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中风后运动功能障碍患者康复管理的最佳证据总结

Summary of best evidence for rehabilitation management of patients with motor dysfunction after stroke.

作者信息

Zhao Hongyu, Zhou Luozhifei, Hu Ling, Chen Ru, Dong Lei, Zhao Qin, Gong Lina

机构信息

Neurology Intensive Critical Unit, Third Xiangya Hospital, Central South University, Changsha 410013.

Nursing Department, Third Xiangya Hospital, Central South University, Changsha 410013.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2024 Apr 28;49(4):497-507. doi: 10.11817/j.issn.1672-7347.2024.240006.

Abstract

OBJECTIVES

The rehabilitation work for patients with motor dysfunction after stroke is crucial. However, there is currently a lack of summarized evidence regarding the rehabilitation management of stroke patients in rehabilitation wards, communities, and at home. This study aims to compile relevant evidence on the rehabilitation management of patients with motor dysfunction after stroke, providing a reference for clinical and community health professionals to carry out rehabilitation interventions.

METHODS

A systematic search was conducted in BMJ Best Practice, UpToDate, National Guidebook Clearinghouse, American Heart Association/American Stroke Association, Canadian Medical Association, National Institute for Health and Clinical Excellence, United States Department of Veterans Affairs/ Department of Defense, Registered Nurses Association of Ontario, JBI Evidence-Based Healthcare Center Database, The Cochrane Library, PubMed, Web of Science, Embase, CINAHL, CNKI, Wanfang Database, SinoMed, and other databases for all literature on the rehabilitation management of patients with motor dysfunction after stroke. This included clinical decision-making, guidelines, expert consensuses, recommended practices, systematic reviews, and evidence summaries, with the search period spanning from the establishment of each database to October 2023. Two researchers independently evaluated the quality of the literature.

RESULTS

A total of twenty-one documents were included, consisting of 11 guidelines, 2 expert consensus, and 8 systematic reviews. Evidence was extracted and integrated from the included literature, summarizing forty-five pieces of evidence across nine areas: rehabilitation management model, rehabilitation institutions, rehabilitation teams, timing of rehabilitation interventions, rehabilitation assessment, rehabilitation programs, rehabilitation duration and frequency, rehabilitation intensity, and rehabilitation support These covered comprehensive rehabilitation management content for stroke patients in the early, subacute, and chronic phases.

CONCLUSIONS

The best evidence summarized in this study for the rehabilitation management of patients with motor dysfunction after stroke is comprehensive and of high quality. It provides important guidance for clinical and community healthcare professionals in carrying out rehabilitation interventions. When applying the evidence, it is recommended to consider the current condition of the stroke patient, the extent of motor dysfunction, environmental factors, and the patient's preferences. Then, select the most appropriate rehabilitation plan, and adjust the type and intensity of training according to each patient's specific needs and preferences.

摘要

目的

中风后运动功能障碍患者的康复工作至关重要。然而,目前缺乏关于中风患者在康复病房、社区和家庭中康复管理的总结性证据。本研究旨在汇编中风后运动功能障碍患者康复管理的相关证据,为临床和社区卫生专业人员开展康复干预提供参考。

方法

在BMJ最佳实践、UpToDate、国家指南交换中心、美国心脏协会/美国中风协会、加拿大医学协会、英国国家卫生与临床优化研究所、美国退伍军人事务部/国防部、安大略省注册护士协会、JBI循证医疗保健中心数据库、考克兰图书馆、PubMed、科学网、Embase、CINAHL、中国知网、万方数据库、中国生物医学文献数据库等数据库中,系统检索有关中风后运动功能障碍患者康复管理的所有文献。这包括临床决策、指南、专家共识、推荐做法、系统评价和证据总结,检索期从每个数据库建立至2023年10月。两名研究人员独立评估文献质量。

结果

共纳入21篇文献,包括11项指南、2项专家共识和8项系统评价。从纳入文献中提取并整合证据,总结出九个领域的45条证据:康复管理模式、康复机构、康复团队、康复干预时机、康复评估、康复方案、康复持续时间和频率、康复强度以及康复支持。这些涵盖了中风患者在急性期、亚急性期和慢性期的全面康复管理内容。

结论

本研究总结的中风后运动功能障碍患者康复管理的最佳证据全面且质量高。它为临床和社区医疗保健专业人员开展康复干预提供了重要指导。在应用这些证据时,建议考虑中风患者的当前状况、运动功能障碍程度、环境因素以及患者偏好。然后,选择最合适的康复计划,并根据每个患者的具体需求和偏好调整训练类型和强度。

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