Eroğlu Mehmet, Karapolat Hale, Atamaz Funda, Tanıgör Göksel, Kirazlı Yeşim
Department of Physical Medicine and Rehabilitation, Medicine Faculty of Ege University, Izmir, Turkey.
Turk J Phys Med Rehabil. 2020 Aug 18;66(3):316-328. doi: 10.5606/tftrd.2020.4321. eCollection 2020 Sep.
The aim of this study was to examine the effects of occupational therapy (OT) combined with standard rehabilitation (SR) on the activities of daily living, quality of life, and psychological symptoms of hemiplegic patients.
Between August 2014 and February 2016, a total of 35 hemiplegic patients with post-diagnostic periods (19 males, 16 females; mean age 58.3 years; range 37 to 77 years) were included. The patients were randomized into two groups as OT+SR group (n=17) and SR only group (n=18). The study was completed by 16 patients in each group. The patients in the OT group were given 45-min SR five days a week plus 45-min OT three days a week over an eight-week period, while the patients in the SR group received SR only (of the same duration and frequency as the OT group). The patients were assessed at enrolment (pre-treatment), and again after eight weeks of treatment using the Pinch and Grip Strength and the Purdue Pegboard tests, Global Daily Living Activities Scale, Performance Assessment of Self-care Skills (PASS), Nottingham Extended Activities of Daily Living (NEADL) Scale, Quality of Life Short Form (SF-36) Questionnaire, and Hospital Anxiety and Depression Scale (HAD) for their psychological state.
Significant improvements were observed in within-group scores for PASS, Pinch and Grip Strength Test, NEADL Scale, and Purdue Pegboard test (p<0.05). After treatment, a significant increase was found in the SF-36 physical function, general health and physical total in-group scores of the OT group, whereas a significant increase was observed only in the physical total scores of the SR group (p<0.05). There was no significant improvement in the HAD scores within both groups (p>0.05). Inter-group comparisons revealed a further significant improvement in PASS instrumental daily activity index-physical subscale and Purdue Pegboard Test scores of the OT group (p<0.05). However, there was no significant difference in PASS activity, self-care and instrumental daily activity cognitive subscale, SF-36, HAD and hand grip and pinch strength scores between the groups (p>0.05).
Occupational therapy combined with SR applications has a beneficial impact on certain daily living activities and hand functions. Occupational therapy does not have any additional benefits on the quality of life, pinch and grip strength, and the psychological state.
本研究旨在探讨职业治疗（OT）联合标准康复治疗（SR）对偏瘫患者日常生活活动能力、生活质量及心理症状的影响。
2014年8月至2016年2月，共纳入35例偏瘫患者（诊断后病程）（男性19例，女性16例；平均年龄58.3岁；年龄范围37至77岁）。患者被随机分为两组，即OT+SR组（n=17）和单纯SR组（n=18）。每组16例患者完成研究。OT组患者在8周内每周5天接受45分钟的SR治疗，每周3天接受45分钟的OT治疗，而SR组患者仅接受SR治疗（治疗时长和频率与OT组相同）。在入组时（治疗前）对患者进行评估，并在治疗8周后再次使用捏力和握力测试、普渡钉板测试、全球日常生活活动量表、自我护理技能性能评估（PASS）、诺丁汉扩展日常生活活动（NEADL）量表、生活质量简表（SF-36）问卷以及医院焦虑抑郁量表（HAD）对其心理状态进行评估。
PASS、捏力和握力测试、NEADL量表以及普渡钉板测试的组内评分有显著改善（p<0.05）。治疗后，OT组SF-36身体功能、总体健康和身体总分的组内评分显著增加，而SR组仅身体总分有显著增加（p<0.05）。两组的HAD评分均无显著改善（p>0.05）。组间比较显示，OT组的PASS工具性日常生活活动指数 - 身体子量表和普渡钉板测试评分有进一步显著改善（p<0.05）。然而，两组在PASS活动、自我护理和工具性日常生活活动认知子量表、SF-36、HAD以及握力和捏力评分方面无显著差异（p>0.05）。
职业治疗联合SR应用对某些日常生活活动和手部功能有有益影响。职业治疗在生活质量、捏力和握力以及心理状态方面没有额外益处。
