill exercise. The number of days of hospitalization for the group decreased from 497 in the year before completing the program to 34 the year after.  相似文献   

16.
BACKGROUND: Self-efficacy is a person's confidence in being able to successfully perform a specific activity or behavior. Self-efficacy has been shown to influence exercise capacity in patients post myocardial infarction, but has not been fully explored in patients with heart failure (HF). This study examined the impact of performance of a single treadmill exercise test and participation in a 3-month program of walking and resistance exercise on self-efficacy in HF patients. METHODS: 24 patients were randomized to either a home-based walking and resistance exercise program or usual care for 3 months. Prior to enrollment into the exercise program all participants performed a single treadmill exercise test with respiratory gas analysis. Self-efficacy questionnaires were completed at 3 time points, 1) prior to performance of an exercise treadmill test; 2) immediately after completing an exercise test; and 3) at the end of a 3-month exercise program. RESULTS: Self-efficacy for walking (p=0.07), climbing (p=0.17), lifting (p=0.73) and general activity (p=0.15) did not improve after performance of a single treadmill exercise test and usual care. However, self-efficacy for walking increased after 3 months of a walking and resistance exercise program. (p=0.04). CONCLUSIONS: The findings from this study suggest that in patients with stable mild to moderate heart failure, self-efficacy is improved with participation in a home-based walking and endurance exercise program. Self-efficacy is not enhanced by performance of a single treadmill exercise test and usual care.  相似文献   

17.
乳腺癌术后患者功能康复训练效果的系统评价   总被引:8,自引:1,他引:7  
目的评价功能康复训练对改善乳腺癌术后患者患侧肢体功能和生活质量的效果。方法计算机检索Cochrane Database of Systematic Renews(2007年第2期)、JBI Database of Systematic Reviews、MEDLINE(1966~2008)、EMbase(1989~2007)、CINAHL(Cumulative Index to Nursing and Allied Health literature)、CBMdisc(1978~2008)、CNKI(1994~2008)中关于康复训练对改善乳腺癌术后患者肢体功能和生活质量的随机对照试验,同时筛检纳入文献的参考文献。由3名研究者对文献质量进行严格评价和资料提取,对符合质量标准的RCT进行Meta分析。结果共纳入19个RCT。9个RCT的结果显示,肢体功能康复训练对改善患者术后的关节活动度有显著作用。4项研究结果表明全身康复运动训练对改善患者的心肺功能、提高身体耐力方面有显著作用,6项研究结果显示乳腺癌术后系统的康复运动对提高其健康相关生活质量有显著效果,6项研究结果表明康复训练对缓解治疗期间的疲乏症状有显著意义。在康复训练的时机上选择上,术后早期开始康复训练是积极而安全的措施。结论乳腺癌术后患者开展肢体渐进式康复训练和全身康复运动可有效改善患者的患肢功能,提高生活质量,对缓解化疗和放疗患者疲乏症状有一定的效果。  相似文献   

18.
Aerobic exercise training has been used as part of the treatment for a variety of chronic disorders, most notably cardiovascular disease. In order to determine the feasibility and utility of regular exercise after renal transplantation, the responses of 10 patients to graded exercise testing were compared before training (T1), immediately after a program of supervised exercise training (T2), and a mean of 2.2 years after completion of the supervised program (T3). Supervised exercise sessions began a mean of 17 days postoperatively and continued for a mean of 5.5 weeks. Patients were encouraged to continue regular unsupervised exercise thereafter. All patients easily tolerated the supervised exercise sessions, which consisted of treadmill walking and cycle ergometry. Exercise capacity improved 90% between T1 and T2 and an additional 12% between T2 and T3. On the average, patients achieved a normal exercise capacity by 8 weeks after transplantation. Of the 10 patients, 7 had continued regular exercise training at T3. The observed increase in aerobic exercise capacity was probably related to improved renal function, an increased hemoglobin concentration, and the surgical healing process as well as the exercise training. We conclude that supervised exercise training for selected patients after renal transplantation is feasible and worthwhile.  相似文献   

19.
目的 构建维持性血液透析合并肌少症患者透析中运动干预方案并评价其应用效果。方法 基于证据总结和德尔菲专家函询法,构建维持性血液透析合并肌少症患者透析中运动干预方案。将2021年3月—7月在连云港市某三级甲等医院行维持性血液透析合并肌少症的51例患者随机分为试验组25例和对照组26例,试验组在常规护理的基础上实施透析中运动干预方案,方案包括运动前评估、运动处方、运动监测、运动相关支持和运动效果评价5个部分。对照组给予常规透析护理。干预后比较两组肌少症患病率、骨骼肌质量指数、上臂肌围、小腿围、握力、步速和简易躯体功能量表评分的差异。结果 试验组干预后肌少症患病率低于对照组(P=0.014),握力、步速、小腿围和简易躯体功能量表评分均高于对照组(P<0.05)。结论 构建的维持性血液透析合并肌少症患者透析中运动干预方案科学可靠,应用该方案能有效改善患者肌少症相关指标,降低肌少症患病率,为临床护理实践提供借鉴。  相似文献   

20.
We have designed a new 4-week hospitalized phase II cardiac rehabilitation program. The purpose of the present study is to clarify whether the physical and psychological status of patients with myocardial infarction (MI) improves after participation in our program. Twenty-nine patients (27 males, two females) with acute MI who enrolled in the 4-week hospitalized phase II rehabilitation program were assessed. All patients enrolled in this study had received coronary interventions. The rehabilitation consisted of exercise training, education and counseling. We evaluated the physical and psychological status of the patients before and just after the program, and at a 6-month follow up. The physical status was assessed by exercise tolerance measured by the peak oxygen consumption and anaerobic threshold, frequency of exercise, and serum concentrations of triglyceride, total cholesterol, high-density lipoprotein-cholesterol, and low-density lipoprotein-cholesterol. The psychological status was assessed by the Spielberger state-trait anxiety inventory questionnaire (STAI) and the self-rating questionnaire for depression (SRQ-D). Thirty-four patients (27 men, seven women) with MI who did not participate in our rehabilitation program served as a control group. After participation in our rehabilitation program, exercise tolerance and the serum lipid profiles of the patients were improved compared with those before rehabilitation. These parameters had improved significantly 6 months after rehabilitation. The STAI anxiety score was improved significantly and the SRQ-D depression score tended to be improved just after the rehabilitation program. Regular physical activity was continued even 6 months after the completion of the program. Our hospitalized phase II cardiac rehabilitation program improved the management of cardiac risk factors and the psychological status in patients with MI. This comprehensive program may contribute to the secondary prevention of MI as well as the recovery of physical and psychological activities.  相似文献   

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