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临床路径联合阻抗运动对老年缺血性脑卒中患者认知功能障碍、运动功能及生活质量的影响

Effects of clinical pathway combined with impedance exercise on cognitive dysfunction, motor function and quality of life in elderly patients with ischemic stroke

    摘要
  • 摘要:
      目的  探讨临床路径联合阻抗运动对老年缺血性脑卒中患者认知功能障碍、运动功能和生活质量的影响。
      方法  将100例缺血性脑卒中患者随机分为对照组和观察组，每组50例。对照组采用普通康复干预，观察组采用临床路径联合阻抗运动。比较2组认知功能障碍发生率、6 min步行距离、Rivermead运动指数(RMI)、改良Barthel指数(MBI)、Fugle-Meyer运动功能评分量表(FMA)评分和生活质量。
      结果  观察组患者认知功能障碍发生率为14.00%, 低于对照组的44.00%, 差异有统计学意义(χ2=9.519, P=0.002)。与干预前相比，干预后2组患者6 min步行距离均延长，且观察组步行距离长于对照组，差异有统计学意义(P < 0.05); 干预后, 2组患者RMI、MBI及上肢、下肢FMA评分均较干预前升高，且观察组高于对照组，差异有统计学意义(P < 0.05)。干预后, 观察组患者心理健康、日常活动功能、精神活动功能评分高于对照组，身体疼痛及并发症相关评分低于对照组，差异有统计学意义(P < 0.05)。
      结论  临床路径联合阻抗运动可降低老年缺血性脑卒中患者认知障碍发生率，提高其运动功能，改善生活质量。

     

    Abstract:
      Objective  To investigate the effects of clinical pathway combined with impedance exercise on cognitive dysfunction, motor function and quality of life in elderly patients with ischemic stroke.
      Methods  A total of 100 patients with ischemic stroke were randomly divided into control group and observation group, with 50 cases in each group. The control group used ordinary rehabilitation intervention, and the observation group used clinical pathway combined with impedance exercise. The incidence of cognitive dysfunction, 6-min walking distance, Rivermead exercise index (RMI), modified Barthel index (MBI), Fugle-Meyer Assessment (FMA) and quality of life were compared in the two groups.
      Results  The incidence of cognitive dysfunction in the observation group was 14.00%, which was significantly lower than 44.00% in the control group (χ2=9.519, P=0.002). Compared with before intervention, 6-min walking distance after intervention was prolonged in both groups, and walking distance in the observation group was significantly longer than that in the control group (P < 0.05); the RMI, MBI and FMA scores of upper and lower limbs after intervention were increased in two groups compared with intervention before, and the observation group was significantly higher than the control group (P < 0.05). The scores of mental health, daily activity function and mental activity function after intervention in the observation group were significantly higher than those in the control group, and the related scores of physical pain and complications were significantly lower than those in the control group (P < 0.05).
      Conclusion  Clinical pathway combined with impedance exercise can reduce the incidence of cognitive impairment in the elderly patients with ischemic stroke, enhance their motor function, and improve quality of life.

     

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