脑卒中患者早期肌力训练的最佳证据总结

目的 筛选国内外脑卒中患者早期肌力训练的相关证据,并对最佳证据进行总结,为制订科学的脑卒中患者早期肌力训练方案提供参考。 方法 系统检索UpToDate、乔安娜布里格斯研究所（Joanna Briggs Institute,JBI）循证卫生保健中心数据库、美国国立指南库、英国国家卫生与临床优化研究所、加拿大安大略注册护士协会、美国危重症护理网、澳大利亚国家脑卒中基金会、Cochrane Library、PubMed、Web of Science、Embase、中国知网、万方数据库、维普数据库和中国生物医学文献数据库等数据库内关于脑卒中患者早期肌力训练的证据,包括指南、系统评价、最佳实践信息册、证据总结、专家共识及原始研究。检索时限为建库至2019年10月30日。由2名研究员对文献质量进行独立评价,并结合专业判断,提取符合标准的文献。 结果 共纳入18篇文献,其中指南5篇,证据总结1篇,系统评价12篇。最佳证据包括评估、干预时机、干预计划、肌力训练干预措施、质量控制、效果评价和经济效益,共总结出28条证据。 结论 本研究总结了脑卒中患者早期肌力训练的最佳证据,为临床医护人员有针对性地开展证据应用提供循证依据。

Summary of the best evidence of early muscle strength training in stroke patients

Objective To collect and summarize the latest relevant evidence of early muscle strength training for stroke patients at home and abroad,so as to provide a reference for the establishment of a scientific program of early muscle strength training after stroke. Methods We systematically searched in UpToDate,Joanna Briggs Institute evidence-based health care center database,National Guideline Clearinghouse,National Institute for Health and Care Excellence,Registered Nurses’ Association of Ontario,American Association of Critical-Care Nurses,National Stroke Foundation of Australia,Cochrane Library,PubMed,Web of Science,Dutch Medical Abstracts database,CNKI,Wanfang database,VIP database and Chinese biomedical literature database for all evidence on early muscle strength training for stroke patients,including guidelines,system reviews,best practice information booklets,evidence summaries,expert consensuses and original research. The retrieval time is from the establishment of the databases to October 30,2019. 2 researchers independently evaluated the quality of literature,and extracted the literature that met the standards with their professional judgment. Results A total of 18 pieces of literature were included,including 5 guidelines,1 evidence summary and 12 systematic reviews. The best evidence includes evaluation,intervention timing,intervention plan,muscle strength training interventions,quality control,effect evaluation and economic benefits. A total of 28 pieces of evidence are summarized. Conclusion We summarized the best evidence of early muscle strength training for stroke patients,and provided evidence-based references for clinical staff to carry out evidence application. It is suggested that the clinical staff should actively carry out the early muscle strength training for stroke patients in combination with the specific situation of the room,the willingness of patients and the evidence of promoting factors,obstacles and coping strategies. At the same time,the evidence should be updated dynamically to ensure the quality.