Klimkiewicz Paulina, Kubsik Anna, Jankowska Agnieszka, Woldańska-Okońska Marta
Pol Merkur Lekarski. 2014 Mar;36(213):191-4.
Rehabilitation of upper limb in patients after ischemic stroke is a major challenge for modern neurorehabilitation. Function of upper limb of patients after ischemic stroke returns on the end of the rehabilitation comparing with another parts of the body. Below presents two groups of patients after ischemic stroke who were rehabilitated with use of the following methods: kinesiotherapy combined with NDT- Bobath method and kinesiotherapy only. The aim of this study was to assess the impact of kinesiotherapy only and NDT- Bobath method combined with kinesiotherapy on the functional state and muscle tone of upper limb in patients after ischemic stroke.
The study involved a group of 40 patients after ischemic stroke with motor control and muscle tone problems of upper limb. Patients were divided into two groups, each of them included 20 people. Upper limb in group I was rehabilitated with the use of kinesiotherapy exercise however group II with the use of kinesiotherapy exercise combined with NDT- Bobath method (Neurodevelopmental Treatment Bobath). To evaluate the patients before and after rehabilitation muscle tone Asworth scale was used and to assess functional status Rivermead Motor Assessment (RMAIII) scale was used.
After 5 weeks of rehabilitation in group II in majority patients were observed decrease of muscle tone and improvement in upper limb functional status. In group I the muscle tone were also decreased and functional status were better but in smaller impact than in II group.
Classical kinesiotherapy combined with the NDT-Bobath method gives better results in neurorehabilitation of upper limb than the use of kinesiotherapy exercises only in patients after ischemic stroke.
缺血性中风患者上肢的康复是现代神经康复的一项重大挑战。与身体其他部位相比,缺血性中风患者上肢功能在康复后期才恢复。以下介绍两组缺血性中风后采用以下方法进行康复的患者:运动疗法结合神经发育疗法-鲍勃ath法和单纯运动疗法。本研究的目的是评估单纯运动疗法以及神经发育疗法-鲍勃ath法结合运动疗法对缺血性中风患者上肢功能状态和肌张力的影响。
该研究纳入了一组40例有上肢运动控制和肌张力问题的缺血性中风患者。患者被分为两组,每组20人。第一组上肢采用运动疗法进行康复,而第二组采用运动疗法结合神经发育疗法-鲍勃ath法(神经发育治疗鲍勃ath法)。使用改良Ashworth量表评估患者康复前后的肌张力,并使用Rivermead运动评估(RMAIII)量表评估功能状态。
康复5周后,第二组大多数患者的肌张力降低,上肢功能状态改善。第一组的肌张力也降低了,功能状态也有所改善,但效果不如第二组明显。
在缺血性中风患者的上肢神经康复中,经典运动疗法结合神经发育疗法-鲍勃ath法比单纯使用运动疗法效果更好。