Li Ying, Wang Qian, Liu Xiao-Ling, Hui Rong, Zhang Yin-Ping
Department of Nursing, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.
Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Front Neurol. 2023 Jun 9;14:1181651. doi: 10.3389/fneur.2023.1181651. eCollection 2023.
It is the most practical goal of limb rehabilitation for stroke patients to make the upper limb, trunk, and lower limb joints link together as a whole and restore the ability to self-care. However, many previous studies focused on the single joint or single muscle group movement of stroke patients and did not integrate self-care ability training into the whole process of rehabilitation, which lacks accuracy, integrity, and systematization.
A quasi-experimental study was conducted in a tertiary hospital. Eligible patients were recruited according to the inclusion criteria and exclusion criteria and then divided into an experimental group ( = 80) and a control group ( = 80) by the medical district. The control group received the routine physical rehabilitation intervention. The experimental group adopted the physical rehabilitation program based on self-care ability led by the nurses specializing in stroke rehabilitation to carry out the multi-joint coordinated exercise based on the control group. The training time and frequency were the same in both groups (45 min per session, one session per day for three consecutive months). The primary outcome was myodynamia. Secondary outcomes were the modified Barthel Index (MBI) and Stroke Specific Quality of Life Scale (SS-QOL). The primary and secondary outcomes were assessed before the intervention and at 1 and 3 months of intervention. In this study, the TREND checklist was followed for non-randomized controlled trials.
A total of 160 participants completed the study. The physical rehabilitation program based on self-care ability was better than the routine rehabilitation program. With the prolongation of intervention time, all outcomes improved gradually in the experimental group ( < 0.05), and the myodynamia of lower limbs recovered faster than that of upper limbs. In the control group, the myodynamia of the affected limb was not significantly improved ( > 0.05), with only a small increase in MBI and SS-QOL scores ( < 0.05).
The physical rehabilitation program based on self-care ability after stroke was beneficial for acute ischemic stroke patients and improved the patient's myodynamia, quality of life, and self-care ability within the third month.
使中风患者的上肢、躯干和下肢关节联动成一个整体并恢复自我护理能力是肢体康复最实际的目标。然而，以往许多研究聚焦于中风患者的单个关节或单个肌肉群运动，未将自我护理能力训练融入康复全过程，缺乏准确性、完整性和系统性。
在一家三级医院进行了一项准实验研究。根据纳入标准和排除标准招募符合条件的患者，然后按病区将其分为实验组（ = 80）和对照组（ = 80）。对照组接受常规物理康复干预。实验组在对照组基础上，采用由中风康复专科护士主导的基于自我护理能力的物理康复方案进行多关节协调运动训练。两组训练时间和频率相同（每次45分钟，每天1次，连续3个月）。主要结局指标为肌力。次要结局指标为改良巴氏指数（MBI）和卒中特异性生活质量量表（SS-QOL）。在干预前以及干预1个月和3个月时评估主要和次要结局指标。本研究遵循非随机对照试验的TREND清单。
共有160名参与者完成了研究。基于自我护理能力的物理康复方案优于常规康复方案。随着干预时间延长，实验组所有结局指标均逐渐改善（ < 0.05），下肢肌力恢复快于上肢。对照组中，患侧肢体肌力无明显改善（ > 0.05），MBI和SS-QOL评分仅略有增加（ < 0.05）。
中风后基于自我护理能力的物理康复方案对急性缺血性中风患者有益，在第三个月内改善了患者的肌力、生活质量和自我护理能力。
