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[基于正念的干预措施在中风后康复中的作用]

[The effects of mindfulness-based interventions in post-stroke rehabilitation].

作者信息

Udvardi Veronika, Szabó Gábor, Fazekas Gábor

机构信息

Országos Mozgásszervi Intézet - Országos Orvosi Rehabilitációs Intézet, Stroke utáni Rehabilitációs Osztály, Budapest.

Szegedi Tudományegyetem, Rehabilitációs Medicina Tanszék, Szeged.

出版信息

Ideggyogy Sz. 2023 Jan 30;76(1-2):11-17. doi: 10.18071/isz.76.0011.

Abstract

Stroke is nowadays one of the most prevalent diseases worldwide causing devastating impairments and negative consequences for survivors. It is a main cause of adult onset disability and it can have a negative impact on psychological health, cognitive function and quality of life. Post-stroke rehabilitation may reduce long-term disability, and in recent years several innovations have emerged to improve recovery. Decades of research suggest that mindfulness-based interventions support a greater capacity to live with chronic medical conditions and contribute to lowering stress levels. Previous works report positive results amoung stroke survivors, improvements in mood, mental fatigue and in some degree in cognitive and physical functioning, plus represent a promising option in secondary prevention. Since the early 2000s, numerous clinical studies have investigated the efficacy of mindfulness-based interventions in post-stroke rehabilitation. In this paper the main results of the relevant international research is reviewed and also, the main modalities of the mindfulness-based interventions are presented. Our primary goal is to evaluate the results in order to draw attention to the importance of rehabilitation of patients with stroke and hopefully the theoretical and practical knowledge of the review will contribute to development effective and secure protocols in future research. Mindfulness-based techniques can become clinically valuable complementary therapeutic interventions in post-stroke rehabilitation. More research in this area is warranted: to evaluate these specific practices and their suitability; using randomized, controlled, follow up designs, rigorous methods, and different treatment settings; expanding outcomes to include physiological, health care use, and health-related outcomes; exploring mediating factors; and discerning dose effects and optimal frequency and length of practice.

摘要

中风是当今全球最普遍的疾病之一,会给幸存者带来严重损伤和负面后果。它是成人残疾的主要原因,会对心理健康、认知功能和生活质量产生负面影响。中风后康复可以减少长期残疾,近年来出现了一些创新方法来促进恢复。数十年的研究表明,基于正念的干预措施有助于提高应对慢性疾病的能力,并有助于降低压力水平。先前的研究报告了中风幸存者的积极结果,包括情绪改善、精神疲劳减轻,以及在一定程度上认知和身体功能的改善,这在二级预防中是一个有前景的选择。自21世纪初以来,众多临床研究调查了基于正念的干预措施在中风后康复中的疗效。本文回顾了相关国际研究的主要结果,并介绍了基于正念的干预措施的主要方式。我们的主要目标是评估结果,以引起对中风患者康复重要性的关注,希望本文的理论和实践知识能为未来研究中制定有效且安全的方案做出贡献。基于正念的技术可以成为中风后康复中具有临床价值的辅助治疗干预措施。该领域需要更多研究:评估这些具体做法及其适用性;采用随机对照随访设计、严谨的方法和不同的治疗环境;扩大结果范围,包括生理、医疗保健使用和与健康相关的结果;探索中介因素;以及识别剂量效应和最佳练习频率及时长。

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