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排序方式: 共有103条查询结果,搜索用时 15 毫秒
1.
ObjectiveTo investigate the associations between participants’ adherence to a physical activity and exercise program after stroke and functional recovery 18 months after inclusion.DesignSecondary analyses of the intervention arm in the multisite randomized controlled trial Life After Stroke (LAST).SettingPrimary health care services in 3 Norwegian municipalities.ParticipantsOf the participants enrolled (N=380), 186 (48.9%) were randomized to the intervention. The study sample comprised community dwelling individuals included 3 months after stroke, with mean age of 71.7 ± 11.9 years and 82 (44.1%) women. According to the National Institutes of Health Stroke Scale, 97.3% were diagnosed as having mild (National Institutes of Health Stroke Scale<8) and 2.7% with moderate (8-16 on the National Institutes of Health Stroke Scale) stroke.InterventionMonthly coaching by physiotherapists encouraging participants to adhere to 30 minutes of daily physical activity and 45-60 minutes of weekly exercise.Main Outcome MeasuresThe primary outcome was Motor Assessment Scale (MAS). Secondary outcome measures were 6-minute walk test, Timed Up and Go (TUG), Berg Balance Scale (BBS), and the physical domains of the Stroke Impact Scale (SIS). Adherence was assessed by combining participants’ training diaries and physiotherapists’ reports.ResultsThe relationship between adherence and functional recovery was analyzed with simple and multiple linear regression models. Adjusted for age, sex, dependency, and cognition, results showed statistically significant associations between adherence and functional outcomes after 18 months, as measured by MAS, TUG, BBS, and SIS (P≤.026).ConclusionsIncreased adherence to physical activity and exercise was associated with improved functional recovery after mild to moderate stroke. This emphasizes the importance of developing adherence-enhancing interventions. Dose-response studies are recommended for future research.  相似文献   
2.

Objective

To determine the impact of long-term, body weight–supported locomotor training after chronic, incomplete spinal cord injury (SCI), and to estimate the health care costs related to lost recovery potential and preventable secondary complications that may have occurred because of visit limits imposed by insurers.

Design

Prospective observational cohort with longitudinal follow-up.

Setting

Eight outpatient rehabilitation centers that participate in the Christopher & Dana Reeve Foundation NeuroRecovery Network (NRN).

Participants

Individuals with motor incomplete chronic SCI (American Spinal Injury Association Impairment Scale C or D; N=69; 0.1–45y after SCI) who completed at least 120 NRN physical therapy sessions.

Interventions

Manually assisted locomotor training (LT) in a body weight–supported treadmill environment, overground standing and stepping activities, and community integration tasks.

Main Outcome Measures

International Standards for Neurological Classification of Spinal Cord Injury motor and sensory scores, orthostatic hypotension, bowel/bladder/sexual function, Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI), Berg Balance Scale, Modified Functional Reach, 10-m walk test, and 6-minute walk test. Longitudinal outcome measure collection occurred every 20 treatments and at 6- to 12-month follow-up after discharge from therapy.

Results

Significant improvement occurred for upper and lower motor strength, functional activities, psychological arousal, sensation of bowel movement, and SCI-FAI community ambulation. Extended training enabled minimal detectable changes at 60, 80, 100, and 120 sessions. After detectable change occurred, it was sustained through 120 sessions and continued 6 to 12 months after treatment.

Conclusions

Delivering at least 120 sessions of LT improves recovery from incomplete chronic SCI. Because walking reduces rehospitalization, LT delivered beyond the average 20-session insurance limit can reduce rehospitalizations and long-term health costs.  相似文献   
3.

Objective

To compare the risk of falls and fall predictors in patients with Parkinson disease (PD), multiple sclerosis (MS), and stroke using the same study design.

Design

Multicenter prospective cohort study.

Setting

Institutions for physical therapy and rehabilitation.

Participants

Patients (N=299) with PD (n=94), MS (n=111), and stroke (n=94) seen for rehabilitation.

Interventions

Not applicable.

Main Outcome Measures

Functional scales were applied to investigate balance, disability, daily performance, self-confidence with balance, and social integration. Patients were followed for 6 months. Telephone interviews were organized at 2, 4, and 6 months to record falls and fall-related injuries. Incidence ratios, Kaplan-Meier survival curves, and Cox proportional hazards models were used.

Results

Of the 299 patients enrolled, 259 had complete follow-up. One hundred and twenty-two patients (47.1%) fell at least once; 82 (31.7%) were recurrent fallers and 44 (17.0%) suffered injuries; and 16%, 32%, and 40% fell at 2, 4, and 6 months. Risk of falls was associated with disease type (PD, MS, and stroke in decreasing order) and confidence with balance (Activities-specific Balance Confidence [ABC] scale). Recurrent fallers were 7%, 15%, and 24% at 2, 4, and 6 months. The risk of recurrent falls was associated with disease type, high educational level, and ABC score. Injured fallers were 3%, 8%, and 12% at 2, 4, and 6 months. The only predictor of falls with injuries was disease type (PD).

Conclusions

PD, MS, and stroke carry a high risk of falls. Other predictors include perceived balance confidence and high educational level.  相似文献   
4.

Objectives

To compare the effects of conventional core stabilization and dynamic neuromuscular stabilization (DNS) on anticipatory postural adjustment (APA) time, balance performance, and fear of falls in chronic hemiparetic stroke.

Design

Two-group randomized controlled trial with pretest-posttest design.

Setting

Hospital rehabilitation center.

Participants

Adults with chronic hemiparetic stroke (N=28).

Interventions

Participants were randomly divided into either conventional core stabilization (n=14) or DNS (n=14) groups. Both groups received a total of 20 sessions of conventional core stabilization or DNS training for 30 minutes per session 5 times a week during the 4-week period.

Main Outcome Measures

Electromyography was used to measure the APA time for bilateral external oblique (EO), transverse abdominis (TrA)/internal oblique (IO), and erector spinae (ES) activation during rapid shoulder flexion. Trunk Impairment Scale (TIS), Berg Balance Scale (BBS), and Falls Efficacy Scale (FES) were used to measure trunk movement control, balance performance, and fear of falling.

Results

Baseline APA times were delayed and fear of falling was moderately high in both the conventional core stabilization and DNS groups. After the interventions, the APA times for EO, TrA/IO, and ES were shorter in the DNS group than in the conventional core stabilization group (P<.008). The BBS and TIS scores (P<.008) and the FES score (P<.003) were improved compared with baseline in both groups, but FES remained stable through the 2-year follow-up period only in the DNS group (P<.003).

Conclusions

This is the first clinical evidence highlighting the importance of core stabilization exercises for improving APA control, balance, and fear of falls in individuals with hemiparetic stroke.  相似文献   
5.
《中国现代医生》2017,55(23):20-22
目的研究和探讨综合康复训练对脊髓损伤患者功能的影响。方法选择我院康复科2015年9月~2016年9月收治的40例脊髓损伤病例,分别采取个体化的综合康复训练方式,治疗3、6个月后对所有患者的ASIA感觉、运动及FIM评分、BI、Berg平衡量表BBS评分进行比较和分析。结果治疗3、6个月后,40例脊髓损伤患者的ASIA感觉、运动及FIM评分、BI、Berg平衡量表BBS评分分别较治疗前显著增加,差异具有显著性(P0.05)。且治疗6个月后40例脊髓损伤患者的ASIA感觉、运动及FIM评分、BI、Berg平衡量表BBS评分分别显著高于治疗3个月后,差异具有显著性(P0.05)。结论对于脊髓损伤患者采取综合康复训练,有利于促进各项功能的恢复和重建,从而提高患者的日常生活能力和生活质量。  相似文献   
6.
尽早开展医学生的科研素质和实践能力培训是现代医学教育改革的一项重要任务。我们针对二年级部分医学类五年制本科生,连续8年开展了"基础医学论坛活动"。通过对本科生科研素质现状的调查分析,探讨培养医学本科生科研素质与创新能力的途径与对策。  相似文献   
7.
目的评价BBS 926全自动医用低速离心机制备的冰冻解冻去甘油红细胞的质量。方法 BBS 926全自动医用低速离心机制备冰冻解冻去甘油红细胞完成后,立即留取样本,检测其血红蛋白含量、游离血红蛋白含量、白细胞残留量、甘油残留量等质量监测指标。结果血红蛋白含量为(23±5)g/L、游离血红蛋白含量为(0.43±0.25)g/L、白细胞残留量为(0.6±0.3)×107个、甘油残留量为(3.6±2.5)g/L、细菌培养试验阴性。结论 BBS 926全自动医用低速离心机制备冰冻解冻去甘油红细胞各项检测指标均达到国家质量标准,能有效地保障临床输血安全。  相似文献   
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10.
Wavelet packet transform decomposes a signal into a set of orthonormal bases (nodes) and provides opportunities to select an appropriate set of these bases for feature extraction. In this paper, multi-level basis selection (MLBS) is proposed to preserve the most informative bases of a wavelet packet decomposition tree through removing less informative bases by applying three exclusion criteria: frequency range, noise frequency, and energy threshold. MLBS achieved an accuracy of 97.56% for classifying normal heart sound, aortic stenosis, mitral regurgitation, and aortic regurgitation. MLBS is a promising basis selection to be suggested for signals with a small range of frequencies.  相似文献   
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