Abstract:

Objective　To explore the rehabilitation effect of nurse-led new bedside exercise mode on stroke patients with hemiplegia. Methods　This study was a randomized controlled trial. From March 2020 to January 2021, this study included 80 patients with stroke and hemiplegia admitted to Department of Rehabilitation Medicine, Guangzhou First People's Hospital as the research subjects, and they were divided into an experimental group (40 cases) and a control group (40 cases) by the random number table method. The sex ratio of the experimental group was 2.08 and the age was (61.63±8.84) years old. The sex ratio of the control group was 1.86 and the age was (64.40±9.87) years old. The experimental group received the new bedside exercise mode led by nurses (including nurses' training guidance, whole-process supervision, and real-time evaluation feedback) plus routine rehabilitation and nursing education, while the control group only received routine rehabilitation and nursing education. Fugl-Meyer Motor Function Assessment (FMA), Mini-Mental State Examination (MMSE), Barthel index, and National Institutes of Health Stroke Scale (NIHSS) assessments were performed in both groups before and after 8 weeks of training. The statistical methods used were independent sample t test, paired t test, and χ² test. Results　After 8 weeks of training, the FMA upper limb score, FMA lower limb score, and Barthel index of the experimental group were (47.78±24.52) points, (24.23±9.40) points, and (77.25±16.91) points, those in the control group were (36.75±25.92) points, (19.85±10.63) points, and (64.88±22.66) points, and the differences of FMA upper limb score, FMA lower limb score, and Barthel index score (post-training to pre-training) in the experimental group [(4.43±1.48) points, (2.50±1.45) points, and (11.63±7.54) points] were more than those in the control group [(0.68±0.76) points, (0.98±0.92) points, and (3.00±2.73) points], with statistically significant differences (t=14.22, 5.62, and 6.80; all P<0.01). There were no statistically significant differences in the differences of MMSE and NIHSS scores before and after training between the two groups (t=-0.63 and -0.58, P=0.53 and 0.56). Conclusion　The new bedside exercise mode led by nurses can effectively improve the movement ability of the hemiplegia side limbs and daily activity ability in stroke patients with hemiplegia, and its effect is better than the conventional rehabilitation treatment plan without this exercise mode, providing an effective potential new strategy for long-term rehabilitation nursing of stroke patients with hemiplegia.

Key words:

Stroke, Hemiplegia, Rehabilitation, Nurse-led, Bedside exercise

摘要：

目的　探究护士主导的新型床边运动模式针对脑卒中偏瘫患者的康复效果。方法　本研究为随机对照试验。选取2020年3月至2021年1月广州市第一人民医院康复医学科收治的脑卒中偏瘫患者80例作为受试者，并采用随机数字表法分为试验组和对照组，每组40例。试验组性别比为2.08，年龄（61.63±8.84）岁；对照组性别比为1.86，年龄（64.40±9.87）岁。试验组采用护士主导的新型床边运动模式（包括护士的训练指导、全程监督和实时评价反馈）+常规康复治疗及护理宣教，对照组采用常规康复治疗及护理宣教。两组训练前以及训练8周后均进行Fugl-Meyer运动功能评估量表（FMA）、简易智力状态检查量表（MMSE）、Barthel指数以及美国国立卫生研究院卒中量表（NIHSS）评估。统计学方法采用独立样本t检验、配对t检验、χ²检验。结果　训练8周后，试验组FMA上肢评分、FMA下肢评分、Barthel指数评分分别为（47.78±24.52）分、（24.23±9.40）分、（77.25±16.91）分，对照组分别为（36.75±25.92）分、（19.85±10.63）分、（64.88±22.66）分；试验组的FMA上肢评分、FMA下肢评分、Barthel指数评分差值（训练后-训练前）分别为（4.43±1.48）分、（2.50±1.45）分、（11.63±7.54）分，对照组分别为（0.68±0.76）分、（0.98±0.92）分、（3.00±2.73）分，差异均有统计学意义（t=14.22、5.62、6.80，均P<0.01）；但两组训练前后MMSE、NIHSS评分差值比较差异均无统计学意义（t=-0.63、-0.58，P=0.53、0.56）。结论　护士主导的新型床边运动模式能有效提高脑卒中偏瘫患者的偏瘫侧肢体活动能力和日常活动能力，效果优于无此运动模式的常规康复治疗方案，为脑卒中偏瘫患者的长期康复护理提供有效的潜在新策略。

关键词:

脑卒中, 偏瘫, 康复, 护士主导, 床边运动