截瘫步行器对截瘫患者日常生活活动能力的影响

目的：应用自行研制的截瘫步行器（RGO），配合综合系统康复治疗，帮助脊髓损伤截瘫患者提高日常生活活动自理能力。方法：先后为16例T4-L1节段完全性脊髓损伤患者安装RGO，并于安装前后对其进行关节活动度、肌肉力量、平衡转移、站立和行走等综合康复训练。结果：16例截瘫患者装配RGO前后改良Barthel指数（MBI）分别为35．26±11.49分和58．69±15．75分；功能独立性测评（FIM）得分分别为57．64±16．37分和82．73±21．69分，其装配前后的MBi和FIM得分差异均有显著性意义（P〈0．05）；患者装配RGO后的MBI和FIM移动能力得分与安装前比较差异亦有显著性意义。11例患者达到功能性步行，5例可作治疗性步行。结论：完全性脊髓损伤患者可以应用RGO提高日常生活活动能力。RGO可以帮助截瘫患者实现功能性步行．提高生存质量。     

新型互动式截瘫行走器在截瘫患者中的应用

目的 探讨新型互动式截瘫行走器(walkabout orthosis，WO)对截瘫患者的作用。方法 针对截瘫患者个体差异，制作并装配WO，对患者进行康复治疗及步态训练。结果 患者经过康复治疗及训练后，其Barthel指数明显提高，患者站立及步行能力明显改善，能够达到治疗性步行及家庭性步行。结论 康复治疗可以有效地改善患者的独立生活能力，WO能明显提高截瘫患者的行走能力，是较好的行走器之一。     

新型互动式截瘫行走器在改善截瘫患者独立生活能力中的作用

目的 脊髓损伤使患者丧失站立和行走功能，为此装配新型互动式截瘫行走器(WO)，以提高患者站立和步行的能力。方法 解放军第三军医大学西南医院康复科收治的脊髓损伤患者6例，男4例，女2例，年龄21—36岁。平均27．6岁。按ASIA的损伤分级标准均为完全性损伤。A级，对患者进行运动功能训练；根据患者肢体情况配制特定的行走器：双下肢取石膏阴型后，制作带关节的髋膝踝足矫形器。再装配互动式铰链装置，再进行康复治疗和步态训练。结果康复治疗后。患者Barthel指数由治疗前的(26&;#177;8)提高到治疗后的(47&;#177;7)(t=4．62．P&;lt;0．01)；运动平面积分由治疗前的(32&;#177;10)提高到治疗后的(37&;#177;6)(t=0.34．P&;gt;0．1)；感觉平面积分由治疗前的(54&;#177;12)提高到治疗后的(61&;#177;12)(t=1．05．P&;gt;0．1)。WO使患者站立和步行能力提高。达到治疗性步行及家庭性步行作用。结论 康复治疗可以有效地改善患者的独立生活能力。     

新型截瘫行走器在临床中的应用

脊髓损伤能使患者站立和行走功能丧失致生活质量明显下降 ,现代医学在脊髓损伤的药物、手术治疗方面尚无重大突破 ,但康复医学在治疗方面却有重要进展。除高位颈部脊髓损伤的康复比较困难外 ,借助高新技术和健存的肌肉、神经及运动功能 ,使患者不同程度地达到生活自理、重返工作岗位和社会已成为现实 [1]。一个根据钟摆原理设计的互动式行走器—— WALKABOUT能重建截瘫患者的运动功能。近期我们为 2例胸段脊髓损伤患者安装了该装置 ,收到较满意的治疗效果。1　结构与制作互动式行走器又称为中部固定髋关节矫正器 ,主要由 2个部分组成 :1…     

强化认知训练对脑卒中后认知障碍患者日常生活活动能力的影响

目的探讨强化认知训练对伴认知功能障碍的脑卒中患者日常生活活动能力(ADL)的影响。方法住院康复脑卒中患者80例,简易精神状态检查(MMSE)评分13～18分,随机分为2组,实验组(n=40)进行强化认知功能训练,对照组(n=40)进行常规康复护理训练,共3个月。干预前后进行MMSE、改良Barthel指数(MBI)评定。结果干预后,实验组MMSE、MBI评分较对照组改善更多(P<0.05)。结论强化认知训练能提高伴认知障碍脑卒中患者的ADL。     

截瘫患者使用截瘫步行器的护理

总结23例截瘫患者使用截瘫步行器的护理。护理重点是重视心理护理,使用截瘫步行器前全面评估患者的情况,确定适应患者后,进行佩带截瘫步行器上肢肌力、关节活动、坐位平衡、站立、步行训练及穿脱步行器的训练。23例患者应用截瘫步行器后重建了站立和行走功能,14例患者改良巴氏指数评分78～93分．佩带截瘫步行器生活完全自理;9例患者改良巴氏指数评分60～73分,生活基本自理。     

往复式截瘫步行矫形器结合强化步行训练对截瘫患者步行能力的疗效研究

目的:本研究旨在探讨往复式截瘫步行矫形器(RGO)结合强化步行训练对截瘫患者步行能力的疗效。方法:选取配置了RGO的30名截瘫患者进行强化步行训练,分别在训练第2周、第4周、第8周测量6min步行距离、10m步行时间和心率,并计算由此产生的生理消耗指数(PCI)。结果:与第2周测试结果相比,受试者第4、第8周后的步行距离显著增加(P0.01),10m步行时间明显下降(P0.01),PCI在第8周明显降低(P0.05)。结论:通过往复式截瘫步行矫形器结合强化步行训练,可提高脊髓损伤患者使用RGO的治疗性步行能力,可进一步临床推广。     

偏瘫患者的行走训练

因偏瘫造成肢体活动障碍的患者，当病情稳定后，基本上能翻身、坐起时，即应开始进行起立动作与行走动作训练。     

帕金森病的日常生活活动训练指导

帕金森病(Parkinson disease)最初于1817年由英国James Parkinson医生在他的论文An Essay on theShaking Palsy加以描述.本病多发生于50岁以上的中老年人.帕金森病又称震颤麻痹,是一种病因不明,缓慢进行性发展的中枢神经系统退行性疾病.表现为运动迟缓与减少,肌肉僵直,静止性振颤和姿势异常(姿势反应障碍)[1]4大特征.目前,帕金森病的治疗以药物疗法为中心,但是随着长期慢性化倾向的不断增强以及高龄患者的不断增加,以运动疗法为中心的康复的重要性逐渐为社会所认识.康复的目的是在适当的药物控制的基础上,维持和改善日常生活活动(ADL).     

Predictors of basic and instrumental activities of daily living performance in persons receiving rehabilitation services

OBJECTIVE: To examine the relations among cognitive and emotional function and other patient impairment and demographic variables and the performance of daily activities. DESIGN: Cohort. SETTING: Acute inpatient rehabilitation, skilled nursing facilities, home care, and outpatient clinics. PARTICIPANTS: Adults (N=534) receiving services for neurologic (32.3%), lower-extremity orthopedic (42.7%), or complex medical (24.9%) conditions. Mean age was 63.8 years; 55% were women; 88.6% were white; and the time since condition onset ranged from 0.2 to 3.9 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Activity Measure for Post-Acute Care: applied cognitive, personal care and instrumental, and physical and movement scales; Mental Health Inventory-5 (MHI-5); and patient-identified problems (vision, grasp). RESULTS: Path analyses resulted in good model fit both for the total sample and 3 patient subgroups (chi(2) test, P>.05; comparative fit index >.95). There was a significant (P<.05) direct relation between the applied cognitive, grasp, and personal care and instrumental variables in all patient groups. There were also significant indirect relations between the MHI-5, visual impairment, and grasp problems with the personal care and instrumental scale through an association with the applied cognitive scale. Strength and significance of associations between age, sex, and physical and movement and personal care and instrumental scales varied more across patient groups. The model R(2) for the personal care and instrumental scale for the total sample was .60, with R(2) values of .10, .72, and .62 for the lower-extremity orthopedic, neurologic, and complex medical groups, respectively. CONCLUSIONS: Results suggest that variations in cognitive function, along with visual impairment and lower perceived well-being are associated with a patient's ability to complete daily activities. Rehabilitation professionals should consider cognitive and emotional factors as well as physical performance when planning treatment programs to restore daily activity function.     

老年卧床患者日常生活能力缺陷的调查分析

目的描述老年卧床患者日常生活能力缺陷,明确老年卧床患者日常生活能力与并发症、社会活动和认知的关系。对象:成都市5所有老年科、干部科的医院老年住院卧床患者。方法用相应量表对卧床时间大于1个月的151位老年患者进行自理能力、社会活动、认知的调查。结果老年卧床患者日常生活能力障碍,自理不需帮助项目主要有服药、用电话、进食等。而入厕、行走、做家务、洗衣等自理明显障碍。老年患者持续卧床的时间不同其日常生活能力有差异。结论应尽量减少卧床时间,改善其日常生活能力。     

脑卒中患者日常生活能力与躯体,心理变量的相关研究

采用Ｂａｒｔｈｅｌ指数对１２０例脑卒中住院患者在发病后５－６周进行ＡＤＬ评定。因脑卒中患者肢体的Ｂｒｕｎｎｓｔｒｏｍ功能分级与ＡＤＬ积分高度相关，下肢相关性高于上肢；多元逐步回归分析显示，躯体（偏瘫）和心理（认知障碍和抑郁）因素对ＡＤＬ均有影响。提示ＡＤＬ能力的提高，不仅依赖于肢体功能障碍的改善，提高认知功能，改善情感状况对于脑卒中患者获得全面康复、回归社会同样是重要的。     

Validation of the advanced activities of daily living scale

The objective was to evaluate the metric properties of the List of Advanced Activities of the Daily Living. A study quantitative was conducted. The sample comprised 200 older adults from the city of Pouso Alegre, Brazil. The following instruments were employed: 1- Questionnaire sociodemographic and health; 2- Vitor Quality of Life Scale for the Elderly (VITOR QLSE); and 3 - List of Advanced Activities in Daily Life – AAVDs. It was verified through the exploratory factorial analysis that the list possesses three denominated domains of Activities of Leisure, Social Activities and Productive Activities. The three-factor solution explained 58.18% of total variance: 30% by the first factor, 18.03% by the second, and 10.14% by the third. The coefficient alpha for the overall scale was 0.80. The list of AADLs presented reliable and valid metric properties to be applied in the elderly.     

手指操锻炼改善轻度老年痴呆患者生活能力的研究

目的观察系统的手指操锻炼对改善轻度老年痴呆患者日常生活能力的效果,为实施系统的康复训练提供理论依据。方法选择2009年10月—2010年10月入住上海交通大学附属第六人民医院老年科的轻度老年痴呆患者60例,随机分为干预组和对照组各30例,给对照组提供手指功能活动的用具,让患者根据自己的兴趣进行手指的自由活动;干预组由专业医务人员进行手指操训练,每天定时练习,坚持6个月。采用日常生活能力量表(ADL)进行评分。结果对照组训练前后躯体自理能力和使用日常工具的基本能力无明显变化,干预组训练6个月后躯体自理能力和使用日常工具的基本能力明显改善,与对照组比较差异有统计学意义(P<0.05)。结论轻度认知障碍患者的各种能力随时间推移逐渐下降,日常手指操的练习能有效改善其日常生活中的自理能力,提高其独立生活的勇气和生活质量。     

工作记忆训练对脑卒中患者执行功能及日常生活活动的影响

目的:观察工作记忆训练对脑卒中患者执行功能及日常生活活动能力的影响。方法:采用随机数字表法将46例脑卒中患者分为观察组及对照组,每组23例。2组患者均常规给予认知康复训练(包括计算机辅助认知训练及上肢机器人虚拟情境训练),观察组患者在此基础上辅以工作记忆训练(主要包括活动记忆训练和回忆任务训练)。于治疗前、治疗4周及8...     

Prevalence of sarcopenia and its association with activities of daily living among japanese nursing home residents

Sarcopenia is an important predictor of adverse outcomes in elderly people. Based on a common clinical experience, sarcopenia may be associated with activities of daily living (ADL). To our knowledge, no study has investigated the association between sarcopenia and ADL in nursing home residents requiring long-term care. This cross-sectional study included 250 nursing home residents. Nutritional status, physical function, ADL and cognitive function were assessed using Mini Nutritional Assessment-Short Form (MNA-SF), Short Physical Performance Battery (SPPB), Barthel Index (BI) and Mini-Mental State Examination (MMSE). To examine the factors that may affect self-care capacity, a stepwise multiple linear regression analysis was performed. The prevalence of sarcopenia was 45.2%. Age, MMSE, MNA-SF, SPPB, and grip strength were independently associated with BI. A high prevalence of sarcopenia was observed among nursing home residents in Japan. However, sarcopenia was not associated with ADL.     

Effect of short-duration,limited rehabilitation on maintenance of the activities of daily living in patients with acute phase of COVID-19

[Purpose] To determine whether short-duration, limited rehabilitation is effective in patients with COVID-19. [Participants and Methods] Single-center, retrospective, observational study. Thirty-six inpatients were classified into the three groups: a close contact (CC) group with a negative polymerase chain reaction (PCR) test (n=14); a PCR–positive (PP) group (n=15); and a PCR–positive and transfer (PT) group with severe COVID-19 patients who were transferred to an acute care hospital for treatment and then returned to our hospital (n=7). Short-duration, limited rehabilitation was provided to the CC and PP groups in isolated rooms by a therapist wearing full personal protective equipment, and we assessed the changes in their activities of daily living. [Results] The patients’ clinical characteristics at baseline were similar among the three groups. Functional Independence Measure scores in the CC, PP, and PT groups were not different at baseline (69 ± 29, 53 ± 26, and 63 ± 32), but differed after control of COVID-19 (63 ± 25, 47 ± 24, and 32 ± 19). Multivariate regression analysis showed that the implementation of a customized self-exercise program and the Mini Nutritional Assessment Short-Form at baseline were independently associated with Functional Independence Measure score after control of COVID-19. [Conclusion] These results suggest that even short-duration, limited rehabilitation may be effective for preventing decreases in activities of daily living in patients with COVID-19.