The Promoting Role of TCM Nursing in the Rehabilitation of Stroke Hemiplegia Patients

Objective: To explore the promoting function of TCM nursing in the rehabilitation of hemiplegia patients with stroke. Methods: 78 stroke hemiplegic patients admitted from April 2022 to April 2024 were randomly divided into a control group of 38 cases who received routine care, and an experimental group of 40 cases who received routine nursing basis plus traditional Chinese medicine nursing;the nursing effects of the two groups of patients were compared. Results: After 12 days of nursing care, the experimental group showed better psychological status [SAS score (21.71 ± 3.21), SDS score (22.18 ± 2.31)], limb motor function, daily living ability, and neurological function [NIHSS score (12.23 ± 2.21)] than the control group, with significant differences in data (P Conclusion: Traditional Chinese medicine nursing for stroke hemiplegia patients is more conducive to promoting rehabilitation than routine nursing.

Acupoint electrogymnastics therapy in stroke hemiplegia

BACKGROUND： Electrogymnastics can offer a range of proprioceptive, motor, and cutaneous sensation impulses to the central nerve system. The center receives perception of the paralyzed muscle through the aid of these impulses. During this process, functional reorganization of connecting network between segment and intersegment takes place. OBJECTIVE： To observe the therapeutic efficacy of acupoint electrogymnastics and traditional electroacupuncture on stroke hemiplegia. DESIGN, TIME AND SETTING： A multicenter, randomized, controlled, blinded, clinical study was performed at the College of Acu-moxibustion and Massage in Shanghai University of Traditional Chinese Medicine from May 2004 to September 2006. PARTICIPANTS： A total of 153 patients suffering from stroke hemiplegia, comprising 83 males and 70 females, aged 63-70 years, were admitted to outpatient and inpatient at LongHua Hospital Affiliated Shanghai University of Traditional Chinese medicine, Putuo District Traditional Chinese Medicine Hospital and Changqiao Street Community Health Service Center of Shanghai. METHODS： The patients were randomly divided into treatment （n = 77） and control （n = 76） groups. They were treated with acupoint electrogymnastics and traditional electroacupuncture, respectively. In the treatment group, two pairs of positive and negative JD-2008 type electrodes from a hemiplegia treatment apparatus were directly pasted on the Shousanli （LI 10） and Waiguan （SJ5） acupoints of the upper limb, as well as the Zusanli （S36） and Yanglingquan （GB34） acupoints of the lower limb, respectively. In the control group, needles were consecutively inserted into the above acupoints. Using the method of lifting-inserting and twisting-rotating, the needle was manipulated with small amplitude of 5-7 mm and a fast frequency of 80-120 times/min when the needle was inserted to a suitable depth. When the sensation of needling was attained, the two pairs of positive and negative electrodes of type G6805-Ⅱelectro-acupuncture apparatus were connected to the Shousanli （LI 10） and Waiguan （SJ5） acupoints of the upper limb, as well as the Zusanli （S36） and Yanglingquan（GB 34） acupoints of the lower limb, respectively. MAIN OUTCOME MEASURES： The Fugl-Meyer evaluation method was used to assess upper limb movement, lower limb movement, sensory stimulation of all limbs, balance, and joint range of motion. RESULTS： Upper-lower limb motor function, limb sensory function, balance, and joint range of motion were significantly ameliorated following treatment, compared with pre-treatment （P 〈0.01）. There was no significant difference in various indexes between the two groups after treatment （P 〉0.05）. CONCLUSION： Acupoint electrogymnastics and traditional electroacupuncture exhibited similar curative effects in the treatment of stroke hemiplegia.

Application of cross-migration theory in limb rehabilitation of stroke patients with hemiplegia

BACKGROUND Stroke is a common cause of neurological dysfunction,often resulting in hemiplegia.Thus,rehabilitation of limb function in stroke patients is an important step towards accelerating recovery and improving quality of life.AIM To investigate whether unilateral strength training in hemiplegic stroke patients could lead to cross-migration,an increase in bilateral muscle strength,and an improvement in lower limb motor function.METHODS We randomly divided 120 patients with hemiplegic stroke into two groups:Eexperimental and control groups,with 60 patients in each group.Both groups received routine rehabilitation treatment,while the experimental group additional-ly received ankle dorsiflexion resistance training on the healthy side for 6 wk.We measured the maximum voluntary contract(MVC),changes in surface electromyography(EMG),and the lower limb motor function using the simplified Fugl Meyer Motor Function Assessment Scale(FMA)before and within 1 wk after training.RESULTS The FMA score in the experimental group improved significantly compared to both their pre-training score and the control group's post-training score(P<0.05).The integrated EMG of the anterior tibialis muscle and pulmonary intestine muscle in the experimental group were significantly different after training than before(P<0.05).Furthermore,the MVC of the anterior tibialis muscle on both the healthy and affected sides and the MVC of the pulmonary intestine muscle on both sides showed significant improvement compared with before training and the control group(P<0.05).CONCLUSION Our findings suggest that ankle dorsiflexion resistance training on the healthy side in hemiplegic stroke patients can increase strength in the opposite tibialis anterior muscle and antagonist's muscle,indicating a cross-migration phenomenon of strength training.Furthermore,this type of training can also improve lower limb motor function,providing a new exercise method for improving early ankle dorsiflexion dysfunction.

Contralateral needling at unblocked collaterals for hemiplegia following acute ischemic stroke

Hemiplegia caused by stroke indicates dysfunction of the network between the brain and limbs, namely collateral shock in the brain. Contralateral needling is the insertion of needles into acupoints on the relative healthy side of the body to treat diseases such as apoplexy. However, there is little well-designed and controlled clinical evidence for this practice. This study investigated whether contralateral needling could treat hemiplegia after acute ischemic stroke in 106 randomly selected patients with acute ischemic stroke. These patients were randomly assigned to three groups： 45 in the contralateral needling group, receiving acupuncture on the unaffected limbs; 45 in the conven- tional acupuncture group, receiving acupuncture on the hemiplegic limbs; and 16 in the control group, receiving routine treatments without acupuncture. Acupuncture at acupoints Chize （LU5） in the upper limb and Jianliao （TEl4） in the lower limb was performed for 45 minutes daily for 30 consecutive days. The therapeutic effective rate, Neurological Deficit Score, Modified Barthel Index and FugI-Meyer Assessment were evaluated. The therapeutic effective rate of contralateral nee- dling was higher than that of conventional acupuncture （46.67% vs. 31.11%, P 〈 0.05）. The neuro- logical deficit score of contralateral needling was significantly decreased compared with conven- tional acupuncture （P 〈 0.01）. The Modified Barthel Index and FugI-Meyer Assessment score of contralateral needling increased more significantly than those of conventional acupuncture （both P 〈 0.01）. The present findings suggest that contralateral needling unblocks collaterals and might be more effective than conventional acupuncture in the treatment of hemiplegia following acute ischemic stroke.

Scalp-cluster acupuncture with electrical stimulation can improve motor and living ability in convalescent patients with post-stroke hemiplegia

OBJECTIVE: To determine whether patients with post-stroke hemiplegia could benefit from long-term treatment with scalp cluster(SC) acupuncture combined with electrical stimulation(ES)and to evaluate the feasibility of this treatment to improve motor and living abilities.METHODS: Twenty patients were enrolled and divided into two groups: SC acupuncture and SC acupuncture with ES(SC and SC + ES, respectively). All participants also received rehabilitation training.All participants were blindly evaluated using the Fugl-Meyer assessment scale for motor ability, the modified Barthel Index for living ability, and a scale for the degree of neurological deficits. Outcome was assessed at three points before randomized grouping, at the beginning or treatment, and after4 weeks of treatment.RESULTS: Following 4 weeks treatment, all the patients exhibited significant improvements in aspects of motor ability, living ability, and the severity of neurological deficits. The experimental group(SC + ES) scored higher on the Fugl-Meyer assessment scale(68 ± 12) and the modified Barthel Index(49 ± 9) than the control(SC) group(50 ± 13,36 ± 13, respectively).CONCLUSION: When patients with post-stroke hemiplegia are treated using SC acupuncture with ES, motor and living ability can improve more than if they were treated with SC acupuncture alone.

Effect of Combined Jin's Three-needle and Rehabilitation Care on Post-stroke Hemiplegia

Objective:To observe and compare the efficacy differences between combined Jin's three-needle and rehabilitation training and rehabilitation training alone for hemiplegia following an ischemic stroke. Methods:A total of 94 cases who met the inclusion criteria were randomized into an observation group using combined Jin's three-needle and rehabilitation training and a control group using rehabilitation training alone. The therapeutic efficacies were then assessed respectively before treatment, 14 d and 28 d after treatment using neurological deficient scale (NDS) and short-form Fugl-Meyer assessment (SFFMA) scale. Results:After treatment, the NDS and SFFMA scores in both groups were significantly improved (P<0.05); after 28-day treatment, the inter-group comparison showed a statistical significance (P<0.05). Conclusion:Combined Jin's three-needle and rehabilitation training and rehabilitation training alone can both enhance the nerve function recovery of patients with post-stroke hemiplegia and improve their motor function; however, the former could obtain better effects than the latter.

Effect of Needle-retaining Time on Therapeutic Efficacy for Post-stroke Hemiplegia

Objective:To observe the effect of needle-retaining time in scalp acupuncture on therapeutic efficacy for post-stroke hemiplegia. Methods:A total of 82 cases who met the inclusion criteria were randomly allocated into a control group (22 cases), a short-time needle- retaining group (30 cases) and a long-time needle-retaining group (30 cases). Conventional Bobath therapy was employed in the control group while the scalp acupuncture was combined in the short-time (0.5 h) needle-retaining group and long-time (24 h) needle-retaining group. Then functional assessments were made 1 month and 3 months after treatment using Fugl-Meyer motor scale (FMMS), Fugl-Meyer assessment of balance (FMA-B) and modified Barthel index (MBI) score. Results:Cases in the long-time needle-retaining group obtained better effects in motor function of the limbs and activities of daily living (ADL) than the other two groups (P<0.05). In addition, there was no statistical significance between the short-time needle-retaining group and the control group (P>0.05). Conclusion:The needle-retaining time in scalp acupuncture is substantially associated with the effect for post-stroke hemiplegia and long-time needle-retaining is more advisable.

Immediate effects of scalp acupuncture with twirling reinforcing manipulation on hemiplegia following acute ischemic stroke: a hidden association study

Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle tension in the upper and lower limbs, reflected by the variation in the Hmax/Mmax ratio, is crucial for recovery of motor function from hemiplegia.

Effects of Progressive Muscle Relaxation Training Combined with Emotion Nursing of Traditional Chinese Medicine on Motor Function and Quality of Life in Patients with Cerebral Stroke Complicated with Hemiplegia

OBJECTIVE: To explore the effects of progressive muscle relaxation training combined with emotion nursing of traditional Chinese medicine(TCM) on the motor function and quality of life in patients with cerebral stroke complicated with hemiplegia. METHODS: A total of 100 cases of patients with cerebral stroke complicated with hemiplegia who were admitted to Rehabilitation Medicine Department of Suzhou Municipal Hospital from May 2016 to May 2017 were selected and randomly divided into study group(50 cases) and control group(50 cases), and they were nursed for 1 month. Control group was given routine nursing, and study group was given progressive muscle relaxation training combined with TCM emotion nursing on the basis of routine nursing. The scores of all items were obtained by nurses through questionnaires, and the motor function and quality of life were analyzed and compared between the 2 groups. RESULTS: After nursing, the scores of muscle strength, Barthel index(BI) and Fugl-Meyer motor function scales in study group were higher than those in control group(P < 0.05). The facing scores of coping style in study group were higher than those in control group, and the avoidance score and yielding score were lower than those in control group(P < 0.05). The scores of depression and anxiety in study group were lower than those in control group(P < 0.05). The scores of items in SF-36 life scale in study group were higher than those in control group(P < 0.05). CONCLUSION: Progressive muscle relaxation training combined with TCM emotion nursing is conducive to the recovery of motor function and improvement of quality of life in patients with cerebral stroke complicated with hemiplegia.

Effect of six-month standardized tertiary rehabilitation program on the activities of daily living in stroke patients with hemiplegia

BACKGROUND： At present, there are many studies on the rehabilitation therapy of stroke patients with hemiplegia, but there is deficiency of corresponding standardized rehabilitation program. OBJECTIVE： To explore the effects of standardized tertiary rehabilitation on the activities of daily living in stroke patients with hemiplegia within 6 months after attack. DESIGN： A clinical observation. SETTING： Department of Rehabilitation Medicine, Huashan Hospital of Fudan University. PARTICIPANTS： Eighty-two outpatients and inpatients with acute stroke were selected from the Department of Neurology, Shanghai Huashan Hosptial from January 1999 to June 2003, including 49 males and 33 females, 40 - 80 years of age, with a mean age of （65 ±11） years old. Inclusive criteria： According to the diagnostic standards for cerebrovascular diseases set by Fourth National Academic Meeting for Cerebrovascular Disease in 1995, the patients were diagnosed as new attack of cerebral infarction or cerebral hemorrhage, and confirmed by CT or MRI to be initial patients; They should be accorded with the following conditions, including within 1 week after stabilization of life signs, Glasgow coma score 〉 8 points, 40 - 80 years of age, with disturbance of limb function. Informed consents were obtained from all the patients or their relatives. Exclusive criteria： Patients were excluded due to active liver disease, liver and kidney malfunction, congestive heart failure, malignant tumor, history of dementia, failure in respiratory function, tetraplegia; cerebral infarction or cerebral hemorrhage for more than 3 weeks; unable to be followed up due to in other cities and provinces; psychiatric history; deafness and muteness. According to the will of the patients or their relatives, the patients who accepted the standardized rehabilitation program were enrolled as the treatment group （n =42）, and the others as the control group （n =40）. Approval was obtained from the ethical committee of the hospital. METHODS： All the patients were given routine therapies of internal medicine after admission. According to the conditions of Brunnstom recovery 6-phase evaluation, the patients in the treatment group were trained with the pre-designed comprehensive standardized rehabilitation program for corresponding period. At early period （within about 1 month after attack）, the patients received rehabilitative interventions in the Department of Emergency or Department of Neurology, once a day, 45 minutes for each time, 5 times a week; At middle period （about 1 - 3 months after attack）, the patients received rehabilitative interventions in the rehabilitation ward or center, once to twice a day, 30 - 45 minutes for each time, 4 - 5 days a week; At late period （about 3 - 6 months after attack）, the patients received rehabilitative intervention mainly assisted by rehabilitation physician in the community, relatives and volunteers, 3 - 4 times a week, and they were followed in the house or outpatient department once every two weeks. MAIN OUTCOME MEASURES： The patients were evaluated blindly by the same rehabilitation physician using scale of modified Barthel index at admission and 1, 3 and 6 months after attack respectively. RESULTS： Totally 82 patients with acute stroke were enrolled, and 3 cases in the treatment group missed, including 2 cases died at 1 month after admission, and 1 case refused the follow up l0 days later, all the others were involved in the analysis of results. The scores of modified Barthel index at corresponding time points after admission in the treatment group were all obviously higher than those in the control group （P 〈 0,01）, and the score differences were also obviously higher than those in the control group （P 〈 0,01）. The activities of daily living at admission and 1, 3 and 6 months after admission in the treatment group were 22,50%, 46.43%, 75,95% and 89,52% of that of normal people respectively, and those in the control group were 17.09%, 25,77%, 43,38% and 55,00% respectively, The activities of daily Diving at admission and 1, 3 and 6 months in the treatment group were 131.66%, 180.17%, 175.08% and 162.76% of those in the controlgroup. As compared with at admission, the percentage of the score difference to the total score at the ends of the 1^st, 3^rd and 6^th months were 23.93%, 53.45% and 67.02% in the treatment group, while 8.67%, 25.36% and 36.98% in the control group. CONCLUSION： Standardized tertiary rehabilitation can obviously promote the activities of daily living in stroke patients with hemiplegia.

Influence of early rehabilitation intervention on motor function of acute stroke patients with severe hemiplegia

Objective To observe influence of early rehabilitation intervention on motor function of acute stroke patients with severe hemiplegia.Method We evaluate 58 cases of acute stroke with severe hemiplegia with FMA method and Barthel index, observe influence of early rehabilitation intervention on recovery of motor function.Result Motor function after treatment was promoted apparently compared with control group(P< 0.05).Conclusion Early rehabilitation intervention can promote motor function recovery of acute stroke patients with severe hemiplegia.

Alternation in F-wave parameters of median nerve from unaffected extremity in stroke patients with hemiplegia under dynamic state

BACKGROUND: For many years, the extremities of stroke patients are divided into affected side and unaffected side according to clinical symptoms and body signs. Moreover, previous rehabilitation function training is developed simply aiming to the dysfunction manifested by unaffected extremity. Problems of unaffected extremity are always ignored, such as left- and right- side connection dysfunction, abnormal muscular tension of unaffected side and so on. OBJECTIVE: To observe neurophysiological change characteristics of unaffected extremity of stroke patients with hemiplegia by electromyographical method. DESIGN: Case-control observation. SETTING: First Hospital, Jilin University. PARTICIPANTS: Eighty stroke patients with hemiplegia confirmed by skull CT or MRI, who firstly hospitalized in the Department of Neurology, First Hospital, Jilin University between July 2004 and March 2005, were retrieved. They were scored > 8 points in Glasgow Coma Scale and had stable vital sign. Nineteen normal persons who received healthy examination in the clinic were involved in normal control group. Following the classification criteria of Brunnstrom's Recovery Stages of Stroke (BRSS), 80 stroke patients with hemiplegia were assigned into 3 groups: BRSS Ⅰ-Ⅱ group (n =36), BRSS Ⅲ-Ⅳ group (n =23) and BRSSⅤ-Ⅵ (n =21). METHODS: F-wave parameters of median nerve of unaffected extremity were detected by electromyographical technique. The recording electrode (muscular belly of abductor pollicis brevis) and reference electrode (first finger bone) were connected with grounding electrode. Stimulating electrode was placed in the median part of wrist joint with stimulation intensity of 130% that of threshold stimulation, stimulation frequency of 2 Hz, current pulse width of 0.2 ms, time course of 5 ms and sensitivity of 2 mV. The F-wave of median nerve of affected extremity under the resting stage (static status) and that of unaffected extremity under the maximum resistant contracted state were detected in order. The amplitude and appearance percentage of F wave were recorded. MAIN OUTCOME MEASURES: Comparison of F-wave parameters of median nerve between the unaffected extremity of stroke patients with hemiplegia and the extremity of control subjects under different status. RESULTS: All the patients accomplished the detection, and all of them participated in the final analysis. ①Under dynamic status, the amplitude and appearance percentage of F wave of unaffected extremity of patients in BRSS Ⅲ-Ⅳ group were significantly higher than those in the normal control group, respectively[(0.803 9±0.157 3) mV vs. (0.406 7±0.170 3) mV; (0.856 1±0.266 8)% vs. (0.650 0±0.197 6)%, P < 0.05]. Under static status, there were no significant differences in F-wave parameters of median nerve in the unaffected extremity of patients between BRSS Ⅰ-Ⅱ group and BRSS Ⅴ-Ⅵ group (P > 0.05). ②F-wave parameters of median nerve of unaffected extremity of patients in BRSS Ⅰ-Ⅱ group and BRSS Ⅴ-Ⅵ group under dynamic statewere higher than those under static status, without significant difference (P > 0.05), while the amplitude and appearance percentage of F wave of median nerve of unaffected extremity of patients in BRSS Ⅲ-Ⅳ group under dynamic statewere significantly higher than those under static state[(0.803 9±0.157 3) mV vs. (0.391 7±0.131 6) mV; (0.856 1±0.266 8 )% vs.(0.639 1 ±0.259 4)%,P < 0.05]. ③ There was no significant difference in F wave parameters among groups under static state(P > 0.05). However, under dynamic status, the amplitude and appearance percentage of F wave parameters of median nerve of unaffected extremity of patients in BRSS Ⅲ-Ⅳ group [(0.803 9±0.157 3) mV,(0.856 1±0.266 8)%] were significantly lower than those in the other two groups [(0.395 1±0.148 8),(0.437 1±0.157 6) mV;(0.612 5±0.232 8)%,(0.657 1±0.232 5)%,P < 0.05]. CONCLUSION: With the development of disease condition and the increase of muscular tension at anesthetic side, combination motor of affected extremity is caused following movement and muscular tension enhances to non-anesthetic-side. Therefore, F-wave parameters increase under dynamic status.

Effects of core stability exercise on rehabilitation in stroke patients with hemiplegia： a meta-analysis

目的：评估核心稳定性训练在脑卒中偏瘫患者康复中的疗效.方法：以“核心稳定性训练/核心稳定训练/核心稳定性力量训练/核心稳定力量训练”,“脑卒中/中风/脑梗死/脑出血/脑血栓/脑栓塞/脑梗/蛛网膜下腔出血/偏瘫”等为关键词检索PubMed、Embase、Webof Science、Cochrane Library、知网、万方、CBM、维普等中英文数据库中有关核心稳定性训练对脑卒中偏瘫患者康复效果的随机对照试验,然后由双人独立进行文献筛选、数据提取和质量评价,采用RevMan5.3软件进行Meta分析.结果：共纳入11篇随机对照试验,包括704名患者,其中实验组和对照组各为352名.Meta分析结果显示,在常规康复的基础上辅以核心稳定性训练对患者躯干控制能力[MD=10.44,95%CI（8.83-12.04）,P〈0.001],平衡能力[MD=5.6,95%CI（4.81-6.39）,P〈0.001],日常生活活动能力[MD=12.06,95%CI（7.65-16.46）,P〈0.001],步行功能[MD=0.72,95%CI（0.32-1.12）,P〈0.001]以及步速[MD=3.39,95%CI（2.03-4.76）,P〈0.001]的作用效果均优于常规康复治疗,但是在步幅方面[MD=2.52,95%CI（-0.25-5.29）,P=0.07]没有显著差异.结论：在常规康复的基础上辅以核心稳定性训练可提高脑卒中偏瘫患者的躯干控制能力,平衡能力,日常生活活动能力、步行功能以及步速,但是对步幅改善方面还缺乏有效证据.由于本研究纳入的随机对照试验质量均为中等水平,未来还需要进行更多高质量的相关研究以进-步评价核心稳定性训练对脑卒中偏瘫患者的康复效果.

肩部控制训练联合神经松动术对脑卒中偏瘫患者肩痛及上肢功能的效果

目的观察肩部控制训练基础上联合神经松动术治疗脑卒中偏瘫患者肩痛的效果。方法2020年1月至2021年11月,南通市第二人民医院脑卒中偏瘫患者43例,随机分为对照组(n=21)和治疗组(n=22)。对照组采用肩部控制训练,治疗组加用神经松动术。治疗前、治疗4周后,采用疼痛数字表法(NRS)和Fugl-Meyer评定量表上肢部分(FMA-UE)进行评定。结果对照组脱落1例,治疗组脱落2例。两组治疗后NRS和FMA-UE评分显著改善(|t|>7.898,P<0.001),且治疗组优于对照组(|t|>2.337,P<0.05)。结论肩部控制训练联合神经松动术能显著缓解脑卒中偏瘫患者的肩痛,改善其上肢运动功能。

基于最佳证据总结的康复护理在脑卒中偏瘫患者中的应用

目的 本研究探讨基于最佳证据总结的康复护理方案在脑卒中偏瘫患者中的应用,并进行分析。方法 选取医院2022年1—12月收治的脑卒中偏瘫患者120例,按照组间基线资料均衡可比的原则分为对照组和观察组,每组60例。对照组给予常规康复护理,观察组在常规康复护理基础上给予基于最佳证据总结的康复护理。比较两组患者干预前后神经功能缺损程度、肌张力、运动功能、日常生活能力和负性情绪。结果 干预前,两组患者的神经功能缺损程度(NIHSS)评分、肌张力(Ashwoth)评分、上肢运动功能(UL-FMA)评分、下肢运动功能(FMA-L)评分、日常生活能力(MBI)评分、焦虑情绪(HAMA)评分、抑郁情绪(HAMD)评分比较差异均无统计学意义(P>0.05)。干预后,观察组患者神经缺损程度的评分低于对照组,差异有统计学意义(P<0.05)。干预后,观察组患者肌张力和运动功能评分优于对照组,差异有统计学意义(P<0.05)。干预后,观察组日常生活能力评分高于对照组,差异有统计学意义(P<0.05)。干预后,观察组焦虑、抑郁评分低于对照组,差异有统计学意义(P<0.05)。结论 基于最佳证据总结的康复护理可减轻脑卒中偏瘫患者神经功能缺损程度,改善肌张力,提升运动功能和日常生活能力,并可缓解负性情绪,促进身心康复。

同情聚焦疗法对脑卒中偏瘫患者认知功能与病耻感的影响

目的 探讨同情聚焦疗法对脑卒中偏瘫患者认知功能与病耻感的影响。方法 选择本院收治的100例脑卒中偏瘫患者作为研究对象,其中2020年12月至2021年12月收治的50例作为对照组,2022年1月至2023年1月收治的50例作为观察组。对照组予以认知行为疗法干预,观察组在对照组的基础上予以同情聚焦疗法干预。比较干预前后两组患者羞耻感、认知功能、自我批评情况。结果 干预后观察组患者病耻感水平评分低于对照组,认知功能评分低于对照组,自我批评水平得分低于对照组,两组比较,差异具有统计学意义(均P<0.05)。结论 同情聚焦疗法可降低脑卒中偏瘫患者自我批评水平、羞耻感,促进患者认知功能恢复。

自我节律性引导对脑卒中偏瘫患者步行功能的即刻影响

目的:观察自我节律性引导对脑卒中偏瘫患者步行功能的即刻影响。方法:选取2023年2—8月就诊于安徽医科大学第一附属医院康复医学科,并符合本次研究入组标准的20例脑卒中肢体偏瘫患者,在节律引导前及自我节律性引导步行过程中,均使用意大利BTS公司的P-WALK平板压力测试系统进行数据采集。采集的参数指标包括:步速、步幅、步态周期、患侧预承重期、患侧单支撑期、患侧预摆动期、患侧摆动期。结果:与节律引导前步行比较,20例测试患者自我节律性引导步行患者步速、患侧步幅、健侧步幅均明显提高(P<0.05),患侧步态周期及健侧步态周期均明显缩短(P<0.05)。患侧预承重期和预摆动期占患侧步态周期比例均显著减小,患侧单支撑期和摆动期占患侧步态周期的比例均明显提高(P<0.05)。结论:脑卒中偏瘫患者行自我节律性引导步行时,可以一定程度提高步速和步幅,同时偏瘫肢体的预承重期、预摆动期、单支撑期和摆动期占患侧步态周期比例均不同程度趋于正常。因此,脑卒中偏瘫患者在下肢步行康复训练过程中行自我节律性引导,可以改善步行功能及纠正偏瘫患者异常步态。

作业疗法联合减重平板步行训练对脑卒中偏瘫患者平衡与功能性步行能力的影响

目的:探讨作业疗法联合减重平板步行训练对脑卒中偏瘫患者平衡与功能性步行能力的影响。方法:选取2019年7月—2021年6月河南科技大学第一附属医院新区医院康复医学科收治的90例脑卒中偏瘫患者作为研究对象,采用随机数表法分为试验组(常规康复护理)与对照组(作业疗法联合联合减重平板步行训练),每组各45例。比较两组患者干预前及干预3个月的平衡功能与功能性步行能力。结果:干预3个月,试验组患者Berg平衡量表(BBS)、功能性步行量表(FAC)评分显著高于对照组,差异有统计学意义(t=23.279、5.555,P<0.05);试验组患者脑卒中专用生活质量量表(SS-QOL)各项评分显著高于对照组,差异有统计学意义(t=8.424、8.637、26.306、5.162、7.579、15.302、8.918、8.080、20.745、10.862、1.397、6.806,P<0.05)。结论:作业疗法联合减重平板步行训练可有效提高脑卒中偏瘫患者平衡功能及功能性步行能力,有利于改善患者的生活质量。

中医康复护理对脑卒中偏瘫患者肢体功能及生活质量的影响

目的观察中医康复护理对脑卒中偏瘫患者肢体功能及生活质量的影响。方法选取108例脑卒中偏瘫患者,按照住院时间分成对照组和观察组各54例;对照组实施常规康复训练,观察组在此基础上结合中医特色护理康复,包括坐式八段锦、中药热敷、按摩等。结果干预3个月后,两组肢体运动功能评分、生活质量评分比较,差异有统计学意义(均P<0.05)。结论对脑卒中偏瘫患者实施中医特色康复护理,可促进患者肢体功能康复,提高生活质量。

中医适宜技术治疗脑卒中后偏瘫的循证临床实践指南

脑卒中是成年人死亡和残疾的主要原因之一。中医适宜技术在脑卒中后偏瘫的康复治疗中广泛应用,然而尚缺乏系统的、高质量的循证指南来指导这些实践。本指南根据《世界卫生组织指南制订手册》和《中西医结合诊疗指南制订手册》制定,遵循卫生保健实践指南的报告要求,并参照推荐分级的评估、制定与评价系统对证据质量及推荐强度进行分级。本指南组建了包括5个小组在内的跨学科工作团队,通过问卷、面对面专家会议和问题解构方法来选择指南中需要回答的关键临床问题。从25个关键问题中筛选出10个进行研究。基于系统评价的结果,考虑到证据的优缺点、干预成本、证据质量、患者偏好及价值观、多学科专家的反馈和共识,本指南提出了20条关于中医适宜技术在脑卒中后偏瘫康复治疗中应用的推荐意见。本指南主要面向中国各级医院和康复机构的医务工作者,专注于中医适宜技术在脑卒中后偏瘫康复治疗中的临床应用。