延伸护理对脑卒中患者生活能力和生活质量的影响

目的：探讨延伸护理对脑卒中患者生活能力和生活质量的影响。方法80例脑卒中患者随机分为观察组与对照组,每组40例,均给予常规治疗及护理,观察组在此基础上予延伸护理,观察干预前后患者日常生活活动能力、运动功能及生活质量的变化。结果2组出院时Fugl-Meyer评分、Barthel指数及QLI评分比较差异无统计学意义（P＞0·05）,干预后观察组上述指标分别为56·5±13·3、71·2±13·6、7·6±1·6,均明显优于对照组,差异有统计学意义（P＜0·05）。结论延伸护理对提高脑卒中日常生活活动能力、运动能力及改善生活质量具有重要作用,值得临床推广。     

身心调节护理对脑卒中后癫痫患者负性情绪及生活功能的影响

目的探讨身心调节护理对脑卒中后癫痫患者负性情绪及生活功能的影响。方法选择同期80例脑卒中后癫痫患者,按照入院先后顺序分为观察组与对照组各40例,对照组采取常规护理,观察组在此基础上加以身心调节护理,分析比较两组干预前后焦虑抑郁情况、运动功能、日常生活活动能力及生活质量水平。结果与干预前比较,两组干预后SDS评分、SAS评分均显著下降,FMA评分、Barthel指数、SF-36量表各项评分均明显上升,差异有统计学意义(P0.05)。干预后观察组SDS评分、SAS评分明显低于对照组,差异有统计学意义(P0.05),且干预后观察组FMA评分、Barthel指数及SF-36各项评分均明显高于对照组(P0.05)。结论身心调节护理能有效缓解脑卒中后癫痫患者的焦虑、抑郁情绪,提高患者运动功能及日常生活活动能力,改善其生活质量。     

日常生活活动训练及常规康复措施对脑血管病后遗症患者预后及生活质量的影响

目的：探讨日常生活活动训练及常规康复措施对脑血管病后遗症患者预后及生活质量的影响。方法将106例脑血管病后遗症患者随机分对照组与观察组，对照组接受常规康复训练措施，观察组同时接受日常生活活动训练。采用Barthel指数评估日常生活能力，采用Fulg‐Meyer运动量表评估肢体功能，采用SF‐36生活质量量表评估生活质量。结果干预后6个月观察组患者Barthel指数及Fulg‐Meyer评分显著优于对照组，差异具有统计学意义（P＜0.05）；观察组Barthel指数评分良、中等级比例显著高于对照组（P＜0.05）；观察组 SF‐36量表QOL躯体健康及精神健康评分显著高于对照组，差异具有统计学意义（P＜0.05）。结论加强对脑血管病后遗症患者日常生活活动训练，可显著提高患者肢体功能及日常生活能力，改善生活质量。     

品管圈护理干预对脑卒中偏瘫患者良姿摆放的影响

目的探讨品管圈护理干预对脑卒中偏瘫患者良姿摆放的影响。方法选取我院160例脑卒中偏瘫患者,根据随机数字法分为对照组(常规护理)和观察组(品管圈护理干预)各80例,观察和比较2组良姿摆放合格率、并发症发生情况,根据Fugl-Meyer运动功能积分法(FMA)、Barthel指数,评估护理前后2组肢体运动能力及日常生活活动能力。结果与对照组相比,观察组良姿摆放合格率明显提高,关节萎缩畸形、肩关节脱位、垂足等并发症发生率均显著降低,护理后FMA、Barthel评分均明显增高,差异均有统计学意义(P0.05)。结论品管圈护理干预能够提高脑卒中偏瘫患者良姿摆放合格率,降低并发症发生率,有利于患者肢体运动功能的恢复,改善患者日常生活活动能力。     

基于King互动达标理论的康复护理干预对脑卒中患者的康复效果观察

目的 探讨实施基于King互动达标理论的康复护理干预对脑卒中患者机体康复的效果。方法 纳入四川大学华西医院2020-01—2022-01收治的90例脑卒中患者为研究对象,以随机数字表法分为2组（每组45例）,对照组患者进行常规康复护理干预,干预组患者进行基于King互动达标理论的康复护理干预,干预1个月后评估2组神经功能（NIHSS）、认知能力（MMSE）、日常生活能力（Barthel指数）、肢体运动能力（FMA）、心理状态[焦虑自评量表（SAS）、抑郁自评量表（SDS）]、生活质量（SF-36）及康复训练依从性。结果 干预前,2组NIHSS评分、MMSE评分、Barthel指数、FMA评分、SAS评分、SDS评分、SF-36评分及依从性评分比较无统计学差异（P>0.05）;干预后,2组NIHSS评分、SAS评分、SDS评分均下降,且干预组低于对照组（P<0.05）;干预后,2组MMSE评分、Barthel指数、FMA评分、SF-36评分及依从性评分较干预前组提高,干预组上述各项评分高于对照组（P<0.05）。结论 针对脑卒中患者实施基于King互动达标理论的康复护理...     

穴位注射鼠神经生长因子结合运动疗法对外伤性截瘫患者运动功能恢复的影响

目的 观察穴位注射鼠神经生长因子结合运动疗法对外伤性截瘫患者运动功能及日常生活能力的影响.方法 按随机数字法将65例患者分为对照组和治疗组,对照组采用系列运动疗法,治疗组采用穴位注射神经生长因子及运动疗法.采用美国脊柱损伤协会（ASIA）运动评分评定截瘫患者功能障碍的程度及运动功能恢复的能力,采用改良Barthel指数评定日常生活活动能力.结果 治疗前2组ASIA运动评分及Barthel指数组间比较差异均无统计学意义（P＞0.05）,治疗3个月时2组ASIA运动评分及Barthel指数均有提高,但治疗组运动功能改善幅度明显优于对照组,差异有统计学意义（P〈0.05）.结论 穴位注射鼠神经生长因子结合运动疗法能显著改善外伤性截瘫患者的运动功能和日常生活活动能力.     

超早期康复护理在脑卒中患者功能恢复中的作用

目的探讨超早期康复护理对脑卒中患者日常生活能力恢复的影响。方法将120例脑卒中患者随机分为对照组和观察组,对照组给予常规护理,观察组在一般药物治疗护理基础上进行超早期综合康复治疗护理。采用自行设计的调查表评价患者对护理质量满意度,采用国际通用量表改良Barthel指数(MBI)、简化Fugl-Meyer运动功能评分量表(FMA)评价患者的运动功能及日常生活能力。结果护理干预后观察组患者对护理满意度为95.00%,明显高于对照组的81.67%,差异有统计学意义(P<0.05);随访4周后,观察组患者的FMA评分及MBI均显著高于对照组,差异有统计学意义(P<0.05)。结论超早期综合康复护理可减少脑卒中患者的残疾发生,能明显改善脑卒中患者偏瘫肢体功能和日常生活活动能力,改善脑卒中后抑郁等不良情绪,值得在临床推广。     

早期康复干预管理模式对急性脑卒中患者神经功能恢复的影响

目的探讨早期康复干预管理模式对急性脑卒中患者神经功能恢复的影响。方法将80例急性脑卒中偏瘫患者随机分成2组,即早期康复干预组40例,患者生命体征平稳48 h即在神经内科病房开始执行康复干预,行床边康复治疗,30 d后转至康复科行常规康复训练30 d;对照组40例,也在神经内科接受神经内科常规治疗及护理,30 d后转至康复科行常规康复训练30 d。所有患者均在生命体征平稳48 h（入选时）及康复系统训练30 d（转到康复科时）及转至康复科30 d给予神经功能评测,即采用简式Fugl—Meyer运动功能评测法及改良Barthel指数（MBI）以评定患者的运动功能及ADL评分。结果两组患者在康复系统训练30和60 d后运动功能及ADL评分均有明显改善,早期康复干预组的治疗效果明显优于对照组（P〈0.01）。结论早期康复干预可促进急性脑卒中患者运动功能的康复,提高日常生活活动能力及生存质量。     

脑卒中患者情感障碍对神经功能及日常生活能力的影响

目的 探讨脑卒中患者情感障碍对神经功能及日常生活能力的影响。方法 对42例脑卒中情感障碍患者入院时及1月后的神经功能缺损评分及日常生活能力（Barthel指数）进行统计，并与对照组进行比较。结果 脑卒中情感障碍患者1月后的神经功能缺损评分及日常生活能力（Barthel指数）与入院时比较均有明显的差异（P〈0．05），而对照组较情感障碍组改善更明显，两组比较均有明显的差异（P〈0．05）。结论 脑卒中并发情感障碍可影响神经功能的恢复，同时降低患者日常生活能力。     

红花黄色素联合康复训练对缺血性脑卒中后轻偏瘫日常生活活动能力的疗效观察

目的 比较红花黄色素联合康复训练与单独康复训练对提高脑卒中后轻偏瘫患者日常生活活动能力的疗效差异.方法 将40例脑卒中患者随机分成2组,治疗组和对照组.治疗组患者每天静滴红花黄色素,并联合现代康复训练治疗患者的偏瘫肢体,训练6 d/周,连续训练2周.对照组仅单独采用现代康复训练治疗.评定患者日常生活活动能力采用改良Barthel指数（BMI）与功能独立性评定（FIM）作为疗效评测工具,分别于治疗前和治疗后2周时进行疗效评估.结果 红花黄色素联合康复训练在提高脑卒中后轻偏瘫患者日常生活活动能力方面,2组间差异具有统计学意义（P〈0.05）.结论 红花黄色素联合康复训练在提高脑卒中后轻偏瘫患者日常生活活动能力方面,其疗效明显优于单独康复治疗.     

镜像训练引导的运动想象疗法对急性缺血性脑卒中偏瘫患者上肢功能的康复效果

目的:本研究旨在对镜像训练引导的运动想象疗法是否能够更有效地改善急性缺血性脑卒中后偏瘫患者的上肢功能以及日常生活能力进行评价。方法:研究对象为2014年1月1日—2016年6月30日符合病例选择标准的76例急性缺血性脑卒中后偏瘫患者。将76例患者随机分入镜像训练引导的运动想象疗法组(38例)和单纯的运动想象疗法组(38例),在常规康复训练的基础上,分别接受镜像训练引导的运动想象疗法和单纯的运动想象疗法,共治疗4周。对2组治疗前后的美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、Barthel指数、上肢动作研究量表(Action Research Arm Test,ARAT)评分和Fugl-Meyer上肢运动功能评分进行比较。结果:2组患者治疗后的NIHSS评分、Barthel指数、ARAT评分和Fugl-Meyer上肢运动功能评分均较治疗前显著改善(P值均0.05)。镜像训练引导的运动想象疗法组治疗后的NIHSS评分、Barthel指数、ARAT评分和Fugl-Meyer上肢运动功能评分的改善幅度均显著大于单纯的运动想象疗法组(P值均0.05)。结论:镜像训练引导的运动想象疗法应用于急性缺血性脑卒中后偏瘫患者上肢功能的康复治疗,与单纯的运动想象疗法相比,可以更好地改善患者的上肢功能和生活自理能力。     

早期康复治疗对急性脑卒中患者运动功能和生活能力的影响

目的探讨早期康复治疗对脑卒中患者运动功能和日常生活活动能力(ADL)的影响。方法将50例脑卒中偏瘫患者随机分成康复组(25例)和对照组(25例)进行临床对照研究,两组均进行常规神经内科药物治疗,康复组加以运动疗法,每例患者入组时、治疗第30d分别用Fugl-Meyer运动功能(FMA)量表测试运动功能和改良Barthel指数量表(MBI)测试ADL。结果MBI值:康复组治疗前、后分别为:20.68±8.98、72.36±17.39,对照组治疗前后分别为:21.24±12.59、51.29±18.52。FMA值:康复组治疗前、后分别为33.84±12.63、68.46±20.45,对照组治疗前、后分别为32.13±11.26、44.25±18.86。康复组和治疗组组间及组内比较差异具有显著统计学意义。结论康复治疗对偏瘫患者运动功能和日常生活活动能力具有良好的促进作用。可明显降低患者的依赖程度,提高其生活质量。     

阶段性责任制护理对卒中患侧肢体功能恢复的影响

目的 探讨阶段性责任制护理对卒中患侧肢体功能恢复的影响。方法 48例卒中偏瘫患者随机分为对照组和试验组,对照组给予常规护理,试验组则由责任护士对患者提供阶段性责任制护理。分别于治疗前、治疗4周后及出院半年后随访时对两组患者进行患肢运动功能和日常活动能力评分,比较两组患者肢体功能恢复情况的差异。结果 试验组患者患肢运动功能和日常活动能力评分明显高于对照组（P =0.03）。结论 阶段性责任制护理对卒中患者患肢功能的恢复有促进作用     

督导员介入在脑卒中偏瘫患者康复护理中的作用

目的探讨康复督导员在脑卒中偏瘫患者康复护理中功能恢复的作用。方法将72例符合入选标准的脑卒中偏瘫患者采用分层随机的方法分为常规护理组(36例)和督导员介入护理组(36例),护理前(0周)、干预护理8周对2组患者由同一康复督导员分别进行偏瘫肢体运动功能、日常生活活动能力和移动能力评定。结果治疗8周后,督导员介入组与常规对照组比较,患侧下肢FMA评分、MBI评分和EMS评分均有明显提高。结论康复督导员在脑卒中偏瘫患者康复护理中能有效提高康复训练及护理效果。     

早期康复治疗对急性脑梗死患者运动、肌痉挛及生活活动能力的影响

目的：应用Fugl-Meyer量表、改良Ashworth量表和简化巴氏指数量表（BI）分别进行评定,探讨早期康复治疗对急性脑梗死偏瘫患者运动功能、肌痉挛及日常生活活动能力（ADL）的影响。方法：选择急性脑梗死偏瘫患者90例,随机分为康复治疗组和对照组。康复治疗组在临床药物治疗的同时进行规范的康复训练,对照组给予临床药物治疗及未经指导的自我锻炼,在患者入组时和30d后分别进行有关的功能评定,评价两组的疗效。结果：治疗前两组的一般资料、运动功能、肌痉挛与ADL的评定差异无统计学意义（P〉0．05）,经30d治疗后,运动能力和BI均有一定程度的改善,改善幅度康复治疗组明显优于对照组（P〈0．05）,肌痉挛评分康复治疗组也明显优于对照组（P〈0．05）。结论：早期康复治疗有助于改善急性脑梗死偏瘫患者的运动、肌痉挛及生活活动能力。     

院外延伸康复护理模式对脑卒中患者的效果

目的研究对于脑卒中患者实施院外延伸康复护理模式的应用效果。方法将我院2014-03—2015-03收治的69例脑卒中患者为对照组,采取常规院内康复指导及功能锻炼,选取2015-05—2016-07收治的69例脑卒中患者为干预组,实施院外延伸康复护理模式,比较2组经护理干预后神经功能、日常活动能力、心理抑郁、生活质量等评分结果。结果出院时2组NIHSS评分结果比较差异无统计学意义(P0.05);出院后6个月、1a后对照组NIHSS神经功能评分均高于干预组(P0.05)。出院后6个月、1a后对照组Barthel指数评分均低于干预组(P0.05)。对照组日常生活质量等指标评分均低于干预组(P0.05)。护理干预后,干预组SDS评分低于对照组(P0.05)。结论院外家庭延伸康复护理指导模式可显著提高脑卒中患者生活质量评分,减轻神经损伤状态,改善患者心理抑郁状态,值得临床应用。     

There's no place like home : an evaluation of early supported discharge for stroke

BACKGROUND AND PURPOSE: Because stroke management is aimed at facilitating community reintegration, it would be logical that the sooner the patient can be discharged home, the sooner reintegration can commence. The purpose of this study was to determine the effectiveness of prompt discharge combined with home rehabilitation on function, community reintegration, and health-related quality of life during the first 3 months after stroke. METHODS: A randomized trial was carried out involving patients who required rehabilitation services and who had a caregiver at home. When medically ready for discharge, persons with stroke were randomized to either the home intervention group (n=58) or the usual care group (n=56). The home group received a 4-week, tailor-made home program of rehabilitation and nursing services; persons randomized to the usual care group received services provided through a variety of mechanisms, depending on institutional, care provider, and personal preference. The main outcome measure was the Physical Health component of the Measuring Outcomes Study Short-Form-36 (SF-36). Associated outcomes measures included the Timed Up & Go (TUG), Barthel Index (BI), the Older Americans Resource Scale for instrumental activities of daily living (OARS-IADL), Reintegration to Normal Living (RNL), and the SF-36 Mental Health component. RESULTS: The total length of stay for the home group was, on average, 10 days, 6 days shorter than that for the usual care group. There were no differences between the 2 groups on the BI or on the TUG at either 1 or 3 months after stroke; however, there was a significantly beneficial impact of the home intervention on IADL and reintegration (RNL). By 3 months after stroke, the home intervention group showed a significantly higher score on the SF-36 Physical Health component than the usual care group. The total number of services received by the home group was actually lower than that received by the usual care group. CONCLUSIONS: Prompt discharge combined with home rehabilitation appeared to translate motor and functional gains that occur through natural recovery and rehabilitation into a greater degree of higher-level function and satisfaction with community reintegration, and these in turn were translated into a better physical health.     

Tele-rehabilitation on independence in activities of daily living after stroke: A Matched Case-Control Study

ObjectivesTo compare independence in activities of daily living (ADLs) in post-acute patients with stroke following tele-rehabilitation and matched in-person controls.Materials and MethodsMatched case-control study. A total of 35 consecutive patients with stroke who followed tele-rehabilitation were compared to 35 historical in-person patients (controls) matched for age, functional independence at admission and time since injury to rehabilitation admission (<60 days). The tele-rehabilitation group was also compared to the complete cohort of historical controls (n=990). Independence in ADLs was assessed using the Functional Independence Measure (FIM) and the Barthel Index (BI). We formally compared FIM and BI gains calculated as discharge score - admission scores, efficiency measured as gains / length of stay and effectiveness defined as (discharge score-admission score)/ (maximum score-admission score). We analyzed the minimal clinically important difference (MCID) for FIM and BI.ResultsThe groups showed no significant differences in type of stroke (ischemic or hemorrhagic), location, severity, age at injury, length of stay, body mass index, diabetes, dyslipidemia, hypertension, aphasia, neglect, affected side of the body, dominance or educational level. The groups showed no significant differences in gains, efficiency nor effectiveness either using FIM or Barthel Index.We identified significant differences in two specific BI items (feeding and transfer) in favor of the in-person group. No differences were observed in the proportion of patients who achieved MCID.ConclusionsNo significant differences were seen between total ADL scores for tele-rehabilitation and in-person rehabilitation. Future research studies should analyze a combined rehabilitation approach that utilizes both models.     

A prospective,randomized, single-blinded trial on the effect of early rehabilitation on daily activities and motor function of patients with hemorrhagic stroke

To investigate whether early rehabilitation has a positive impact on the recovery of the activities of daily living and motor function after intracerebral hemorrhagic stroke, 364 patients with hemorrhagic stroke were selected and randomly divided into a rehabilitation group and a control group. The rehabilitation group underwent a standardized, three-stage rehabilitation program. The control group was treated with standard hospital ward, internal medical intervention. The simplified Fugl-Myere assessment scale (FMA) and Modified Barthel Index (MBI) were administered at various time points. The magnitude of improvement was significantly higher in the rehabilitation group than in the control group for both the FMA (p < 0.05) and MBI scores (p < 0.05). The greatest improvement was observed in the first month post-stroke. Thus, our study shows that early rehabilitation can significantly improve the daily activities and motor functions of patients with stroke.     

Randomized controlled trial of rehabilitation at home after stroke: one-year follow-up of patient outcome, resource use and cost

BACKGROUND AND PURPOSE: This study sought to evaluate early supported discharge and continued rehabilitation at home after stroke, at a minimum of 6 months after the intervention, in terms of patient outcome, resource use and health care cost. METHODS: Eighty-three patients, moderately impaired 5-7 days after acute stroke, were included in a randomized controlled trial, 42 being allocated to the intervention and 41 to routine rehabilitation. One-year follow-up of patient outcome included mortality, motor capacity, dysphasia, activities of daily living, social activities, perceived dysfunction, and self-reported falls. Resource use over 12 months included inpatient hospital care, outpatient health care, use of health-related services, informal care, and cost of health care. RESULTS: On univariate analysis there was no difference in patient outcome. Multivariate regression analysis showed that intervention had a significant effect on independence in activities of daily living. A significant difference in inpatient hospital care, initial and recurrent, was observed, with a mean of 18 (intervention) versus 33 days (control) (p = 0.002). Further significant differences were that the control group registered more outpatient visits to hospital occupational therapists (p = 0.02), private physical therapists (p = 0.03) and day-hospital attendance (p = <0.001), while the intervention group registered more visits to nurses in primary care (p = 0.03) and home rehabilitation (p = <0.001). Other differences in outcomes or resource utilization were nonsignificant. CONCLUSION: In Sweden, early supported discharge with continued rehabilitation at home proved no less beneficial as a rehabilitation service, and provided care and rehabilitation for 5 moderately disabled stroke patients over 12 months after stroke onset for the cost of 4 in routine rehabilitation.