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The mediating roles of caregiver needs and caregiver readiness in the relation between family resilience and benefit finding in family caregivers of patients with stroke in China. 中国脑卒中患者家庭照护者的照护者需求和照护者准备在家庭复原力与受益发现之间的中介作用。
IF 2.2 4区 医学 Q1 REHABILITATION Pub Date : 2024-08-14 DOI: 10.1080/10749357.2024.2387482
Qitong Zhao, Xinyue Zhao, Jingwei Zhang, Xiangmin Xu, Haoxin Kong, Shuhao Lin, Haijun Zhao, Mingxia Li

Objectives: The purpose of this study was to assess the effects of family resilience, caregiver needs, and caregiver readiness on benefit finding for family caregivers of patients with stroke and to examine the mediating role of caregiver needs and caregiver readiness between family resilience and benefit finding.

Methods: In this cross-sectional study, convenience sampling was designed and used to recruit participants from three general hospitals in Jinan, Shandong Province, China, from February to September 2022, in which 340 participants completed the General Information Questionnaire, Chinese version of the Family Resilience Assessment Scale (C-FRAS), Caregiver Needs Assessment Scale (CNAS) Chinese version of the Caregiver Preparedness Scale (C-CPS), and Caregiver Benefit Finding Scale (CBFS). Model 6 in process version 4.0 was used to test the chain mediation model between family resilience and benefit finding for caregiver needs and caregiver readiness.

Results: Correlation analysis showed that benefit finding in family caregivers was positively associated with family resilience and caregiver readiness and negatively associated with caregiver needs; mediation model tests showed that the total indirect effect of family resilience on benefit finding was 0.163, with the specific mediating effects of caregiver needs and caregiver readiness accounting for 33.74% and 59.51%, and the chain mediating effect of both accounting for 6.75%.

Conclusions: Family resilience not only directly influences benefit finding for family caregivers but also indirectly affects benefit finding through caregiver needs and caregiver readiness. Caregiver needs and caregiver readiness have a mediating role between family resilience and benefit finding in family caregivers.

研究目的本研究旨在评估家庭复原力、照护者需求和照护者准备度对脑卒中患者家庭照护者获益发现的影响,并探讨照护者需求和照护者准备度在家庭复原力和获益发现之间的中介作用:在这项横断面研究中,我们设计并使用了便利抽样法,于2022年2月至9月在山东省济南市的三家综合医院招募了340名参与者,他们填写了一般信息问卷、中文版家庭复原力评估量表(C-FRAS)、照顾者需求评估量表(CNAS)、中文版照顾者准备量表(C-CPS)和照顾者受益发现量表(CBFS)。使用 4.0 版流程模型 6 检验家庭复原力与照护者需求和照护者准备度的利益发现之间的链式中介模型:相关分析表明,家庭照顾者的受益发现与家庭复原力和照顾者准备度呈正相关,与照顾者需求呈负相关;中介模型检验表明,家庭复原力对受益发现的总间接效应为 0.163,照顾者需求和照顾者准备度的具体中介效应分别占 33.74% 和 59.51%,二者的连锁中介效应占 6.75%:家庭复原力不仅直接影响家庭照顾者的受益发现,还通过照顾者需求和照顾者准备程度间接影响受益发现。照护者需求和照护者准备在家庭复原力和家庭照护者受益发现之间起着中介作用。
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引用次数: 0
Effects of aerobic and resistance exercises on psychological and cognitive functions in patients with post-stroke migraine. 有氧运动和阻力运动对中风后偏头痛患者心理和认知功能的影响。
IF 2.2 4区 医学 Q1 REHABILITATION Pub Date : 2024-07-14 DOI: 10.1080/10749357.2024.2377515
Nana Niu, Yanzhe Hao, Yang Cui, Miao Li

Objective: To investigate the impact of a combination of aerobic and resistance exercises on the psychological and cognitive functions of post-stroke migraine patients.

Methods: This study recruited 100 patients suffering from post-stroke migraine pain who were admitted to the hospital, categorizing them into a control group (n = 50) and an intervention group (n = 50). The control group received conventional drug treatment, while the intervention group received the exercise-based intervention that combined aerobic exercise with resistance exercise.

Results: Before treatment, both groups displayed similar Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Mini-mental State Examination (MMSE) and MoCA scores. However, after the intervention, the intervention group exhibited lower scores on these measures compared to the control group (all p < 0.05). Additionally, there were no discernible disparity in Migraine Disability Assessment (MIDAS) and Headache Impact Test (HIT-6) scores between the two cohorts of patients before treatment (p > 0.05), whereas the intervention group demonstrated significantly lower MIDAS and HIT-6 scores following the intervention (p < 0.05). Although there were no discernible distinctions in National Institute of Health stroke scale (NIHSS) and Stroke Specialized Quality of Life Scale (SS-QOL) measurements between the two patient groups before treatment (p > 0.05), the intervention group exhibited a significant decrease in NIHSS scores and a notable increase in SS-QOL scores after the intervention (p > 0.05). Moreover, the satisfaction rate and overall satisfaction rate were significantly higher in the intervention group (p < 0.05).

Conclusion: The combination of aerobic and resistance exercises demonstrated positive effects on the psychological well-being and overall quality of life for post-stroke migraine patients.

目的:研究有氧运动和阻力运动相结合对中风后偏头痛患者心理和认知功能的影响:研究有氧运动和阻力运动相结合对中风后偏头痛患者心理和认知功能的影响:本研究招募了 100 名入院的中风后偏头痛患者,将其分为对照组(50 人)和干预组(50 人)。对照组接受常规药物治疗,而干预组则接受以运动为基础的干预,即有氧运动与阻力运动相结合:结果:治疗前,两组患者的患者健康问卷-9(PHQ-9)、广泛性焦虑症-7(GAD-7)、迷你精神状态检查(MMSE)和 MoCA 分数相似。然而,干预后,干预组在这些指标上的得分低于对照组(所有 p p > 0.05),而干预组在干预后的 MIDAS 和 HIT-6 分数显著降低(p p > 0.05),干预组在干预后的 NIHSS 分数显著降低,SS-QOL 分数显著增加(p > 0.05)。此外,干预组的满意率和总体满意率明显更高(P 结论:干预组的满意率和总体满意率明显高于干预组(P > 0.05):有氧运动和阻力运动相结合对脑卒中后偏头痛患者的心理健康和整体生活质量有积极影响。
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引用次数: 0
Efficacy of plantar tactile sensation and balance in patients with subacute stroke following plantar kinesio taping: a randomized, cross-over preliminary study. 亚急性中风患者足底肌动贴后足底触觉和平衡的疗效:一项随机、交叉初步研究。
IF 2.2 4区 医学 Q1 REHABILITATION Pub Date : 2024-07-10 DOI: 10.1080/10749357.2024.2377519
Seongho Yun, Youngsook Bae

Background: Kinesio tape (KT) is known to enhance tactile sensation. In stroke rehabilitation, KT is often used alongside conventional therapy (CT) to improve balance recovery.

Objective: In this study, we aimed to evaluate the effectiveness of plantar KT in enhancing plantar tactile sensation (PTS) and balance ability in subacute stroke patients.

Methods: In this randomized crossover trial, 22 subacute stroke participants were randomly assigned to receive no taping, paretic plantar KT, or bilateral plantar KT, with a 24-h washout period between each condition. All participants underwent 30 min of CT. The primary outcome was PTS, involving tactile sensitivity in five areas on the plantar surface and the contact area with the ground of the paretic foot. The one-leg stand (OLS) time, functional reach test (FRT), and timed up-and-go test (TUG) were employed as secondary outcomes.

Results: Paretic plantar KT application led to significant increases in the contact area, OLS, FRT, and TUG test times. Particularly, bilateral plantar KT showed significantly greater improvement in PTS compared to paretic plantar KT. Additionally, bilateral plantar KT significantly improved OLS (p < 0.001, η2 = 0.575), FRT (p < 0.001, η2 = 781), and TUG (p < 0.001, η2 = 0.771) times compared with paretic plantar KT.

Conclusions: This study demonstrated that plantar KT improved PTS and balance ability in stroke rehabilitation. The findings suggest that bilateral plantar KT as an adjunct to CT may have a beneficial effect on balance recovery in patients with subacute stroke.

Trial registration: Clinical trial KCT0009048.

背景:已知肌动胶带(KT)可增强触觉。在中风康复治疗中,KT 通常与传统疗法(CT)一起用于改善平衡恢复:本研究旨在评估足底 KT 在增强亚急性中风患者足底触觉(PTS)和平衡能力方面的效果:在这项随机交叉试验中,22 名亚急性中风患者被随机分配接受无绑带、瘫痪足底 KT 或双侧足底 KT,每个条件之间有 24 小时的冲洗期。所有参与者都接受了 30 分钟的 CT 检查。主要结果是PTS,包括足底表面五个区域的触觉灵敏度以及瘫痪足与地面的接触面积。单腿站立(OLS)时间、功能性伸展测试(FRT)和定时起立行走测试(TUG)是次要结果:结果:应用瘫痪足底 KT 能显著增加接触面积、OLS、FRT 和 TUG 测试时间。与瘫痪型足底 KT 相比,双侧足底 KT 对 PTS 的改善尤为明显。此外,与瘫痪型足底 KT 相比,双侧足底 KT 显著改善了 OLS(p 2 = 0.575)、FRT(p 2 = 781)和 TUG(p 2 = 0.771)时间:本研究表明,足底 KT 可改善卒中康复中的 PTS 和平衡能力。研究结果表明,双侧足底 KT 作为 CT 的辅助治疗可能对亚急性中风患者的平衡恢复有好处:临床试验 KCT0009048。
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引用次数: 0
Correction. 更正。
IF 2.2 4区 医学 Q1 REHABILITATION Pub Date : 2024-07-07 DOI: 10.1080/10749357.2024.2372148
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引用次数: 0
Comparing acute hospital outcomes for people with post-stroke aphasia who do and do not require an interpreter. 比较需要和不需要翻译的脑卒中后失语症患者的急性期住院治疗效果。
IF 2.2 4区 医学 Q1 REHABILITATION Pub Date : 2024-07-01 Epub Date: 2023-12-20 DOI: 10.1080/10749357.2023.2295128
Kathleen Mellahn, Monique Kilkenny, Samantha Siyambalapitiya, Ali Lakhani, Tara Purvis, Megan Reyneke, Dominique A Cadilhac, Miranda L Rose

Background: People with communication differences are known to have poorer hospital outcomes than their peers. However, the combined impact of aphasia and cultural/linguistic differences on care and outcomes after stroke remains unknown.

Objectives: To investigate the association between cultural/linguistic differences, defined as those requiring an interpreter, and the provision of acute evidence-based stroke care and in-hospital outcomes for people with aphasia.

Methods: Cross-sectional, observational data collected in the Stroke Foundation National Audit of Acute Services (2017, 2019, 2021) were used. Multivariable regression models compared evidence-based care and in-hospital outcomes (e.g., length of stay) by interpreter status. Models were adjusted for sex, hospital location, stroke type and severity, with clustering by hospital.

Results: Among 3122 people with aphasia (median age 78, 49% female) from 126 hospitals, 193 (6%) required an interpreter (median age 78, 55% female). Compared to people with aphasia not requiring an interpreter, those requiring an interpreter had similar care access but less often had their mood assessed (OR 0.50, 95% CI 0.32, 0.76), were more likely to have physiotherapy assessments (96% vs 90% p = 0.011) and carer training (OR 4.83, 95% CI 1.70, 13.70), had a 2 day longer median length of stay (8 days vs 6 days, p = 0.003), and were less likely to be independent on discharge (OR 0.54, 95% CI 0.33, 0.89).

Conclusions: Some differences exist in the management and outcomes for people with post-stroke aphasia who require an interpreter. Further research to explore their needs and the practical issues underpinning their clinical care pathways is required.

背景:众所周知,与同龄人相比,有交流障碍者的住院治疗效果较差。然而,失语症和文化/语言差异对中风后护理和预后的综合影响仍然未知:调查文化/语言差异(定义为需要翻译人员的差异)与为失语症患者提供急性循证中风护理及住院预后之间的关系:采用卒中基金会全国急性期服务审计(2017、2019、2021 年)中收集的横断面观察数据。多变量回归模型比较了口译员状态下的循证护理和住院结果(如住院时间)。模型根据性别、医院位置、中风类型和严重程度进行调整,并按医院进行聚类:在来自 126 家医院的 3122 名失语症患者(中位年龄 78 岁,49% 为女性)中,有 193 人(6%)需要翻译(中位年龄 78 岁,55% 为女性)。与不需要口译员的失语症患者相比,需要口译员的患者获得护理的机会相似,但较少接受情绪评估(OR 0.50,95% CI 0.32,0.76),更有可能接受物理治疗评估(96% 对 90% P = 0.011)和照护者培训(OR 4.83,95% CI 1.70,13.70),住院时间中位数延长两天(8 天 vs 6 天,P = 0.003),出院时独立生活的可能性较小(OR 0.54,95% CI 0.33,0.89):结论:对于需要翻译的卒中后失语患者,其管理和治疗效果存在一定差异。结论:需要口译服务的卒中后失语症患者在管理和治疗效果方面存在一些差异,需要进一步研究探讨他们的需求及其临床护理路径中的实际问题。
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引用次数: 0
Fatigue predicts level of community integration in people with stroke. 疲劳可预测中风患者融入社区的程度。
IF 2.2 4区 医学 Q1 Nursing Pub Date : 2024-07-01 Epub Date: 2024-01-04 DOI: 10.1080/10749357.2023.2298536
Lily Y W Ho, Cynthia Y Y Lai, Claudia K Y Lai, Shamay S M Ng

Background: The independent predictive power of fatigue for community integration has not been investigated, although there is an increasing amount of literature that recognizes the importance of fatigue in people with stroke.

Objectives: To examine the correlation between community integration and fatigue, walking endurance, and fear of falling; and to quantify the relative contribution of fatigue to community integration in people with stroke.

Methods: This was a cross-sectional study with 75 community-dwelling people with stroke. Data were collected using the Community Integration Measure (CIM), Fatigue Assessment Scale (FAS), 6-minute walk test (6MWT), and Survey of Activities and Fear of Falling in the Elderly (SAFE). Multiple linear regressions (forced entry method) were used to quantify the relative power of the FAS score to predict community integration in a model covering distance in the 6MWT and the SAFE score.

Results: After controlling for age, the CIM score significantly correlated with the scores for FAS (r=-0.48, p < 0.001), 6MWT distance (r = 0.24, p = 0.039), and SAFE (r=-0.39, p = 0.001). The entire model, including age, FAS score, 6MWT distance, and SAFE score, explained 26.1% of the variance in the CIM scores (F [4, 70] = 7.52, p < 0.001). The FAS scores independently explained 10.6% of the variance in the CIM scores.

Conclusions: This study suggests that fatigue is an independent predictor of community integration among people with stroke, taking into account walking endurance and fear of falling.

背景:尽管越来越多的文献认识到疲劳对脑卒中患者的重要性,但尚未研究疲劳对社区融合的独立预测能力:研究社区融合与疲劳、行走耐力和跌倒恐惧之间的相关性,并量化疲劳对脑卒中患者社区融合的相对影响:这是一项横断面研究,对象是 75 名居住在社区的脑卒中患者。方法:这是一项对 75 名居住在社区的中风患者进行的横断面研究,使用社区融合测量(CIM)、疲劳评估量表(FAS)、6 分钟步行测试(6MWT)和老年人活动与跌倒恐惧调查(SAFE)收集数据。多重线性回归(强制进入法)用于量化 FAS 评分在涵盖 6MWT 距离和 SAFE 评分的模型中预测社区融合的相对能力:在控制年龄后,CIM 评分与 FAS 评分(r=-0.48,p r = 0.24,p = 0.039)和 SAFE 评分(r=-0.39,p = 0.001)显著相关。包括年龄、FAS 评分、6MWT 距离和 SAFE 评分在内的整个模型解释了 26.1% 的 CIM 评分变异(F [4, 70] = 7.52,p 结论):本研究表明,考虑到行走耐力和跌倒恐惧,疲劳是脑卒中患者融入社区的一个独立预测因素。
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引用次数: 0
The Association between fatigue and physical activity in patients hospitalized with subacute stroke. 亚急性脑卒中住院患者疲劳与体力活动之间的关系。
IF 2.2 4区 医学 Q1 Nursing Pub Date : 2024-07-01 Epub Date: 2023-12-30 DOI: 10.1080/10749357.2023.2293337
Ayano Makihara, Masashi Kanai, Kazuhiro P Izawa, Hiroki Kubo, Asami Inamoto, Asami Ogura, Ikko Kubo, Shinichi Shimada

Background: Little is known about the association between fatigue and physical activity in patients hospitalized with subacute stroke.

Objectives: The aim of this study was to investigate the association between fatigue and physical activity in patients hospitalized with subacute stroke.

Methods: This cross-sectional study enrolled 244 consecutive patients with stroke who were admitted to a subacute rehabilitation ward at our hospital. We assessed fatigue with the Fatigue Assessment Scale (FAS) and used an accelerometer (Active style Pro HJA750-C, OMRON) to record the mean duration of sedentary behavior, light-intensity physical activity (LIPA), and moderate-to-vigorous-intensity physical activity (MVPA). We assessed all factors at 1 month after stroke. Multivariate linear regression analysis revealed the associations between FASscore and objectively measured physical activity.

Results: In total, we analyzed 85 patients. The duration of the sedentary behavior was significantly associated with the FAS score (β  = 1.46, p = 0.037) and the Functional Balance Scale score (β = -1.35, p = 0.045). The LIPA time was significantly associated only with the FBS score (β = 1.38, p = 0.045), whereas MVPA was not associated with any variable.

背景:亚急性脑卒中住院患者的疲劳与体力活动之间的关系鲜为人知:人们对亚急性脑卒中住院患者疲劳与体力活动之间的关系知之甚少:本研究旨在调查亚急性脑卒中住院患者疲劳与体力活动之间的关系:这项横断面研究连续纳入了 244 名在我院亚急性康复病房住院的脑卒中患者。我们使用疲劳评估量表(FAS)评估疲劳程度,并使用加速度计(Active style Pro HJA750-C,欧姆龙)记录久坐行为、轻度体力活动(LIPA)和中度至剧烈体力活动(MVPA)的平均持续时间。我们在中风后 1 个月对所有因素进行了评估。多变量线性回归分析显示了 FAS 评分与客观测量的体力活动之间的关系:结果:我们总共分析了 85 名患者。久坐行为的持续时间与 FAS 评分(β = 1.46,p = 0.037)和功能平衡量表评分(β = -1.35,p = 0.045)显著相关。LIPA 时间仅与 FBS 评分有明显相关性(β = 1.38,p = 0.045),而 MVPA 与任何变量均无相关性。
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引用次数: 0
High-intensity locomotor training during inpatient rehabilitation improves the discharge ambulation function of patients with stroke. A systematic review with meta-analysis. 住院康复期间的高强度运动训练可改善脑卒中患者的出院行走功能。系统回顾与荟萃分析。
IF 2.2 4区 医学 Q1 Nursing Pub Date : 2024-07-01 Epub Date: 2024-01-29 DOI: 10.1080/10749357.2024.2304960
Annie Tapp, David Griswold, Daniel Dray, Nancy Landgraff, Kenneth Learman

Objective: To evaluate the evidence of high-intensity locomotor training on outcomes related to gait and balance for patients with stroke in inpatient rehabilitation.

Methods: Four databases were searched (PubMed, CINAHL, Web of Science, and MedLINE) for articles published prior to 13 June 2023. Studies of adults (>18 years old) with a diagnosis of stroke who received a high-intensity locomotor intervention while admitted to an inpatient rehabilitation facility were included. A functional outcome in the domain of gait speed, gait endurance, or balance must have been reported. Following the screening of 1052 studies, 43 were selected for full-text review. Studies were assessed for risk of bias using the tool appropriate to the study type. Gait speed, gait endurance, and balance outcome data were extracted for further analysis.

Results: Eight studies were selected with risk of bias ratings as moderate (4), high (2), and low (2). Six studies were analyzed in the meta-analysis (N = 635). A random-effects model analyzed between-group differences. Standard mean differences demonstrated that high-intensity locomotor training produces a moderate effect on gait endurance (0.50) and gait speed (0.41) and a negligible effect on balance (0.08) compared with usual care.

Conclusions: The meta-analysis supports the use of high-intensity locomotor training over usual care for improving gait speed and gait endurance during inpatient post-stroke. Future studies should investigate dose-response relationships of high-intensity locomotor training in this setting.

Prospero registration: #CRD42022341329.

目的评估高强度运动训练对中风住院康复患者步态和平衡相关结果的影响:检索四个数据库(PubMed、CINAHL、Web of Science 和 MedLINE)中 2023 年 6 月 13 日之前发表的文章。研究对象包括确诊为中风并在住院康复机构接受高强度运动干预的成年人(18 岁以上)。必须报告步态速度、步态耐力或平衡方面的功能结果。在对 1052 项研究进行筛选后,选出 43 项研究进行全文综述。使用与研究类型相适应的工具对研究进行了偏倚风险评估。提取步态速度、步态耐力和平衡能力结果数据进行进一步分析:结果:共筛选出 8 项研究,偏倚风险分为中度(4 项)、高度(2 项)和低度(2 项)。在荟萃分析中分析了六项研究(N = 635)。随机效应模型分析了组间差异。标准均值差异表明,与常规护理相比,高强度运动训练对步态耐力(0.50)和步态速度(0.41)有中等程度的影响,对平衡能力(0.08)的影响可忽略不计:荟萃分析支持在脑卒中后住院患者中使用高强度运动训练比常规治疗更能改善步态速度和步态耐力。未来的研究应探讨在这种情况下高强度运动训练的剂量-反应关系:#crd42022341329.
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引用次数: 0
Effects of non-pharmacological interventions on fatigue in people with stroke: a systematic review and meta-analysis. 非药物干预对中风患者疲劳的影响:系统综述和荟萃分析。
IF 2.2 4区 医学 Q1 Nursing Pub Date : 2024-07-01 Epub Date: 2024-01-21 DOI: 10.1080/10749357.2024.2304966
Lily Y W Ho, Claudia K Y Lai, Shamay S M Ng

Background: Fatigue, a common problem following a stroke, can have negative effects on a person's daily life. There are no good interventions thus far for alleviating fatigue among those affected.

Objective: This review aimed to evaluate the effects of non-pharmacological interventions on fatigue among people with stroke.

Methods: A search was conducted for articles in seven databases, clinical trial registry, and backward and forward citations of included publications. Randomized controlled trials, including feasibility and pilot trials, of non-pharmacological interventions for managing fatigue or promoting sleep or both in people with stroke were included. The standardized mean difference in scores for fatigue was analyzed using random effects models.

Results: Ten studies, with 806 participants, were analyzed. The identified interventions included physical interventions, cognitive interventions, a combination of physical and cognitive interventions, oxygen therapy, and complementary interventions. Non-pharmacological interventions had no significant immediate, short-term and medium-term effects on fatigue. The adverse effects of falls and arrhythmia were each found in one participant in circuit training. The risk of bias was high in all studies. The certainty of the evidence ranged from very low to low.

Conclusions: The evidence in support of any non-pharmacological interventions for alleviating fatigue is still inconclusive in people with stroke. In view of the inadequacies of existing interventions and study designs, addressing the multidimensional characteristics of fatigue may be a possible direction in developing interventions. A robust study design with a larger sample size of people with stroke experiencing fatigue is required to evaluate the effects of interventions.

背景:疲劳是中风后的常见问题,会对患者的日常生活产生负面影响。迄今为止,还没有很好的干预措施来缓解患者的疲劳:本综述旨在评估非药物干预对中风患者疲劳的影响:方法: 在 7 个数据库、临床试验登记处和已收录出版物的前后引文中检索文章。包括可行性试验和试点试验在内的随机对照试验均涉及对中风患者进行非药物干预以控制疲劳或促进睡眠或两者兼而有之。采用随机效应模型分析了疲劳评分的标准化平均差异:结果:共分析了 10 项研究,806 名参与者。已确定的干预措施包括物理干预、认知干预、物理和认知干预相结合、氧疗和辅助干预。非药物干预对疲劳没有明显的即时、短期和中期影响。参加循环训练的一名参与者分别出现了跌倒和心律失常的不良反应。所有研究的偏倚风险都很高。证据的确定性从很低到很低不等:在中风患者中,支持缓解疲劳的非药物干预措施的证据仍不确定。鉴于现有干预措施和研究设计的不足,解决疲劳的多维特征可能是制定干预措施的一个方向。要评估干预措施的效果,需要对出现疲劳的中风患者进行样本量更大的可靠研究设计。
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引用次数: 0
Effects of scapulo-humeral training on ultrasonographic and clinical evaluations in stroke: a randomized controlled trial. 肩胛肱骨训练对中风患者超声波和临床评估的影响:随机对照试验。
IF 2.2 4区 医学 Q1 REHABILITATION Pub Date : 2024-07-01 Epub Date: 2024-01-09 DOI: 10.1080/10749357.2024.2302720
Özge Onursal Kilinç, Muhammed Kilinç, Ender Ayvat, Irem Düzgün, Levent Özçakar

Background: After stroke, the effects of focused scapulo-humeral training with simultaneous assessment of the changes in shoulder subluxation, related muscle thicknesses and upper limb performance have not been studied in the literature.

Objectives: This study aimed to investigate the effects of an 8-week scapulo-humeral training program in addition to conventional rehabilitation on upper extremity/trunk functions, shoulder pain, and sonographic measurements of the shoulder joint and periscapular muscles.

Methods: Thirty stroke individuals were randomly separated into two groups as Group I-scapulo-humeral training (5F/10 M) and Group II - control (5F/10 M). Conventional rehabilitation program was applied to both groups, and a scapulo-humeral training exercise protocol was added for the scapulo-humeral group. All the treatments were applied for 1 hour/day, 3 days/week, 8 weeks. Clinical evaluations were made using the Fugl Meyer Assessment-Upper Extremity(FMA-UE), Action Research Arm Test(ARAT), ABILHAND, Visual Analog Scale, and Trunk Impairment Scale(TIS). Ultrasound was used to measure serratus anterior/lower trapezius muscle thicknesses, and acromion-greater tubercule/acromio-humeral distances.

Results: FMA-UE, ARAT, ABILHAND and TIS scores increased in both groups, with greater increases in most parameters in the scapulo-humeral training group. Shoulder pain decreased only in the scapulo-humeral training group. Subacromial distances were decreased on the paretic side, and muscle thicknesses increased on both sides in the scapulo-humeral training group, and in the control group, only serratus anterior muscle thickness increased on the paretic side (p < 0.05 for all).

Conclusions: Additional scapulo-humeral exercises to conventional rehabilitation was seen to improve upper extremity/trunk performance and shoulder pain, and to increase scapula stabilizer muscle thicknesses in stroke individuals with mild-moderate upper extremity disability.

背景:中风后,重点肩胛骨-肱骨训练同时评估肩关节半脱位、相关肌肉厚度和上肢功能变化的效果尚未见文献研究:本研究旨在探讨除常规康复训练外,为期8周的肩胛肱骨训练计划对上肢/躯干功能、肩痛以及肩关节和肩胛周围肌肉声学测量的影响:方法:将 30 名中风患者随机分为两组,第一组为肩胛肱骨训练组(5F/10M),第二组为对照组(5F/10M)。两组均采用常规康复计划,肩胛肱骨组增加了肩胛肱骨训练方案。所有治疗均为每天 1 小时,每周 3 天,共 8 周。临床评估采用 Fugl Meyer 评估-上肢(FMA-UE)、行动研究手臂测试(ARAT)、ABILHAND、视觉模拟量表和躯干损伤量表(TIS)。超声波用于测量前锯肌/斜方肌下部厚度和肩峰-大结节/肩峰-肱骨距离:两组的 FMA-UE、ARAT、ABILHAND 和 TIS 评分均有所提高,其中肩胛骨-肱骨训练组的大部分参数提高幅度更大。只有肩胛骨-肱骨训练组的肩部疼痛有所减轻。在肩胛骨-肱骨训练组中,瘫痪侧的肩峰下距离减少,两侧肌肉厚度增加,而在对照组中,只有瘫痪侧的前锯肌厚度增加(P 结论:肩胛骨-肱骨训练组和对照组的肩峰下距离和肌肉厚度都增加了:在常规康复训练的基础上增加肩胛骨-肱骨训练可改善上肢/躯干功能和肩部疼痛,并增加中风患者中轻度-中度上肢残疾者的肩胛骨稳定肌厚度。
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Topics in Stroke Rehabilitation
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