de Jong Lex D, van Wijck Frederike, Stewart Roy E, Geurts Alexander C H, Dijkstra Pieter U
Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, The Netherlands.
Institute for Applied Health Research, School for Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
Physiother Res Int. 2018 Jan;23(1). doi: 10.1002/pri.1683. Epub 2017 Jan 16.
Physiotherapy (PT) and occupational therapy (OT) are key professions providing treatment for the arm after stroke; however, knowledge about the content of these treatments is scant. Detailed data are needed to replicate interventions, evaluate their effective components, and evaluate PT and OT practice. This paper describes PT and OT treatment for the severely affected arm in terms of duration, content according to components and categories of the International Classification of Human Functioning, Disability and Health, and to analyze differences between professions.
Design: This is a retrospective analysis of randomized trial data.
46 patients after stroke with poor arm motor control recruited from inpatient neurological units from three rehabilitation centers in the Netherlands.
PTs and OTs recorded duration and content of arm treatment interventions for 8 weeks using a bespoke treatment schedule with 15 International Classification of Human Functioning, Disability and Health categories.
PTs and OTs spent on average 4-7 min per treatment session (30 min) on arm treatment. OTs spent significantly more time providing arm treatment and treatment at the activities level than PTs. PTs spent 79% of their arm treatment time on body functions, OTs 41%. OTs spent significantly more time on "moving around using transportation," "self care," and "household tasks" categories.
Patients after stroke with a severely affected arm and an unfavorable prognosis for arm motor recovery receive little arm-oriented PT and OT. Therapists spent most arm treatment time on body functions. There was a considerable overlap in the content of PT and OT in 12 of the 15 categories. Results can be generalized only to patients with poor arm motor control and may not represent practice in other countries.
物理治疗（PT）和职业治疗（OT）是为中风后上肢提供治疗的关键专业；然而，关于这些治疗内容的知识却很少。需要详细数据来复制干预措施、评估其有效成分以及评估物理治疗和职业治疗的实践。本文根据治疗时长、按照《国际功能、残疾和健康分类》的组成部分和类别划分的内容，描述了针对严重受影响上肢的物理治疗和职业治疗，并分析了不同专业之间的差异。
设计：这是一项对随机试验数据的回顾性分析。
从荷兰三个康复中心的住院神经科病房招募了46例上肢运动控制差的中风患者。
物理治疗师和职业治疗师使用定制的治疗时间表，在15个《国际功能、残疾和健康分类》类别下，记录了8周内上肢治疗干预的时长和内容。
物理治疗师和职业治疗师每次治疗 session（30分钟）在上肢治疗上平均花费4 - 7分钟。职业治疗师在上肢治疗和活动层面的治疗上花费的时间明显多于物理治疗师。物理治疗师将其上肢治疗时间的79%用于身体功能，职业治疗师为41%。职业治疗师在“使用交通工具四处移动”“自我护理”和“家务任务”类别上花费的时间明显更多。
上肢严重受影响且上肢运动恢复预后不佳的中风患者接受的以手臂为导向的物理治疗和职业治疗很少。治疗师将大部分上肢治疗时间用于身体功能。在15个类别中的12个类别中，物理治疗和职业治疗的内容有相当大的重叠。结果仅可推广到上肢运动控制差的患者，可能不代表其他国家的实践情况。
