社区视力残疾者定向行走训练的效果分析

目的 分析社区38例视力残疾者定向行走训练的效果.方法 组织社区38例视力残疾者参加定向行走训练,根据视力残疾者定向行走技能评估标准进行评价.结果38例视力残疾者定向行走训练后,能进行短距离、长距离和不同路面独立行走者分别为12例、15例、10例,1例因病退出；年龄和致残原因对训练效果有影响.结论 视力残疾者参加定向行...     

上海社区脊髓损伤者康复训练情况调查分析

摘要 目的：分析上海市社区样本脊髓损伤患者康复训练情况。 方法：在上海市养志康复医院（上海市阳光康复中心）参加社区康复指导员培训的脊髓损伤患者中开展问卷调查，调查内容是个人基本情况、受伤情况、康复认知和意向情况、康复训练历史情况等，同时对全市脊髓损伤者“希望之家”康复训练的情况进行调查。 结果：调查了16个区31名脊髓损伤者和全市21个脊髓损伤者希望之家。调查对象平均受伤24年，康复认知水平总体较高，了解及以上的比例高达85.0%，但少数患者对部分康复原则不了解。上海市各区希望之家开展康复训练的比例高达90.5%，患者对社区康复训练的好处、重要性和开展的必要性有明确认同，大部分人认同每月组织1—2次集中康复训练，这与实际情况一致。调查对象认为影响社区开展康复训练的第一位影响因素是缺乏专业人员指导（85.7%），影响患者定期参加社区集中康复训练的第一位因素是交通因素（64.5%）。54.8%调查对象在受伤1年内进行过早期康复训练。患者受伤1年以后参加机构康复训练的比例是87.1%，但训练次数较少，迄今平均5年参加0.48次训练。康复训练效果方面，机构康复训练最好，其次是社区康复训练，早期和家庭康复训练的效果有待进一步提升。 结论：上海脊髓损伤患者的康复训练已经初步形成了服务体系，未来应进一步加大脊髓损伤者早期康复训练和机构康复训练服务的供给。连续系统的康复训练模式是未来的发展方向，目前通过培训社区康复训练指导员，促进社区和家庭康复训练工作是可以探索的途径。     

Kinect体感交互技术在运动康复中的应用设计

目的设计基于Kinect体感交互技术的运动功能康复系统，为实现家庭环境下的运动功能康复训练。 方法利用Kinect的骨骼实时跟踪技术，设计了三维运动、提手臂和姿势识别三种运动康复范式，系统能指导患者进行康复训练，并且能够对训练效果进行量化评估。选取5例健康受试对象采用该康复系统进行了测试。 结果5例受试者的三维运动平均得分为（79.15±4.89）分，提手臂运动平均得分为（98.89±0.67）分，姿势识别平均准确率为（90.37±5.21）%。 结论基于Kinect体感交互技术的康复系统可实现家庭环境下对患者的指导性康复训练及对训练效果的量化评估。     

盲人定向行走的历史与现状

在我国 8 77万视力残疾人中 ,低视力者约 5 0 0万人 ,盲人近 4 0 0万人。视力残疾人因各种原因导致双眼视力障碍或视野缩小 ,很难像健全人那样自由行走和参加社会活动 ,因而丧失作为社会一员的权利、资格和尊严。采取各种措施对视力残疾人进行治疗、训练和辅助 ,尽量补偿、提高其丧失或削弱的功能 ,使其恢复做人的基本权利 ,重返社会和适应社会生活是社会的责任和义务。定向行走作为视力残疾康复的重要手段 ,是视力残疾个体最基本的特殊需要之一。1我国视力残疾人的基本状况我国视力残疾者占残疾人总数的 14 6 1% ,其中15— 6 4岁的视力残…     

社区康复模式对脑卒中吞咽障碍患者吞咽功能恢复的研究

目的探讨社区康复模式对脑卒中吞咽障碍患者吞咽功能恢复的影响。方法将80例脑卒中吞咽障碍患者按实施社区康复模式干预先后分为A组和B组各40例,A组实施为期1个月的家庭康复训练,B组实施为期1个月的社区康复模式干预,社区康复模式内容包括培训,制定及实施康复训练方案和康复目标等。在出院患者训练前及训练1月后采用洼田氏饮水试验法对其进行吞咽功能评估。结果经过1个月训练后,B组患者的吞咽功能较A组改善明显,两者比较,差异有统计学意义(P0.05)。结论社区康复服务模式的建立有利于脑卒中吞咽障碍患者吞咽功能的康复。     

社区康复改善断指再植病人术后生活能力

[目的]观察社区康复对断指再植病人术后生活能力的影响。[方法]对我科出院断指再植病人90例实施社区康复训练，采用运动训练、感觉训练、作业方法、职业训练、心理护理等一体系化的康复训练，按中野和立井手指功能评定法进行评分。[结果]社区康复优良率迭88．46％。较社区康复前（7．69％）显著提高。[结论]社区康复能改善断指再植病人的生活能力，增加病人重返工作岗位的几率。     

湖北省视力残疾人的康复现状和需求调查分析

目的:了解湖北省视力残疾人接受康复的情况及康复需求.方法:对湖北省地区符合残疾评定标准的1142例视力残疾患者进行康复现状调查,内容包括①接受康复的项目:医疗服务与救助、辅助器具、康复训练与服务;②康复需求:机构康复,延伸服务、社区和家庭服务等.结果:1142例视力残疾患者中接受过一种或以上康复服务469例(41.1%);对康复形式的需求中机构康复760例(66.6%),延伸服务53例(4.6%),社区和家庭服务329例(28.8%).对康复内容的需求中医疗服务与救助898例(78.6%),辅助器具276例(24.2%),康复训练与服务120例(10.5%).结论:对视力残疾患者应根据不同年龄、不同地区、残疾程度和不同康复需求,在医疗机构和社区内提供相应的康复服务,满足视力残疾患者的康复需求.     

开展劳动作业训练对社区精神分裂症患者康复效果的分析

目的评价开展劳动作业训练在社区精神分裂症患者康复中的效果。方法选择社区内32名精神分裂症患者，按照自愿参与原则，分成康复训练组和家庭监护组，并应用日常生活能力量表（ADL）和简明精神病量表（BPRS）来评价精神分裂症患者康复效果。结果两组间ADL和BPRS前后变化对比差异有显著意义（P〉0．05），康复训练组明显优于家庭监护组。结论对社区精神分裂症患者开展劳动作业康复训练，能有效增强精神分裂症患者的社会功能和日常生活能力，提高患者的健康状况和生活质量。     

社区康复改善断指再植病人术后生活能力

[目的]观察社区康复对断指再植病人术后生活能力的影响。[方法]对我科出院断指再植病人90例实施社区康复训练,采用运动训练、感觉训练、作业方法、职业训练、心理护理等一体系化的康复训练,按中野和立井手指功能评定法进行评分。[结果]社区康复优良率达88.46%,较社区康复前(7.69%)显著提高。[结论]社区康复能改善断指再植病人的生活能力,增加病人重返工作岗位的几率。     

社区护理指导高血压脑出血恢复期病人肢体功能训练

自1999年1月～2001年1月通过对58例高血压脑出血恢复期病人进行出院指导,定期上门服务,家庭康复护理指导,取得较满意的效果,现报道如下。1 对象与方法本组58例均由CT确诊为：急性高血压脑出血,其中男36例,女22例,年龄46～77岁,平均年龄61.5岁,偏瘫44例,肢体肌力均在Ⅰ～Ⅲ级。方法：（1）由社区护士在病人出院时给予病人健康状况全面评估,然后制定适合病人的康复训练计划,教会家属及病人康复训练的方法,步骤,并掌握训练过程中的注意事项。（2）肢体康复训练指导：病人瘫痪肢体保持良好的功能位,至少1次/d,15～20 min/次,…     

Measuring the effectiveness of bioptic telescopes for persons with central vision loss

PURPOSE: 1) To evaluate a vision rehabilitation program aimed at training persons with central vision loss to use a bioptic telescope for improving life skills, including driving and 2) to compare the outcomes of subjects who are given bioptic telescopes and training, with subjects who are prescribed telescopic lenses without training. METHODS: Twenty-five subjects ranging in age from 16 to 78 years were included in the study. Each subject was randomized to one of three groups: Group 1 received bioptic telescopes and training during the first approximately 3-month-long period of the approximately 6-month-long study; Group 2 received lenses and training during the second approximately 3-month-long period of the study; and Group 3 received the lenses for approximately 3 months without any training. An assessment battery consisting of clinical vision tests, functional tasks evaluated by an orientation and mobility specialist, driving skills evaluated by a kinesiotherapist specializing in driver's education, and psychophysical measures was administered to Groups 1 and 2 at baseline, and at approximately 3 and 6 months, and to Group 3 at baseline and at approximately 3 months. The tasks were categorized into 6 major functional categories: Recognition, Mobility, Peripheral Identification, Scanning, Tracking, and Visual Memory. Training consisted of 5 weeks of laboratory-based training focusing on skills within these 6 categories, and 8 weeks of on-road driving training. RESULTS: There was significant improvement in all task categories with use of the telescopes. There was improvement in all task groups with training, though a significant difference between the trained and untrained groups existed only in the Recognition, Peripheral Identification, and Scanning Categories, but not in Mobility, Tracking, or Visual Memory. When the tasks involving driving-related skills were analyzed separately, training also had a significant effect. CONCLUSION: There was significant improvement in visual skills with the use of a bioptic telescope. This improvement was greater with training in the use of the lenses in a number of visual skills categories including driving-related skills.     

How mobility officers assess need for mobility training

Little is known about how Mobility Officers (O&M specialists) assess the training needs of visually impaired clients. In principle, these assessments may be based on estimates of existing travel skills, and the visual and psychological status of clients. In this study, the priority-for-training ratings made when residents arrived at a residential rehabilitation centre were correlated with measures of clients' feelings when travelling, and with visual status. The feelings checklist contained twenty-one items which clients themselves identified as describing how they felt on a journey. Priority for training was related to six of these feelings, which together accounted for 60.24% of the variance of training priorities. These data suggest that Mobility Officers do respond to how their clients are feeling when assessing their need for training. Clinical measures of visual status, surprisingly, were not directly involved in the assessments. However, lower peripheral field status, which could not have been known to Mobility Officers, was significantly correlated with assessments, accounting for a further 15.57% of the variance of priorities; in total, therefore, 75.81% of the variance of assessments were accounted for by the combination of psychological factors, and this visual factor. It is suggested that the latter correlation was due to the effects of an intervening variable. This may have been some aspect of mobility performance, which depends particularly on lower peripheral visual information for its execution.     

对儿童血液肿瘤科护理人员进行能力本位培训的效果评价

目的确定开展能力本位培训对儿童血液肿瘤科护理人员专科知识及技能的影响。方法选择2003年在上海儿童医学中心血液肿瘤科全体临床护理人员26名。根据美国St.Jude儿童研究医院的认证经验和相关文献设立儿童血液肿瘤科护理人员的专科能力本位培训内容与方法;每项项目是重复3次的滚动式标准培训,培训共持续8个月。根据培训内容设计知识试卷和操作评分标准;培训前用知识试卷进行前测,培训结束后用同一张试卷进行后测,比较前测和后测结果。同时培训后用操作评分标准测试操作技能。结果培训后临床护理人员的知识水平比以前有显著提高,P=0.000;培训后护理人员操作第1次合格率为96.2%。结论系统的标准临床专科能力本位培训能显著提高儿童血液肿瘤科护理人员的专科核心能力。     

家庭肺康复联合移动医疗应用程序在稳定期COPD患者中的应用效果研究

【】目的：探讨家庭肺康复联合移动医疗应用程序对慢性阻塞性肺疾病(COPD)患者肺康复的效果。方法：便利抽样法选取2016年5月至2017年8月在上海同济大学附属同济医院门诊就诊的91名稳定期COPD患者为研究对象,按随机数字表法分为对照组(43人)和试验组(48人)。对照组给予常规家庭肺康复训练,试验组给予常规家庭肺康复训练和COPD管家应用程序进行干预。评价两组患者出院时、出院后3个月的肺功能、6 min步行试验距离和生活质量。结果：出院后3个月,试验组患者的肺功能与对照组相比无统计学差异(P > 0.05);6 min步行距离和生活质量评分均优于对照组(P < 0.05)。结论：家庭肺康复联合COPD管家应用程序有助于提高COPD患者的身体活动能力,改善其生活质量,值得在COPD患者中推广应用。     

视觉感知训练对低视力儿童视觉感知能力、社会技能和活动表现的作用

目的探讨两种不同的视觉感知训练方式对低视力儿童视觉感知能力、社会技能和活动表现的作用。方法便利抽样选取2016年1月至2018年1月我院接诊及盲校筛查的300例低视力儿童,随机分为纸笔训练组(n=150)和计算机训练组(n=150)。采用运动视觉感知测试(motor-free visual perception test-fourth edition,MVPT-4)、视觉障碍儿童社会技能评估工具(social skills assessment tool for children with visual impairments,SSAT-VI)和加拿大作业表现量表(Canadian occupational performance measure,COPM)评估受试者干预前后的视觉感知能力、社会技能和活动表现。结果相对于训练前,两组训练后MVPT-4总评分、SSAT-VI总评分和COPM表现评分均显著增加(均P<0.001),但COPM满意度评分未发生明显变化(均P>0.05);且两组训练后的MVPT-4、SSAT-VI和COPM各项评分比较差异无统计学意义(均P>0.05)。结论纸笔和计算机两种视觉感知训练方式对低视力儿童的视觉感知能力、社交技能和活动表现均具有积极的作用,且效果相当,家长或者教师可根据实际需求进行选择。     

The effect of neurofeedback on a brain wave and visual perception in stroke: a randomized control trial

[Purpose] This study investigated a brain wave and visual perception changes in stroke subjects using neurofeedback (NFB) training. [Subjects] Twenty-seven stroke subjects were randomly allocated to the NFB (n = 13) group and the control group (n=14). [Methods] Two expert therapists provided the NFB and CON groups with traditional rehabilitation therapy in 30 thirst-minute sessions over the course of 6 weeks. NFB training was provided only to the NFB group. The CON group received traditional rehabilitation therapy only. Before and after the 6-week intervention, a brain wave test and motor free visual perception test (MVPT) were performed. [Results] Both groups showed significant differences in their relative beta wave values and attention concentration quotients. Moreover, the NFB group showed a significant difference in MVPT visual discrimination, form constancy, visual memory, visual closure, spatial relation, raw score, and processing time. [Conclusion] This study demonstrated that NFB training is more effective for increasing concentration and visual perception changes than traditional rehabilitation. In further studies, detailed and diverse investigations should be performed considering the number and characteristics of subjects, and the NFB training period.Key words: Neurofeedback (NFB), Brain wave, Visual perception     

Wheelchair skills training program: A randomized clinical trial of wheelchair users undergoing initial rehabilitation

OBJECTIVE: To test the hypothesis that a brief, formalized period of additional wheelchair skills training is safe and results in significantly greater improvements in wheelchair skills performance than a standard rehabilitation program. DESIGN: Randomized controlled trial. SETTING: Rehabilitation center. PARTICIPANTS: Thirty-five wheelchair users (20 with musculoskeletal disorders, 15 with neurologic disorders) admitted for initial rehabilitation. Subjects' mean age +/- standard deviation (SD) was 59+/-18.3 years. INTERVENTION: Subjects randomly allocated to the treatment group participated in the Wheelchair Skills Training Program (WSTP), averaging 4.5+/-1.5 training sessions, each 30 minutes long. Subjects in the control group did not receive any wheelchair skills training beyond that given in a typical rehabilitation stay. MAIN OUTCOME MEASURES: Wheelchair Skills Test (WST), version 2.4, before and after training. Changes in total percentage WST score and individual skill scores were examined. RESULTS: There were no adverse incidents. The control group's mean percentage score +/- SD increased from 60.1%+/-14.4% to 64.9%+/-13.3%, an 8% improvement of the posttest relative to the pretest (P=.01). The WSTP group's mean score increased from 64.9%+/-9.4% to 80.9%+/-5.6%, a 25% improvement of the posttest relative to the pretest (P<.000). The WSTP group showed significantly greater improvements than the control group (P<.000). Among the specific skills, significantly greater improvements were seen in the WSTP group for the gravel and high-curb descent skills (P<.001). CONCLUSIONS: The WSTP is safe and practical and has a clinically significant effect on the independent wheeled mobility of new wheelchair users. These findings have implications for the standards of care in rehabilitation programs.     

游戏结合言语训练在2~5岁语言发育迟缓高危儿童康复护理中的应用观察

目的探讨游戏结合言语训练在2~5岁语言发育迟缓高危儿童康复护理中的应用。方法采用便利抽样法,选取2016年1月—2018年12月泸州市人民医院190例2~5岁伴有语言发育迟缓的高危儿童为研究对象,采用随机数字表法分为观察组和对照组,每组各95例。对照组患儿接受常规言语训练,观察组患儿结合游戏进行言语训练,均干预6个月。比较两组患儿的康复训练效果,采用Gesell发育量表评定患儿的言语发育商。比较两组家长对康复的满意度。结果干预6个月后,观察组患儿的康复训练有效率为86.32%(82/95),对照组为73.68%(70/95),两组比较差异有统计学意义(P<0.05);观察组患儿Gesell发育量表评分(60.36±8.25)分,对照组(56.67±7.84)分,两组比较差异有统计学意义(P<0.05);观察组患儿家长对康复效果、服务态度、专业技能、人文关怀的满意率均高于对照组,两组比较差异有统计学意义(P<0.05)。结论在2~5岁伴有语言发育迟缓的高危儿童中,结合游戏进行言语训练可改善患儿言语发育商,更好地促进患儿康复。     

Efficacy and retention of the French-Canadian version of the wheelchair skills training program for manual wheelchair users: a randomized controlled trial

Routhier F, Kirby RL, Demers L, Depa M, Thompson K. Efficacy and retention of the French-Canadian version of the Wheelchair Skills Training Program for manual wheelchair users: a randomized controlled trial.ObjectivesTo test the hypotheses that, in comparison with a control group that received standard care, users of manual wheelchairs who also received the French-Canadian version of the Wheelchair Skills Training Program (WSTP) would significantly improve their wheelchair-skills capacity and that these improvements would be retained at 3 months.DesignMulticenter, single-blind, randomized controlled trial.SettingThree rehabilitation centers in Montréal, Quebec, Canada.ParticipantsManual wheelchair users (N=39), a sample of convenience.InterventionParticipants were randomly allocated to the WSTP or control groups. Participants in both groups received standard care. Participants in the WSTP group also received a mean of 5.9 training sessions (a mean total duration of 5h and 36min).Main Outcome MeasuresThe French-Canadian version of the Wheelchair Skills Test (WST) (Version 3.2) was administered at evaluation at first time period (baseline) (t1), evaluation at second time period (posttraining) (t2) (a mean of 47d after t1), and at evaluation at third time period (follow-up) (t3) (a mean of 101d after t2).ResultsAt t2, the mean ± SD total percentage WST capacity scores were 77.4%±13.8% for the WSTP group and 69.8%±18.4% for the control group (P=.030). Most of this difference was due to the community-level skills (P=.002). The total and subtotal Wheelchair Skills Test scores at t3 decreased by ≤0.5% from the t2 values, but differences between groups at t3, adjusting for t1, did not reach statistical significance (P≥.017 at a Bonferroni-adjusted α level of .005).ConclusionWSTP training improves wheelchair skills immediately after training, particularly at the community-skills level, but this study did not show statistically significant differences between the groups at 3 months.     

上肢康复机器人训练治疗脑卒中偏瘫患者

目的:探讨上肢康复机器人训练治疗脑卒中偏瘫患者上肢功能的疗效.方法:脑卒中偏瘫患者46例,随机分为对照组和观察组各23例,2组均接受基础药物和常规康复治疗,观察组增加上肢康复机器人训练.治疗前后进行上肢Brunnstrom分级、简式Fugl-Meyer运动量表上肢部分(FMA-UE)和改良Barthel指数(MBI)评定.结果:治疗4周后,2组上肢Brunnstrom分级均较治疗前显著改善(P＜0.05),但2组间差异无统计学意义;2组FMA-UE和MBI评分较治疗前明显提高(P＜0.05),且观察组提高更显著(P＜0.05).结论:上肢康复机器人训练有利于改善脑卒中患者上肢功能,且能促进日常生活活动能力的恢复.