综合性康复指导对老年人脑卒中偏瘫患者日常生活活动能力及骨密度水平的影响

EFFECTS OF COMPREHENSIVE REHABILITATION DIRECTION ON ACTIVITIES OF DAILY LIVING AND BONE MINERAL DENSITY OF SENILE STROKE PATIENTS WITH HEMIPLEGIA

目的探讨综合性康复指导对老年人脑卒中偏瘫患者日常生活活动能力(activities of daily living,ADL)及骨密度(BMD)水平的影响。方法选择60～75岁老年脑卒中偏瘫患者76例,其中,接受综合性康复指导者46例,未接受综合性康复指导者30例,以及老年健康体检者(正常对照组)50例,使用日常生活活动能力量表(barthel index,BI)评价二组脑卒中偏瘫患者入组时及病程1年时日常生活活动能力,使用法国生产的UBIS5000型定量超声骨密度仪测定老年健康体检者及二组脑卒中偏瘫患者病程1年时跟骨骨密度同性别骨峰对照值(T值:T-score),统计骨量减少及骨质疏松发生率,然后进行相关性分析。结果①综合性康复指导组病程1年时日常生活活动能力量表评分明显优于未接受康复指导组,差异有统计学意义(P<0.05)。②综合性康复指导组病程1年时骨密度水平明显高于未接受康复指导组,差异有统计学意义(P<0.05)。③与正常对照组比较:综合性康复指导组病程1年时骨密度水平无明显下降,差异无统计学意义(P>0.05);未接受康复指导组病程1年时骨密度水平明显下降,差异有统计学意义(P<0.01)。结论综合性康复指导可明显改善老年人脑卒中偏瘫患者日常生活活动能力及骨密度下降水平,提高老年偏瘫患者生活质量。

Objective To study the effects of comprehensive rehabilitation direction on activities oi daily Irving and bone mineral density of senile strola pationts with hemiplegia. Methods Total 76 patients aged 60-75 with hemiplegia were enrolled, among whom 46 were provided with comprehensive rehabilitation and 30 were not while a team of 30 seniles for routine health care was studied as controls. Barthel index scale was used to evaluate the activities of daily living in the two groups of hemiplegic patients at the time of enrollment and 1 year after onset of stroke. Bone mineral density same sex peak bone match（T - score）, bone mass and osteoporosis in calcaneus bone were measured by France - made UBIS 5000 ultrasonic in both study and match groups at time of 1 year after onset of stroke followed by a relevant analysis. Results ①A notable elevation in ADL scale was found in therapy group compared with that of nontherapy group 1 year after onset（P〈0.05）.②BMD level in therapy group showed remarkably increase compared with that in nontherapy group （P〈0. 05）.③BMD level in therapy group measured 1 year after onset revealed had no significant decrease compared with that in controls; while that in non- therapy group showed significant decrease compared with that in control. Conclusion Comprehensive rehabilitation direction may greatly improve activities of daily living and bone mineral density in senile stroke patients with hemiplegia, and therefore improve the living quality of theirs.