Abstract:

Objective　To study the effect of functional rehabilitation training based on the model of human occupation (MOHO) on limb function and quality of survival in patients with ischaemic stroke with hemiparesis. Methods　This study was a prospective single-blind trial. A total of 60 patients with ischaemic stroke with hemiparesis treated in Chang'an Hospital from February 2022 to February 2024 were selected as the study objects. They were divided into a control group and a study group according to the random number table method. In the control group, there were 14 males and 16 females, aged (68.12±4.26) years, and the course of disease was (3.80±1.20) months. In the study group, there were 12 males and 18 females, aged (68.16±4.30) years, and the course of disease was (3.89±1.24) months. The control group received routine rehabilitation training, and the study group received MOHO-based functional rehabilitation training on the basis of the control group, about 40 min each time. The intervention duration of both groups was 6 months. Exercise compliance and motor function and activity of daily living on the next day after admission and 6 months after intervention were compared between the two groups. χ² test and t test were used for statistical analysis. Results　The scores of physical participation, effect monitoring, and advice seeking and total score of the Functional Exercise Compliance Scale for Stroke Patients in the study group were (15.02±1.26), (9.82±1.12), (4.52±0.62) and (24.29±1.60) points, and those in the control group were (14.16±1.22), (9.20±1.10), (4.10±0.56), and (23.19±1.52) points, with statistically significant differences (all P<0.05). After 6 months of intervention, the upper limb and lower limb motor function scores of the study group were higher than those of the control group [(25.37±3.61) points vs. (22.93±3.04) points, (20.16±2.24) points vs. (18.95±2.16) points], with statistically significant differences (t=2.831 and 2.130, both P<0.05); the scores of exercise, self-care, mobility, and sphincter control and total score of the modified Barthel index were higher than those of the control group (all P<0.05). Conclusion　Functional rehabilitation training based on the MOHO can effectively improve the exercise compliance in patients with ischaemic stroke with hemiparesis, and enhance the function of the upper and lower limbs and the ability of daily activities.

Key words:

Ischaemic stroke, Hemiparesis, Model of human occupation, Functional rehabilitation training, Activity of daily living

摘要：

目的　研究以人类作业模式（MOHO）为基础的功能康复训练对缺血性脑卒中伴偏瘫患者肢体功能和生活质量的影响。方法　本研究为前瞻性单盲试验。选取2022年2月至2024年2月在长安医院接受治疗的60例缺血性脑卒中伴偏瘫患者作为研究对象，根据随机数字表分为对照组和研究组，每组30例。对照组男14例，女16例，年龄（68.12±4.26）岁，病程（3.80±1.20）个月，实施常规康复训练。研究组男12例，女18例，年龄（68.16±4.30）岁，病程（3.89±1.24）个月，在对照组基础上实施以MOHO为基础的功能康复训练。两组每次训练时间为40 min左右，干预时长均为6个月。对比两组患者锻炼依从性以及入院次日、干预6个月后的运动功能、日常生活活动能力。采用χ²检验、t检验进行统计分析。结果　研究组的脑卒中患者功能锻炼依从性量表中身体参与、效果监督、寻求建议评分及总分分别为（15.02±1.26、9.82±1.12、4.52±0.62、24.29±1.60）分，对照组分别为（14.16±1.22、9.20±1.10、4.10±0.56、23.19±1.52）分，差异均有统计学意义（均P<0.05）。干预6个月后，研究组Fugl-Meyer运动功能评定量表的上肢、下肢运动功能评分均高于对照组［（25.37±3.61）分比（22.93±3.04）分、（20.16±2.24）分比（18.95±2.16）分］，差异均有统计学意义（t=2.831、2.130，均P<0.05）；改良Barthel指数评定量表中运动、自我照顾、移动、括约肌控制评分和总分均高于对照组（均P<0.05）。结论　以MOHO为基础的功能康复训练可提高缺血性脑卒中伴偏瘫患者的锻炼依从性，提高患者的上下肢功能和日常生活活动能力。

关键词:

脑卒中, 偏瘫, 人类作业模式, 功能康复训练, 日常生活活动能力