作业技能再学习策略对脑卒中偏瘫上肢功能效果的随机对照试验

doi:10.3969/j.issn.1006-9771.2024.07.011

Abstract

Abstract:

Objective To explore the effect of occupational skills relearning programme on hemiplegic arm motor function and activities of daily living (ADL) in stroke patients.
Methods From February, 2022 to August, 2023, 74 stroke patients in Guangdong Work Injury Rehabilitation Hospital were enrolled and randomly divided into control group (n = 37) and experimental group (n = 37). The control group received conventional rehabilitation training, and the experimental group received additional occupational skills relearning programme, for three weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Functional Test for the Hemiplegic Upper Extremity-Hong Kong (FTHUE-HK), Motor Activity Log (MAL)-amount of use (AOU) and MAL-quality of movement (QOM), modified Barthel Index (MBI), and Stroke Impact Scale (SIS)-Hand and SIS-ADL before and after treatment.
Results The scores in all assessments improved significantly in both groups (|t| > 3.597, P < 0.05) after treatment, while the scores of FMA-UE, FTHUE-HK, MAL-AOU, MAL-QOM were higher in the experimental group than in the control group (|t| > 2.352, P < 0.05).
Conclusion Occupational skills relearning programme could promote the recovery of hemiplegic arm motor and activity, and facilitate the use of the hemiplegic arm in daily life in stroke patients.

Key words: stroke, occupational skills relearning, upper limb, motor function, activities of daily living, randomized controlled trial

CLC Number:

R743.3

HE Aiqun, LI Jingbo, HE Maoli, YE Simei, SONG Qiushuang, LIU Haiou, XIE Youshu. Effect of occupational skills relearning on hemiplegic arm function after stroke: a randomized controlled trial[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(7): 823-830.

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References 41

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组别	n	性别(男/女)/n	年龄/岁	病程/d	卒中类型(出血/梗死)/n	偏瘫侧(左/右)/n	利手(左/右)/n
对照组	37	27/10	54.19±13.37	77.11±41.79	14/23	18/19	0/37
试验组	37	32/5	48.14±14.69	75.86±49.68	16/21	18/19	1/36
χ²/t值		2.090	-1.854	-0.116	0.224	0.000
P值		0.148	0.068	0.908	0.636	1.000	0.314^a

组别	n	测试	$\bar{x}±s$	t值	P值
对照组	37	前测	28.81±10.68	8.290	< 0.001
		后测	37.00±13.52
试验组	37	前测	30.39±12.23	9.693	< 0.001
		后测	44.49±13.86
治疗前两组均值差			1.57±14.98	0.590	0.557
治疗后两组均值差			7.49±19.38	2.352	0.021

组别	n	测试	$\bar{x}±s$	t值	P值
对照组	37	前测	3.68±0.67	3.597	0.001
		后测	4.08±1.09
试验组	37	前测	3.65±0.68	6.524	< 0.001
		后测	4.78±1.23
治疗前两组均值差			0.03±0.76	-0.173	0.863
治疗后两组均值差			0.70±1.71	2.604	0.011

组别	n	测试	$\bar{x}±s$	t值	P值
对照组	37	前测	1.23±0.76	6.093	< 0.001
		后测	1.74±1.04
试验组	37	前测	1.10±0.85	10.137	< 0.001
		后测	2.30±0.80
治疗前两组均值差			0.13±0.80	-0.703	0.484
治疗后两组均值差			0.56±0.90	2.602	0.011

组别	n	测试	$\bar{x}±s$	t值	P值
对照组	37	前测	1.27±0.79	9.374	< 0.001
		后测	1.76±0.84
试验组	37	前测	1.32±0.90	8.511	< 0.001
		后测	2.34±0.72
治疗前两组均值差			0.05±0.65	0.274	0.785
治疗后两组均值差			0.58±0.44	3.170	0.002

Effect of occupational skills relearning on hemiplegic arm function after stroke: a randomized controlled trial

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组别	n	测试	$\bar{x}±s$	t值	P值
对照组	37	前测	63.05±22.17	5.407	< 0.001
		后测	74.08±18.94
试验组	37	前测	62.16±24.74	6.846	< 0.001
		后测	78.00±21.61
治疗前两组均值差			0.89±31.82	-0.163	0.871
治疗后两组均值差			3.92±26.10	0.829	0.410

组别	n	测试	$\bar{x}±s$	t值	P值
对照组	37	前测	16.35±16.14	8.317	< 0.001
		后测	35.41±22.02
试验组	37	前测	18.50±19.13	13.176	< 0.001
		后测	39.22±23.19
治疗前两组均值差			2.15±22.78	0.522	0.603
治疗后两组均值差			3.82±29.53	0.727	0.470

组别	n	测试	$\bar{x}±s$	t值	P值
对照组	37	前测	40.28±19.09	5.293	< 0.001
		后测	49.44±20.27
试验组	37	前测	44.07±17.36	5.080	< 0.001
		后测	54.81±17.71
治疗前两组均值差			3.79±23.50	0.894	0.374
治疗后两组均值差			5.37±24.63	1.215	0.228

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