站立桌辅助上肢作业治疗对脑梗死患者活动功能的影响

摘要

目的:研究站立桌辅助下的上肢作业治疗对脑梗死偏瘫患者功能活动的影响,探讨更为积极的上肢作业治疗模式.方法:选择60例脑梗死偏瘫伴有上肢功能障碍,能维持静态站立≥30 min的患者,将其按数表法随机分为观察组和对照组,每组30例.观察组在常规康复治疗的基础上采用自行研制的站立桌辅助患者站立位上肢作业功能训练;对照组采取传统的坐位下上肢作业功能训练.比较两组患者治疗前及治疗2周和4周上肢运动功能(FMA)、平衡功能(BBS)和日常生活活动(ADL)能力恢复情况.结果:①对照组治疗2周后仅ADL评分与治疗前比较,差异有统计学意义(t=4.712,P<0.05),而FMA、BBS评分均无差异;治疗4周后FMA、BBS和ADL评分与治疗前比较,差异有统计学意义(t=4.376,t=5.832, t=5.812;P<0.05).②观察组治疗2周后FMA、BBS和ADL评分与治疗前比较,差异有统计学意义(t=2.496,t=5.945, t=4.945;P<0.05),治疗4周后FMA、BBS和ADL评分与治疗前比较,差异有统计学意义(t=5.172,t=7.123,t=6.123;P<0.05),ADL评分均比对照组改善明显.③治疗2周后两组FMA、BBS和ADL评分比较差异有统计学意义(t=2.458, t=6.778,t=2.010;P<0.05);治疗4周后两组FMA、BBS和ADL评分比较差异有统计学意义(t=2.411,t=5.871, t=4.276;P<0.05).结论:站立桌辅助患者站立位上肢作业功能训练与传统坐位下上肢作业功能训练相比,上下肢一体化的上肢作业治疗模式能提高平衡能力及日常生活能力,改善患者上肢的运动功能.%Objective: To explore the effect of standing desk assisted upper limb occupational therapy on the active function of patients with cerebral infarction, and discuss a more positive therapeutic mode for upper limb occupational therapy. Methods: 60 patients with hemiplegia resulting from cerebral infarction companying with dysfunction of upper limb who can keep standing in static state over 30 min at least were divided into observation group (n=30 cases) and control group (n=30 cases). The patients of the observation group were treated with self-developed standing desk assisting to the training of upper limb occupational function of patient at erect position on the basis of routine rehabilitation, while patients of the control group only were treated with conventional upper limb occupational function on sitting position. And then, the recovery situations of Fugl-Meyer motor assessment (FMA), Berg Balance Scale (BBS) and daily living activity (ADL) of the patients among pretreatment and 2weeks, 4 weeks post-treatment were compared and analyzed. Result: In control group, only the difference of ADL score between pretreatment and 2 weeks post treatment was significant (t=4.712, P<0.05), and the differences of FMA, BBS and ADL between pretreatment and 4 weeks post treatment were significant (t=4.376, t=5.832, t=5.812; P<0.05), respectively. In the observation group,the differences of FMA, BBS and ADL between pretreatment and 2 weeks post treatment were significant (t=2.496, t=5.945, t=4.945, P<0.05), respectively, and the differences of FMA, BBS and ADL between pretreatment and 4 weeks post treatment still were significant (t=5.172, t=7.123, t=6.123; P<0.05), respectively. These results indicated that ADL has been obviously improved than previous situation. Besides, the differences of FMA, BBS and ADL at 2 weeks post treatment between two group were significant (t=2.458, t=6.778, t=2.010; P<0.05), respectively. Similarly,the differences of FMA, BBS and ADL at 4 weeks post treatment between two group still were significant (t=2.411,t=5.871, t=4.276; P<0.05), respectively. Conclusion: Compared to the traditional training of upper limb occupational function on sitting positions, the integrated upper and lower limb treatment modes can enhance the balanced capacity and activity of daily living, and significantly improve motor function of upper limb for patients with hemiplegia resulting from cerebral infarction.