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运动对中风的临床获益证据。

Clinical Evidence of Exercise Benefits for Stroke.

机构信息

Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China.

Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China.

出版信息

Adv Exp Med Biol. 2017;1000:131-151. doi: 10.1007/978-981-10-4304-8_9.

Abstract

Even though stroke is the third, not the first, most common cause of disability-adjusted life years in developed countries, it is one of the most expensive to treat. Part of the expense is due to secondary problems in the post-stroke period including: cognition, memory, attention span, pain, sensation loss, psychological issues, and problems with mobility and balance. Research has identified that exercise has both positive physical and psychosocial effects for post-stroke patients. Therefore, this scientific statement provides an overview on exercise rehabilitation for post-stroke patients.We will use systematic literature reviews, clinical and epidemiology reports, published morbidity and mortality studies, clinical and public health guidelines, patient files, and authoritative statements to support this overview.Evidence clearly supports the use of various kinds of exercise training (e.g., aerobic, strength, flexibility, neuromuscular, and traditional Chinese exercise) for stroke survivors. Aerobic exercise, the main form of cardiac rehabilitation, may play an important role in improving aerobic fitness, cardiovascular fitness, cognitive abilities, walking speed and endurance, balance, quality of life, mobility, and other health outcomes among stroke patients. Strength exercise, included in national stroke guidelines and recommended for general health promotion for stroke survivors, can lead to improvements in functionality, psychosocial aspects, and quality of life for post-stroke patients. Flexibility exercises can relieve muscle spasticity problems, improve motor function, range of motion, and prevent contractures. Stretching exercises can also prevent joint contractures, muscle shortening, decrease spasticity, reduce joint stiffness and improve a post-stroke patient's overall function. Neuromuscular exercises can improve activities of daily living (ADL) through coordination and balance activities. Traditional Chinese exercises are used to improve walking and balance ability as well as increase muscle strength, which is important for post-stroke patients.The present evidence strongly supports the power of exercise for post-stroke patients, which in this study combined aerobic exercises, strength training, flexibility exercises, neuromuscular exercises, and traditional Chinese exercises. This research can encourage post-stroke survivors to consider the importance of exercise in the rehabilitation process.

摘要

尽管中风是在发达国家中排名第三、而非第一的最常见的导致失能调整生命年的原因,但它是治疗费用最高的疾病之一。部分费用是由于中风后出现的继发性问题,包括认知、记忆、注意力持续时间、疼痛、感觉丧失、心理问题以及行动和平衡能力受损。研究表明,运动对中风患者具有积极的生理和心理社会影响。因此,本科学声明提供了中风后患者运动康复的概述。我们将使用系统文献回顾、临床和流行病学报告、已发表的发病率和死亡率研究、临床和公共卫生指南、患者档案和权威声明来支持这一概述。有明确的证据支持各种运动训练(例如,有氧运动、力量训练、柔韧性训练、神经肌肉训练和传统中医运动)用于中风幸存者。有氧运动是心脏康复的主要形式,可能对改善有氧运动能力、心血管健康、认知能力、步行速度和耐力、平衡、生活质量、移动能力和中风患者的其他健康结果发挥重要作用。力量训练包含在国家中风指南中,也被推荐用于中风幸存者的一般健康促进,可以提高中风后患者的功能、心理社会方面和生活质量。柔韧性训练可以缓解肌肉痉挛问题,改善运动功能、活动范围,并预防挛缩。拉伸运动还可以预防关节挛缩、肌肉缩短、降低痉挛、减轻关节僵硬,提高中风患者的整体功能。神经肌肉训练可以通过协调和平衡活动改善日常生活活动(ADL)。传统中医运动用于改善步行和平衡能力以及增加肌肉力量,这对中风后患者很重要。目前的证据强烈支持运动对中风后患者的作用,本研究将有氧运动、力量训练、柔韧性训练、神经肌肉训练和传统中医运动结合在一起。这项研究可以鼓励中风幸存者考虑运动在康复过程中的重要性。

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