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脑卒中的康复治疗
刁建生;沈敏杰
现代康复 1999年 3卷2期 页码:204-205页,共2页
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脑卒中(脑血管疾病)是指发展迅速具有血管源性的局限性脑功能障碍,且症状持续24h以上或导致死亡的临床症候群,在我国是常见病多发病.其特点为后遗症多、致残率高、复发性大,残疾主要是偏瘫(肢体运动功能障碍).应用综合的康复医疗技术治疗卒中后偏瘫,能在很大程度上提高或改善其肢体运动功能而减轻残疾.但病后的康复治疗是一个较长的过程,还存在着很多影响因素:病人入院的标准不一致,疾病的类型,治疗期限,康复开始的时间差别等.若无完善的康复治疗措施,便不能达到预期的效果.卒中后的康复是指病侧神经系统重新获得对病侧的控制,这是卒中康复的重要内容.用传统的方法与神经生理学方法通过感觉输入促进或抑制中枢神经系统的活动,应用神经发育学概念促进神经肌肉的反应,通过全身各关节的运动强调其协调性并反复学习与强化.早期积极预防关节挛缩、畸型,用PROM(关节全范围被动体操)保持关节活动度,尽早进行从床到椅到站立的活动,训练和强化健侧功能以代偿患侧,可收到较好的治疗效果.在出现随意运动后不引起异常运动反应的情况下,进行加强肌力、耐力和协调张力训练.本文就近年来国内外有关资料,结合临床经验将影响脑卒中康复的因素和康复治疗措施,介绍如下.
Curative effects on muscle function and proprioception in patients with chronic lumbar disk herniation using isokinetic trunk muscle strength training
Zhang, XH; Bi, X; Shao, JW; Sun, D; Zhang, C; Liu, ZH
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE 2019年 12卷4期 页码:4311-4320
LOW-BACK-PAIN; STABILITY; EXERCISE; PATTERNS
The aim of this study was to evaluate the curative effects on muscle function and proprioception in patients with chronic lumbar disk herniation (LDH) using two kinds of kinesitherapies: isokinetic trunk muscle strength training and core muscle training. Eighty patients with clinical features of lumbar disk herniation were randomly divided into treatment and control groups (40 patients in each group). All participants were given routine rehabilitation treatment, including interferential electrotherapy, microwave therapy, lumbar traction treatment, and other physical therapies. The treatment group received isokinetic trunk muscle strength training, while the control group received core muscle training, both lasting for 8 weeks, three times per week. Improvement in patient motor and sensory function, before and after treatment, was evaluated using lower back pain standard scoring criteria of Japanese Orthopedic Association (JOA), Oswestry disability index (ODI), and visual analogue scale (VAS). After 8 weeks of continuous training, trunk muscle strength evaluation indexes of the patients in the two groups significantly increased, compared to before treatment. Moreover, JOA, ODI and VAS scores suggested that both treatments could significantly improve lumbar function concerning trunk muscle strength, rehabilitation evaluation of lumbar function, and lumbar proprioception assessment. Furthermore, the ontology sense test indicated that the absolute error value of proprioception was reduced after both routine rehabilitation treatment and isokinetic trunk muscle strength training treatment. In conclusion, this study showed that isokinetic trunk muscle strength training could improve proprioception in patients with chronic lumbar disk herniation. It also enhanced muscle function, compared with core muscle training.
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