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一项针对中风后患者的奥斯威斯屈立位架的随机试验评估。

A randomized trial evaluation of the Oswestry Standing Frame for patients after stroke.

作者信息

Bagley Pam, Hudson Mary, Forster Anne, Smith Jane, Young John

机构信息

School of Health Studies, University of Bradford, Bradford BD5 0BB, UK.

出版信息

Clin Rehabil. 2005 Jun;19(4):354-64. doi: 10.1191/0269215505cr874oa.

Abstract

BACKGROUND

Standing is believed to have benefits in addressing motor and sensory impairments after stroke. One device to facilitate standing for severely disabled patients is the Oswestry Standing Frame.

OBJECTIVE

To evaluate the effectiveness of the Oswestry Standing Frame for severely disabled stroke patients.

DESIGN

A single centre, randomized controlled trial.

SETTING

An inpatient stroke rehabilitation unit.

SUBJECTS

Patients were recruited if they had a clinical diagnosis of stroke, were medically stable and unable to achieve any score on the Trunk Control Test or unable to stand in mid-line without the assistance of two therapists.

INTERVENTION

The intervention (n = 71) and control (n = 69) groups both received usual stroke unit care but the intervention group also received a minimum of 14 consecutive days' treatment using the standing frame.

MAIN OUTCOME MEASURES

The primary outcome measure was the Rivermead Mobility Index (RMI). Secondary measures included the Barthel Index; the Rivermead Motor Assessment; the balanced sitting and sitting to standing components of the Motor Assessment Scale; the Trunk Control Test and the Hospital Anxiety and Depression Scale. Blind assessment was undertaken at baseline, six weeks, 12 weeks and six months post stroke. Information on resource use was also collected.

RESULTS

There was no statistically significant difference between groups in any of the outcome measures or for resource use. Mann-Whitney U-tests for the RMI change from baseline scores to six weeks, 12 weeks and six months post stroke were p = 0.310; p = 0.970 and p = 0.282, respectively.

CONCLUSION

Use of the Oswestry Standing Frame did not improve clinical outcome or provide resource savings for this severely disabled patient group.

摘要

背景

人们认为站立对中风后运动和感觉障碍的恢复有益。一种帮助严重残疾患者站立的设备是奥斯维斯垂站立架。

目的

评估奥斯维斯垂站立架对严重残疾中风患者的有效性。

设计

单中心随机对照试验。

地点

住院中风康复单元。

研究对象

招募临床诊断为中风、病情稳定且在躯干控制测试中无法取得任何分数或在没有两名治疗师协助的情况下无法在中线站立的患者。

干预措施

干预组(n = 71)和对照组(n = 69)均接受常规中风单元护理,但干预组还使用站立架接受了至少连续14天的治疗。

主要结局指标

主要结局指标是里弗米德运动指数(RMI)。次要指标包括巴氏指数;里弗米德运动评估;运动评估量表中的平衡坐姿和从坐姿到站姿部分;躯干控制测试和医院焦虑抑郁量表。在中风后基线、六周、十二周和六个月进行盲法评估。还收集了资源使用信息。

结果

两组在任何结局指标或资源使用方面均无统计学显著差异。中风后六周、十二周和六个月时,RMI从基线分数变化的曼-惠特尼U检验p值分别为0.310;0.970和0.282。

结论

对于该严重残疾患者群体,使用奥斯维斯垂站立架并未改善临床结局或节省资源。

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