脑卒中患者居家运动康复的最佳证据总结

Best Evidence Summary of Home-Based Exercise Rehabilitation of Stroke Patients

目的总结脑卒中患者居家运动康复的最佳证据。方法按照“6S”循证资源金字塔证据模型,计算机检索JBI循证卫生保健中心数据库、英国国家临床医学研究所指南库(NICE)、苏格兰学院间指南网(SIGN)、加拿大安大略省注册护士协会(RNAO)网站、国际指南协作网(GIN)、BMJ最佳临床实践网站、UpToDate、Cochrane Library、PubMed、EmBase、CINAHL、Web of Science、医脉通、中国知网、万方数据知识服务平台和中国生物医学文献数据库中脑卒中患者居家运动康复的文献,检索时限从建库至2023年12月。由两名研究人员独立进行文献筛选及内容提取、文献质量评价、证据提取与证据等级评价。结果共纳入文献18篇,包括10篇指南、5篇系统评价、2篇临床决策、1篇专家共识。通过证据提取与整合,最终形成了脑卒中患者居家运动康复的最佳证据,包括组织体系要求、居家运动康复获益、居家运动康复目标、居家运动康复评估、居家运动康复处方、辅助器具的选择、居家运动康复监测与安全保障、居家运动康复维持8个方面,共34条证据。结论本研究总结了脑卒中患者居家运动康复的最佳证据,包括组织体系要求、居家运动康复获益、居家运动康复目标、居家运动康复评估、居家运动康复处方、辅助器具的选择、居家运动康复监测与安全保障、居家运动康复维持,为医护人员制定脑卒中患者居家运动康复方案提供了一定的循证依据。

Objective To summarize the best evidence of home-based exercise rehabilitation of stroke patients.Methods According to the"6S"evidence-based resource pyramid model,the literature on home-based exercise rehabilitation of stroke patients were retrieved from JBI Evidence Based Health Care,National Institute foRHealth and Care Excellence(NICE),Scottish Intercollegiate Guidelines Network(SIGN),Registered Nurses'Association of Ontario(RNAO)website,Guideline International Network(GIN),BMJ Best Practice website,UpToDate,Cochrane Library,PubMed,Embase,CINAHL,Web of Science,Medlive,CNKI,Wanfang Data,China Biology Medicine Literature Database.The search period was from database establishment to DecembeR2023.Two researchers independently selected articles,extracted content,evaluated the quality of the literature,extracted evidence and evaluated the evidence grading.Results A total of 18 articles were included,including 10 guidelines,5 systematic reviews,2 clinical decisions,and 1 expert consensus.Through extracting and integrating evidence,the best evidence of home-based exercise rehabilitation of stroke patients had been formed,which included 34 items in 8 aspects of organizational system requirements,home-based exercise rehabilitation benefits,home-based exercise rehabilitation goals,home-based exercise rehabilitation assessment,home-based exercise rehabilitation prescription,selection of assistive devices,home-based exercise rehabilitation monitoring and safety assurance,and home-based exercise rehabilitation maintenance.Conclusion This study summarizes the best evidence of home-based exercise rehabilitation of stroke patients including 34 items in 8 aspects of organizational system requirements,home-based exercise rehabilitation benefits,home-based exercise rehabilitation goals,home-based exercise rehabilitation assessment,home-based exercise rehabilitation prescription,selection of assistive devices,home-based exercise rehabilitation monitoring and safety assurance,and home-based exercise rehabilitation maintenance,and provides a basis foRmedical staff to make home-based exercise rehabilitation programs in stroke patients.