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中风患者康复动机与上肢运动功能之间的关系。

The relationship between rehabilitation motivation and upper limb motor function in stroke patients.

作者信息

Li Wenxi, Zhu Guangyue, Lu Yang, Wu Jinglei, Fu Zhuoxin, Tang Junyi, Zhang Guohui, Xu Dongsheng

机构信息

Department of Rehabilitation Medicine, Shanghai University of Traditional Chinese Medicine, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai, China.

Department of Rehabilitation, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

出版信息

Front Neurol. 2024 May 28;15:1390811. doi: 10.3389/fneur.2024.1390811. eCollection 2024.

Abstract

OBJECTIVE

Insufficient motivation among post-stroke survivors may be an important factor affecting their motor function recovery. This study seeks to investigate the relationship between motivation and functional recovery in stroke patients undergoing rehabilitation training.

MATERIALS AND METHODS

103 stroke patients with upper limb impairments were studied during their hospital stays. Assessments were done before and after rehabilitation training to measure motivation, emotional state, motor function, and independence in daily activities. Data analysis was conducted to examine the distribution of these factors among the participants. Pearson and Spearman correlation analyses were used to study the relationships between motivation, emotional state, and motor function. Patients were divided into high and low motivation groups based on the Rehabilitation Motivation Scale (RMS), and chi-square and rank-sum tests were used to compare functional differences before and after treatment among patients with varying levels of motivation.

RESULTS

66 participants were found to have low motivation in the initial assessment of the RMS (64.08%). Consistency in motivation levels was observed among patients with high motivation ( = 0.648, <0.001). Apathy was identified as the main factor affecting motivation in patients with low motivation ( = 0.027), while depression and anxiety were not significantly correlated. Motivation was strongly linked to improvements in upper limb motor function, daily living activities, and self-exercise duration ( < 0.001) for stroke patients undergoing rehabilitation. Post-training, there was a notable increase in motivation, motor function, and independence in daily activities ( < 0.001). Increased rehabilitation motivation was linked to better upper limb motor function and daily independence in patients, particularly those with low motivation. This correlation was significant for both the FMA-UE and FIM scores.

DISCUSSION

Old patients with poor upper limb motor function often have low motivation, which hinders their recovery. Using strategies to boost motivation in stroke patients with impaired upper limb function could greatly improve their rehabilitation and motor skills. It is crucial to prioritize these intervention strategies.

CONCLUSION

Enhancing rehabilitation motivation in stroke patients with low motivation and upper limb motor impairments can foster the restoration of their functional capabilities.

摘要

目的

脑卒中幸存者动力不足可能是影响其运动功能恢复的重要因素。本研究旨在探讨接受康复训练的脑卒中患者动力与功能恢复之间的关系。

材料与方法

对103例上肢功能障碍的脑卒中患者在住院期间进行研究。在康复训练前后进行评估,以测量动力、情绪状态、运动功能和日常生活中的独立性。进行数据分析以检查这些因素在参与者中的分布情况。采用Pearson和Spearman相关分析来研究动力、情绪状态和运动功能之间的关系。根据康复动力量表(RMS)将患者分为高动力组和低动力组,并采用卡方检验和秩和检验比较不同动力水平患者治疗前后的功能差异。

结果

在RMS初始评估中,66名参与者动力较低(64.08%)。高动力患者的动力水平具有一致性(=0.648,<0.001)。冷漠被确定为低动力患者动力的主要影响因素(=0.027),而抑郁和焦虑无显著相关性。动力与接受康复治疗的脑卒中患者上肢运动功能、日常生活活动和自我锻炼时间的改善密切相关(<0.001)。训练后,动力、运动功能和日常生活独立性显著提高(<0.001)。康复动力增加与患者更好的上肢运动功能和日常独立性相关,尤其是低动力患者。这种相关性在FMA-UE和FIM评分中均显著。

讨论

上肢运动功能差的老年患者往往动力较低,这阻碍了他们的恢复。采用策略提高上肢功能受损的脑卒中患者的动力,可极大地改善其康复和运动技能。优先考虑这些干预策略至关重要。

结论

提高动力不足且上肢运动功能受损的脑卒中患者的康复动力,可促进其功能能力的恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12ad/11165190/067ac583122f/fneur-15-1390811-g001.jpg

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