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定制化坐姿太极拳方案用于亚急性脑卒中幸存者:一项随机对照试验。

Tailored Sitting Tai Chi Program for Subacute Stroke Survivors: A Randomized Controlled Trial.

机构信息

School of Nursing, Yunnan University of Traditional Chinese Medicine, Kunming (J.Z.).

Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong (J.Z., J.P.C.C., A.W.K.C., K.C.C.).

出版信息

Stroke. 2022 Jul;53(7):2192-2203. doi: 10.1161/STROKEAHA.121.036578. Epub 2022 Apr 7.

Abstract

BACKGROUND

The initiation of exercise during rehabilitation at the subacute stage could provide stroke survivors with an approach to recovery that capitalizes on unique physiological conditions and promotes spontaneous recovery. We aimed to examine the effects of a tailored sitting Tai Chi program on recovery outcomes among subacute stroke survivors.

METHODS

We conducted a 12-week assessor-blind randomized controlled trial in China. Subacute stroke survivor-caregiver dyads were recruited and randomly assigned to either the sitting Tai Chi group (n=80) or attention control group (n=80). Outcomes including upper limb function (Fugl-Meyer Assessment Upper Extremity & Wolf Motor Function Test), balance control (Berg Balance Scale), sitting balance control (Trunk Impairment Scale), depressive symptoms (Geriatric Depression Scale Short Form), shoulder range of motion, shoulder pain (ShoulderQ), activities of daily living (Modified Barthel Index), and quality of life (Stroke Specific Quality of Life Scale) were measured at baseline, in-process, immediately post, and 4-week postintervention.

RESULTS

Immediately postintervention, the sitting Tai Chi group (n=69) showed significant upper limb function improvement in the primary outcomes including the performance time (regression coefficient of the group-by-time interaction, B=-21.415 [95% CI, -31.000 to -11.831]) and functional ability (B=10.146 [95% CI, 4.886-15.406]) domains of the Wolf Motor Function Test, balance control (B, 4.972 [95% CI, 1.356-8.588]), and sitting balance control (B=4.397 [95% CI, 2.699-6.096]). Compared with the control group (n=65), improvements were also observed in secondary outcomes including depressive symptoms (B=-1.626 [95% CI, -2.304 to -0.948]), shoulder extension (B=4.518 [95% CI, 0.893-8.144]), activities of daily living (B=5.510 [95% CI, 0.450-10.569]), and quality of life (B=15.680 [95% CI, 7.255-24.105]).

CONCLUSIONS

The results support the effectiveness of a tailored sitting Tai Chi program in improving recovery outcomes among subacute stroke survivors and provide additional knowledge to support the clinical implementation of such a program.

REGISTRATION

URL: https://www.

CLINICALTRIALS

gov; Unique identifier: NCT04138407.

摘要

背景

在亚急性康复阶段开始运动,可以为中风幸存者提供一种利用独特生理条件和促进自发康复的恢复方法。我们旨在研究量身定制的坐姿太极方案对亚急性中风幸存者康复结果的影响。

方法

我们在中国进行了一项为期 12 周的评估员盲随机对照试验。招募了亚急性中风幸存者-照顾者二人组,并将其随机分配到坐姿太极组(n=80)或注意对照组(n=80)。结果包括上肢功能(Fugl-Meyer 上肢评估和 Wolf 运动功能测试)、平衡控制(Berg 平衡量表)、坐姿平衡控制(躯干损伤量表)、抑郁症状(老年抑郁量表简短版)、肩部活动范围、肩部疼痛(肩 Q)、日常生活活动能力(改良巴氏指数)和生活质量(中风专用生活质量量表),在基线、过程中、干预后即刻和 4 周后进行测量。

结果

干预后即刻,坐姿太极组(n=69)在主要结局的上肢功能表现时间(组间时间交互作用的回归系数,B=-21.415[95%CI,-31.000 至-11.831])和功能能力(B=10.146[95%CI,4.886-15.406])、平衡控制(B,4.972[95%CI,1.356-8.588])和坐姿平衡控制(B=4.397[95%CI,2.699-6.096])方面均有显著改善。与对照组(n=65)相比,次要结局包括抑郁症状(B=-1.626[95%CI,-2.304 至-0.948])、肩部伸展(B=4.518[95%CI,0.893-8.144])、日常生活活动能力(B=5.510[95%CI,0.450-10.569])和生活质量(B=15.680[95%CI,7.255-24.105])也有改善。

结论

结果支持量身定制的坐姿太极方案在改善亚急性中风幸存者康复结果方面的有效性,并提供了额外的知识支持该方案的临床实施。

登记

网址:https://www.clinicaltrials.gov;唯一标识符:NCT04138407。

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