【摘要】 目的 观察悬吊运动系统治疗（sling exercise therapy， SET）联合神经发育疗法治疗对痉挛型脑性瘫痪儿童肌张力及日常生活活动能力（activities of daily living，ADL ）的影响。 方法 2008年8月-2009年3月收治的40例双下肢痉挛型脑性瘫痪儿童纳入研究。根据随机数字表法分为治疗组与对照组，每组各20例。对照组与治疗组均采用神经发育疗法进行康复训练，治疗组在神经发育疗法基础上配合悬吊运动系统治疗。观察两组患儿治疗1、3个月时肌张力与ADL变化。 结果 治疗1个月时，治疗组患儿肌张力缓解明显优于对照组（P＜0.05），3个月时，治疗组肌张力缓解程度明显优于对照组。两组ADL评分比较，治疗组ADL评分改善情况明显优于对照组（P＜0.05）。 结论 悬吊运动系统治疗联合神经发育疗法可明显缓解痉挛型脑性瘫痪患儿童肌张力，提高ADL。【Abstract】 Objective To observe the effects of sling exercise therapy (SET) combined with neurodevelopmental therapy on muscle tension and activities of daily living (ADL) of children with spastic cerebral palsy. Methods Forty children with spastic cerebral palsy on bilateral lower limb were selected in our study. The children were randomly divided into a treatment group and a control group, 20 children in each group. Both the two groups were accepted rehabilitation training by neurodevelopmental therapy, while the treatment group was received SET as cooperate cure based on the neurodevelopmental therapy. The changes of muscle tension and ADL on the one and three months after treatment were observed. Results On the one and three months after treatment, the remission of muscle tension and improvement of ADL score were better than those in the control group, the differences were statistically significant(Plt;0.01). Conclusion SET combined with neurodevelopmental therapy can relieve the muscle tension, and improve the ADL of children with spastic cerebral palsy.
目的：了解ICU病房地震伤员的功能障碍的特点，为临床康复治疗提供依据。方法：运动功能评定应用MMT方法；运用关节角度尺评定关节活动度（ROM）；利用被动关节活动法评定肌张力、痉挛评定选用改良的Ashworth分级法；坐位平衡和站位平衡采用平衡反应试验评定；日常生活活动（ADL）能力选用国际通用的Barthel指数量表评定。由我科研究生作为评定人员。结果：①ICU病房地震伤员以骨折患者为主,占70%，神经系统损伤占20%，挤压综合症和肺挫伤各占5%；②女性骨折比例高于男性，为11∶3；神经系统损伤没有多大差异；截肢和瘫痪的患者中，男性高于女性，比例分别为4∶1和3∶2；肺部感染以女性更为明显，为7∶1；③47.6%的地震伤员关节活动受限（评定21人），93.3%的肌力下降（评定15人），15.8%肌张力下降（评定19人），36.8%肌张力增高（评定19人），30.0%的坐位平衡下降（评定10人），96.4%站立平衡下降；④ADL能力100%受限（评定20人），其中洗澡、修饰、如厕、平地行走45 m、上下楼梯受限均为100%，95%地震伤员进食能力下降，90%穿衣能力受限，35%大便失禁，60%小便控制能力下降，多数使用导尿管，95%地震伤员床椅转移能力下降；⑤40%出现肺部感染。结论：关节活动度受限、肌力下降、肌张力异常、平衡功能障碍、ADL能力受限及肺部感染是ICU地震伤员主要功能障碍。早期康复介入、维持和改善关节活动度、肌力训练、减张和牵伸训练、平衡训练、呼吸训练、站立和行走训练及ADL能力训练应当作为康复治疗的基本原则和方法。
Objective To investigate the status of health condition and activities of daily living of “50630” retired cadres in Mianzhu, and analyze the related factors affecting their activities of daily living. Methods According to the registration information of Mianzhu administration of elderly cadres in Sichuan, the method of cluster sampling was adopted in March 2019 to select retired cadres who participated in work between October 1st, 1949 and June 30th, 1950 in urban and rural areas respectively. The survey and analysis were carried out using the self-designed general condition questionnaire, Berg balance scale, Hoffer walking ability rating scale, and modified Barthel Index, to understand the activities of daily living ability of retired cadres and analyze the relevant factors affecting their self-care ability of daily life. Results A total of 64 “50630” retired cadres were investigated, with an average age of (86.39±3.37) years. 64.06% of the patients with poor balance function needed wheelchair, 10.94% could not walk, and 56.25% were heavily dependent on activities of daily living. Age (r=−0.421, P=0.001) and underlying diseases (r=−0.060, P=0.032) were negatively correlated with activities of daily living. Balance ability (r=0.658, P<0.001), walking ability (r=0.393, P=0.001), spouse status (r=0.669, P<0.001), care status (r=0.830, P<0.001), place of residence (r=0.706, P<0.001) were positively correlated with activities of daily living. Education level (r=0.096, P=0.380) and gender (r=0.122, P=0.265) had no correlation with activities of daily living. Multiple linear regression analysis showed that the main influencing factors of daily living activities of “50630” retired cadres in Mianzhu were balance function, walking ability, spouse or not and type of care. Conclusions There are many related factors affecting the activities of daily living of “50630” retired cadres, which can be intervened according to basic diseases, balance function and walking ability. Through multi-disciplinary and multi-sectoral cooperation, integrating community health service resources, providing all-round health care services, formulating personalized rehabilitation measures, and organizing community group activities, it is possible to improve their social participation, psychological status, and ability of daily living activities, and reduce the disability, so as to further improve the quality of life of veteran cadres.
Objective To explore whether the effect of cloud rehabilitation system on motor dysfunction and activities of daily living (ADL) of stroke patients is not inferior to hemiplegia manual treatment. Methods This study adopted a multicenter randomized controlled trial design. A total of 118 stroke patients were enrolled from 5 hospitals in China between April 2018 and April 2019, and they were randomly divided into a trial group and a control group, with 59 patients in each group. The trial group adopted hemiplegia manual treatment (≥30 min per time, once a day) and cloud rehabilitation training (30 min per time, once a day), and the control group adopted hemiplegia manual treatment alone (≥30 min per time, twice a day). All patients received continuous treatment for 2 weeks, and followed up for 2 weeks after that. The Brunnstrom stage (BRS), IK exercise stage, and Modified Barthel Index (MBI) were used to evaluate the motor function and ADL before and 4 weeks after treatment. Results There was no significant difference in gender, age, course, hemiplegia side, source (inpatient/outpatient) or hospital grade between the two groups (P>0.05), which were comparable. Compared with those before treatment, there were significant improvements in the BRS (upper and lower extremities), IK exercise stages (upper and lower extremities), and MBI scores in both groups 4 weeks after treatment (P<0.05). The four-week improvements in motor function indicators (BRS and IK) of the trial group were not inferior to those of the control group (P<0.05), and there was no significant difference in MBI score between the two groups 4 weeks after treatment (F=1.498, P>0.05). Conclusion The cloud rehabilitation system is not inferior to hemiplegia manual treatment in improving the limb motor function or ADL of patients .