职业能力训练与评估系统对上肢损伤工伤患者的疗效

Effects of Baltimore Therapeutic Equipment on Traumatic Upper Extremity Injury from Work

目的将职业能力训练与评估系统(BTE)应用于上肢损伤工伤患者的康复,观察其疗效。方法 2014年9月至2015年8月住院接受康复治疗的手或上肢损伤患者为对照组(n=42),2015年9月至2016年8月住院接受康复治疗患者为实验组(n=36)。在常规康复治疗的基础上,对照组接受常规模拟训练,实验组接受BTE模拟训练,共4周。训练前后采用BTE测试患者立位双肘提举力、蹲位提举力、动态搬运至腰部、动态搬运至肩部、患手握力、健手握力,采用上肢功能障碍评定量表(DASH)进行评定;出院半年后,电话随访患者复工状态。结果治疗后,实验组较对照组立位双肘提举力(t=4.290,P<0.001)、蹲位提举力(t=2.645,P=0.010)、动态搬运至腰部(t=2.639,P=0.010)、动态搬运至肩部(t=5.361,P<0.001)、患侧握力(t=2.320,P=0.023)、健侧握力(t=3.130,P=0.002)均增强,两组DASH评分(t=-0.851,P=0.398)和复工状态(χ~2=0.05,P=0.944)无显著性差异。结论 BTE能有效改善上肢损伤工伤患者的功能状态。但需更多关注其他因素对患者复工的影响。

Objective To apply the Baltimore Therapeutic Equipment(BTE), a kind of vocational training and evaluation system, in rehabilitaion of patients post traumatic upper extremity injury from work, and to observe the effects.Methods Inpatients from September, 2014 to August, 2015 for rehabilitation of traumatic upper extremity injury from work were selected as control group(n=42), and inpatients from September, 2015 to August, 2016 were selected as intervention group(n=36). Both groups received routine rehabilitation, while the control group received conventional work simulation training, and the intervention group received work simulation training with BTE, for four weeks. They were measured the standing lifting strength(elbow), squatting lifting strength, dynamic lifting strength(floor to waist), dynamic lifting strength(floor to shoulder), and grip strength of the injured hand and the healthy hand with BTE, before and after rehabilitation; while they were assessed with Disability of Arm Shoulder and Hand(DASH). The incidence of return to work was investigated at six months of follow-up.Results The standing lifting strength(elbow)(t=4.290, P<0.001), squatting lifting strength(t=2.645, P=0.010), dynamic lifting strength(floor to waist)(t=2.639, P=0.010), dynamic lifting strength(floor to shoulder)(t=5.361, P<0.001), and grip strength of the injured hand(t=2.320, P=0.023) and the healthy hand(t=3.130, P=0.002) improved better in the intervention group than in the control group after rehabilitation. However, there was no significant difference between two groups in score of DASH(t=-0.851, P=0.398), as well as incidence of return towork(χ~2=0.05, P=0.944).Conclusion BTE may help to improve the body function in patients post traumatic upper extremity injury from work.However, vocational rehabilitation should focus on the factors other than body function, to improve their return to work.