Hantikainen Virpi, Riesen-Uru Seija, Raemy-Röthl Brigit, Hirsbrunner Therese
Inselspital Bern, Schweiz.
Pflege. 2006 Feb;19(1):11-22. doi: 10.1024/1012-5302.19.1.11.
This case study examined whether the movement support based on Kinaesthetics furthers the body perception, movement abilities and functional independency of elderly nursing home residents with movement restrictions. Two elderly nursing home residents who showed a strong dependence (Barthel-Index II; 20-60 points) after a stroke and who were not previously cared based on Kinaesthetics took part in the study. A four months follow-up with pre-test, Kinaesthetics interventions, and monthly evaluations (n = 4) was carried out. The data was gathered by means of observation. Structured observation was used in order to assess the functional independence by means of Barthel-Index and unstructured observation was used for qualitative information by means of Kinaesthetics assessment from. In addition, the care personnel kept a diary over the development of the participants during the study. Both cases showed clear improvement of the information processing, body perception, and the movement abilities. However, Barthel-Index showed only a little increase in functional development in case A (from 30 to 40 points). Based on the Kinaesthetics concepts, case A however showed a higher level of functional development. The score of case B on the Barthel-Index increased cleary from 55 to 95 points. Movement support based on principles of Kinaesthetics if used consistently, continuously, and adapted to the situation of the assisted person can increase the body perception, movement abilities, and the functional independence of patients in old age. Barthel-Index is not sensitive enough to detect small development in functional status, whereas with Kinaesthetics assessment form it is possible. Besides of quantitative scales it is recommended to use qualitative measures that focus more on qualitative progress and on the way how the level of score is achieved.
本案例研究探讨了基于动觉学的运动支持是否能促进行动受限的老年疗养院居民的身体感知、运动能力和功能独立性。两名中风后表现出严重依赖（巴氏指数II级；20 - 60分）且此前未接受过基于动觉学护理的老年疗养院居民参与了该研究。研究进行了为期四个月的跟踪，包括预测试、动觉学干预和每月评估（n = 4）。数据通过观察收集。采用结构化观察通过巴氏指数评估功能独立性，采用非结构化观察通过动觉学评估获取定性信息。此外，护理人员在研究期间记录了参与者的进展情况。两个案例均显示出信息处理、身体感知和运动能力有明显改善。然而，巴氏指数显示案例A的功能发展仅略有提升（从30分提高到40分）。不过，基于动觉学概念，案例A显示出更高水平的功能发展。案例B的巴氏指数得分从55分明显提高到95分。如果持续、连贯且根据受助者情况进行调整地运用基于动觉学原理的运动支持，可提高老年患者的身体感知、运动能力和功能独立性。巴氏指数对功能状态的微小变化不够敏感，而动觉学评估形式则可行。除了定量量表外，建议使用更关注定性进展以及得分水平实现方式的定性测量方法。
