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近期脑卒中患者远程康复治疗的发展趋势:一项叙述性综述。

Recent trends in telerehabilitation of stroke patients: A narrative review.

机构信息

Pirogov Russian National Research Medical University (Pirogov Medical University), Moscow, Russia.

I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.

出版信息

NeuroRehabilitation. 2022;51(1):1-22. doi: 10.3233/NRE-210330.

Abstract

BACKGROUND

Stroke is the main reason for disabilities worldwide leading to motor dysfunction, spatial neglect and cognitive problems, aphasia, and other speech-language pathologies, reducing the life quality. To overcome disabilities, telerehabilitation (TR) has been recently introduced.

OBJECTIVE

The aim of this review was to analyze current TR approaches for stroke patients' recovery.

METHODS

We searched 6 online databases from January 2018 to October 2021, and included 70 research and review papers in the review. We analyzed TR of 995 individuals, which was delivered synchronously and asynchronously.

RESULTS

Findings show TR is feasible improving motor function, cognition, speech, and language communication among stroke patients. However, the dose of TR sessions varied significantly. We identified the following limitations: lack of equipment, software, and space for home-based exercises, insufficient internet capacity and speed, unavailability to provide hands on guidance, low digital proficiency and education, high cognitive demand, small samples, data heterogeneity, and no economic evaluation.

CONCLUSIONS

The review shows TR is superior or similar to conventional rehabilitation in clinical outcomes and is used as complementary therapy or as alternative treatments. More importantly, TR provides access to rehabilitation services of a large number of patients with immobility, living in remote areas, and during COVID-19 pandemic or similar events.

摘要

背景

脑卒中是全球导致残疾的主要原因,可引起运动功能障碍、空间忽略和认知问题、失语症以及其他言语-语言病理学,降低生活质量。为了克服残疾,远程康复(TR)最近已经引入。

目的

本综述旨在分析当前用于脑卒中患者康复的 TR 方法。

方法

我们从 2018 年 1 月至 2021 年 10 月检索了 6 个在线数据库,并在综述中纳入了 70 篇研究和综述论文。我们分析了 995 名接受同步和异步 TR 的个体。

结果

研究结果表明,TR 可改善脑卒中患者的运动功能、认知、言语和语言交流。然而,TR 疗程的剂量差异很大。我们发现了以下限制因素:缺乏设备、软件和家庭锻炼空间、互联网容量和速度不足、无法提供实地指导、数字水平和教育程度低、认知需求高、样本量小、数据异质性以及缺乏经济评估。

结论

综述表明,TR 在临床结果方面优于或等同于常规康复,可作为补充治疗或替代治疗。更重要的是,TR 为大量行动不便、居住在偏远地区的患者以及在 COVID-19 大流行或类似事件期间提供了康复服务。

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