Severe Medicine, Hebei University of Engineering Affiliated Hospital, Handan City, Hebei Province, China.
Integrated Internal Section II, Hebei University of Engineering Affiliated Hospital, Handan City, Hebei Province, China.
J Pak Med Assoc. 2020 Sep;70 [Special Issue](9):38-44.
To explore the clinical effect of comprehensive rehabilitation nursing intervention on hemiplegia patients in the sequela stage of stroke.
Patients with knee reflex after stroke were divided into the treatment group and the control group. Patients in the control group received Activities of Daily Living (ADL) training. Patients in the treatment group received comprehensive rehabilitation training in addition to the ADL training of the control group, including joint flexion and extension training, active resistance training, low-frequency electrotherapy, and standing training. The knee reflex angle and ankle dorsiflexion angle of patients in both groups were measured before and after 4 weeks of treatment. Also, the Manual Muscle Testing (MMT) scale, the modified Ashworth scale, the Fugl-Meyer assessment (FMA), and Barthel index (lower limb) rating scale of patients in both groups were compared.
It was found that there was significant difference between the two groups in the changes of knee and ankle joint angles after treatment (P < 0.05). In the Ashworth and MMT (Manual Muscle Testing) grading analysis of patients, it was found that the Ashworth grading of quadriceps femoris and triceps leg improved significantly before and after treatment (P < 0.01). There was significant difference in MMT grade between the two groups after treatment of quadriceps and hamstring muscles (P < 0.05). There was significant difference in satisfaction degree of pain control or relief methods (P < 0.05). In the analysis of Fugl-Meyer and Barthel integral effects of lower limbs for the patients with knee reflex before and after treatment, a significant difference (P < 0.05) was found in the Fugl-Meyer motor function and Barthel index scores of the two groups.
Therefore, the results suggested that comprehensive rehabilitation nursing could promote the treatment of sequelae of hemiplegia. Although there were some shortcomings in the experimental process, it still provided a reliable basis for the clinical treatment of sequelae of stroke.
探讨综合康复护理干预对脑卒中后遗症期偏瘫患者的临床效果。
将脑卒中后出现膝反射亢进的患者分为治疗组和对照组,对照组患者进行日常生活活动(ADL)训练,治疗组患者在对照组 ADL 训练的基础上进行综合康复训练,包括关节屈伸训练、主动抗阻训练、低频电疗、站立训练等。分别于治疗前及治疗 4 周后测量两组患者的膝反射角度和踝关节背屈角度,并比较两组患者的徒手肌力测试(MMT)评分、改良 Ashworth 量表评分、Fugl-Meyer 评估量表(FMA)评分和 Barthel 指数(下肢)评分。
治疗后两组患者膝关节和踝关节角度的变化差异均有统计学意义(P<0.05)。在患者的 Ashworth 和 MMT(徒手肌力测试)分级分析中,发现股四头肌和小腿三头肌的 Ashworth 分级在治疗前后均有显著改善(P<0.01)。治疗后两组患者股四头肌和腘绳肌的 MMT 分级差异有统计学意义(P<0.05)。在疼痛控制或缓解方法的满意度方面差异有统计学意义(P<0.05)。在治疗前后两组患者膝反射的 Fugl-Meyer 和 Barthel 积分效应分析中,发现 Fugl-Meyer 运动功能和 Barthel 指数评分差异均有统计学意义(P<0.05)。
因此,结果表明综合康复护理可以促进偏瘫后遗症的治疗。尽管实验过程存在一些缺陷,但仍为脑卒中后遗症的临床治疗提供了可靠的依据。