层级运动疗法联合推拿对老年脑卒中患者心理状态、肢体功能的影响

Effects of hierarc hical exercise therapy in combination with Tuina on psychological state and limb function of elderly stroke patients

目的探析层级运动疗法联合推拿对老年脑卒中患者心理状态、肢体功能的影响。方法选取2020年6月—2021年6月南阳市某医院收治的96例老年脑卒中患者为研究对象,采用随机数字表法分为对照组(n=50)和研究组(n=46)。对照组患者给予常规护理结合推拿干预,研究组患者在对照组基础上加用层级运动疗法,2组患者均持续干预1个月。比较2组患者临床护理效果及护理前后汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分、肢体功能FuglMeyer运动功能(FMA)评分、Berg平衡量表(BBS)评分、Barthel指数以及运动诱发电位(MEP)的变化情况。结果护理后,2组患者FMA评分、BBS评分均高于护理前,且研究组高于对照组,差异均有统计学意义(P<0.05)。护理后,2组患者MEP波幅大于护理前且研究组大于对照组,MEP潜伏期短于护理前且研究组短于对照组,差异均有统计学意义(P<0.05)。护理后,2组患者HAMA评分、HAMD评分均低于护理前,且研究组低于对照组,差异均有统计学意义(P<0.05)。护理后,2组患者脑卒中专用生活质量量表(SS-QOL)评分、Barthel评分均高于护理前,且研究组高于对照组,差异均有统计学意义(P<0.05)。结论层级运动疗法联合推拿可有效改善老年脑卒中患者的肢体功能与心理状态,提高患者生活质量,可在临床上推广使用。

Objective To explore the effects of hierarchical exercise therapy combined with Tuina on the psychological state and limb function of elderly stroke patients.Methods A total of 96 elderly stroke patients admitted to a hospital in Nanyang from June 2020 to June 2021 were selected as subjects,who were assigned to a control group(n=50)and a study group(n=46)using the random number table method.Patients in the control group received conventional care in combination with Tuina intervention,while patients in the study group used hierarchical exercise therapy in addition to the care in the control group,and both groups continued the intervention for one month.The clinical nursing effect and the changes of psychological state and limb function before and after the nursing were compared between the 2 groups of patients.Results The FMA scores and BBS scores of patients in the 2 groups after nursing were higher than those before care,with the study group higher than the control group,and the differences were statistically significant(P<0.05).The MEP wave amplitude after nursing was longer in the 2 groups than before nursing,with the study group longer than the control group,and MEP latency was shorter than before nursing,with the study group shorter than the control group,and the differences were statistically significant(P<0.05).After nursing,the HAMA and HAMD scores of the two groups were lower than before nursing,with the study group lower than the control group,and the difference was statistically significant(P<0.05).After nursing,SS-QOL and Barthel scores of patients in the 2 groups were higher than those before nursing,with the study group higher than the control group,and the difference was statistically significant(P<0.05).Conclusion Hierarchical exercise therapy in combination with Tuina can effectively improve the physical function,psychological state and quality of life of elderly stroke patients.These benefits justify a wider application of this nursing in clinical practice.