规范三级康复治疗对卒中后遗症期偏瘫患者关节活动度和肢体运动功能的影响

Clinical Study of Effect of Three Stages' Rehabilitation Program on Joint Motion and Limb Motor Function in Stroke Patients with Hemiplegia

目的探讨规范三级康复治疗对卒中后遗症期偏瘫患者关节活动度和下肢运动功能的影响。方法将2011年11月至2013年11月聊城市东昌府人民医院收治的60例脑卒中偏瘫患者按照随机数字表法分为观察组和对照组,各30例。对照组给予常规康复训练,观察组实施规范三级康复治疗。6个月后评价两组患者关节活动度、肢体运动功能和生活质量。结果 6个月后两组患者髋关节、膝关节活动度均显著提高,其中观察组髋关节、膝关节活动度显著高于对照组[(15.4±3.6)°比(12.3±2.4)°、(26.6±3.5)°比(22.0±3.5)°,P<0.01];观察组上肢简式运动功能评分量表(FAM)评分、下肢FAM评分及独立性检测量表(FIM)评分亦显著高于对照组[(26±8)比(22±7)、(27±7)比(22±8)、(58±10)比(44±12),P<0.05或P<0.01]。6个月后观察组患者角色功能、社会功能、身体功能、情绪功能以及总生活质量评分均显著高于对照组[(1.6±0.4)比(0.9±0.4)、(1.07±0.41)比(0.79±0.27)、(1.87±0.21)比(1.55±0.18)、(1.8±0.5)比(1.0±0.3)、(5.0±1.2)比(4.0±1.1),P<0.01]。结论规范三级康复能改善脑卒中偏瘫患者髋关节、膝关节活动度,促进患侧肢体运动功能恢复,提高患者生活质量。

Objeetive To explore the effect of three stages＇ rehabilitation program on the joint motion and motor function in stroke patients with hemiplegia. Methods A total of 60 stroke patients with hemiple- gia admitted to Dongchangfu People＇s Hospital from Nov. 2011 to Nov. 2013 were randomly divided into ob- servation group of 30 cases and control group of 30 cases：the control group was given conventional rehabilita- tion tsaining,and theobservation group received three stages＇ rehabilitation program. After 6 months of reha- bilitation therapy, the joint activities, limb motor function and quality of life of the two groups were compared. Results After rehabilitation, the hip, knee joint activity of both groups increased, while the observation group＇ s performance was significantly higher than the control group [ （ 15.4 ± 3.6） vs （ 12.3 ± 2.4）, （26. 6 ± 3.5 ） vs （22. 0 ± 3.5）, P 〈 0.01 ] ; upper limb FAM score, lower limb FAM score, FIM score of the observation group were significantly higher than the control group [ （26 ± 8 ） vs （ 22 ± 7 ）, （ 27 ± 7 ） vs （ 22 ± 8 ）, （58 ± 10 ） vs （44 ± 12 ）, P 〈 0.05 or P 〈 0.01 ]. After the rehabilitation, the role function, social function, physical function, emotional function and the total score of life quality of the observation group were significantly high- er than that of the control group[ （1.6 ±0.4） vs （0.9 ±0.4） ,（1.07 ±0.41） vs （0.79 ±0.27） ,（1.87 ± 0.21） vs （1.55±0.18）,（1.8 ±0.5） vs （1.0±0.3）,（5.0±1.2） vs （4.0±1.1）,P〈0. 01].Con- dusion Three stages＇ rehabilitation program can improve hip,knee joint activities,promotion body function restoration of the stroke hemiplegia patients,thus improve patients＇ life quality.