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急性卒中后对抗性推挤的新型治疗方法:一例报告

Novel Treatment Approach to Contraversive Pushing after Acute Stroke: A Case Report.

作者信息

Romick-Sheldon Devra, Kimalat Andrea

机构信息

Physical Therapy Department, Schwab Rehabilitation Hospital, Chicago, Ill.

Acute Rehabilitation Department, Harborview Medical Center, Seattle, Wash.

出版信息

Physiother Can. 2017;69(4):313-317. doi: 10.3138/ptc.2016-28.

Abstract

The purpose of this case report is to provide an alternative treatment approach to pushing behavior (PB), adapting widely used equipment for persons with stroke demonstrating such behaviour. The aim is to change their graviceptive experience during interventions while performing repeated stepping and righting practice to resolve PB more quickly. The subject is a man aged 56 years who sustained a right middle-cerebral-artery ischemic stroke. He entered in-patient rehabilitation from an acute care hospital 7 days post-stroke. Lateral stepping with body weight-supported treadmill training (LS-BWSTT) was used such that the subject stepped laterally toward the uninvolved side. Scores on the Scale for Contraversive Pushing and the FIM were recorded at regular intervals. After intervention, the subject demonstrated decreased PB and improved function. The individual's PB improved after LS-BWSTT. LS-BWSTT is a novel treatment intervention that could be considered in future clinical decision making using evidence-based principles.

摘要

本病例报告的目的是提供一种针对推挤行为(PB)的替代治疗方法,对表现出此类行为的中风患者采用广泛使用的设备。目的是在干预过程中改变他们的重力感受体验,同时进行重复的踏步和平衡练习,以更快地解决推挤行为。受试者是一名56岁男性,患有右大脑中动脉缺血性中风。中风后7天,他从一家急症医院进入住院康复治疗。采用体重支持跑步机训练的侧向踏步(LS-BWSTT),使受试者侧向朝着未受累侧踏步。定期记录对侧推挤量表和功能独立性测量(FIM)的评分。干预后,受试者的推挤行为减少,功能得到改善。个体的推挤行为在体重支持跑步机训练的侧向踏步后得到改善。使用基于证据的原则,体重支持跑步机训练的侧向踏步是一种未来临床决策中可考虑的新型治疗干预措施。

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Outcomes with stroke and lateropulsion: a case-matched controlled study.中风与偏侧推挤的结局:一项病例匹配对照研究。
Neurorehabil Neural Repair. 2008 Jul-Aug;22(4):415-23. doi: 10.1177/1545968307313511. Epub 2008 Mar 11.
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The scale for contraversive pushing: A reliability and validity study.对侧推挤量表:一项信效度研究。
Neurorehabil Neural Repair. 2006 Dec;20(4):468-72. doi: 10.1177/1545968306291849.

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