脑卒中社区康复简易适宜技术在社区脑卒中患者中的应用及效果分析

摘要

目的 应用脑卒中社区康复简易适宜技术指导回归社区的脑卒中存活患者开展康复训练,并评价其应用效果.方法 2008年9月-2009年8月,永外社区卫生服务中心的5名社区医师接受脑卒中社区康复简易适宜技术培训后,社区医师应用简易适宜技术,对辖区内征集的70例脑卒中患者,以8～12人为一组,分7组先后开展为期3个月的集体康复训练和指导,比较康复训练前后患者的运动功能、日常生活活动能力和社会活动能力变化.结果 经过3个月的集体康复训练,入组的70例社区脑卒中患者的简化Fugl-Meyer运动功能量表评分从(51.9±25.0)分提高到(62.1±25.2)分,差异有统计学意义(t=-14.056,P＜0.0001);Barthel指数量表中位数评分从82.5分(25分位分值到75分位分值:70～95分)提高到90.0分(25分位分值到75分位分值:75～100分),差异有统计学意义(Z=-4.728,P＜0.0001);社会功能活动问卷评分从(11.0±7.8)分降低到(9.6±7.4)分,差异有统计学意义(t=4.051,P＜0.0001).结论 符合现代康复理念的脑卒中社区康复简易适宜技术易于社区脑卒中患者掌握,能很好地贯彻到患者的日常生活中,并对患者的生活质量有改善作用.%Objective The study was aimed at directing stroke survivors' rehabilitation practice with appropriate community rehabilitation technologies for stroke survivors in communities and assessing its application effects. Methods Between September 2008 and August 2009, five medical professionals from the Yongwai CCHS had been trained the appropriate technologies of community rehabilitation for stroke survivors. 70 stroke survivors were recruited and divided into 7 groups with 8 ~ 12 patients each. The patients of each group successively and separately joined 3 - month training of collective rehabilitation with the appropriate technologies directed by community medical professionals. The application effects of the appropriate technologies were assessed by changes in motion function, activities of daily living ( ADL ) and social activities before and after practice. Results Through 3 - month rehabilitation training and practice, mean scores of motion function at Fugl - Meyer assessment in 70 recruited patients were improved from ( 51. 9 ±25. 0 ) before practice to ( 62. 1 ± 25. 2 ) after, with significance by paired t - test ( t = - 14. 056, P <0. 0001 ); median scores of ADL at Barthel index were improved from 82. 5 ( IQR: 70 ~ 95 ) before practice to 90.0 ( IQR: 75 ~100) after, with significance by paired Wilcoxon signed - rank test ( Z = -4.728, P < 0.0001 ); mean scores of social activities at Functional Activities Questionnaire ( FAQ ) were decreased from ( 11.0 ±7. 8) before practice to ( 9. 6 ±7. 4 ) after, with significance by paired t -test ( t =4. 051, P <0. 0001 ). Conclusion The appropriate technologies of community rehabilitation for stroke survivors are easy to master. Stroke patients in communities can practice them in the course of their daily life,　and their quality of life can be improved.