基于PSM分析作业疗法系统训练联合强制性运动疗法对脑卒中患者肢体运动康复治疗的效果评价

Evaluation of effect of PSM-based analysis of systematic training of occupational therapy combined with compulsory exercise therapy on limb movement rehabilitation of stroke patients

目的探讨作业疗法系统训练联合强制性运动疗法应用于脑卒中患者中的效果,分析其应用价值。方法选取138例脑卒中患者为研究对象,均于2020年1月—2023年1月期间被河南省直第三人民医院收治。将受试者随机均分为对照组和观察组。基于PSM对两组患者一般资料进行匹配,得到52对组间协变量均衡的样本。对照组给予常规康复训练结合强制性运动疗法,观察组在对照组基础上给予作业疗法系统训练。比较两组干预前及治疗3个月后运动Fugl-Meyer运动功能评分法(fugl-meyer motor function scale,FMA)评分、蒙特利尔认知评估量表(montreal cognitive assessment scale,MoCA)评分、美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)及生活质量。结果PSM后,与治疗前相比,两组患者上下肢FMA、总FMA、MoCA、SF-36量表中各维度评分水平更高(P<0.05);与对照组相比,观察组患者上下肢FMA、总FMA、MoCA、SF-36量表中各维度评分水平更高(P<0.05)。观察组患者MoCA评分≥26分的占比高于对照组,差异有统计学意义(P<0.05)。与治疗前相比,两组患者NIHSS评分更低(P<0.05);与对照组相比,观察组患者NIHSS评分更低(P<0.05)。结论在强制性运动疗法的基础上给予作业疗法系统训练可有效改善脑卒中患者肢体运动康复,提高生活质量、认知功能及神经功能。

Objective To explore the effect of occupational therapy system training combined with compulsory exercise therapy in stroke patients and analyze its application value.Methods A total of 138 stroke patients admitted to the Third People's Hospital of Henan Province from January 2020 to January 2023 were selected as the study objects.The subjects were randomly divided into control group and observation group.Based on PSM,the general data of the two groups were matched,and 52 pairs of covariate balanced samples were obtained.The control group was given routine rehabilitation training combined with compulsory exercise therapy,and the observation group was given systematic training of occupational therapy based on the control group.Fugl-meyer motor function scale(FMA)score,montreal cognitive assessment scale(MoCA)score,national institutes of health stroke scale(NIHSS)score and quality of life were compared between the two groups before intervention and 3 months after treatment.Results After PSM,compared with before treatment,the scores of FMA,total FMA,MoCA and SF-36 scales in both groups were higher(P<0.05).Compared with the control group,the scores of FMA,total FMA,MoCA and SF-36 scales in the upper and lower limbs in the observation group were higher(P<0.05).The proportion of MoCA score≥26 points in observation group was higher than that in control group,and the difference was statistically significant(P<0.05).Compared with before treatment,the NIHSS score in two groups was lower(P<0.05).The NIHSS score of observation group was lower than that of control group(P<0.05).Conclusion Occupational therapy system training on the basis of compulsory exercise therapy can effectively improve the limb movement rehabilitation of stroke patients,improve the quality of life,cognitive function and neurological function.