CAJ | 학술논문

目的：探讨自制手指活动量控制板对脑卒中肢体偏瘫患者手挛缩预防及功能恢复的效果。方法便利抽样法选取2012年1月至2013年4月在长征医院神经内科住院的脑卒中肢体偏瘫患者100例为研究对象,按入院日的单、双号分为试验组和对照组,每组各50例。两组患者均给予脑卒中临床路径常规治疗护理及10~30 min/d被动康复锻炼；试验组患者在此基础上给予佩戴手指活动量控制板2 h/次,期间30 min松解,并详细填写“手指活动量控制板使用记录表”。1、3个月后比较两组患者康复训练的主要效果指标[患侧手关节总主动活动度(total activemovement,TAM)及肌力恢复情况]及次要效果指标(患者使用手指活动量控制板的使用意愿及舒适度)。结果干预1个月和3个月时,试验组研究对象的 TAM优良率为28．0％和48．0％,明显大于对照组的12．0％和26．0％,差异均有统计学意义(均P＜0．05)。且试验组肌力恢复明显优于对照组,差异有统计学意义(P＜0．05)。94％~98％的患者愿意使用,96％~98％的患者感觉佩戴舒适。结论手指活动量控制板对脑卒中手功能障碍患者预防手挛缩、关节僵硬、肌腱粘连及肌力恢复中起到了一定的作用,可在临床推广使用。
목적：탐토자제수지활동량공제판대뇌졸중지체편탄환자수련축예방급공능회복적효과。방법편리추양법선취2012년1월지2013년4월재장정의원신경내과주원적뇌졸중지체편탄환자100례위연구대상,안입원일적단、쌍호분위시험조화대조조,매조각50례。량조환자균급여뇌졸중림상로경상규치료호리급10~30 min/d피동강복단련；시험조환자재차기출상급여패대수지활동량공제판2 h/차,기간30 min송해,병상세전사“수지활동량공제판사용기록표”。1、3개월후비교량조환자강복훈련적주요효과지표[환측수관절총주동활동도(total activemovement,TAM)급기력회복정황]급차요효과지표(환자사용수지활동량공제판적사용의원급서괄도)。결과간예1개월화3개월시,시험조연구대상적 TAM우량솔위28．0％화48．0％,명현대우대조조적12．0％화26．0％,차이균유통계학의의(균P＜0．05)。차시험조기력회복명현우우대조조,차이유통계학의의(P＜0．05)。94％~98％적환자원의사용,96％~98％적환자감각패대서괄。결론수지활동량공제판대뇌졸중수공능장애환자예방수련축、관절강경、기건점련급기력회복중기도료일정적작용,가재림상추엄사용。
Objective To explore the application effect of homemade finger activity panel in functional re-covery and prevention of hand contracture of stroke hemiplegia patients.Methods By convenience sam-pling,100 patients with hemiplegia after stroke were selected and equally divided into experimental group and control group according to the calendar date of admission,two groups were all given stroke clinical pathway conventional treatment,care and passive rehabilitation exercise of 10 to 30 minutes,the experi-mental group was wear finger activity panels of 2 hours per time with 30 min per release,and filling “the finger activity panel using forms”.Total Active Motion(TAM)and hand joint muscle recovery and using intention and comfort level were observed after 1 month and 3 months.Results After 1 month and 3 months intervention,the experimental group TAM rate and score were 28.0% and 48.0% ,which were sig-nificantly higher than control group of 12.0% and 26.0% (all P<0.05).The experimental group had the statistically significant higher hand muscle recovery score comparing with the control group(P<0.05). There were 94%-98% of patients willing to use,and 96%-98% of patients feel comfortable wearing it. Conclusion Finger activity panel could be well used in clinic patients with hands dysfunction after stroke to prevent hand contracture,j oint stiffness,tendon adhesion and muscle recovery,which can promote in clinical trial.