综合康复护理对脑卒中足下垂患者跌倒相关危险因素的影响

Effect of comprehensive rehabilitation nursing on fall related factors in stroke patients with foot drop

目的探讨综合康复护理对脑卒中足下垂患者跌倒相关危险因素的影响。方法选取乌鲁木齐市某三甲医院康复医学科脑卒中足下垂住院患者90例,按照入院先后顺序随机分为3组:常规组、情志护理组和综合康复护理组,各30例,分别采用简明国际跌倒效能感量表、Holden步行功能分级、Berg平衡量表及改良Barthel指数评估患者的跌倒效能、步行能力、平衡功能以及日常生活活动能力。结果与干预前比较,3组患者的简明国际跌倒效能感量表得分均降低(P<0.05),综合康复护理组下降程度明显高于常规组及情志护理组,差异有统计学意义(P<0.05);与干预前比较,3组患者的Berg平衡量表及日常生活活动能力评分均提高(P<0.05),综合康复护理组与常规组、情志护理组比较,差异均有统计学意义(P<0.05)。脑卒中足下垂患者平衡功能与步行能力(r=0.851,P<0.01)、日常生活活动能力(r=0.749,P<0.01)均呈正相关(P<0.01)、与跌倒效能得分呈负相关(r=-0.550,P<0.01)。多元线性回归分析显示,步行能力、跌倒效能及日常生活活动能力是脑卒中足下垂患者平衡功能的主要影响因素(P<0.05)。结论综合康复护理能有效改善患者跌倒效能、平衡功能及日常生活活动能力与跌倒相关的危险因素,改善效果优于常规组及情志护理组。

Objective To investigate the effect of comprehensive rehabilitation nursing on fall related risk factors in stroke patients with foot drop.Methods According to the order of admission,90 foot drop inpatients with stroke at hospital in Urumqi were randomly divided into three groups:routine group,emotional nursing group and comprehensive rehabilitation nursing group,with 30 patients in each group.The fall efficacy,walking ability,balance function and activities of daily living were assessed by Short Falls-Efficacy Scale International,Functional Ambulation Category Scale,Berg Balance Scale and Modified Barthel Index respectively.Results Compared with the before intervention,the scores of the fall efficacy in the three groups were all decreased(P<0.05),the degree of decline in the comprehensive rehabilitation nursing group was significantly higher than that in the routine group and emotional nursing group(P<0.05),and the difference was statistically significant.Compared with the before intervention,the Berg Balance Scale and Modified Barthel Index of the patients in the three groups were improved,and the comprehensive rehabilitation nursing group was compared with the routine group and emotional nursing group,the differences were statistically significant(P<0.05).Balance function with walking ability(r=0.851,P<0.01),and activities of daily living(r=0.749,P<0.01)were positively correlated(P<0.01)instroke patients with foot drop,and it was negatively correlated with fall efficacy score(r=-0.550,P<0.01).The results of multiple linear regression analysis showed that walking ability,fall efficacy and activities of daily living were the main influencing factors of balance function in stroke patients with foot drop(P<0.05).ConclusionComprehensive rehabilitation nursing can effectively improve the fall-related factors,including fall efficacy,balance function and activities of daily living in stroke patients with foot drop,and the effect is better than that of routine group and emotional nursing group.