评估在急性脑血管意外后患者环境视听重构硬件培训综合设施上重构社会日常技能的有效性

E. Koneva, G. V. Derevyashkina, T. Shapovalenko, K. Lyadov, A. Mikhailova, V. Portnov
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引用次数: 0

摘要

背景:急性脑血管意外导致的运动障碍是最常见的致残原因,不仅大大降低了患者的生活质量,还限制了患者在熟悉环境中的社交和家务独立性。目的:评估右侧大脑中动脉卒中患者在接受视听环境重建的特殊器械训练后,恢复社交和家务活动技能--超市购物的有效性。材料与方法:该研究包括 65 名参与者,他们被分为三组,第一组和第二组--中风患者(主要组和对照组):主要组患者接受基本标准康复计划(运动疗法、循环器械机械疗法、按摩)和额外的社交与家务训练,并进行环境视听重建。对照组--基础标准康复计划。康复课程为期 21 天。第三个对比组是健康参与者,他们是确定 "etalon "方案以训练重要社会技能的必要条件。结果:与最初的研究结果相比,两组(主要组和对照组)的研究结果都降低了缺血性中风的严重程度(NIHSS):第一组为 6.2±0.4,第二组为 6.8±0.7,而第一组为 4.2±0.2,第二组为 5.9±0.8(р ≤0.05)。通过将第一组和第二组与健康参与者进行比较,发现在主要组中,在掌握以下技能时,学习时间选项有显著的统计学变化:拿包并从肩上穿过、打开包的口袋(2 个口袋)、从衣架上取下外套并穿上。虽然第一组患者在使用以空间为导向的功能康复方法恢复威胁过程后,日常生活活动受到的干扰确实较少:巴特尔指数(Bartel Index)为 61.3±4.9 vs. 43.75±5.1(初始值)(р ≤0.05),与对照组结果相比明显增加。在通过改良量表 FIM 评估功能独立性方面:主要组为 71.4±4.9 vs. 53.7±3.1(初始值)(р ≥0.05),尽管与第二组相比显著增加。通过 HADS,第一组的焦虑症状从 13.02±1.9 降至 10.12±1.2(р ≤0.05),而对照组的焦虑水平一直居高不下,从最初的 13.14±1.5(р ≥0.05)降至 12.6±0.6。结论:研究结果表明,在脑卒中患者的威胁恢复计划中使用以空间为导向的功能康复训练能有效提高患者在现实生活中的自理能力。还有一点是,这种训练对患者实现主动运动以改善社会和家庭适应能力的积极性有明显的促进作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of the effectiveness of the reconstraction of social-everyday skills on the hardware-training complex of audio-visual reconstruction of the environment of patients after acute cerebrovascular accident
BACKGROUND: Motor disorders as a result of аcute cerebrovascular accident are the most common cause of disability and not only significantly reduce the quality of life of patients, but also cause restriction of social and household independence of patients in a familiar environment. AIM: the evaluation of the effectiveness for restoring the social and domestic activity skill ― shopping in the supermarket in patients undergoing stroke in the right middle cerebral artery after course of the special apparat trainings with audio-visual reconstruction of the environment. MATERIALS AND METHODS: The study included 65 participants, they were divided into 3 groups, the first and the second group ― the patients who undergoing the stroke (main and control groups): the main group of patients received a base standard rehabilitation program (kinesiotherapy, mechanotherapy on cyclic apparatгs, massage) and additional the social and domestic trainings with audio-visual reconstruction of the environment. The control group ― a base standard rehabilitation program. The duration of the rehabilitation course was 21 days. The third comparison group are the healthy participants, who were necessary for defining "etalon" options for training of socially important skill. RESULTS: As a result of the study in both groups (main and control) as compared with the initial findings the lowering of the heaviness ischemic stroke outcome (NIHSS): 6.2±0.4 in the first group and 6.8±0.7 in the second group vs. 4.2±0.2 and 5.9±0.8 (р ≤0.05). By comparison the first and the second groups with the health participants were defined the statistically significant changes of the studing time options in the main group during making these skills: take the bag and sling it through the shoulder, open the pockets of the bag (2 pockets), take the jacket from the clothes hanger and put on. Although in patients of the first group after restoring threatment course with using method of functional spatially-oriented rehabilitation it was authentic lesser disturbance of everyday life activity: in estimating Bartel Index 61.3±4.9 vs. 43.75±5.1 (initial) (р ≤0.05), what was signuficantly higher be comparison with control group results. In estimating functional independence by Modified Scale FIM: 71.4±4.9 in the main group vs. 53.7±3.1 (initial) (р ≥0.05), what was although significantly higher in comparison with the second group. By HADS it was lowering of the anxiety symptoms in the first group from 13.02±1.9 till 10.12±1.2 (р ≤0.05) as compared with the control group where the level of anxiety was staying quietly high and was 12.6±0.6 by comparison the initial findings 13.14±1.5 (р ≥0.05). CONCLUSION: The obtained resalts point at the effectiveness of using functional spatially-oriented rehabilitation in restoring threatment programs for patient undergoing stroke for elevation of the independence level in real life terms. An additional point is that this kind training promote significantly positive influence on the patient’s motivation for actualization of active movement to improvement of the social and domestic adaptation.
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