稳定训练在卒中患者运动康复中的应用:一项前瞻性随机研究

N. F. Miryutova, Liudmila V. Mikhailova, N. N. Minchenko
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引用次数: 0

摘要

介绍。本体感觉缺损是脑卒中后常见的感觉障碍之一,对运动活动有负面影响。评价稳定训练对脑卒中患者临床和功能指标动态及运动康复效果的影响。材料和方法。中风的运动(运动功能、活动)和非运动(认知和情绪意志)后果的动态,以及稳定训练复杂应用影响下的生活质量,使用量表(美国国立卫生研究院中风量表、医学研究委员会量表、修正Ashworth肌肉痉挛量表、“图像记忆”和“10个词”、Schulte-Platonov表、Lusher颜色测试、医院焦虑和抑郁量表)。国际功能分类(ICF), EQ-5D问卷和稳定性法。采用健康水平综合指标动态评价运动康复效果。结果和讨论。脑卒中患者经过复杂康复后,发现神经功能障碍的消退(几乎一半的患者康复后表现为轻度损伤,6%的患者瘫腿肌力完全恢复,重度和中度瘫瘫患者比例下降,瘫肌高张力下降)。以稳定的运动来补充运动康复的复杂性,导致功能限制程度的降低(康复后48.5%的患者Hauser步行指数显示轻度行走障碍,患者可以在不使用辅助设备的情况下在房间里走动,减少了日常生活中对他人的依赖),平衡功能质量和生活质量得到改善。对患者的心理情绪状态有积极影响,提高了康复措施的有效性。稳定训练在复杂运动康复患者中的应用,可以改善患者的行走和平衡功能,改善患者的心理情绪状态,提高患者的生活质量,从而提高脑卒中后康复措施的有效性。
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Stabilotraining in Motor Rehabilitation of Patients after Stroke: a Prospective Randomized Study
INTRODUCTION. Proprioceptive deficits are one of the common sensory impairments after stroke and have a negative impact on motor activity. AIM. Evaluation of the effect of stabilization training on the dynamics of clinical and functional indices and the efficiency of motor rehabilitation in patients after stroke. MATERIAL AND METHODS. The dynamics of motor (motor functions, activity) and non-motor (cognitive and emotional volitional) consequences of stroke, as well as the quality of life under the influence of complex application of stabilization training with the use of scales (National Institutes of Health Stroke Scale, Medical Research Council Scale, Modified Ashworth Scale of muscle spasticity, «Memory for images» and «10 words», Schulte-Platonov Table, Lusher Color Test, The Hospital Anxiety and Depression Scale), International Classification of Functioning (ICF), EQ-5D questionnaire and stabilography method. The effectiveness of motor rehabilitation was evaluated by the dynamics of the integral index of health level. RESULTS AND DISCUSSION. After complex rehabilitation in stroke patients the regression of neurological disorders was detected (almost half of patients after rehabilitation showed mild degree of impairment, in 6 % of cases full recovery of paretic leg muscle strength was achieved, the share of patients with severe and moderate paresis decreased, hypertonicity of paretic muscles decreased). Complementing the complex of motor rehabilitation with stable exercise led to a decrease in the degree of functional limitations (in 48.5 % of patients after rehabilitation the Hauser walking index indicated a mild degree of walking disorder, patients became able to walk around the room without using aids, reduced dependence on others in everyday life), improved quality of balance function and quality of life, a positive impact on the psychoemotional state of patients and increased effectiveness of rehabilitation measures. CONCLUSION. Stabilotraining application in the complex of motor rehabilitation of patients allowed to improve walking and balance functions, psycho-emotional state of patients, to increase their quality of life and, accordingly, to increase the effectiveness of rehabilitation measures after stroke.
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