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太极拳应用于中风后上肢康复的可行性研究

Adapting Tai Chi for Upper Limb Rehabilitation Post Stroke: A Feasibility Study.

作者信息

Pan Shujuan, Kairy Dahlia, Corriveau Hélène, Tousignant Michel

机构信息

School of Rehabilitation, Université de Montréal, Montréal, QC H3N 1X7, Canada.

Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal-IRGLM Site, Montreal, QC H3S 2J4, Canada.

出版信息

Medicines (Basel). 2017 Sep 30;4(4):72. doi: 10.3390/medicines4040072.

Abstract

Tai chi (TC) has been reported as being beneficial for improving balance post stroke, yet its utility in upper limb rehabilitation remains unknown. Twelve chronic stroke survivors with persistent paresis of an upper limb underwent 60 minutes of adapted TC twice a week for eight weeks, with a 4-week follow up. A 10-min TC home program was recommended for the days without sessions. TC level of performance, attendance to the sessions, duration of self-practice at home, and adapted TC movements used were recorded. Eleven participants completed the study. A clinical reasoning algorithm underlying the adaptation of TC was elaborated throughout the trial. Participants with varying profiles including a severely impaired upper limb, poor balance, shoulder pain, and severe spasticity were not only capable of practicing the adapted TC, but attended all 16 sessions and practiced TC at home for a total of 16.51 ± 9.21 h. The degree of self-practice for subgroups with low upper limb function, shoulder pain, or moderate-to-severe spasticity was similar to that of subgroups with greater upper limb function, no shoulder pain, and minimal-to-no spasticity. Adapted TC seems feasible for upper limb rehabilitation post stroke. Although the study was based on a small sample size and requires confirmation, low upper limb function, insufficient balance, spasticity, and shoulder pain do not appear to hinder the practice of TC.

摘要

据报道,太极拳(TC)有助于改善中风后的平衡能力,但其在上肢康复中的作用尚不清楚。12名上肢持续麻痹的慢性中风幸存者每周两次,每次进行60分钟的适应性太极拳训练,共持续八周,并进行为期4周的随访。在没有训练课程的日子里,建议进行10分钟的家庭太极拳训练。记录太极拳的表现水平、训练课程的出勤情况、在家自我训练的时长以及所使用的适应性太极拳动作。11名参与者完成了该研究。在整个试验过程中,详细阐述了适应性太极拳背后的临床推理算法。包括上肢严重受损、平衡能力差、肩部疼痛和严重痉挛等不同情况的参与者不仅能够进行适应性太极拳训练,还参加了所有16节课程,并在家中进行了总计16.51±9.21小时的太极拳训练。上肢功能低下、肩部疼痛或中度至重度痉挛亚组的自我训练程度与上肢功能较好、无肩部疼痛且极少或无痉挛亚组相似。适应性太极拳似乎对中风后的上肢康复是可行的。尽管该研究基于小样本量且需要进一步证实,但上肢功能低下、平衡能力不足、痉挛和肩部疼痛似乎并不妨碍太极拳训练。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a57e/5750596/59c184f54e08/medicines-04-00072-g001.jpg

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